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NREMT Paramedic Prep - 200 Questions and answers
Typology: Exams
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You are called to assist an adult with chest pain. The patient has a cardiac history of two-posterior myocardial infarctions. He is conscious and alert, stating he is having a hard time breathing, and the chest pain worsens when he attempts to lay flat on his back. His skin is pale and hot, while auscultation of his lung sounds reveals mild crackles. He reports the pain worsens on deep inspiration and movement. Based on the patient's history, and signs and symptoms, which of the following should you suspect? A. Unstable angina pectoris B. Pericarditis C. Myocardial infarction D.
Cardiomyopathy - B. You are the first ambulance to arrive on the scene of a single-car accident. As you approach the scene, you see four patients, two have been ejected from their vehicle, and two are still in the vehicle. What should be your next course of action? A. Call medical control, and advise them of the situation B. Request additional resources, such as fire rescue, and additional ambulances to respond to the scene C. Begin immediate triage and treatment of the two patients ejected first while awaiting fire department response D.
Notify the local trauma center so they can prepare for the patients - B. A patient is experiencing a possible neurological emergency from a blunt force closed head injury. He is found to have abnormal pupillary reactions to light and has lost the ability to move his eyes from side to side to follow your finger movements. He is also unable to identify the number of fingers you are holding up. He reports he is able to see the fingers but is not able to focus enough to identify how many fingers are present. Which of the following cranial nerves should you suspect may be involved in his injury? A. Cranial nerves I, V, and VI B. Cranial nerves V and VII C. Cranial nerves IX and X
Cranial nerves II, III, and IV - D. Simply put, shock is a state of hypoperfusion due to several different causes. Which one of the following types of shock would be considered distributive shock? A. Hypovolemic shock B. Cardiogenic shock C. Anaphylactic shock D. Toxic shock syndrome - C.
Which of the following is responsible for initiating the sympathetic response to shock during a traumatic event? A. Increased oxygen level and increased PCO B. Increased peripheral vascular resistance and alkalosis C. Decreased perfusion and increased acidosis D. Peripheral vasodilation and increased capillary permeability - C. During which wave, complex, interval, or segment of an electrocardiogram tracing does the absolute refractory period take place in a normally functioning heart?
S-T segment B. P-R interval C. P wave D. Q-T interval - D. You are preparing to perform synchronized electrical cardioversion with a biphasic defibrillator on your unstable adult patient who is experiencing supraventricular tachycardia at 160 beats per minute on the monitor. Which of the following initial energy settings would be recommended if he was exhibiting a narrow complex, regular supraventricular tachycardia, in which his palpable carotid pulse matches the rhythm on the monitor?
Synchronized cardioversion at 50-100 joules B. Defibrillation at 100 joules C. Synchronized cardioversion at 360 joules D. Defibrillation at 360 joules - A. Other than a stroke, what is a common cause of one-sided facial droop and paralysis in an adult patient who exhibits no other neurological findings? A. Amyotrophic lateral sclerosis (ALS) B.
Multiple sclerosis C. Huntington's disease D. Bell's palsy - D. You are on-scene with a patient who was struck by a car on her bicycle. She is conscious and alert but has a possible closed right mid-shaft femur fracture. The patient advises you that she is sixteen but does not need parental consent to be treated. Which of the following situations would make this statement true? A. She can be treated under implied consent because her injury may become life- threatening B. She is not an American citizen, visiting on a student visa
She is an emancipated minor granted by the court D. She is an orphaned minor who lives alone - C. Your adult patient is showing signs and symptoms of being severely hyperkalemic. Medical control recommends the administration of a high-dose nebulized albuterol treatment as well as calcium chloride. Why is high-dose albuterol being recommended for this patient? A. To improve the patient's ventilatory status B. To assist with metabolic acidosis C.
