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MICN LA COUNTY FINAL EXAM PREP
2026 | 150 QUESTIONS AND CORRECT
DETAILED ANSWERS | ALREADY A
GRADED |NEW!!
1. A 62-year-old male presents with chest pain radiating to the left
arm. He is diaphoretic and nauseous. ECG shows ST-elevation in
leads II, III, and aVF. Which intervention is most appropriate first?
A. Administer nitroglycerin sublingually
B. Administer aspirin 325 mg orally and prepare for rapid transport
C. Begin high-flow oxygen at 15 L/min
D. Administer morphine 2 mg IV
Immediate aspirin administration is indicated for suspected STEMI to
reduce platelet aggregation. Nitroglycerin is contraindicated if
hypotension is present. Oxygen is secondary if SpO₂ <94%. Morphine
is adjunctive after aspirin and nitro if pain persists.
2. A patient is unresponsive with agonal respirations and no pulse.
What is the first action?
A. Begin rescue breathing
B. Start CPR immediately
C. Attach AED and analyze rhythm
D. Administer epinephrine IV
For pulseless patients, high-quality chest compressions are the
priority. Rescue breathing alone is insufficient. Epinephrine is given
after CPR is initiated according to ACLS.
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3. Which of the following medications is first-line for anaphylactic
shock in the prehospital setting?
A. Diphenhydramine IV
B. Epinephrine IM
C. Hydrocortisone IV
D. Albuterol nebulized
Epinephrine is the first-line treatment for anaphylaxis to counteract
airway compromise and hypotension. Antihistamines and steroids are
adjuncts.
4. A 45-year-old diabetic patient is found with confusion,
diaphoresis, and a blood glucose of 38 mg/dL. What is the most
appropriate initial intervention?
A. Administer oral glucose
B. Administer IV dextrose 25 g
C. Monitor and recheck blood glucose in 5 minutes
D. Administer subcutaneous insulin
Severe hypoglycemia with altered mental status requires rapid IV
glucose. Oral glucose is only appropriate if the patient is alert and can
swallow.
5. You are caring for a trauma patient with suspected tension
pneumothorax. Which clinical sign is most indicative?
A. Bilateral clear lung sounds
B. Tracheal deviation away from affected side
C. Slow, shallow respirations
D. Bradycardia
,3|Page
Tracheal deviation is a hallmark sign of tension pneumothorax, along
with hypotension and absent breath sounds on the affected side.
6. According to LA County MICN protocols, which patient requires
immediate 12-lead ECG and telemetry monitoring?
A. 22-year-old with ankle sprain
B. 34-year-old with mild headache
C. 50-year-old with palpitations and syncope
D. 65-year-old with chest pressure and dyspnea
Patients with cardiac symptoms such as chest pressure, dyspnea, or
syncope require ECG and continuous monitoring per EMS cardiac
protocols.
7. A patient has been exposed to a chemical burn. What is the first
action?
A. Apply topical antibiotic
B. Flush the area with copious amounts of water
C. Cover with sterile gauze immediately
D. Administer IV analgesics
Immediate decontamination with water is critical to prevent further
tissue damage. Topical treatments or covering are secondary.
8. Which rhythm requires immediate defibrillation?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus tachycardia
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Ventricular fibrillation is a shockable rhythm. Asystole and PEA are
non-shockable and require CPR and medications.
9. A 28-year-old female is 32 weeks pregnant and experiencing
vaginal bleeding with hypotension. What is the priority
intervention?
A. Administer IV fluids and position in left lateral tilt
B. Prepare for immediate delivery
C. Rapid transport to appropriate facility
D. Administer uterotonic medications
Pregnant patients with bleeding and hypotension require rapid
transport to a facility equipped for obstetric emergencies. Positioning
and fluids are supportive.
10. During transport, a MICN notes the patient’s SpO₂ has dropped
from 96% to 88% on 2L nasal cannula. What is the next best
action?
A. Increase nasal cannula to 4L
B. Switch to non-rebreather at 15 L/min
C. Begin CPAP immediately
D. Continue monitoring
For significant hypoxia, escalating oxygen delivery to a non-
rebreather is indicated. CPAP may be considered if respiratory distress
persists.
11. Which of the following is considered an absolute
contraindication to thrombolytic therapy in acute STEMI?
