Paramedic Medical Scenarios Exam
Questions & Answers (Grade A+)
A 19-year-old female ingested an unknown quantity of Elavil and
Ativan approximately 3 hours ago. She is slow to answer your
questions and her speech is slurred. Her BP is 80/60 mm Hg, her
pulse is 150 beats/min, and her respirations are 22 breaths/min.
The ECG reveals sinus tachycardia with QRS complexes that
measure 0.08 seconds. Treatment should include:
A) 1 mEq/kg of sodium bicarbonate.
B) sequential 20 mL/kg IV fluid boluses.
C) 1 to 2 g/kg of activated charcoal.
D) 0.4 to 2 mg of naloxone slow IV push. -
correct answer ✅B) sequential 20 mL/kg IV fluid boluses.
A 71-year-old male presents with chest pain and shortness of
breath. He is conscious, but confused, and is profusely diaphoretic.
He has weakly palpable radial pulses, a BP of 70/40 mm Hg, and
diffuse crackles in all lung fields. You administer high-flow oxygen
and apply the cardiac monitor, which reveals sinus tachycardia. The
closest appropriate hospital is 40 miles away. Which of the
following is the MOST appropriate next action?
A) Obtain a 12-lead ECG tracing.
B) Begin an infusion of dopamine.
C) Perform a head-to-toe exam.
,Paramedic Medical Scenarios Exam
Questions & Answers (Grade A+)
D) Give 20 mL/kg fluid boluses. -
correct answer ✅B) Begin an infusion of dopamine.
A 60-year-old male presents with an acute onset of confusion and
slurred speech. His family states that the episode began while he
was watching TV, and that he was normal all morning. Which of the
following assessments would be the MOST likely to reveal a
possible cause of his altered mental status?
A) Oxygen saturation
B) Blood glucose level
C) Palpation of the skull
D) Systolic blood pressure -
correct answer ✅B) Blood glucose level
A 65-year-old man has had vomiting and diarrhea for the past 2
days and complains of severe weakness. His cardiac rhythm is
shown below. Treatment for him should include:
A) crystalloid fluid boluses.
B) adenosine, 6 mg rapid IV.
C) synchronized cardioversion.
D) diltiazem, 0.25 mg/kg.
,Paramedic Medical Scenarios Exam
Questions & Answers (Grade A+)
Feedback :
Given the patient's history of vomiting and diarrhea, the paramedic
should conclude that he has a compensatory tachycardia, likely
sinus in nature. Heart rates can exceed 150 per minute and still be
sinus in origin. The rhythm shown has clearly visible P waves.
Treatment should include crystalloid fluid boluses. The patient's
tachycardia is likely not of a primary cardiac etiology; it is in
response to dehydration. Therefore, interventions aimed at
decreasing his heart rate (ie, adenosine, diltiazem) are not
indicated; in fact, they could be harmful. Cardioversion is not
indicated either; again, this is not a primary cardia -
correct answer ✅A) crystalloid fluid boluses.
Feedback :
Given the patient's history of vomiting and diarrhea, the paramedic
should conclude that he has a compensatory tachycardia, likely
sinus in nature. Heart rates can exceed 150 per minute and still be
sinus in origin. The rhythm shown has clearly visible P waves.
Treatment should include crystalloid fluid boluses. The patient's
tachycardia is likely not of a primary cardiac etiology; it is in
response to dehydration. Therefore, interventions aimed at
decreasing his heart rate (ie, adenosine, diltiazem) are not
indicated; in fact, they could be harmful. Cardioversion is not
indicated either; again, this is not a primary cardiac dysrhythmia. As
, Paramedic Medical Scenarios Exam
Questions & Answers (Grade A+)
the patient is properly rehydrated, the tachycardia should resolve
on its own.
Which of the following complications would MOST likely occur if a
patient with renal failure missed his or her dialysis treatment?
A) Pulmonary edema
B) Bacterial infection
C) Severe dehydration
D) Marked hypokalemia -
correct answer ✅A) Pulmonary edema
A 60-year-old female presents with confusion, shortness of breath,
and diaphoresis. Her blood pressure is 70/40 mm Hg and her heart
rate is 40 beats/min. The cardiac monitor reveals a slow, wide
complex rhythm with dissociated P waves. After applying
supplemental oxygen, you should:
A) give her up to 325 mg of baby aspirin.
B) start an IV and give 0.5 mg of atropine.
C) start an IV and give a rapid fluid bolus.
