EMT 224 Review Flashcards
Which of the following is NOT found in patient with hypoglycemia? A) Tachycardia B) Diaphoresis C) Flushed skin D) Pale skin
C) Flushed skin
You are called to provide care for an unresponsive 64 yo male. His wife tells you that he complained of a severe headache and then immediately collapsed. Your patient is MOST likely suffering from a/an: A) Embolic stroke B) Cluster headache C) Trombotic stroke D) Hemorrhagic stroke
D) Hemorrhagic stroke
Which of the following medications administered by EMS has the greatest potential to cause an immediate outcome?
A) Dextrose in cases of hypoglycemia
B) Epinephrine in cases of cardiac arrest
C) Amiodarone in cases of cardiac arrest
D) Dopamine in cases of cardiogenic shock
A) Dextrose in cases of hypoglycemia
You arrive on scene of an unresponsive female who is barely breathing. Witness stated she just stopped seizing before you arrived. Which information will be MOST useful to the providers if available?
A) Bystanders’ detailed description of seizure activity
B) Additional information from 911 dispatch center
C) Locating a medical alert bracelet on the patient’s wrist
D) information from a friend who says the patient smokes alot
C) Locating a medical alert bracelet on the patient’s wrist
Which diagnostic test should be a routine part of an assessment in any patient with an altered mental status? A) Babinski reflex B) Blood glucose measurement C) Breathalyzer D) Orthostatic vital signs
B) Blood glucose measurement
You are assessing a 27 yo who is complaining of severe abdominal pain. Which of the following should you view as a worst case scenario as you develop you differential diagnosis ? A) Miscarriage B) Ovarian cyst C) Endometriosis D) Ectopic pregnancy
D) Ectopic pregnancy
Which of the following would be the BEST definition of renal calculi?
A) A hardening of the renal tissue
B) Blockages occurring in the urethra
C) Infection of the nephrons and surrounding tissue
D) Crystal aggregation in the kidney collection system
D) Crystal aggregation in the kidney collection system
When does non-oliguria failure occur?
A) The condition is chronic
B) The patient excretes more than 500 ml/day of urine
C) The patient will not benefit from dialysis
D) urine is produced but is not removed from the kidneys
B) The patient excretes more than 500 ml/day of urine
You are called to the scene of a 57 YO male patient with a 5 day history of abdominal pain, heartburn and fever. Which of the following would you MOST likely select for a field diagnosis?
A) Cardiac ischemia
B) Esophageal varices
C) H-pyloric caused chronic gastroenteritis
D) Salmonella caused acute gastroenteritis
C) H-pyloric caused chronic gastroenteritis
Which of the following would be the most consistent with signs and symptoms of Hep C?
A) Polyuria, back pain and vomiting
B) Jaundice, fatigue anemia and photophobia
C) Dark urine, abdominal pain, jaundice and fatigue
D) Distended abdomen, jaundice nausea and fatigue
C) Dark urine, abdominal pain, jaundice and fatigue
You are called to treat a patient with a history of Crohn's disease who is unresponsive, tachycardia, pale, cool, clammy, and hypotensive. The patient had diarrhea, vomiting and abdominal pain. Which of the following will MOST improve patient responsiveness? A) Fluid resuscitation B) Oxygen administration C) Dextrose administration D) Antipasmodic administration
C) Dextrose administration
What is the MOST appropriate name for the types of cerebral vascular incident where all symptoms resolve within 24 hours of onset? A) Transient ischemic attack B) Hemorrhagic stroke C) Thrombotic stroke D) Embolic stroke
A) Transient ischemic attack
You are called to assess and treat a 57-year-old male complaining of a severe headache, vomitng, visual disturbances and left sided paralysis. The patient’s pulse is 56 and his blood pressure is 220/160. He is supposed to take “blood pressure” medication, but he did not care for the side effects. Which of the following is your MOST important intervention for this patient?
A) Administration of Nifedipine
B) Administration of antiemetics
C) Hyperventilation with supplemental oxygen
D) Rapid transportation to an emergency department
D) Rapid transportation to an emergency department
A 38 YO female reports that she is having an auditory aura. This is a warning sign of which impending conditions? A) Hemorrhagic stroke B) Cerebral embolism C) Brain tumor D) Seizure
D) Seizure
What is the difference that separates a Transient Ischemic Attack (TIA) from a stroke?
A) Patients undergoing a TIA have no real risk for having a stroke
B) Patients undergoing a TIA exhibit only weakness and paralysis
C) The signs and symptoms of a TIA resolve within 24 hours
D) The only mechanism of a TIA is occlusive injury
C) The signs and symptoms of a TIA resolve within 24 hours
Your 62-year-old patient developed a sudden onset of left-sided weakness 20 minutes ago. She is very anxious, crying and is difficult to manage. Her vital signs are: BP-168/100, P-108 R, Resp-20/min and Pox-98% RA. Which intervention is most critical?
