Paramedic National Registry Exam Review
Questions and Answers A Graded
Stridor Correct Answer: harsh, high-pitched sound, swelling, FB in upper airway
Snoring Correct Answer: tongue blocking airway
Gurgling Correct Answer: indicates presence of fluid in the upper airway, need for
suctioning
Decorticate posturing Correct Answer: characterized by upper extremities flexed
at the elbows and held closely to the body and lower extremities that are externally
rotated and extended. occurs when the brainstem is not inhibited by the motor
function of the cerebral cortex.
Decerebrate posturing Correct Answer: (worse) extended and internally rotated
elbows and legs, teeth clenched, legs stiff and feet extended
Babinski response Correct Answer: big toe moves upward and other toes fan out
when stroking bottom of foot, means CNS problem
Dilated pupils Correct Answer: Mydriasis
cardiac arrest, shock, cereal hypoxia, cocaine, epinephrine, amphetamines
Small/constricted pupils Correct Answer: -Miosis
narcotics, central nervous system disorder, glaucoma medication, bright light
Unequal pupils Correct Answer: -Anisocoria
brain injury, brain tumor, stroke, artificial eye, some eye medications, eye injury or
disease, ICP
Nystagmus Correct Answer: rapid involuntary movements of the eyes
Causes of distended neck veins (JVD) Correct Answer: -Tension penumothorax
-Cardiac tamponade
,-Right heart failure
-Traumatic asphyxia
-Pulmonary embolus
-Emphysema
-Chronic bronchitis
-best seen at a 45 degree angle
Flat neck viens Correct Answer: -Hemothorax
-Dehydration
-Shock
-best seen with patient supine
Apenustic Correct Answer: long, deep breaths that are stopped during inspirations
then periods of apnea
Causes of apneustic breath sounds Correct Answer: CNS injury or stroke
Biot (ataxic) respirations Correct Answer: Irregular pattern, rate, and depth of
respirations with intermittent periods of apnea; result from increased intracranial
pressure.
Cheyne-Stokes respiration Correct Answer: Increasing in rate and depth,
decreasing in rate and depth with period of apnea, results from a neurological
condition
Hyperventilation Correct Answer: Rapid and shallow
Kussmaul respirations Correct Answer: Deep, rapid breathing; usually the result
of an accumulation of certain acids when insulin is not available in the body.
Fruity breath
Rales/Crackles Correct Answer: Fluid in small airways/alveoli
Causes of Rales/Crackles Correct Answer: CHF, pulmonary edema, drowning,
pneumonia, COPD
Rhonchi Correct Answer: Mucus or fluid in larger airways/bronchi
, Causes of rhonchi Correct Answer: Bronchitis, COPD, penumonia
Wheezing Correct Answer: Whistling sound due to bronchoconstriction or
narrowing of the terminal bronchioes due to edema
Causes of wheezing Correct Answer: Asthma and allergic reactions
Right upper quadrant Correct Answer: -Liver
-Gallbladder
-Stomach
Left upper quadrant Correct Answer: -Spleen
-Liver
-Stomach
-Pancreas
Right Lower Quadrant (RLQ) Correct Answer: -Appendix
-Right ovary & tube
-Bladder if distended
Left Lower Quadrant (LLQ) Correct Answer: -Left ovary & tube
-Bladder if distended
Somatic pain Correct Answer: -irritation of peritoneal lining
-sharp, localized, throbbing, deep breath increases pain
Referred pain Correct Answer: Discomfort perceived in other parts of body, such
as cardiac pain referred to jaw or arm
Cullen's sign Correct Answer: Ecchymosis around umbilicus, bleeding in
abdominal cavity
Grey Turner's sign Correct Answer: -ecchymosis involving the flanks.