Questions & Answers (Grade A+)
A 19-year-old female ingested an unknown quantity of Elavil and
Ativan approximately 3 hours ago. She is slow to answer your
questions and her speech is slurred. Her BP is 80/60 mm Hg, her
pulse is 150 beats/min, and her respirations are 22 breaths/min.
The ECG reveals sinus tachycardia with QRS complexes that
measure 0.08 seconds. Treatment should include:
A) 1 mEq/kg of sodium bicarbonate.
B) sequential 20 mL/kg IV fluid boluses.
C) 1 to 2 g/kg of activated charcoal.
D) 0.4 to 2 mg of naloxone slow IV push. -
correct answer ✅B) sequential 20 mL/kg IV fluid boluses.
A 71-year-old male presents with chest pain and shortness of
breath. He is conscious, but confused, and is profusely diaphoretic.
He has weakly palpable radial pulses, a BP of 70/40 mm Hg, and
diffuse crackles in all lung fields. You administer high-flow oxygen
and apply the cardiac monitor, which reveals sinus tachycardia. The
closest appropriate hospital is 40 miles away. Which of the
following is the MOST appropriate next action?
A) Obtain a 12-lead ECG tracing.
B) Begin an infusion of dopamine.
C) Perform a head-to-toe exam.
,Paramedic Medical Scenarios Exam
Questions & Answers (Grade A+)
D) Give 20 mL/kg fluid boluses. -
correct answer ✅B) Begin an infusion of dopamine.
A 60-year-old male presents with an acute onset of confusion and
slurred speech. His family states that the episode began while he
was watching TV, and that he was normal all morning. Which of the
following assessments would be the MOST likely to reveal a
possible cause of his altered mental status?
A) Oxygen saturation
B) Blood glucose level
C) Palpation of the skull
D) Systolic blood pressure -
correct answer ✅B) Blood glucose level
A 65-year-old man has had vomiting and diarrhea for the past 2
days and complains of severe weakness. His cardiac rhythm is
shown below. Treatment for him should include:
A) crystalloid fluid boluses.
B) adenosine, 6 mg rapid IV.
C) synchronized cardioversion.
D) diltiazem, 0.25 mg/kg.
,Paramedic Medical Scenarios Exam
Questions & Answers (Grade A+)
Feedback :
Given the patient's history of vomiting and diarrhea, the paramedic
should conclude that he has a compensatory tachycardia, likely
sinus in nature. Heart rates can exceed 150 per minute and still be
sinus in origin. The rhythm shown has clearly visible P waves.
Treatment should include crystalloid fluid boluses. The patient's
tachycardia is likely not of a primary cardiac etiology; it is in
response to dehydration. Therefore, interventions aimed at
decreasing his heart rate (ie, adenosine, diltiazem) are not
indicated; in fact, they could be harmful. Cardioversion is not
indicated either; again, this is not a primary cardia -
correct answer ✅A) crystalloid fluid boluses.
Feedback :
Given the patient's history of vomiting and diarrhea, the paramedic
should conclude that he has a compensatory tachycardia, likely
sinus in nature. Heart rates can exceed 150 per minute and still be
sinus in origin. The rhythm shown has clearly visible P waves.
Treatment should include crystalloid fluid boluses. The patient's
tachycardia is likely not of a primary cardiac etiology; it is in
response to dehydration. Therefore, interventions aimed at
decreasing his heart rate (ie, adenosine, diltiazem) are not
indicated; in fact, they could be harmful. Cardioversion is not
indicated either; again, this is not a primary cardiac dysrhythmia. As
, Paramedic Medical Scenarios Exam
Questions & Answers (Grade A+)
the patient is properly rehydrated, the tachycardia should resolve
on its own.
Which of the following complications would MOST likely occur if a
patient with renal failure missed his or her dialysis treatment?
A) Pulmonary edema
B) Bacterial infection
C) Severe dehydration
D) Marked hypokalemia -
correct answer ✅A) Pulmonary edema
A 60-year-old female presents with confusion, shortness of breath,
and diaphoresis. Her blood pressure is 70/40 mm Hg and her heart
rate is 40 beats/min. The cardiac monitor reveals a slow, wide
complex rhythm with dissociated P waves. After applying
supplemental oxygen, you should:
A) give her up to 325 mg of baby aspirin.
B) start an IV and give 0.5 mg of atropine.
C) start an IV and give a rapid fluid bolus.
