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Paramedic Readiness Exam 5
Prep (2026): 200+ Scenarios,
Advanced Pathophysiology &
Verified Solutions (Graded A+)
A 43 year old male was involved in a car crash. He has a forehead contusion, and he complains of a headache and nausea. A witness says he was unconscious for one minute after the collision. Now, he is asking repeatedly what happened. What is the most likely cause?- Correct answer-Concussion A confused 68 year old male complains of dyspnea. He states that he has a history of atrial fibrillation. You hear crackles in upper right lobe of the chest. His skin is warm and dry Vital signs are BP 70/40, P matches ECG below, R 30. What should you suspect?- Correct answer-Pneumonia A 6 year old female was struck by a car and thrown 10 feet. Vital signs are BP 60/P P 140, R 10 and labored. She has subcutaneous emphysema and absent breath sounds on the left side. What should you suspect?- Correct answer-Tension pneumothorax A 22 year old male who was hit with a sledge hammer has an open skull fracture , unequal pupils , and a decerebrate posture. Vital signs are BP 188/110, P 66, R 18. What should you do?- Correct answer-Ventilate at 20 breaths per minute
An intoxicated 18 year old is mumbling obscenities. You note empty bottles of lithium and hydrocodone on the floor. He states 1 can't take it anymore " What should you do?- Correct answer-Ask about a suicide plan At a multiple casualty incident (MCI), people were struck by lightning. Which patient is the highest priority for treatment?- Correct answer-A 49 year old male who is unable to move his extremities A 20 year old female is 10 weeks pregnant. She reports vaginal bleeding and abdominal cramps. What should you suspect?- Correct answer-Spontaneous abortion When arriving on a potential Hazmat incident on the highway, you should stage emergency apparatus in which direction?- Correct answer-Uphill and upwind You are ordered to administer a 1000 mL bolus of normal saline over 1 hour. The tubing factor is 10 drops/mL. What is the correct drops per minute?- Correct answer- How do partial seizures typically present?- Correct answer-Localized to one extremity A 25 year old male was involved in an ATV crash at the local racetrack. He is wearing a full face helmet and is unresponsive. There is blood oozing from his mouth and his jaw is clenched. Vital signs are P 130, R 30 and gurgling, SpO2 86% What should you do?- Correct answer-Leave the helmet on and attempt to suction his mouth
Her last menstrual cycle was 5 weeks ago and are normally irregular. What should you suspect?- Correct answer-Appendicitis A 67 year old female complains of a sudden onset of chest pain that began 10 minutes ago. She points to her left axillary area and states the pain is "right here". She is on antibiotics for an infection she developed during hip surgery last week. Vital signs are BP 150/90, P matches ECG below, R 20. What should you suspect?- Correct answer-Pulmonary embolism How are seizures most often caused in the case of children?- Correct answer-An abrupt rise in body temperature A 43 year old male experienced slight chest discomfort and shortness of breath while playing basketball. He admits to smoking a pack of cigarettes per day. Vital signs are BP 150/88, pulse matches the ECG, R 18. His skin is warm and pink what should you suspect ?- Correct answer-Angina pectoris Which patient is most likely to suffer a bad outcome if they refuse transportation to a hospital?- Correct answer-A 67 year old female with signs of unstable angina A 69 year old male complains of severe chest pain at a restaurant. An on scene physician from another agency requests you to "administer 0.3 mg of Epinephrine IM" What should you do?- Correct answer-Continue to follow your protocol A febrile 83 year old female is confused. Her daughter states yesterday she was acting normally, but complained
of difficulty urinating. Vitals signs are BP 106/72, P 116, R 24, Sp02 94%. What is the most likely cause?- Correct answer-Urinary tract infection A febrile 3 month old male who weighs 13 lbs has a weak cry. He has been sick with diarrhea. His history includes Tetralogy of Fallot Pulse matches ECG below. What should you do?- Correct answer-Administer 120 mL of normal saline IV A 72 year old female complains of abdominal pain and bright, red blood when she has a bowel movement. What should you suspect?- Correct answer-Lower Gl bleeding An 81 year old female is in cardiac arrest. A family member has initiated CPR while other family members are arguing that she has a DNR order. What should you do?- Correct answer-Continue CPR and ask family members for proof of the DNR You have just received a subpoena for a patient that you treated 2 years ago. You documented "the patient was obviously drunk on arrival." Subsequently the patient was diagnosed with hypoglycemia. Your documentation should be considered which of the following?- Correct answer-Libel A 56 year old male with a significant cardiac history complains of sudden onset shortness of breath. He is alert, awake anxious and showing signs of orthopnea. Vital signs are BP 162/100, P matches ECG below, R 22 with crackles. What should you do?- Correct answer-Apply CPAP A 45 year old female is supine on the floor and unresponsive. Her family states prior to EMS arrival she
