1. A febrile seizure would most likely occur in a child:
a. With a fever that acutely spikes
2. Which of the following actions demonstrates a paramedics knowledge of crime
scene preservation?
a. Advising a law enforcement officer after moving a coffee table to access
a critically injured oatient
3. Which of the following signs or symptoms occurs more commonily in patietns
with stable angine than in those with unstable angina?
a. Chest pain that begins during exertion
4. In contrast to an anaphylactic reaction, an anaphylactoid reaction:
a. Can occur without prior exposure to an offending agent
5. You are transporting an 80-year-old female to the hospital and are
preparing to call in your radio report. Which of the following is an
example of a practice that will maximize the receiving facility's ability to
understand your transmission?
a. State the patient's age as 80, that is, eight-zero
6. A 9-month-old infant presents with respiratory distress. On appearance,
the infant is active and has moderate retractions. Your assessment
reveals diffuse wheezing; pink, warm, dry skin; and an oxygen saturation
of 92%. This infant is MOST likely experiencing:
a. bronchiolitis
7. You are ventilating a severely dehydrated apneic 70-year-old male with
a history of end-stage emphysema. In order to minimize the risk of
lowering his cardiac output and blood pressure, you should:
a. Adjust the ventilation rate to allow complete exhalation
8. Which of the following cardiac rhythms is associated with
bradycardia, and is characterized by regular R-R intervals and a
greater ratio of P waves to QRS complexes?
a. B) Third-degree AV block
9. According to Haddon's matrix, which of the following is an
environmental factor that has a direct effect on the event phase of a
motor-vehicle crash?
a. C) Lack of guardrails
10. Immediately following delivery, your patient is experiencing heavy
vaginal bleeding. In an attempt to control the bleeding, you should:
a. ) firmly massage the fundus of her uterus.
11. A 30-kg child presents with a regular, monomorphic, wide-complex
tachycardia at 190 beats/min. He tells you that his chest feels funny,
but otherwise has no other symptoms. He is conscious and alert and
his vital signs are stable. Which of the following interventions is
indicated?
a. Adenosine, 3mg
12. You are ventilating an apneic, intubated patient and note that his
ETCO2 reading, per waveform capnography, is 56 mm Hg. You should:
a. Increase the rate of ventilations
13. An unresponsive trauma patient has sonorous respirations and blood
draining from the corner of his mouth. What should be your FIRST
action?
a. B) Perform a jaw-thrust maneuver
,14. An older man is suddenly awakened in the middle of the night, gasping
for air. He is extremely restless and pale, and is coughing up blood. His
clinical presentation is MOST consistent with:
a. C) left side heart failure.
15. At the scene of a motor vehicle accident, you note that the driver, a
young woman, is lying next to her car and has agonal gasps and no
palpable pulse. Other than a closed tibial fracture, she has no other
obvious trauma. She is wearing a bracelet that identifies her as an organ
donor. How should you manage this situation?
a. A) Begin aggressive treatment and transport immediately.
16. Upon arriving at the residence of an unresponsive patient, you find a
middle-aged male lying on the couch. He is unresponsive, apneic, and
pulseless. His wife tells you that she does not want you to attempt
resuscitation, and further states that he has high blood pressure. The
patient's skin is warm and there is no evidence of lividity. You should:
a. B) begin CPR, apply the ECG electrodes, ask her if he has a living
will, and contact medical control for guidance.
17. Which of the following findings is MOST suggestive of right-sided heart
failure?
a. Engorged jugular veins
18. A 71-year-old female presents with an altered mental status. According to
her husband, she has type II diabetes and hypertension, and was recently
diagnosed with a urinary tract infection. Her medications include
Glucophage, Zestril, and Bactrim. The patient is confused, and has
slurred speech and poor skin turgor. Her blood pressure is 112/60 mm
Hg, pulse is 120 beats/min and weak, and respirations are 30 breaths/min
and shallow. Her blood glucose level reads "high," but you do not notice
any unusual odors on her breath. The primary cause of this patient's
problem is MOST likely:
a. D) hyperosmolar hyperglycemic nonketotic state.
19. The clinical presentation of thyroid storm MOST closely resembles that of:
a. Amphetamine use
20. Which of the following reasons would indicate that a medical director’s
decision to remove a specific drug from the protocols was evidence-
based?
a. B) Patient outcomes are worse when the specific drug is
administered
21. A 54-year-old man presents with chest pressure, confusion, and profuse
diaphoresis. As your partner administers supplemental oxygen, you apply
the cardiac monitor. In lead II, you observe a wide QRS complex rhythm
with dissociated P waves and a ventricular rate of 35 beats/min. You
should:
a. Begin transcutaneous pacing at once
22. A 49-year-old man presents with acute shortness of breath. He is
conscious, but confused, and is gasping for air. The pulse oximeter
reads 79% on room air. Initial management should consist of:
a. B: some form of ventilatory assistance.
23. A 9-year-old child has generalized weakness; blood in the stool; and
bruising, even from minor trauma. These findings are MOST consistent
with:
a. C) leukemia.