A) Administer Diazepam 5 mg
B) Provide oxygen 15 LPM by nonrebreather mask
C) Administer Nitro (0.4) SL
D) Alert the stroke team and provide rapid transport to a stroke center
D) Alert the stroke team and provide rapid transport to a stroke center
What are Glyburide and Glipizide examples of? A) Ingestible insulin B) Oral hypoglycemic agent C) Anti-hypoglycemic D) Injectable insulin
B) Oral hypoglycemic agent
What does Addison's disease cause a deficiency in? A) Epinephrine and norepinephrine B) Insulin and glucagon C) Acetylcholine and dopamine D) Cortisol and aldosterone
D) Cortisol and aldosterone
Paramedics are called to treat an unconscious patient with a known history of diabetes and alcoholism. The patient's friend reports that he didn't eat all day while they were a!ending a tailgate party. Paramedics note that he has an insulin pump in place. Before administering dextrose, what should the paramedic consider administering? A) Flumazenil B) Insulin C) Thiamine D) Glucagon
C) Thiamine
A patient taking Beta Blockers who is suffering with anaphylaxis and does not respond to epinephrine should be given which medication? A) Methylprednisolone B) Albuterol C) Glucagon D) Diphenhydramine
C) Glucagon
About \_\_% of the white blood cell are lymphocytes. A) 30 B) 35 C) 20 D) 25
D) 25
Which is released by mast cells and basophils? A) Leukotrienes B) Histamine C) Basophils D) Eosinophils
B) Histamine
Hep B is most commonly spread through which method? A) Airborne exposure B) Blood or serum secretions C) Oral/fecal transmission D) Bacterial infection
B) Blood or serum secretions
What is a characteristic of gastroenteritis?
A) An inflammation of the stomach and the intestine
B) Caused by influenza virus
C) Has slow onset and causes intestinal cramping but rarely vomiting or diarrhea
D) Limited primarily to small children
A) An inflammation of the stomach and the intestine
You might suspect a patient has Cholecystitis if pain is experienced in which quadrant? A) RLQ B) RUQ C) LLQ D) LUQ
B) RUQ
How is pain associated with a kidney stone described? A) Excruciating pain B) Throbbing pain C) Moderate pain D) Dull pain
A) Excruciating pain
Paramedics are dispatched to the home of a 54-year-old male with a history of kidney failure. On arrival, the patient states that he receives 4 to 5 hours of dialysis 3 days per week. He called 911 today because his internal shunt is painful and red at the access site. Given this patient’s history, what can paramedics conclude about the patient?
A) An insulin dependent diabetic
B) In early renal failure
C) On dialysis as a result of trauma to the kidneys
D) In late stage renal failure
D) In late stage renal failure
Which statement is true of UTIs?
A) Many contraceptive devices help kill the causative agents of UTIs
B) UTIs commonly occur when enteric flora enter the urethra
C) UTIs are more common in men than in women
D) UTIs are rarely caused by STDs
B) UTIs commonly occur when enteric flora enter the urethra
A fertilized oocyte secrets \_\_\_ to keep the corpus luteum from degenerating A) Chorionuc gonadotropin B) Follicle stimulating hormone C) Estrogen D) Progesterone
C) Estrogen
Abdominal pain in woman that presents one week after menstruation is typically experiencing? A) Ruptured ovarian cyst B) Mittelschmerz C) Pelvic inflammatory disease D) Ruptured ectopic pregnancy
C) Pelvic inflammatory disease
What stimulates the development of the follicle, including the cells that produce estrogen? A) Progesterone B) Follicle stimulating hormone C) Chorionic gonadotropin D) Luteinizing hormone
B) Follicle stimulating hormone
When treating a patient who was sexually assaulted, the paramedic should take the following approach:
A) Allow the patient to express feelings with no fear that his or her words will be reported
B) limit the history of the event to elements necessary for care
C) Genital examination is mandatory for accurate assessment
D) Assess a thorough history for the assault for reporting purposes
B) limit the history of the event to elements necessary for care
What is the correct terminology for seizure phase where the patient experiences continuous muscle tension? A) Tonic B) Clonic C) Dystonic D) Postictal
A) Tonic
Which of the following would be the BEST definition of a seizure?
A) A loss of consciousness from idiopathic causes
B) The alternating contraction and relaxation of muscles
C) a temporary alteration in behavior due to a massive electrical discharge in the brain
D) a change of behavior due to an electrolyte imbalance within a group of neurons in the brain
C) a temporary alteration in behavior due to a massive electrical discharge in the brain
You are called to the residence of a 38-year-old male found unresponsive on the floor of his bathroom. His skin is very pale, cool and clammy. He has complained of abdominal pain for the last month as well as black, foul-smelling feces. His respiratory rate is 28, pulse is 120 and blood pressure is 70/50. Which of the following field diagnoses and interventions is the MOST appropriate?