What type of blade should be used when intubating an infant or small child?- Correct answer-Miller An 80 year old male is short of breath and is spitting up pink, frothy sputum. He has no improvement after oxygen administration. What should you do?- Correct answer-Apply CPAP While driving with lights and sirens you approach a car that is stopped in the middle of a narrow road. What should you do?- Correct answer-Slow the ambulance and proceed with caution A 76 year old male with a history of back problems responds only to painful stimuli. His skin is pale and diaphoretic. Vital signs are P 56, R 6 and shallow, pupils are constricted. What should you administer ?- Correct answer-Naloxone An alert 56 year old male is trapped underneath an overturned tractor. His hips and legs are underneath the tractor. Vital signs are P 126, R 24, SpO2 88%. What should you do?- Correct answer-Apply high flow oxygen You are the first emergency vehicle to arrive on the scene of a multiple vehicle crash on an icy freeway bridge. Two lanes of traffic are open and cars are passing you at freeway speeds. What should you do?- Correct answer-Request additional police and fire resources You are approaching an automobile accident that is on the same side of traffic as you are. You are the first vehicle on the scene. How should you position the ambulance?-
Correct answer-Between the crash and the traffic During transport, an intubated post-cardiac arrest patient starts to cough against ventilations. Tidal volume suddenly decreases, and vital signs are P 91, ETC02 43 mmHg. What should you do?- Correct answer-Administer midazolam A 5 year old male swallowed three of his grandmother's digoxin tablets several hours ago. He is lethargic to respond. His vitals are BP 74/40, P matches ECG below, R 8. What should you do?- Correct answer-Administer 0.01 mg / kg epinephrine A 14 year old male complains of a swollen ankle. He jumped from a height of 15 feet. He is unable to put pressure on the injured foot but refuses care. His "best friend" promises will take him to the hospital. Vital signs are BP 128/88, P 106 , R 22 What should you do?- Correct answer-Contact the patient's parent or guardian A 9 year old female has a large laceration to her left calf. She is anxious, and the laceration continues to bleed despite your initial treatments. What should you do?- Correct answer-Apply a tourniquet Which of the following is a primary concern when treating a sexual assault victim in the prehospital setting?- Correct answer-Preserving the patient's privacy and dignity A 75 year old male complains of a headache and blurred vision which began 3 hours ago. He has a history of hypertension and a recent upper respiratory infection Vital signs are BP 190/88, P matches ECG below, R 18. What should you suspect?- Correct answer-Meningitis
A 36 year old female in her third trimester of pregnancy presents with severe abdominal pain and vaginal bleeding. Her husband tells you that she has a history of drug use and was recently seen by her OB physician and was 4 cm dilated, 30% effaced. Vital signs are BP 98/60, P 110, R
- What should you do?- Correct answer-Place in left lateral recumbent position and transport An 18 month old female has central and peripheral cyanosis. She is struggling to breathe and has a concave abdomen. What should you do?- Correct answer-Assist ventilations with a bag valve mask A 23 year old male has both legs trapped under a fallen tree. He has been trapped for 6 hours and rescuers are still trying to free him. What should you suspect?- Correct answer-Hyperkalemia Your ambulance agency provides children in the neighborhood with bikes and helmets. What is this an example of?- Correct answer-Community relations A female patient presents with urinary urgency and frequency, a moderate fever, and suprapubic tenderness. What should you suspect?- Correct answer-Urinary tract infection You arrive at a factory to discover a large amount of chlorine has spilled and is uncontained. Multiple people complain of difficulty breathing. What should you do?- Correct answer-Move back to the ambulance 61 year old female complains of a severe headache and right arm weakness. Her medications include HCTZ and Glucophage. Vital signs are BP 178/102, P matches ECG
