NREMT Paramedic Prep: 200 Questions with Correct Answers, Exams of Nursing

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NREMT Paramedic Prep 200 Questions With

Correct Answers

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 - Correct answer 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 - Correct answer 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 D. Cranial nerves II, III, and IV - Correct answer 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

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? A. Synchronized cardioversion at 50-100 joules B. Defibrillation at 100 joules C. Synchronized cardioversion at 360 joules D. Defibrillation at 360 joules - Correct answer 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 - Correct answer 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 C. She is an emancipated minor granted by the court D. She is an orphaned minor who lives alone - Correct answer 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 - Correct answer 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)

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 D. The heart rate and r - Correct answer 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 - Correct answer 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 D. Hemoglobin saturated with red blood cells - Correct answer 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 - Correct answer 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.

Respiratory acidosis C. Metabolic acidosis D. Metabolic alkalosis - Correct answer 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 C. Pitting edema D. Ascites - Correct answer 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 D. Left main coronary artery - Correct answer 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 - Correct answer 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

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 - Correct answer 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 - Correct answer 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 skin. Your glucometer will not power up, so blood glucose analysis is impossible at the present time. Which of the following would be most appropriate after controlling the patient's airway and delivering high- flow oxygen therapy? A. Administer glucagon to the patient intramuscularly in a large muscle group like the gluteal muscles B. Start an intravenous line, draw blood samples, and administer one amp of dextrose 50 percent (D50) C. Start an intravenous line, and draw blood samples before administering a glucose-containing IV fluid bolus D. Quickly establish an intravenous line, and transport the patient to the nearest hospital for blood glucose analysis prior to medication administration - Correct answer B.

You arrive on-scene to a two-vehicle MVA. One vehicle is already being attended to by another ambulance, so you head to the other car. Your patient is a 40-year-old male, standing outside of his car. Immediately, you can see your patient slightly swaying on his feet, and his breath smells of alcohol, but he has no noticeable injuries. There is slight crumpling on the driver's side of his car, and airbags have been deployed. Your patient adamantly says that he is not injured, but upon an assessment of his mental faculties, he is unsure of what month it is or what city he is in at the time. The patient does admit that he has only had two beers and is not inebriated. What C-Spine precautions, if any, should you take? A. Patient is ambulatory, and the lack of ability to remember the city he is in or what month it is can be attributed to the shock of the crash and his being inebriated B. Patient will need full C-spine - Correct answer B. What can a paramedic expect to occur in a closed-head injury patient when the intracranial pressure increases and the mean arterial pressure decreases? A. The patient's cerebral blood flow decreases B. The patient has likely suffered a brainstem herniation C. A marked increase in the patient's blood glucose level D. The formation of an intracranial abscess - Correct answer A. When determining an estimated time of death on-scene, what is the terminology used to describe blood and fluid leaving the areas of the face, nose, and chin assisted by gravity and allowed to settle in the lowest parts of the body? A. Dependent lividity B. Cyanosis

B. Atelectasis from the compressive forces C. Aortic dissection D. Thrombin formation - Correct answer A. Your adult asthma patient is experiencing a severe attack characterized by inspiratory and expiratory wheezes with potential airway compromise due to laryngospasm. Which of the following interventions would be most appropriate after oxygen therapy is applied? A. 2.5 to 5 mg of albuterol solution mixed with 3 mL of 0.9 normal saline and nebulized with 6-8 lpm of oxygen B. Rapid sequence intubation with sedation C. 0.31 mg of levalbuterol nebulized with 6-8 lpm of oxygen D. 0.3-0.5 mL (1:1000) of epinephrine delivered IM/SC; repeat in 15 minutes if needed - Correct answer A. You are preparing to perform fluid replacement on an adult trauma patient who lost a significant amount of his circulating blood volume when you note the presence of a drastic systolic blood pressure decline from 100 mmHg to 86 mmHg systolic after the patient's bleeding is controlled. The patient has no obvious new bleeding, but his abdomen is distended and is painful on palpation. There are no obvious masses, bruises, or deformity, and he has active bowel sounds over the epigastric region. Which of the following intravenous fluids would be most appropriate in this situation if the medical command physician recommends a fluid challenge? A. 0.9% normal saline B. 0.45% sodium chloride C. 0.45% normal saline with 5% dextrose D. Lactated Ringer's solution - Correct answer D.