1) Vagal response; 0.5 to 1.0 mg of atropine
2) Dissecting aortic aneurysm; PASG, fluids and rapid transport
3) Anemia from a slow GI bleed; fluid resuscitation and rapid transport
4) Hypovolemia from a rapid GI bleed; fluid resuscitation and rapid transport
3) Anemia from a slow GI bleed; fluid resuscitation and rapid transport
You are dispatched to a college dormitory for a 20-year-old female who is the victim of sexual assault. The scene is safe and police have not yet arrived. The patient indicates she has changed her clothing and wants to take a shower before she is transported to the hospital. What would your MOST appropriate recommendation be?
A) Encourage her to take a shower as this will more than likely make her feel be!er
B) Discourage her from taking a shower and place her removed clothing in a paper bag
C) Discourage her from taking a shower and place her removed clothing in a plastic bag
D) Clear the scene when law enforcement arrives as this is a police ma!er and she has no apparent life-threatening emergencies
2) Discourage her from taking a shower and place her removed clothing in a paper bag
Which of the following respiratory patterns is associated with an a!empt to compensate for diabetic ketoacidosis? A) Eupnea B) Kussmaul C) Biot's D) Cheyne-Stokes
B) Kussmaul
Which type of antibody causes the release of histamine? A) IgB B) IgE C) IgG D) IgM
B) IgE
What is the name of the arthritic condition caused by an increase in uric acid crystals deposited at the joints? A) Bursitis
B) Gout
C) Osteoporosis
D) Spondylosis
B) Gout
Which of the following gastrointestinal diseases causes swelling and thickening of the intestinal wall resulting in formation of scar tissue and narrowing of the passageways? A) Crohn disease B) Diverticulitis C) Gastroenteritis D) Ulcerative colitiS
A) Crohn disease
Which of the following endocrine conditions will MOST likely require advance life support to transport due to life-threatening complications associated with it?
A) 79-year-old with myxedema related to Addison’s disease
B) 65-year-old with acute hypoglycemia related to type II diabetes
C) 80-year-old with Cushing’s syndrome related to an adrenal tumor
D) 70-year-old with thyroid storm symptoms related to hyperthyroidism
D) 70-year-old with thyroid storm symptoms related to hyperthyroidism
Which of the following endocrine emergencies typically requires a significant fluid resuscitation as a part of patient management? A) Myxedema B) Hypothyroidism C) Hyperadrenal crisis D) Diabetic ketoacidosis
D) Diabetic ketoacidosis
Hypothermia, a puffy appearance and constipation are found in which of the following?
A) Graves disease
B) Myxedema
C) Cushing’s syndrome D) Addison’s disease
B) Myxedema
What do Acini glands produce? A) Steroids B) Glucagon C) Pancreatic juice D) Insulin
C) Pancreatic juice
Which of the following neurological disorders would be the MOST difficult to distinguish from a cerebral vascular accident? A) Dystonia B) Myoclonus C) Bell's palsy D) Parkinson's disease
C) Bell’s palsy
Which of the following would be the appropriate treatment for a patient with aphasia as a result of a transient ischemic attack?
A) Place an advanced airway
B) Place the patient in a supine position
C) Place the patient in a Trendelenburg position
D) Place the patient in a left lateral recumbent position
D) Place the patient in a left lateral recumbent position
Which of the following cells of the pancreas is responsible for the production of insulin? A) Alpha B) Beta C) Gamma D) Delta
B) Beta
When assessing a patient with a neuromuscular disorder such as spinal shock or muscular dystrophy, which of the following would be your primary concern? A) Assessing tidal volume B) Assessing blood pressure C) Assessing ventilatory rate D) Assessing ability to move extremities
A) Assessing tidal volume
You are preparing to transport a 30-year-old female who is semi-responsive, confused and talking. You suspect she is having some type of diabetic reaction. What would be the FIRST step in treating this patient properly? A) Repeat vital signs every 15 minutes B) Administer oral glucose C) Insert an oropharyngeal airway D) Put patient on high-flow oxygen
D) Put patient on high-flow oxygen
You are called to treat a diabetic patient with warm, dry skin, hypotension, tachycardia and normal respirations who is responsive only to painful stimulation. The patient takes an oral hypoglycemic medication. Which of the following would BEST apply to this situation? A) DKA, administer fluids B) HHNS, administer fluids C) Hypoglycemia, administer dextrose D) Diabetes insipidus, administer fluids
B) HHNS, administer fluids
Which of the following describes the appropriate management of a patient with renal calculi? A) Avoid analgesics B) Position the patient supine C) Administer large amounts of fluid D) Percuss the flank to loosen the stone
C) Administer large amounts of fluid
Which of the following describes the method of action of oral contraceptives?