below. R 18, blood glucose level 64 mg/dL. What should you suspect?- Correct answer-Stroke A 10 year old female is lethargic to respond. She has urticaria on her chest and neck. She has been undergoing antibiotic treatment for a bacterial UTI for the past day. Vital signs are BP 80/40, P 132. and R 36 with diminished wheezing. What type of shock should you suspect?- Correct answer-Anaphylactic A 36 year old female has been involved in an explosion at a chemical laboratory. She has superficial and partial thickness burns to her face. Witnesses state that her shirt was on fire for a "brief moment." What should you suspect?- Correct answer-Extensive airway burns A febrile 1 year old male has a barking cough. He is restless with expiratory stridor and marked retractions. What should you administer?- Correct answer-Racemic epinephrine 0.5 mg nebulized Side effects of oral contraceptives include which of the following?- Correct answer-Pulmonary embolism and stroke Identify this rhythm- Correct answer-Sinus bradycardia with bigeminal PVCs A 29 year old female leaped from the fourth floor hospital window. She is unresponsive with agonal respirations. A nursing aide rushes up and says, "She is terminally ill with a DNR. Don't do anything!" What should you do ?- Correct answer-Provide assisted ventilations
An alert 22 year old male complains of palpitations and weakness after having been up nearly all night studying for a college exam. He has had several cups of coffee and multiple caffeine tablets. His skin is cool and moist Vital signs are BP 106/68, R 26. His pulse matches the ECG below. What should you do?- Correct answer-Ask the patient to bear down In which intercostal space should you insert a needle for pleural decompression?- Correct answer-Midclavicular and above the 3rd rib A 3 month old infant who weighs 6kg has a history of congenital heart disease. Vital signs R 60 with cyanotic nailbeds, SpO2 at 88%, P matches ECG below. What should you administer?- Correct answer-0.6 mg of adenosine , IV push A 44 year old male is unresponsive after a penetrating injury to his chest. His jugular veins are flat and his vital signs are BP 70/44, P 130, R 22 with unequal breath sounds. What should you suspect?- Correct answer-Simple pneumothorax While using the START system at a major incident, you encounter a patient who is apneic. After positioning the airway, the patient has a respiratory rate of 16 breaths/minute. How should you classify this patient?- Correct answer-Immediate A 47 year old male with a tracheostomy has shallow respirations and mottled skin. His caretaker tells you that she just replaced the tracheostomy tube What should you do ?- Correct answer-Ventilate by bag - valve mask
An unconscious 44 year old female is cyanotic and has agonal respirations. Her lips and tongue are swollen and her tongue is protruding from her mouth. She recently left her physician's office after receiving an injection of antibiotics. You are unable to ventilate her. What should you do?- Correct answer-Perform needle cricothyrotomy An unresponsive 82 year old female is on the concrete floor in her basement. Vital signs are BP 100/70, P 44, R 10, temp 90 degrees F. What should you do?- Correct answer-Begin active external warming An anxious 15 year old male was the unrestrained passenger in a rollover car crash. He denies pain and refuses treatment. Law enforcement is on scene and unable to contact the patient's parents. What should you do?- Correct answer-Obtain baseline vital signs While lifting a patient with the stretcher your partner complains of sharp back pain. What should you do?- Correct answer-Stop lifting A 59 year old female with a history of asthma is seated in the tripod position. She speaks in 2-3 word sentences. She used her inhaler twice prior to EMS arrival. Vital signs are BP 124/66, P matches ECG below, R 22 and distant. What should you suspect?- Correct answer-Status asthmaticus A 40 year old male has a hearing impairment. His 9 year old daughter knows limited American Sign Language. While attempting to establish IV access he pushed your hand away. What should you do?- Correct answer-Carefully document your inability to obtain informed consent