To increase the amount of available calcium at the cellular level D. To help lower dangerous potassium levels - D. When monitoring the electrical activity of a patient's heart, which standard limb lead records the difference in electrical potential between the left leg and the right arm when the left leg is positive and the right arm is negative? A. Augmented limb lead aVL B. Bipolar limb lead II (LII) C. Bipolar limb lead III (LIII) D.
Bipolar limb lead I (LI) - B. You are evaluating a trauma patient who may have sustained a spinal cord injury. Which of the following would you expect to see in a trauma patient with a spinal cord injury with autonomic nervous system involvement? A. Bradycardia, hypotension, and a loss of sweating or shivering ability B. Bradycardia, hypertension, warm, dry skin, and numbness of fingertips C. Tachycardia, hypertension, one-sided paralysis, and amnesia D. Tachycardia, hypotension, diaphoresis, cool, and clammy skin - A.
You are on-scene with an adult patient exhibiting unusual activity and appears to be intoxicated. He is anxious and hyperactive. His heart rate and respirations are fast, but his blood pressure remains within normal range for his age. The patient denies alcohol or drug consumption but reports he has diabetes. His blood glucose level is found to be 54 milligrams per deciliter. How would hypoglycemia cause the patient to present with the above findings? A. The low blood sugar levels stimulate the sympathetic nervous system to trigger the release of epinephrine into the bloodstream to promote liver glycogenolysis B. Low blood sugar levels mimic alcohol intoxication in the brain because of elevated insulin levels in the bloodstream C. The elevated heart rate and respirations stimulate the adipose tissue to increase glucose and fatty acid uptake in an attempt to correct the blood glucose level
The heart rate and r - A. You are on scene at a motor vehicle accident, and your 20-year-old patient is entrapped. He is unconscious, unresponsive, and has a palpable carotid pulse that is weak and thready. His breathing is slow and shallow at four times a minute with equal chest wall expansion. There are no obvious deformity injuries or hemorrhage noted. Fire department on-scene has stabilized the vehicle and provided you and your partner a relatively safe environment to manage the entrapped patient. However, access is limited to the seated patient, and extrication is expected to take another twenty minutes. After having your partner maintain cervical spine stabilization, which of the following would be the best choice for securing the patient's airway? A. Insert a nasal airway and administer high-flow oxygen therapy B.
Use nasotracheal intubation techniques to gain complete control of the patient's airway and assist ventilation C. Intub - D. You are on-scene with a 60-year-old COPD patient complaining of shortness of breath. During your exam, you note the presence of clubbed fingertips. Which of the following is most likely to cause this finding? A. Congestive heart failure especially left ventricular failure B. Long-term hypoxemia C. Hypocapnia resulting from low carbon-dioxide levels
Hemoglobin saturated with red blood cells - B. When involved in transporting a patient from the hospital (regardless of the destination), which of the following disease processes, along with HIV/AIDS, must be reported to the transporting crew members to prevent the accidental transmission of the disease? A. Shingles and pneumonia B. Hepatitis and tuberculosis C. ARDS and sepsis D. Syphilis and gonorrhea - B.
