FISDAP PARAMEDIC FINAL LATEST EXAM /PARAMEDIC FISDAP FINAL
EXAM TEST BANK REAL EXAM QUESTIONS AND CORRECT ANSWERS|
AGRADE
Question 1
A 65-year-old male presents with sudden onset of crushing substernal chest
pain radiating to his left arm and jaw. He is diaphoretic, pale, and anxious.
His vital signs are BP 90/60 mmHg, HR 110 bpm, RR 22 bpm, SpO2 94% on
room air. ECG shows ST elevation in leads II, III, and aVF. What is the most
appropriate initial intervention for this patient, after ensuring scene safety
and airway patency?
A) Administer aspirin 325 mg orally and transport immediately.
B) Administer nitroglycerin 0.4 mg sublingually and establish IV access.
C) Administer oxygen via non-rebreather mask, establish IV access, and
administer aspirin 325 mg orally.
D) Prepare for immediate synchronized cardioversion due to unstable angina.
E) Administer morphine sulfate 2-4 mg IV for pain relief and transport.
Correct Answer: C) Administer oxygen via non-rebreather mask,
establish IV access, and administer aspirin 325 mg orally.
Rationale: The patient is exhibiting signs and symptoms consistent
with an acute inferior ST-elevation myocardial infarction (STEMI),
indicated by crushing chest pain, diaphoresis, pallor, anxiety, and ST
elevation in inferior leads. Initial management for suspected STEMI
includes oxygen administration to maintain SpO2 >94%,
establishing IV access, and administering aspirin 325 mg orally to
inhibit platelet aggregation. Nitroglycerin can be considered after
,establishing IV access and if blood pressure is adequate, but aspirin
is a higher priority initial medication in the absence of
contraindications. Synchronized cardioversion is not indicated for
this rhythm. Morphine can be given for pain but should follow initial
critical interventions.
Question 2
A 4-year-old child presents with a sudden onset of barking, seal-like cough,
inspiratory stridor, and mild respiratory distress. The child is afebrile and has
no history of recent foreign body aspiration. Which of the following conditions
is most likely causing these signs and symptoms?
A) Epiglottitis
B) Bacterial Tracheitis
C) Croup (Laryngotracheobronchitis)
D) Anaphylaxis
E) Asthma exacerbation
Correct Answer: C) Croup (Laryngotracheobronchitis)
Rationale: The classic presentation of Croup
(Laryngotracheobronchitis) in a child includes a barking, seal-like
cough, inspiratory stridor, and respiratory distress, typically without
significant fever or drooling. Epiglottitis usually presents with a
high fever, dysphagia, drooling, and a muffled voice, often without a
cough. Bacterial tracheitis is similar to croup but more severe and
usually involves high fever and a toxic appearance. Anaphylaxis
,would have other systemic signs like hives, angioedema, and
wheezing. Asthma exacerbation typically presents with expiratory
wheezing and a history of asthma.
Question 3
You respond to a 28-year-old male who was found unresponsive in his
apartment. On arrival, the patient is pulseless and apneic. ECG shows a
chaotic, disorganized ventricular rhythm with no discernible P waves, QRS
complexes, or T waves. What is the immediate priority intervention?
A) Administer epinephrine 1 mg IV/IO.
B) Initiate transcutaneous pacing.
C) Defibrillate immediately at 200 J (biphasic) or 360 J (monophasic).
D) Perform synchronized cardioversion.
E) Establish an advanced airway.
Correct Answer: C) Defibrillate immediately at 200 J (biphasic) or
360 J (monophasic).
Rationale: The ECG rhythm described is ventricular fibrillation (VF),
which is a shockable rhythm and a common cause of sudden cardiac
arrest. Immediate defibrillation is the most critical intervention to
terminate VF and allow for a perfusing rhythm to resume. While
other interventions like epinephrine and advanced airway are part
of the cardiac arrest algorithm, defibrillation for VF takes immediate
priority. Transcutaneous pacing and synchronized cardioversion are
not indicated for VF.
, Question 4
A 72-year-old patient with a history of hypertension and diabetes presents
with sudden onset of right-sided weakness, facial droop, and slurred speech.
Her blood glucose is 110 mg/dL. Her last known well time was approximately
2 hours ago. What is the most critical prehospital action for this patient?
A) Administer aspirin 325 mg orally.
B) Rapid transport to a stroke-capable facility.
C) Administer IV fluids to maintain blood pressure.
D) Prepare for intubation due to potential airway compromise.
E) Perform a comprehensive neurological exam on scene.
Correct Answer: B) Rapid transport to a stroke-capable facility.
Rationale: The patient's presentation is highly suggestive of an
acute ischemic stroke, given the sudden neurological deficits and
the last known well time. Time is brain in stroke management, and
rapid transport to a facility capable of stroke evaluation and
intervention (e.g., thrombolytics, thrombectomy) is the most critical
prehospital action. While airway, breathing, and circulation should
be managed, and a focused neurological assessment performed,
delaying transport for extensive on-scene procedures or
medications like aspirin (which is contraindicated in hemorrhagic
stroke and not universally indicated prehospital for ischemic stroke)
is generally not recommended.