A 22 year old female was involved in a bar fight and has a large knife impaled in the center of her right thigh. Vital signs are BP 122/78, P 90, R 16. What should you do?- Correct answer-Stabilize the object with bulky dressing material A 23 year old female is prima gravida at 32 weeks gestation. She complains of bright red bleeding that started as "spotting." She denies the vaginal bleeding being painful. What should you suspect?- Correct answer-Placenta previa An 86 year old female complains of a headache. She has decreased extremity mobility due to severe arthritis. Her medical history consists of atherosclerosis and hypertension. Vital signs are BP 146/90, P matches ECG below, R 16. What should you suspect?- Correct answer-Ischemic stroke A 57 year old female complains of shortness of breath and was initially hypotensive. During administration of a fluid she complains of chest pain with increasing shortness of breath. Vital signs are BP 92/40, P matches ECG below, R 24 with crackles, SpO2 98% on high-flow oxygen. What should you do?- Correct answer-Administer acetylsalicylic acid An anxious 52 year old male tells you that he's not feeling right today. His pulse matches the monitor. Vital signs are BP 112/68, R 22. What should you do?- Correct answer-Administer amiodarone A 23 year old female is 36 weeks pregnant. She is bleeding from her nose and ears after being hit by a car while crossing the street. She moans when you apply a painful stimulus and you feel her lower abdomen
contracting. Vital signs are BP 88/46, P 142, R 20. What should you do?- Correct answer-Administer a normal saline fluid bolus A 29 year old female complains of labor pains and screams "the baby is coming." She is scheduled for cesarean next week due to the baby being breech. What should you expect to see?- Correct answer-Buttocks How should you dispose of dressings and bandages that are saturated with blood?- Correct answer-In a red bag with a biohazard seal You are called to a nursing home on a hot summer day for an unconscious 88 year old male. The nurse tells you he missed his dialysis appointment because he was complaining of nausea, vomiting, headache, and running a fever. Which differential diagnosis should you consider first?- Correct answer-Sepsis and hyperkalemia A newborn is limp and cyanotic immediately after delivery. She is unresponsive to initial stimulation. Her APGAR score is 6. What should you do?- Correct answer-Ventilate her with a BVM A 32 year old female has minor vaginal bleeding after a delivery of a newborn. What should you do?- Correct answer-Perform external fundal massage A 17 year old female is 28 weeks pregnant. She complains of severe swelling of her hands and feet. Vital signs are BP 160/100, P 108, R 24. What should you suspect?- Correct answer-Preeclampsia
bases. Vital signs are BP 96/52, P matches ECG below, R 28, SpO2 96% on high-flow oxygen. What should you administer?- Correct answer-Aspirin A 76 year old male with a history of hypertension is unresponsive. Family members state he has been ill for several days with decreasing mental status. Vital signs are BP 60/30, P 56, R 24, BGL 40 mg/dL. What should you suspect?- Correct answer-Addison's disease A 21 year old male was having a seizure upon your arrival. He was administered 5 mg of midazolam and is now unresponsive and pale. Vital signs are BP 78/40, P 50 and weak, R 4 and shallow. What should you do?- Correct answer-Begin ventilations A 74 year old female is short of breath. She has a history of emphysema. What position are you most likely to find her?- Correct answer-Tripod position A 24 year old male has been stung by a bee. You note urticaria and redness on his chest and neck. Vital signs are BP 80/20, P 100, R 10. What is the cause of his hypotension?- Correct answer-Increased capillary permeability A 36 year old male was stabbed in the abdomen and has no radial pulses. Effective treatments should show which change?- Correct answer-BP reaches 90 systolic Which of the following patients may sign a refusal for treatment?-
Correct answer-A 35 year old male with signs and symptoms of an acute myocardial infarction most commonly associated Which of the following is most commonly associated with right ventricular failure?- Correct answer-Peripheral edema What neural reflex signal prevents the lungs from over- inflating?- Correct answer-Hering-Breuer A 65 year old homeless man complains of a cough, abdominal pain and fever. His cough has lasted a few weeks, but today it's "worse" with bright red phlegm. What should you suspect?- Correct answer-Tuberculosis A 90 year old female lives at a nursing home. She has difficulty breathing with 2 word dyspnea. During the primary survey her son arrives and begins shouting and blaming nursing home staff for poor treatment. He demands she is transported immediately. What should you do?- Correct answer-Treat the patient and attempt to reason with her son A 4 year old boy at a birthday party suddenly collapsed after blowing up a balloon. He is unresponsive and apneic with a pulse of 40. What should you suspect?- Correct answer-Airway obstruction A 42 year old female is responsive to pain only and presents with miosis. Vital signs are BP 92/40, P matches ECG below, R 6. What should you do?- Correct answer-Assist ventilations