A) The fallopian tubes spasm, preventing fertilization
B) Estrogen and progesterone inhibit the release of the egg
C) The uterine wall is not capable of maintaining a pregnancy
D) Chemicals are released that destroy the sperm prior to fertilization
B) Estrogen and progesterone inhibit the release of the egg
Ulcerative Colitis is defined as which of the following?
A) Inflammatory condition of the large intestine, classified as inflammatory bowel disease
B) The presence of bright red blood in the stool
C) An inflammation of the entire gastrointestinal mucosa
D) Blockage of the lumen of the small intestines
A) Inflammatory condition of the large intestine, classified as inflammatory bowel disease
You are called to a private home to care for a 16-year-old female who was found passed out on the bathroom floor but now has regained consciousness. She is cool and pale, with sweaty skin. Her pulse is 128, BP-86/44 and respirations are 22 and shallow. She will not answer questions with her mother present. After asking the mother to leave, she states that she is having heavy vaginal bleeding while on the toilet today and her last menstruation was 45 days ago. The condition that needs the most URGENT treatment with this pa"ent is: A) Abortion B) Hypovolemia C) Hypothermia D) Pelvic Inflammatory Disease
B) Hypovolemia
Which answer would BEST describe a patient that results in hemorrhaging from the mouth, extreme dyspnea, cyanosis, anxiousness, pallor and a history of liver cirrhosis? A) Crohn's disease B) Laryngeal cancer C) Esophageal varices D) Lower GI hemorrhage
C) Esophageal varices
Your patient is complaining of cramping pain that varies in level of intensity. This type of pain is called: A) Visceral pain B) Somatic pain C) Referred pain D) None of the above
A) Visceral pain
You have been dispatched to the residence of a female patient who has been sexually assaulted. Which of the following should be your HIGHEST priority?
A) Providing care for the patient
B) Preventing destruction of evidence
C) Maintaining the patient’s modesty and privacy
D) Providing accurate and complete documentation
A) Providing care for the patient
Your ambulance is requested for abdominal pain. Your patient has a history of gallstones. He is experiencing diffuse upper epigastric pain, nausea and emesis. Upon palpation he has a positive Murphy’s sign. Select the correct SUPPORTIVE treatment.
A) IV normal saline, cardiac monitor, oxygen 2 LPM via nasal cannula
B) Oxygen 2 LPM via nasal cannula, saline lock, cardiac monitor and morphine 2-4 mg
C) IV normal saline, Demerol 50 mg, cardiac monitor and oxygen 2 LPM via nasal cannula
D) Oxygen 15 LPM via non-rebreather, IV normal saline bolus, cardiac monitor and Dilaudid 10 mg
A) IV normal saline, cardiac monitor, oxygen
You are transporting a 45-year-old male whose penis was reportedly injured during vigorous sex and the penis is now bent at an angle and the patient is in severe pain. Which of the following would be the appropriate way to communicate this on the radio?
A) Wait to inform the staff until arrival
B) Indicate that the patient hurt his private parts
C) State the observed assessment and request pain relief
D) State the facts but leave out the part about the penis being bent
C) State the observed assessment and request pain relief
A sudden onset of inflammation of the stomach and intestines accompanied by the sudden onset of vomiting and diarrhea would best fit the definition of which of the following? A) Crohn's disease B) Gastritis C) Gastroenteritis D) Pancolitis
C) Gastroenteritis
A patient who that takes a beta-blocker, a calcium channel blocker and an ACE inhibitor, likely has a history of? A) Asthma B) Depression C) Hypertension D) Over-medication
C) Hypertension
You have a patient with a history of Addison's disease who has a decreased level of consciousness. Which mediation does this patient most likely need to increase the level of consciousness? A) Narcan B) Dextrose C) Prednisone D) A Beta Blocker
B) Dextrose
Which of the following degenerative neurological disorders presents with weakness of one or more limbs, sensory loss, paresthesia and changes in vision? A) Multiple sclerosis B) Parkinson's disease C) Muscular dystrophy D) Alzheimer's disease
A) Multiple sclerosis
In the condition of rhabdomyolysis, how are the kidneys affected?