,24. Which of the following is the MOST reliable immediate indicator
that you have successfully placed an endotracheal (ET) tube into
the trachea?
a. B) Visualization of the ET tube passing in between the vocal cords.
, 25. Which of the following represents the low normal systolic blood
pressure for a 6- year-old child?
a. 82 mm Hg
26. A 64-year-old man presents with an acute onset of left-sided weakness,
right-sided facial droop, and slurred speech. He is conscious, but
confused. You should be MOST suspicious for:
a. Right-sided ischemic stroke
27. The main purpose of listening to heart sounds is to:
a. B) determine if the cardiac valves are functioning properly.
28. In which of the following situations would it be MOST appropriate to
insert a King LT supraglottic airway?
a. Comatose patient who ingested aspirin
29. A woman began experiencing contractions 30 minutes ago. She is 38
weeks pregnant. You determine that she is gravida-5 and para-3.
Which of the following statements regarding this patient is correct?
a. B) She will become para-4 when she delivers her baby
30. A 60-year-old man reports dyspnea. While auscultating his chest, you
hear fine, moist, thin sounds in all lung fields. What is this MOST
suggestive of?
a. Fluid in the small lower airways
31. Assessment of a patient with acute respiratory distress reveals that he is
conscious and alert, but wheezing on exhalation. In addition to oxygen,
management should include:
a. C) administration of an inhaled beta-2 agonist medication.
32. You are sitting in the front passenger seat of a small car assessing the
driver after he struck a tree head-on. Your partner is maintaining manual
stabilization of the patient's head from the back seat. The driver's side
airbag deployed, but the passenger's side airbag did not. The patient's
legs are pinned by the dashboard, and rescue personnel are preparing to
disentangle him. What should be your MOST immediate priority?
a. B) Remaining at least 20 inches from the passenger's side
dashboard if possible
33. Which of the following findings is the MOST clinically significant when
assessing a patient with a severe headache?
a. An unsteady gait
34. Which of the following is an example of providing treatment based
on standing orders?
a. C) Defibrillating a patient with pulseless V-tach,
performing CPR, administering epinephrine, and
contacting medical control
35. Your assessment of a 33-year-old man with generalized weakness and
nausea reveals a blood glucose level of 39 mg/dL. The patient is
conscious and alert to person, place, time, and event. As you are
preparing the IV equipment and dextrose, the patient tells you that he
will not allow you to start an IV on him or give him any drugs; he will only
allow you to transport him to the hospital. You should:
a. C) advise him that if you don't give him glucose, his condition could
potentially deteriorate and he could die.
36. Which of the following statements regarding Cheyne-Stokes respirations is
correct?
a. With a fever that acutely spikes
2. Which of the following actions demonstrates a paramedics knowledge of crime
scene preservation?
a. Advising a law enforcement officer after moving a coffee table to access
a critically injured oatient
3. Which of the following signs or symptoms occurs more commonily in patietns
with stable angine than in those with unstable angina?
a. Chest pain that begins during exertion
4. In contrast to an anaphylactic reaction, an anaphylactoid reaction:
a. Can occur without prior exposure to an offending agent
5. You are transporting an 80-year-old female to the hospital and are
preparing to call in your radio report. Which of the following is an
example of a practice that will maximize the receiving facility's ability to
understand your transmission?
a. State the patient's age as 80, that is, eight-zero
6. A 9-month-old infant presents with respiratory distress. On appearance,
the infant is active and has moderate retractions. Your assessment
reveals diffuse wheezing; pink, warm, dry skin; and an oxygen saturation
of 92%. This infant is MOST likely experiencing:
a. bronchiolitis
7. You are ventilating a severely dehydrated apneic 70-year-old male with
a history of end-stage emphysema. In order to minimize the risk of
lowering his cardiac output and blood pressure, you should:
a. Adjust the ventilation rate to allow complete exhalation
8. Which of the following cardiac rhythms is associated with
bradycardia, and is characterized by regular R-R intervals and a
greater ratio of P waves to QRS complexes?
a. B) Third-degree AV block
9. According to Haddon's matrix, which of the following is an
environmental factor that has a direct effect on the event phase of a
motor-vehicle crash?
a. C) Lack of guardrails
10. Immediately following delivery, your patient is experiencing heavy
vaginal bleeding. In an attempt to control the bleeding, you should:
a. ) firmly massage the fundus of her uterus.
11. A 30-kg child presents with a regular, monomorphic, wide-complex
tachycardia at 190 beats/min. He tells you that his chest feels funny,
but otherwise has no other symptoms. He is conscious and alert and
his vital signs are stable. Which of the following interventions is
indicated?
a. Adenosine, 3mg
12. You are ventilating an apneic, intubated patient and note that his
ETCO2 reading, per waveform capnography, is 56 mm Hg. You should:
a. Increase the rate of ventilations
13. An unresponsive trauma patient has sonorous respirations and blood
draining from the corner of his mouth. What should be your FIRST
action?
a. B) Perform a jaw-thrust maneuver
,14. An older man is suddenly awakened in the middle of the night, gasping
for air. He is extremely restless and pale, and is coughing up blood. His
clinical presentation is MOST consistent with:
a. C) left side heart failure.