EXAM TEST BANK REAL EXAM QUESTIONS AND CORRECT ANSWERS|
AGRADE
Question 1
A 65-year-old male presents with sudden onset of crushing substernal chest
pain radiating to his left arm and jaw. He is diaphoretic, pale, and anxious.
His vital signs are BP 90/60 mmHg, HR 110 bpm, RR 22 bpm, SpO2 94% on
room air. ECG shows ST elevation in leads II, III, and aVF. What is the most
appropriate initial intervention for this patient, after ensuring scene safety
and airway patency?
A) Administer aspirin 325 mg orally and transport immediately.
B) Administer nitroglycerin 0.4 mg sublingually and establish IV access.
C) Administer oxygen via non-rebreather mask, establish IV access, and
administer aspirin 325 mg orally.
D) Prepare for immediate synchronized cardioversion due to unstable angina.
E) Administer morphine sulfate 2-4 mg IV for pain relief and transport.
Correct Answer: C) Administer oxygen via non-rebreather mask,
establish IV access, and administer aspirin 325 mg orally.
Rationale: The patient is exhibiting signs and symptoms consistent
with an acute inferior ST-elevation myocardial infarction (STEMI),
indicated by crushing chest pain, diaphoresis, pallor, anxiety, and ST
elevation in inferior leads. Initial management for suspected STEMI
includes oxygen administration to maintain SpO2 >94%,
establishing IV access, and administering aspirin 325 mg orally to
inhibit platelet aggregation. Nitroglycerin can be considered after
,establishing IV access and if blood pressure is adequate, but aspirin
is a higher priority initial medication in the absence of
contraindications. Synchronized cardioversion is not indicated for
this rhythm. Morphine can be given for pain but should follow initial
critical interventions.
Question 2
A 4-year-old child presents with a sudden onset of barking, seal-like cough,
inspiratory stridor, and mild respiratory distress. The child is afebrile and has
no history of recent foreign body aspiration. Which of the following conditions
is most likely causing these signs and symptoms?
A) Epiglottitis
B) Bacterial Tracheitis
C) Croup (Laryngotracheobronchitis)
D) Anaphylaxis
E) Asthma exacerbation
Correct Answer: C) Croup (Laryngotracheobronchitis)
Rationale: The classic presentation of Croup
(Laryngotracheobronchitis) in a child includes a barking, seal-like
cough, inspiratory stridor, and respiratory distress, typically without
significant fever or drooling. Epiglottitis usually presents with a
high fever, dysphagia, drooling, and a muffled voice, often without a
cough. Bacterial tracheitis is similar to croup but more severe and
usually involves high fever and a toxic appearance. Anaphylaxis
,would have other systemic signs like hives, angioedema, and
wheezing. Asthma exacerbation typically presents with expiratory
wheezing and a history of asthma.
Question 3
You respond to a 28-year-old male who was found unresponsive in his
apartment. On arrival, the patient is pulseless and apneic. ECG shows a
chaotic, disorganized ventricular rhythm with no discernible P waves, QRS
complexes, or T waves. What is the immediate priority intervention?
A) Administer epinephrine 1 mg IV/IO.
B) Initiate transcutaneous pacing.
C) Defibrillate immediately at 200 J (biphasic) or 360 J (monophasic).
D) Perform synchronized cardioversion.
E) Establish an advanced airway.
Correct Answer: C) Defibrillate immediately at 200 J (biphasic) or
360 J (monophasic).
Rationale: The ECG rhythm described is ventricular fibrillation (VF),
which is a shockable rhythm and a common cause of sudden cardiac
arrest. Immediate defibrillation is the most critical intervention to
terminate VF and allow for a perfusing rhythm to resume. While
other interventions like epinephrine and advanced airway are part
of the cardiac arrest algorithm, defibrillation for VF takes immediate
priority. Transcutaneous pacing and synchronized cardioversion are
not indicated for VF.
, Question 4
A 72-year-old patient with a history of hypertension and diabetes presents
with sudden onset of right-sided weakness, facial droop, and slurred speech.
Her blood glucose is 110 mg/dL. Her last known well time was approximately
2 hours ago. What is the most critical prehospital action for this patient?
A) Administer aspirin 325 mg orally.
B) Rapid transport to a stroke-capable facility.
C) Administer IV fluids to maintain blood pressure.
D) Prepare for intubation due to potential airway compromise.
E) Perform a comprehensive neurological exam on scene.
Correct Answer: B) Rapid transport to a stroke-capable facility.
Rationale: The patient's presentation is highly suggestive of an
acute ischemic stroke, given the sudden neurological deficits and
the last known well time. Time is brain in stroke management, and
rapid transport to a facility capable of stroke evaluation and
intervention (e.g., thrombolytics, thrombectomy) is the most critical
prehospital action. While airway, breathing, and circulation should
be managed, and a focused neurological assessment performed,
delaying transport for extensive on-scene procedures or
medications like aspirin (which is contraindicated in hemorrhagic
stroke and not universally indicated prehospital for ischemic stroke)
is generally not recommended.