A) Increase the spread of infection
B) Release of calcium causes kidney stones
C) Release of myoglobin blocks renal tubules
D) Loss of electrolytes overwhelms the kidneys
C) Release of myoglobin blocks renal tubules
Systemic lupus erythematosus is a result of which type of reaction of the body? A) Allergic B) Isoimmune C) Autoimmune D) Anaphylactic
C) Autoimmune
Which of the following physiological causes of a seizure would be the MOST alarming yet easily correctable? A) Febrile B) Idiopathic C) Eclampsia D) Hypoglycemia
D) Hypoglycemia
You are called to the scene of an elderly male patient with chest pain and palpitations. Your assessment reveals a heart rate of 210 per minute. Your goal should be which of the following?
A) Decrease inotropy
B) Increase chronotropy C) Increase inotropy
D) Decrease chronotropy
D) Decrease chronotropy
This virus can exist only if the Hepatitis B virus is present. A) Hepatitis A B) Hepatitis C C) Hepatitis D D) Hepatitis E
C) Hepatitis D
You are called to the scene of a 70-year-old female patient complaining of lower left-sided colicky pain. The patient has a low grade fever, nausea and vomiting. She called you because she had a bright red, bloody bowel movement. This patient is MOST likely suffering from:
1) Appendicitis
2) Crohn’s disease
3) Diverticulitis
4) Hemorrhoids
3) Diverticulitis
What is the treatment for any altered mental status patient with a blood glucose measured of 50 mg/dL even before the patient’s medical history is known?
A) Spinal immobilization B) Administer naloxone C) Administer glucose
D) Administer crystalloids
C) Administer glucose
Why should the administration of CPAP be considered in a patient with pulmonary edema?
A) CPAP can deliver very high concentrations of oxygen
B) CPAP can keep the lungs inflated and the upper airway open
C) CPAP pressure helps bring the left and right heart into homeostasis
D) CPAP provides ventilation pressure within the alveoli that may reduce fluid entering the alveoli
D) CPAP provides ventilation pressure within the alveoli that may reduce fluid entering the alveoli
Which of the following medical conditions is caused by the formation of a blood clot within the vasculature of the brain? A) Cerebral embolism
B) Cerebral thrombosis
C) Intracerebral hemorrhage
D) Subarachnoid hemorrhage
B) Cerebral thrombosis
Which of the following is the causative organism of Mononucleosis? A) Clostridium tetani B) DNA Oncogenes C) Epstein-Barr virus D) Hantavirus
C) Epstein-Barr virus
Which of the following agents involved in food poisoning is the MOST toxic? A) E. coli B) Shigella C) Salmonella D) Clostridium botulinum
C) Salmonella
According to ACLS, most stroke patients who may be candidates for fibrinolytic therapy should receive definitive treatment within how many hours of onset? A) 3 B) 6 C) 12 D) 24
A) 3
You have a patient with rapid ventricular response atrial fibrillation. Which of the following medications would provide this patient the greatest benefit? A) Beta agonist B) Sodium channel blocker C) Calcium channel blocker D) Potassium channel blocker
C) Calcium channel blocker
An absence seizure is also known by which of the following? A) Simple partial seizure B) Complex partial seizure C) Grand mal seizure D) Petit mal seizure
D) Petit mal seizure
The force of attraction between a medication and a receptor is referred to as: A) Affinity B) Efficacy C) Agonism D) Up-regulation
A) Affinity
Which of the following would MOST likely present with jaundice?
1) Appendicitis
2) Crohn’s disease
3) Hepatitis
4) Diverticulitis
3) Hepatitis
Your patient has Graves’ disease that is a result of hormonal issues. Which of the following hormonal imbalances would be responsible?