Which of the following patients best fits the criteria for a critical burn? A. A 10-year-old patient with superficial burns over 60% of the body B. A 15-year-old patient with full-thickness burns on the left upper/lower arm, non- circumferential Which of the following patients best fits the criteria for a critical burn? A. A 10-year-old patient with superficial burns over 60% of the body B. A 15-year-old patient with full-thickness burns on the left upper/lower arm, non- circumferential
A 60-year-old patient with partial-thickness burns across 25% of the body, not involving the hands, feet, face, or genitals D. A 20-year-old patient with partial-thickness burns on 25% of the body, not including the hands, feet, face, or genitals D. A 20-year-old patient with partial-thickness burns on 25% of the body, not including the hands, feet, face, or genitals - C. Which of the following common toxic substances is a colorless, flammable, and extremely hazardous gas that smells like rotten eggs and is capable of affecting several body systems, especially the nervous system? A. Hydrogen sulfide
Methyl bromide C. Halogenated hydrocarbon D. Hydrogen cyanide - A. Your adult respiratory insufficiency patient's respirations are shallow and irregular at six times per minute. His SpO2 is 76 mm Hg, and you suspect carbon dioxide retention due to the decreased respiratory effort. Which of the following should you suspect? A. Respiratory alkalosis B. Respiratory acidosis
Metabolic acidosis D. Metabolic alkalosis - B. You are assessing an adult patient experiencing sudden-onset chest pain and dyspnea. He quickly exhibits jugular vein distension and cool, clammy skin. His trachea is midline, but there are palpable air pockets under the skin on his upper chest on the left side that feel as though they pop or vanish when you palpate them. What is this abnormal finding? A. Subcutaneous emphysema B. Atelectasis
Pitting edema D. Ascites - A. You are treating a 68-year-old cardiac history patient experiencing chest pain. If it is determined at the hospital that he experienced an acute myocardial infarction of the septal wall, which of the coronary arteries was most likely occluded? A. Circumflex artery B. Right main coronary artery C. Posterior descending artery
Left main coronary artery - D. You are on-scene with a 70-year-old female who complains of being awakened in the middle of the night by sudden onset dyspnea and sweating. She is breathing 32 times per minute with inspiratory/expiratory wheezing and rales auscultated in all fields bilaterally, with an SpO2 of 88 percent on room air. Her heart rate is 136 beats per minute, showing an irregularly irregular sinus tachycardia on the monitor. Which of the following is most likely causing the patient's current signs and symptoms? A. Acute renal failure B. Chronic bronchitis C.
Paroxysmal nocturnal dyspnea D. Acute respiratory distress syndrome - C. Your adult female postpartum patient delivered her newborn with the assistance of her husband five minutes prior to your arrival on the scene. The infant's Apgar score is 10, and the baby seems to be fine. However, the mother continues to bleed heavily after an adequate fundal massage and encouraging the infant to breastfeed. Her current heart rate is 125 bpm; her blood pressure is 108/60, and she is breathing 22 times a minute with an SpO2 of 97. After ensuring a second infant is not present, which of the following interventions would medical command most likely recommend? A. Continue fundal massage, and pack the vagina with sterile ABD or trauma pads B. Administer lactated Ringer's solution run wide open using macro-drip tubing under pressure
C. Administer a fluid bolus of 1,000 mL of normal saline, and transport the patient in the Trendelenburg position D. Administer oxytocin infusion (1 unit per 100 mL of la - D. Which of the following operational modes used in EMS communication can transmit voice as well as telemetry simultaneously? A. Trunk system mode B. Multiplex mode C. Duplex mode D. Simplex mode - B. You are evaluating a 58-year-old who presented with sudden onset chest pain that radiates downward to his lumbar spine region. His peripheral pulses are present but unequal with a significant difference in blood pressure between his left and
right arms. Which of the following conditions is most likely to cause the patient's presentation? A. A pulmonary embolus B. An aortic aneurysm dissection C. A cardiac tamponade D. A myocardial infarction - B. You are ordered to administer 3 mg/min of lidocaine via intravenous infusion to your cardiac patient who presents with a heart rate greater than 130 beats per minute as well as greater than 10 multifocal PVCs every minute. Therefore, you quickly but carefully mix 2 grams of the medication in 500 mL of normal saline and attach micro-drip tubing to the solution bag. Which of the following drip rates would effectively deliver the ordered dose of lidocaine?
A. 15 gtts/min B. 30 gtts/min C. 60 gtts/min D. 45 gtts/min - D. You are ordered to administer 0.3 mL of epinephrine for a moderate allergic reaction. What is the preferred initial route of administration of epinephrine for an allergic reaction? A. Subcutaneous B. Intramuscular C. Intravenous D. Endotracheal - B. You are called to assist an adult diabetic who was found unconscious in bed. On arrival, your patient is unresponsive with snoring respirations and cool, clammy