-Indication for bleeding from kidneys, hemorrhagic pancreatitis
Kehr's sign Correct Answer: Refereed pain to shoulder
Ectopic or spleen injury, blood under diaphragm
Questions and Answers A Graded
Stridor Correct Answer: harsh, high-pitched sound, swelling, FB in upper airway
Snoring Correct Answer: tongue blocking airway
Gurgling Correct Answer: indicates presence of fluid in the upper airway, need for
suctioning
Decorticate posturing Correct Answer: characterized by upper extremities flexed
at the elbows and held closely to the body and lower extremities that are externally
rotated and extended. occurs when the brainstem is not inhibited by the motor
function of the cerebral cortex.
Decerebrate posturing Correct Answer: (worse) extended and internally rotated
elbows and legs, teeth clenched, legs stiff and feet extended
Babinski response Correct Answer: big toe moves upward and other toes fan out
when stroking bottom of foot, means CNS problem
Dilated pupils Correct Answer: Mydriasis
cardiac arrest, shock, cereal hypoxia, cocaine, epinephrine, amphetamines
Small/constricted pupils Correct Answer: -Miosis
narcotics, central nervous system disorder, glaucoma medication, bright light
Unequal pupils Correct Answer: -Anisocoria
brain injury, brain tumor, stroke, artificial eye, some eye medications, eye injury or
disease, ICP
Nystagmus Correct Answer: rapid involuntary movements of the eyes
Causes of distended neck veins (JVD) Correct Answer: -Tension penumothorax
-Cardiac tamponade
,-Right heart failure
-Traumatic asphyxia
-Pulmonary embolus
-Emphysema
-Chronic bronchitis
-best seen at a 45 degree angle
Flat neck viens Correct Answer: -Hemothorax
-Dehydration
-Shock
-best seen with patient supine
Apenustic Correct Answer: long, deep breaths that are stopped during inspirations
then periods of apnea
Causes of apneustic breath sounds Correct Answer: CNS injury or stroke
Biot (ataxic) respirations Correct Answer: Irregular pattern, rate, and depth of
respirations with intermittent periods of apnea; result from increased intracranial
pressure.
Cheyne-Stokes respiration Correct Answer: Increasing in rate and depth,
decreasing in rate and depth with period of apnea, results from a neurological
condition
Hyperventilation Correct Answer: Rapid and shallow
Kussmaul respirations Correct Answer: Deep, rapid breathing; usually the result
of an accumulation of certain acids when insulin is not available in the body.
Fruity breath
Rales/Crackles Correct Answer: Fluid in small airways/alveoli
Causes of Rales/Crackles Correct Answer: CHF, pulmonary edema, drowning,
pneumonia, COPD
Rhonchi Correct Answer: Mucus or fluid in larger airways/bronchi
, Causes of rhonchi Correct Answer: Bronchitis, COPD, penumonia
Wheezing Correct Answer: Whistling sound due to bronchoconstriction or
narrowing of the terminal bronchioes due to edema
Causes of wheezing Correct Answer: Asthma and allergic reactions
Right upper quadrant Correct Answer: -Liver
-Gallbladder
-Stomach
Left upper quadrant Correct Answer: -Spleen
-Liver
-Stomach
-Pancreas
Right Lower Quadrant (RLQ) Correct Answer: -Appendix
-Right ovary & tube
-Bladder if distended
Left Lower Quadrant (LLQ) Correct Answer: -Left ovary & tube
-Bladder if distended
Somatic pain Correct Answer: -irritation of peritoneal lining
-sharp, localized, throbbing, deep breath increases pain
Referred pain Correct Answer: Discomfort perceived in other parts of body, such
as cardiac pain referred to jaw or arm
Cullen's sign Correct Answer: Ecchymosis around umbilicus, bleeding in
abdominal cavity
Grey Turner's sign Correct Answer: -ecchymosis involving the flanks.
-Indication for bleeding from kidneys, hemorrhagic pancreatitis
Kehr's sign Correct Answer: Refereed pain to shoulder
Ectopic or spleen injury, blood under diaphragm