15. At the scene of a motor vehicle accident, you note that the driver, a
young woman, is lying next to her car and has agonal gasps and no
palpable pulse. Other than a closed tibial fracture, she has no other
obvious trauma. She is wearing a bracelet that identifies her as an organ
donor. How should you manage this situation?
a. A) Begin aggressive treatment and transport immediately.
16. Upon arriving at the residence of an unresponsive patient, you find a
middle-aged male lying on the couch. He is unresponsive, apneic, and
pulseless. His wife tells you that she does not want you to attempt
resuscitation, and further states that he has high blood pressure. The
patient's skin is warm and there is no evidence of lividity. You should:
a. B) begin CPR, apply the ECG electrodes, ask her if he has a living
will, and contact medical control for guidance.
17. Which of the following findings is MOST suggestive of right-sided heart
failure?
a. Engorged jugular veins
18. A 71-year-old female presents with an altered mental status. According to
her husband, she has type II diabetes and hypertension, and was recently
diagnosed with a urinary tract infection. Her medications include
Glucophage, Zestril, and Bactrim. The patient is confused, and has
slurred speech and poor skin turgor. Her blood pressure is 112/60 mm
Hg, pulse is 120 beats/min and weak, and respirations are 30 breaths/min
and shallow. Her blood glucose level reads "high," but you do not notice
any unusual odors on her breath. The primary cause of this patient's
problem is MOST likely:
a. D) hyperosmolar hyperglycemic nonketotic state.
19. The clinical presentation of thyroid storm MOST closely resembles that of:
a. Amphetamine use
20. Which of the following reasons would indicate that a medical director’s
decision to remove a specific drug from the protocols was evidence-
based?
a. B) Patient outcomes are worse when the specific drug is
administered
21. A 54-year-old man presents with chest pressure, confusion, and profuse
diaphoresis. As your partner administers supplemental oxygen, you apply
the cardiac monitor. In lead II, you observe a wide QRS complex rhythm
with dissociated P waves and a ventricular rate of 35 beats/min. You
should:
a. Begin transcutaneous pacing at once
22. A 49-year-old man presents with acute shortness of breath. He is
conscious, but confused, and is gasping for air. The pulse oximeter
reads 79% on room air. Initial management should consist of:
a. B: some form of ventilatory assistance.
23. A 9-year-old child has generalized weakness; blood in the stool; and
bruising, even from minor trauma. These findings are MOST consistent
with:
a. C) leukemia.
,24. Which of the following is the MOST reliable immediate indicator
that you have successfully placed an endotracheal (ET) tube into
the trachea?
a. B) Visualization of the ET tube passing in between the vocal cords.
, 25. Which of the following represents the low normal systolic blood
pressure for a 6- year-old child?
a. 82 mm Hg
26. A 64-year-old man presents with an acute onset of left-sided weakness,
right-sided facial droop, and slurred speech. He is conscious, but
confused. You should be MOST suspicious for:
a. Right-sided ischemic stroke
27. The main purpose of listening to heart sounds is to:
a. B) determine if the cardiac valves are functioning properly.
28. In which of the following situations would it be MOST appropriate to
insert a King LT supraglottic airway?
a. Comatose patient who ingested aspirin
29. A woman began experiencing contractions 30 minutes ago. She is 38
weeks pregnant. You determine that she is gravida-5 and para-3.
Which of the following statements regarding this patient is correct?
a. B) She will become para-4 when she delivers her baby
30. A 60-year-old man reports dyspnea. While auscultating his chest, you
hear fine, moist, thin sounds in all lung fields. What is this MOST
suggestive of?
a. Fluid in the small lower airways
31. Assessment of a patient with acute respiratory distress reveals that he is
conscious and alert, but wheezing on exhalation. In addition to oxygen,
management should include:
a. C) administration of an inhaled beta-2 agonist medication.
32. You are sitting in the front passenger seat of a small car assessing the
driver after he struck a tree head-on. Your partner is maintaining manual
stabilization of the patient's head from the back seat. The driver's side
airbag deployed, but the passenger's side airbag did not. The patient's
legs are pinned by the dashboard, and rescue personnel are preparing to
disentangle him. What should be your MOST immediate priority?
a. B) Remaining at least 20 inches from the passenger's side
dashboard if possible
33. Which of the following findings is the MOST clinically significant when
assessing a patient with a severe headache?
a. An unsteady gait
34. Which of the following is an example of providing treatment based
on standing orders?
a. C) Defibrillating a patient with pulseless V-tach,
performing CPR, administering epinephrine, and
contacting medical control
35. Your assessment of a 33-year-old man with generalized weakness and
nausea reveals a blood glucose level of 39 mg/dL. The patient is
conscious and alert to person, place, time, and event. As you are
preparing the IV equipment and dextrose, the patient tells you that he
will not allow you to start an IV on him or give him any drugs; he will only
allow you to transport him to the hospital. You should:
a. C) advise him that if you don't give him glucose, his condition could
potentially deteriorate and he could die.
36. Which of the following statements regarding Cheyne-Stokes respirations is
correct?
