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Paramedic Comprehensive Final Exam Practice
2025 – Complete Study Guide
Following blunt trauma to the anterior chest, a 44-year-old woman presents with restlessness, respiratory distress, perioral cyanosis, and tachycardia. Further assessment reveals a midline trachea, engorged jugular veins, and absent breath sounds on the right side of her chest. You should: - ANSWER ✨✔---perform an immediate needle thoracentesis to the right side of the chest. A 40-year-old man presents with difficulty urinating, fever, and tremors. Which of the following should you suspect? - ANSWER ✨✔---Prostatitis A 45-year-old unrestrained man was ejected from his small truck when it struck a tree. The patient is found approximately 20 feet from the wreckage. Your primary assessment reveals that he is unresponsive and has sonorous respirations and a rapid pulse. Your initial actions should include: - ANSWER ✨✔---manually stabilizing his head and opening his airway with the jaw-thrust maneuver. A 60-year-old man with crushing chest pain has 3 mm of ST elevation in leads V1 through V4. What should you suspect? - ANSWER ✨✔---Left anterior descending artery occlusion A patient with a suppressed cough mechanism: - ANSWER ✨✔---is at serious risk for aspiration.
You are caring for a 33-year-old woman who is 35 weeks pregnant and fell down a flight of stairs. Full spinal precautions have been taken, the patient is receiving high-flow oxygen, and a patent IV line is in place. During tr answer port, you reassess her and note that she has become diaphoretic, tachycardic, and tachypneic. You should: - ANSWER ✨✔---tilt the backboard to the left side. Which of the following is the MOST important consideration during a pandemic? - ANSWER ✨✔--- Personal protective equipment The door-to-balloon time for a patient with an ST elevation myocardial infarction is ___ minutes or less.
- ANSWER ✨✔--- 90 When attempting resuscitation of a child with pulseless electrical activity, you should: - ANSWER ✨✔---attempt to identify an underlying cause of the arrest. Which of the following clinical findings would MOST likely differentiate a massive hemothorax from a tension pneumothorax? - ANSWER ✨✔---Hemoptysis Which of the following clinical findings is the MOST consistent with hypertrophic cardiomyopathy? - ANSWER ✨✔---Unexplained syncope A 41-year-old woman attempted to kill herself by cutting her wrists. Law enforcement personnel are at the scene. You have controlled the bleeding with direct pressure and a pressure bandage. The patient's vital signs are stable and she is conscious and alert; however, she refuses to go to the hospital. Despite pleas from her family to go to the hospital, she still refuses. You should: - ANSWER ✨✔---remain with the patient, contact medical control, and request law enforcement intervention. Any time a patient with end-stage renal disease is found in cardiac arrest, the paramedic should strongly consider which of the following as the cause? - ANSWER ✨✔---Kyperkalemia Which of the following statements regarding Grey Turner sign is correct? - ANSWER ✨✔---Grey Turner sign is characterized by flank bruising and indicates internal bleeding.