A) Too much adrenocorticotropic hormone
B) Too little adrenocorticotropic hormone
C) Too much thyroid stimulating hormone
D) Too little thyroid stimulating hormone
C) Too much thyroid stimulating hormone
Chronic bronchitis can be defined as:
A) Inflammatory changes and excessive mucus production in the bronchial tree
B) Chronic enlargement of the alveoli, with loss of elasticity
C) Recurrent reactive bronchospasm
D) A chronic fungal infection leading to pus-filled epithelial tissue and bronchoconstriction
A) Inflammatory changes and excessive mucus production in the bronchial tree
Emphysema is described as a:
A) Reactive airway disease
B) Constriction of the bronchial passage
C) Permanent abnormal enlargement of the air spaces and destruction of the alveoli
D) Long term bacterial infection in the lungs
C) Permanent abnormal enlargement of the air spaces and destruction of the alveoli
One factor that may help differentiate pneumonia from COPD is the presence of: A) Rales B) Rhonchi C) Productive cough D) Fever
D) Fever
Positive End Expiratory Pressure is used to: A) Open constricted bronchi B) Overcome upper airway obstructions C) Keep alveoli open D) Ventilate patients with pneumothorax
C) Keep alveoli open
If a patient's atrial fibrillation has been present for more than 48 hours, conversion of this patient's rhythm may lead to: A) Release of emboli B) Sudden ventricular fibrillation C) Refractory hypotension D) Rebound tachycardia
A) Release of emboli
A drug that may improve the symptoms of cardiogenic shock patients in the field is: A) Amiodarone B) Furosemide C) Dopamine D) Atropine
C) Dopamine
You are called to the local airport to evaluate a 40-year-old obese woman who is complaining of pain in her left lower leg. She has just completed a 12-hour flight, and the pain developed as she got off the plane. Her leg is warm, swollen, and painful. You suspect:
A) Arterial occlusion of the popliteal artery
B) Dissection of the femoral artery
C) Deep-vein thrombosis
D) A venous aneurysm
C) Deep-vein thrombosis
The organ(s) most at risk in a hypertensive crisis include the: A) Kidneys B) Lungs C) Liver D) Eyes
A) Kidneys
A single elongated projection of a neuron that transmits impulses away from the cell body is called a(n): A) Neuroglia B) Body C) Dendrite D) Axon
D) Axon
A brain abscess is a(n): A) Tumor B) Lesion inside the cranial vault C) Neoplasm D) Accumulation of pus
D) Accumulation of pus
Parkinson's disease is caused by damage to or degeneration of nerve cells in the: A) Cerebrum B) Pons C) Basal ganglia D) Hypothalamus
C) Basal ganglia
A patient calls 911 because he fears that the cookie he has just eaten may have contained peanuts, which he is highly allergic to. He ate the cookie 1 hour ago. You tell him:
A) Anaphylaxis usually occurs within 30 minutes of the introduction of the antigen
B) If you haven’t developed symptoms by now you will have no problems
C) Symptoms can be delayed for up to 3 hours
D) He should watch for symptoms of anaphylaxis for the next 48 hours
A) Anaphylaxis usually occurs within 30 minutes of the introduction of the antigen
SQ or IM epinephrine may not be effective for a patient having severe anaphylactic reactions because of:
1) The patient’s age
2) Decreased peripheral perfusion
3) Bronchoconstriction
4) The type of allergen
2) Decreased peripheral perfusion
Which of the following signs or symptoms would BEST lead you to suspect your patient has pain associated with abdominal bleeding?
1) Cullen’s sign
2) Referred pain
3) Fetal positioning
4) Distension of the abdomen
3) Fetal positioning
Which of the following is an upper urinary tract infection? A) Cystitis B) Urethritis C) Prostatitis D) Pyelonephritis
D) Pyelonephritis
The most common locations of peptic ulcers are: A) Jejunum and ileum B) Large intestine and rectum C) Stomach and duodenum D) Stomach and esophagus
C) Stomach and duodenum
At a college soccer tournament, you are escorted to a medical trainer who states a player collapsed. Initial assessment reveals a patient experiencing lethargy, nausea, guarding of the abdomen and left shoulder discomfort. Select the MOST likely field impression.
A) Cholecystitis
B) Ruptured spleen
C) Lacerated gallbladder with referred shoulder pain
D) Ruptured kidney with retroperitoneal hemorrhaging
B) Ruptured spleen
Cessation of inspiration during examination of the right upper quadrant is described as: A) Cullen's sign B) Lloyd's sign C) Murphy's sign D) McBurney's sign
C) Murphy’s sign
Which of the following would be the BEST way to reduce the likelihood of renal calculi? A) Exercise regularly B) Drink plenty of water C) Avoid foods high in calcium D) Avoid foods high in oxalates
B) Drink plenty of water
The tearing of the mucosa of the esophagus as the result of prolonged violent vomiting is known as: A) Kerr's sign B) Crohn's disease C) Mallory-Weiss syndrome D) Chronic emesis pressure syndrome
C) Mallory-Weiss syndrome
You are assessing an 18-year-old female complaining of abdominal pain. All of the following questions would be appropriate EXCEPT:
A) Do you take oral contraceptives?
B) Are you or could you be pregnant?
C) When was your last menstrual period?
D) When did you last have sexual intercourse?
D) When did you last have sexual intercourse?
You are called to treat a 56-year-old male with a history of peptic ulcers. The patient is unresponsive, pale, cool, clammy, tachycardic, tachypnic, hypotensive and vomiting copious amount of blood. Which of the following is your MOST important immediate intervention? A) Airway protection B) Fluid resuscitation C) Application of PASG D) Administration of antiemetics
A) Airway protection
You are called to treat a patient with a suspected bowel obstruction. The patient is unresponsive, tachycardic, tachypnic, hypotensive, significant abdominal distention, hyperresonant to abdominal percussion and vomiting feces containing emesis. Which of the following is your MOST important immediate intervention?