What type of communication system operational mode is required for an EMS agency to be able to communicate simultaneously in both directions while also performing telemetry transmission? A. Multiplex mode B. Duplex mode C. Simplex mode D. Complex mode - Correct answer A. You suspect your adult trauma patient has a potential complete spinal cord transection. If so, which of the following would you expect to find? A. Total loss of pain and sensation below the waist bilaterally with some loss of movement below the waist B. Bradycardia associated with loss in vascular tone C. Total absence of pain, sensation, and movement (paralysis) below the point of the transection (injury) D. Right-sided paralysis with decreased sensation on the opposite side of the body - Correct answer C. You are on-scene with a patient who you suspect may be experiencing a myocardial infarction. He is conscious and alert, anxious, and has dilated pupils. He complains of substernal chest pain and admits to recent cocaine use. How does the use of cocaine increase the risk of experiencing an acute myocardial infarction? A. It speeds the heart rate to the point of asystole B. It causes the blood in the periphery to clot and travel to the coronary arteries C. It actually numbs the heart, making coronary perfusion difficult

C. Hypokalemia associated with the sudden release of the compressive force D. Cardiac tamponade associated with increased intrathoracic pressure and blood pressure - Correct answer A. The alpha, beta-1, and beta-2 receptors are important in the maintenance of heart rate and respiratory function. What can we expect to occur if a patient's beta-1 receptors are stimulated? A. Decrease in the diameter of the bronchioles to help retain carbon dioxide when needed B. Increased heart rate and strength of contraction C. Increase in the diameter of the bronchioles to let more air in and out during ventilation D. Decrease in the heart rate and the size of the bronchioles - Correct answer B. You are called to stage at a mass casualty incident involving exposure to possible chemical agents during the event. Knowing you will likely transport one or more patients from the scene that have been grossly decontaminated in the decontamination section, what measures can you take to minimize the possible contamination of your unit during the patient care/transport encounter? A. Use disposable equipment as much as possible, remove all equipment that will not likely be needed during transport, cover the patient and stretcher with plastic B. Patient should be transported in a full hazmat suit after gross decontamination to prevent infecting EMS and ER staff C. Cover the patient with sheets and blankets and administer oxygen via a non-rebreather mask to prevent spread of toxins

D. Transport the patient on stretcher and treat appropriately. Decontamination has taken place so no further danger of contamination exist - Correct answer A. You are monitoring the cardiac rhythm of your 60-year-old female patient with shortness of breath when you note the presence of a possible first- degree atrioventricular block in lead II on the EKG. Which of the following electrocardiogram abnormalities makes you think there is a first-degree AV block present? A. There are more than one P wave for each QRS complex B. A P-R interval greater than five small boxes (0.20 seconds) wide on the electrocardiogram tracing C. The P-R intervals become progressively longer until a QRS complex is dropped altogether D. The P waves are present but bear no relationship to the QRS complexes

• Correct answer B. You are called to assist a 50-year-old cardiac history patient complaining of chest pain. On arrival, the patient rates his pain at an eight on the pain scale. His skin is cool, clammy, and diaphoretic with a SpO2 of 88 percent on room air. His respirations are at 33 per minute and shallow but clear. His heart rate is 40 beats per minute with a blood pressure of 90 systolic. Which of the following interventions would be inappropriate at this point? A. Intravenous access B. High-flow oxygen therapy C. Twelve-lead electrocardiogram analysis with continuous Lead II monitoring D. Nitroglycerin therapy - Correct answer D. You are called to assist a 20-year-old male for a severe headache. On- scene, you learn the patient was involved in an accident that caused a