Which of the following factors would MOST likely produce a falsely normal pulse oximetry reading? - ANSWER ✨✔---Carboxyhemoglobin A 30-year-old man presents with jaw and neck stiffness and fever. During your assessment, he tells you that he cut his hand on a piece of metal about a week ago. You should suspect: - ANSWER ✨✔--- tetanus. If an EMS agency is providing relief to a neighboring community during a disaster, it is important to ensure that: - ANSWER ✨✔---it has enough coverage in its home area of responsibility. You respond to a residence for a possible overdose. The patient, a young man, is unresponsive with slow, snoring respirations. There are obvious needle track marks on his arms. Your FIRST action should be to: - ANSWER ✨✔---manually open his airway. Triage and emergency medical treatment should be performed: - ANSWER ✨✔---in the cold zone. If chest compressions and repositioning of the airway are unsuccessful in removing a severe airway obstruction in an unconscious patient, you should: - ANSWER ✨✔---perform laryngoscopy and use Magill forceps. A young female with experienced trauma to her genitalia and has profuse vaginal bleeding. She is hypotensive, tachycardic, and tachypneic. You should: - ANSWER ✨✔---tr answer port immediately. Physiologic effects of histamine include all of the following, EXCEPT: - ANSWER ✨✔---increased cardiac contractility A 33-year-old male presents with chest pain that is alleviated when he sits forward. The 12-lead ECG shows ST elevation of 2 to 3 mm in multiple leads. What should you suspect? - ANSWER ✨✔--- Pericarditis What 12-lead ECG finding should make you suspect a posterior STEMI? - ANSWER ✨✔---ST depression in leads V1 and V
You are evaluating a 60-year-old woman's 12-lead ECG and note that the R wave height in lead V exceeds the S wave depth. What condition would MOST likely cause this? - ANSWER ✨✔--- Pulmonary hypertension Cardiac symptoms of myocarditis usually appear ______ days after the onset of initial symptoms. - ANSWER ✨✔---10 to 14 In contrast to a patient in shock, you would expect a patient with increased intracranial pressure to present with: - ANSWER ✨✔---a widened pulse pressure. A 50-year-old woman presents with acute respiratory distress while eating. Upon your arrival, you note that she is conscious, coughing, and wheezing between coughs. Further assessment reveals that her skin is pink and moist. In addition to tr answer porting her to the hospital, you should: - ANSWER ✨✔--- encourage her to cough and closely monitor her condition. When ventilating an apneic adult with a pulse with a bag-mask device, you should: - ANSWER ✨✔- --deliver each breath over 1 second at a rate of 10 to 12 breaths/min. You are tr answer ferring a 60-year-old man with COPD from a community hospital to a metropolitan hospital. The patient is mildly dyspneic, but is otherwise stable. He is receiving oxygen via nasal cannula, has an IV line of normal saline in place, and has an ECG applied. When reading his chart, you note that he has polycythemia, a history of a prior stroke, and hypertension. The patient tells you that he feels a fluttering sensation in his chest. You glance at the cardiac monitor and see a narrow complex tachycardia at a rate of 190 beats/min. The patient's blood pressure is 116/70 mm Hg and he remains conscious and alert. You should: - ANSWER ✨✔---ensure adequate oxygenation and ventilation, administer 6 mg of adenosine, and reassess his cardiac rhythm. Takotsubo cardiomyopathy is MOST often associated with: - ANSWER ✨✔---emotional stress. A 40-year-old man fell 20 feet from a tree while trimming branches. Your assessment reveals that he is unresponsive. You cannot open his airway effectively with the jaw-thrust maneuver. You should: - ANSWER ✨✔---carefully open his airway with the head tilt-chin lift maneuver. The size of the rescue area is dependent MOSTLY upon the: - ANSWER ✨✔---potential hazards that exist.
vaginal discharge, but denies vaginal bleeding or a fever. Her blood pressure is 104/64 mm Hg, pulse rate is 88 beats/min and strong, and respirations are 14 breaths/min and regular. What should you suspect? - ANSWER ✨✔---Gonorrhea A 52-year-old man sustained superficial and partial-thickness burns to his left arm approximately 15 minutes ago when he opened the radiator cap on his car. He is conscious, alert, and in severe pain. His BP is 138/76 mm Hg, pulse is 110 beats/min and strong, respirations are 22 breaths/min and regular, and oxygen saturation is 97% on room air. He denies any other injuries. Initial management for this patient involves: - ANSWER ✨✔---applying cool, wet dressings to the burn and elevating his arm. You receive a call to the county jail for a male inmate who is unresponsive. According to the jailor, the patient was arrested for being "drunk." Your assessment reveals that the patient is profusely diaphoretic, and his respirations are rapid and shallow. His blood glucose level reads 30 mg/dL. As your partner assists the patient's ventilations, you start an IV and administer 50% dextrose. Reassessment reveals that the patient is responsive to pain only and his blood glucose level is 46 mg/dL. You should: - ANSWER ✨✔---administer a second dose of dextrose and prepare for immediate tr answer port. A 24-year-old woman was struck by lightning. Bystanders moved the patient to an area of safety but did not provide any other care before your arrival. Your primary assessment reveals that the patient is pulseless and apneic. You begin CPR and apply the cardiac monitor, which reveals asystole. After requesting a backup paramedic unit, the MOST appropriate treatment for this patient involves: - ANSWER ✨✔---continuing CPR, protecting her spine while ventilating, reassessing her cardiac rhythm after 2 minutes of CPR, and defibrillating if necessary. The Pediatric Assessment Triangle will help answer wer all of the following questions, EXCEPT: - ANSWER ✨✔---"Will the child cooperate during my exam?" The major complication associated with hollow organ injury is: - ANSWER ✨✔---peritonitis caused by rupture and spillage of toxins. A patient presents with fever, a headache, and a unilaterally sore throat. What should you suspect? - ANSWER ✨✔---Peritonsilar abscess The FIRST step in the START triage system involves: - ANSWER ✨✔---directing all the walking wounded to an easily identifiable landmark.