A) Intubation
B) Fluid resuscitation
C) Abdominal decompression
D) Oxygen administration with a non-rebreather
D) Oxygen administration with a non-rebreather
Which of the following is the greatest pathophysiological concern regarding appendicitis? A) Bowel obstruction B) Necrosis of the appendix C) Spillage of appendiceal contents D) Ischemia of the appendicular artery
C) Spillage of appendiceal contents
You are dispatched to the honeymoon suite of a local hotel. The husband called you as a result of his wife's complaint of severe unilateral abdominal pain during intercourse. The patient appears nervous, but all vital signs are within normal ranges and she does not have a fever. Which of the following is the MOST likely cause of the unilateral abdominal pain? A) Cystitis B) Endometritis C) Ruptured ovarian cyst D) Pelvic inflammatory disease
C) Ruptured ovarian cyst
Your patient is a 70-year-old female with rectal bleeding. She reveals she had a difficult bowel movement. After straining for fifteen minutes, she noticed red blood on her toilet paper. Initial assessment is unremarkable. What is the most likely field impression. A) Hemorrhoids B) Diverticulitis C) Protruding bowel D) Upper GI hemorrhage
A) Hemorrhoids
You are treating a patient with a history of renal failure who is currently dehydrated. Which of the following is the MOST important consideration for this patient in terms of administration of IV fluids?
A) Continuous monitoring for over-hydration is crucial
B) The largest catheter possible should be used
C) Lactated ringers is the solution of choice
D) Normal saline is the solution of choice
A) Continuous monitoring for over-hydration is crucial
Which of the following assessment findings would be associated more with chronic renal failure than acute renal failure? A) Tachycardia B) Uremic frost C) Hyperkalemia D) Fluid retention
B) Uremic frost
The Helicobacter pylori bacillus is usually the cause of:
A) Acute gastritis
B) Chronic hepatitis
C) Acute gastroenteritis D) Chronic gastroenteritis
D) Chronic gastroenteritis
Which of the following is responsible for the jaundice seen in patients with hepatitis? A) Increased bilirubin levels B) Increased glucagon levels C) Release of toxins by the liver D) Decreased nutrients absorption
A) Increased bilirubin levels
The primary cause of esophageal varices is: A) Acid reflux B) Excessive vomiting C) Portal hypertension D) Ingestion of caustics
C) Portal hypertension
The common site of pain for appendicitis, located 1 1⁄2-2 " above the anterior iliac crest, is referred to as: A) Cullen's point B) Murphy's point C) McBurney's point D) Grey-Turner's point
C) McBurney’s point
What is the name for mid-cycle abdominal pain as a result of ovulation? A) Menses B) Menarche C) Mittelschmerz D) Premenstrual syndrome
C) Mittelschmerz
Inflammation of the gallbladder is known as which of the following? A) Appendicitis B) Peptic ulcer disease C) Gastroenteritis D) Cholecystitis
D) Cholecystitis
What is the term for the symptoms of headache, restlessness, nausea and fatigue occurring after dialysis? A) Postictal dialysis syndrome B) Disequilibrium syndrome C) Refractory dialysis syndrome D) Post-dialysis syndrome
B) Disequilibrium syndrome
You are on-scene with a 68-year-old male with a chief complaint of nausea and abdominal and lower back pain. Further assessment reveals a pulsatile epigastric mass; pale, cool skin; a blood pressure of 86/50; and a heart rate of 112 beats per minute. Based upon this clinical examination, your field impression would be a (an):
A) Umbilical hernia
B) Small bowel obstruction
C) Abdominal aortic aneurysm
D) Splenic rupture with retroperitoneal irritation
C) Abdominal aortic aneurysm
Cor pulmonale is directly associated with which of the following? A) Left ventricular failure
B) Increased pulmonary pressures
C) Increased pulmonary edema
D) Excessive mucus production
B) Increased pulmonary pressures
You have a 26-year-old male who has a chief complaint of pain in the lower posterior lateral back that radiates to his genitals. He indicates he has had this pain before. Which of the following would be the BEST way to assess his current condition?
A) Performing a rapid medical assessment
B) Doing a DCAP-BTLS assessment of the affected area
C) Asking him about his current medications and allergies
D) Asking him to compare this pain to the last time he had it
D) Asking him to compare this pain to the last time he had it
Which of the following is a sign of left-sided heart failure?
1) Sacral edema
2) Jugular venous distension
3) Pulmonary edema
4) Pedal edem
3) Pulmonary edema
Which of the following complications of dialysis would be seen in cases of hemodialysis but NOT in cases of peritoneal dialysis?