A. Age >75
B. Active internal bleeding
MICN LA COUNTY FINAL EXAM PREP
2026 | 150 QUESTIONS AND CORRECT
DETAILED ANSWERS | ALREADY A
GRADED |NEW!!
1. A 62-year-old male presents with chest pain radiating to the left
arm. He is diaphoretic and nauseous. ECG shows ST-elevation in
leads II, III, and aVF. Which intervention is most appropriate first?
A. Administer nitroglycerin sublingually
B. Administer aspirin 325 mg orally and prepare for rapid transport
C. Begin high-flow oxygen at 15 L/min
D. Administer morphine 2 mg IV
Immediate aspirin administration is indicated for suspected STEMI to
reduce platelet aggregation. Nitroglycerin is contraindicated if
hypotension is present. Oxygen is secondary if SpO₂ <94%. Morphine
is adjunctive after aspirin and nitro if pain persists.
2. A patient is unresponsive with agonal respirations and no pulse.
What is the first action?
A. Begin rescue breathing
B. Start CPR immediately
C. Attach AED and analyze rhythm
D. Administer epinephrine IV
For pulseless patients, high-quality chest compressions are the
priority. Rescue breathing alone is insufficient. Epinephrine is given
after CPR is initiated according to ACLS.
,2|Page
3. Which of the following medications is first-line for anaphylactic
shock in the prehospital setting?
A. Diphenhydramine IV
B. Epinephrine IM
C. Hydrocortisone IV
D. Albuterol nebulized
Epinephrine is the first-line treatment for anaphylaxis to counteract
airway compromise and hypotension. Antihistamines and steroids are
adjuncts.
4. A 45-year-old diabetic patient is found with confusion,
diaphoresis, and a blood glucose of 38 mg/dL. What is the most
appropriate initial intervention?
A. Administer oral glucose
B. Administer IV dextrose 25 g
C. Monitor and recheck blood glucose in 5 minutes
D. Administer subcutaneous insulin
Severe hypoglycemia with altered mental status requires rapid IV
glucose. Oral glucose is only appropriate if the patient is alert and can
swallow.
5. You are caring for a trauma patient with suspected tension
pneumothorax. Which clinical sign is most indicative?
A. Bilateral clear lung sounds
B. Tracheal deviation away from affected side
C. Slow, shallow respirations
D. Bradycardia
,3|Page
Tracheal deviation is a hallmark sign of tension pneumothorax, along
with hypotension and absent breath sounds on the affected side.
6. According to LA County MICN protocols, which patient requires
immediate 12-lead ECG and telemetry monitoring?
A. 22-year-old with ankle sprain
B. 34-year-old with mild headache
C. 50-year-old with palpitations and syncope
D. 65-year-old with chest pressure and dyspnea
Patients with cardiac symptoms such as chest pressure, dyspnea, or
syncope require ECG and continuous monitoring per EMS cardiac
protocols.
7. A patient has been exposed to a chemical burn. What is the first
action?
A. Apply topical antibiotic
B. Flush the area with copious amounts of water
C. Cover with sterile gauze immediately
D. Administer IV analgesics
Immediate decontamination with water is critical to prevent further
tissue damage. Topical treatments or covering are secondary.
8. Which rhythm requires immediate defibrillation?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus tachycardia
, 4|Page
Ventricular fibrillation is a shockable rhythm. Asystole and PEA are
non-shockable and require CPR and medications.
9. A 28-year-old female is 32 weeks pregnant and experiencing
vaginal bleeding with hypotension. What is the priority
intervention?
A. Administer IV fluids and position in left lateral tilt
B. Prepare for immediate delivery
C. Rapid transport to appropriate facility
D. Administer uterotonic medications
Pregnant patients with bleeding and hypotension require rapid
transport to a facility equipped for obstetric emergencies. Positioning
and fluids are supportive.
10. During transport, a MICN notes the patient’s SpO₂ has dropped
from 96% to 88% on 2L nasal cannula. What is the next best
action?
A. Increase nasal cannula to 4L
B. Switch to non-rebreather at 15 L/min
C. Begin CPAP immediately
D. Continue monitoring
For significant hypoxia, escalating oxygen delivery to a non-
rebreather is indicated. CPAP may be considered if respiratory distress
persists.
11. Which of the following is considered an absolute
contraindication to thrombolytic therapy in acute STEMI?
A. Age >75
B. Active internal bleeding