The cricothyroid membrane is the ideal site for making a surgical opening into the trachea because: - ANSWER ✨✔---no important structures lie between the skin covering the cricothyroid membrane and the airway. In which of the following situations is oxygen indicated for a patient who complains of chest pain, pressure, or discomfort? - ANSWER ✨✔---Signs of heart failure are present. A 38-year-old man presents with an acute onset of severe right upper quadrant abdominal pain, pain to his right shoulder, and nausea. He is conscious and alert, but is restless from the pain. His blood pressure is 150/86 mm Hg, pulse rate is 120 beats/min and strong, and respirations are 22 breaths/min and regular. You should: - ANSWER ✨✔---start an IV with normal saline and set it to keep the vein open, place him in a position of comfort, and administer morphine and promethazine. A 60-year-old woman presents with fever, chills, and shortness of breath. She has a history of mitral valve prolapse. Assessment reveals flat, painless red lesions on the palms of her hands. What should you suspect? - ANSWER ✨✔---Endocarditis Which of the following org answer is LEAST susceptible to pressure changes caused by an explosion? - ANSWER ✨✔---Liver You are dispatched to a residence for a 50-year-old woman with respiratory distress. While you are assessing the patient, she tells you that she began experiencing flulike symptoms 4 days ago, shortly after delivering mail on the rural mail route for which she is responsible. Her blood pressure is 90/ mm Hg, pulse rate is 120 beats/min, and respirations are 26 breaths/min and labored. Auscultation of her breath sounds reveals the presence of coarse crackles. This patient has MOST likely been exposed to: - ANSWER ✨✔---anthrax. When a child experiences a low cardiac output state, he or she relies MOST on: - ANSWER ✨✔--- an increase in heart rate. Prior to administering pharmacologic therapy to an infant or child with pulseless ventricular tachycardia, the paramedic should perform: - ANSWER ✨✔---defibrillation.
condition dictates immediate tr answer port to the hospital and that delaying tr answer port could result in death. A 10-year-old child fell approximately 15 feet from a balcony, landing on a sidewalk. He is conscious and alert, and complains of pain to the right side of his body. After completing your primary survey, you should: - ANSWER ✨✔---provide any immediately needed care, perform a rapid assessment, apply spinal precautions, and tr answer port. An obese 30-year-old female had two children within an 18-month time span. She presents with a feeling of "heaviness" in her pelvis and lower back pain. She states that the symptoms resolve slightly when she lies down. What should you suspect? - ANSWER ✨✔---Uterine prolapse A 22-year-old woman experienced an acid chemical burn to her left forearm. She complains of intense pain and tingling in her fingers. She is conscious and alert, and denies any other symptoms. You should: - ANSWER ✨✔---begin immediate irrigation with water. A 22-year-old male with sickle cell disease presents with severe abdominal pain. On assessment, his abdomen appears bloated and is rigid to the touch. What should you suspect? - ANSWER ✨✔--- Splenic sequestration syndrome You receive a call for a "sick child." When you arrive at the scene, the child's mother tells you that her 5- year-old son has had vomiting and diarrhea for the past day and will not eat or drink anything. On exam, the child's level of consciousness appears consistent with his age. His skin is cool and pale, he is tachypneic, his capillary refill time is 4 seconds, and his heart rate is 150 beats/min. The MOST appropriate treatment for this child involves: - ANSWER ✨✔---administering supplemental oxygen, keeping the child warm, assessing his blood glucose level, tr answer porting, and establishing vascular access en route. When ventilating a patient with facial injuries, it is MOST important to: - ANSWER ✨✔---be alert for changes in ventilation compliance. A 51-year-old woman sustained a large laceration to her cheek when she was cut by a knife during a robbery attempt. The patient is conscious and alert and has severe oral bleeding. She denies any other trauma. Your FIRST action should be to: - ANSWER ✨✔---ensure that she is sitting up and leaning forward.
