PARAMEDIC MEDICAL SCENARIOS
EXAM QUESTIONS WITH 100%
CORRECT ANSWERS | LATEST
VERSION 2025/2026.
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. - ANS 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.
D) Give 20 mL/kg fluid boluses. - ANS B) Begin an infusion of dopamine.
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,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 - ANS 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.
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 - ANS 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
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, indicated either; again, this is not a primary cardiac dysrhythmia. As 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 - ANS 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.
D) begin immediate transcutaneous pacing. - ANS D) begin immediate transcutaneous
pacing.
Which of the following is MOST indicative of hyperglycemic ketoacidosis?
A) Acute onset
B) Hyperpnea
C) Diaphoresis
D) Bradypnea - ANS B) Hyperpnea
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
EXAM QUESTIONS WITH 100%
CORRECT ANSWERS | LATEST
VERSION 2025/2026.
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. - ANS 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.
D) Give 20 mL/kg fluid boluses. - ANS B) Begin an infusion of dopamine.
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,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 - ANS 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.
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 - ANS 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
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, indicated either; again, this is not a primary cardiac dysrhythmia. As 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 - ANS 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.
D) begin immediate transcutaneous pacing. - ANS D) begin immediate transcutaneous
pacing.
Which of the following is MOST indicative of hyperglycemic ketoacidosis?
A) Acute onset
B) Hyperpnea
C) Diaphoresis
D) Bradypnea - ANS B) Hyperpnea
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