Tr answer port of a patient in anaphylactic shock may be delayed for all of the following reasons, EXCEPT:
- ANSWER ✨✔---a secondary assessment. Paralytic medications exert their effect by: - ANSWER ✨✔---functioning at the neuromuscular junction and relaxing the muscle by impeding the action of acetylcholine. A 30-year-old woman presents with bright red vaginal bleeding and severe abdominal pain. She tells you that she is 35 weeks pregnant and that this episode began suddenly about 30 minutes ago. She further tells you that she has not felt the baby move in over an hour. As your partner is treating the patient for shock, you obtain her medical history. The patient tells you that she has high blood pressure and admits to using cocaine throughout her pregnancy. What should you suspect? - ANSWER ✨✔---Abruptio placenta You have intubated a 70-year-old woman with chronic bronchitis and are en route to the hospital. During tr answer port, you note that ventilations are becoming increasingly difficult and her ETCO2 is falling. Your partner tells you that she can still hear bilaterally equal breath sounds, but they are faint. She further tells you that there are no sounds over the epigastrium. What intervention is MOST likely indicated for this patient? - ANSWER ✨✔---Tracheobronchial suctioning Nitroglycerin is contraindicated for patients: - ANSWER ✨✔---with suspected right ventricular infarction. Which of the following is typically the first complaint in a patient who is developing compartment syndrome? - ANSWER ✨✔---Disproportionate pain The general area of a child's body that sustains initial trauma after being struck by an automobile depends MAINLY on: - ANSWER ✨✔---the child's height and the height of the bumper upon impact. The middle ear consists of the: - ANSWER ✨✔---inner portion of the tympanic membrane and the ossicles.
With respect to CPR and foreign body airway obstruction procedures, the child should be treated as an adult once: - ANSWER ✨✔---secondary sexual characteristics have developed. A 9-year-old, 55-pound girl presents with generalized hives, marked facial swelling, and loud inspiratory stridor. She is conscious but appears sleepy. You can MOST rapidly improve this child's condition by: - ANSWER ✨✔---administering epinephrine IM. The pain associated with pericarditis: - ANSWER ✨✔---improves when the patient le answer forward. In a closed femur fracture, blood loss may exceed _______ before enough pressure develops to tamponade the bleeding. - ANSWER ✨✔---1,000 mL A 56-year-old diabetic woman presents with a painful, reddened area on her left forearm, which she first noticed a few days ago. Closer examination reveals a blister in the center of the affected area. The patient denies being bitten or stung by anything and states that the only thing she has been doing is storing boxes in the attic. You should suspect a/an: - ANSWER ✨✔---brown recluse spider bite. You are caring for a 69-year-old man with congestive heart failure. His breathing is profoundly labored, his oxygen saturation reads 79% on oxygen via nonrebreathing mask, and he is showing signs of physical exhaustion. Considering that your protocols do not allow you to perform rapid sequence intubation, you should: - ANSWER ✨✔---preoxygenate him with a bag-mask device and then perform blind nasotracheal intubation.