1) Hypotension
2) Hyperkalemia
3) Closing of the fistula
4) Neurological abnormalities
3) Closing of the fistula
The major concern for the patient with end stage renal disease is that the kidneys are:
A) Unable to remove waste from the body
B) Unable to circulate blood back to the heart
C) Infection that may spread throughout the body
D) Prone to hemorrhaging into the retro peritoneum
A) Unable to remove waste from the body
Which of the following is a benzodiazepine commonly used by perpetrators of sexual assault?
1) Ketamine
2) Rohpynol
3) GHB
4) Ecstasy
2) Rohypnol
You are utilizing the R-R interval method to calculate a heart rate on the ECG and you have counted 30 small boxes between two consecutive R-wave. What is the heart rate of this ECG?
1) 36
2) 42
3) 50
4) 72
3) 50
Which of the following terms BEST describes the natural process of removing impurities such as urea and creatinine from the blood as well as sodium, potassium and hydrogen ions?
1) Hemodialysis
2) Renal dialysis
3) Peritoneal lavage
4) Peritoneal dialysis
2) Renal dialysis
A sharp type of pain from the abdomen that travels along neural routes is known as which of the following? 1) Referred pain
2) Visceral pain
3) Somatic pain
4) Inflammation
3) Somatic pain
Your 23-year-old female patient who is complaining of abdominal pain indicates she had a D&C procedure performed earlier last week. What does the abbreviation D&C represent?
1) Dusting and cleaning
2) Dilation and curettage
3) Dyspareunia and coitus
4) Dysmenorrhea and cervicalitis
2) Dilation and curettage
When stretch receptors are stimulated by expansion of the lungs, information is conveyed to the medulla by which nerve?
1) Intercostal
2) Vagus
3) Phrenic
4) Diaphragmatic
3) Phrenic
What form does activated charcoal come in?
1) Gel
2) Spray
3) Fine powder
4) Suspension
4) Suspension
Acetone breath odor is found in which of the following?
1) Hypoglycemia
2) Diabetic ketoacidosis 3) HHNC coma
4) Insulin shock
2) Diabetic ketoacidosis
Which part of a drug profile informs us how a drug is absorbed, distributed and eliminated?
1) Classification
2) Pharmacokinetics
3) Mechanism of action
4) Special considerations
2) Pharmacokinetics
Your partner complains he is unable to sleep, his mood seems disrupted and his physician indicates it is a hormone issue. Which of the following hormones would be involved?
1) Thymosin
2) Melatonin
3) Calcitonin
4) Somatostatin
2) Melatonin
From which of the following sources is Atropine obtained?
1) Animal
2) Mineral
3) Plant
4) Synthetic
3) Plant
What term describes relaxation of the heart? 1) Systole
2) Diastole
3) Refractory period
4) Propagation
2) Diastole
Your 24-year-old female asthmatic patient is breathing at 20 times per minute with a tidal volume of 200 ml. What is her minute volume?
1) 200 ml
2) 400 ml
3) 1000 ml
4) 4000 ml
4) 4000 ml
Which of the following BEST describes the term aphasia?
1) The patient cannot speak
2) The patient cannot swallow
3) The patient is weak on one side
4) The patient cannot feel one side
1) The patient cannot speak
Which of the following type of diabetes accounts for 90% of all cases of diabetes mellitus?
1) Type II diabetes
2) Diabetes insipidus
3) Juvenile onset diabetes
4) Hyperglycemic hyperosmolar nonketotic diabetes
1) Type II diabetes
A “moon-faced” appearance is associated with which of the following?
1) Cushing’s syndrome
2) Addison’s disease
3) Myxedema
4) Thyroid storm
1) Cushing’s syndrome
Which of the following reasons explains why the patient with hyperglycemia is dehydrated?
1) The associated nausea and vomiting decreased fluid intake
2) The kidneys removed the excess sugar and therefore water
3) The elevated sugar levels caused a decrease in ADH production
4) The elevated blood sugar drew water from the interstitial space
2) The kidneys removed the excess sugar and therefore water
Which of the following is produced by the posterior pituitary?
1) Prolactin
2) Oxytocin
3) Calcitonin
4) Testosterone
2) Oxytocin
Which of the following is an appropriate rule for determining an idioventricular rhythm?
1) The pacemaker site is at the SA node
2) The P-wave are inverted
3) The rate is greater than 60
4) The QRS duration is >0.12
4) The QRS duration is >0.12
Which of the following degenerative neurological disorders is the most common cause of dementia in the elderly?
1) Stroke
2) Parkinson’s
3) Alzheimer
4) Lou Gehrig’s disease
3) Alzheimer
Which of the following blood vessels supplies approximately 80% of the cerebral blood flow? 1) Circle of Willis
2) Carotid arteries
3) Vertebral arteries
4) Collateral blood flow
2) Carotid arteries
Which of the following statements is correct regarding the body’s attempt to maintain homeostasis when hypoglycemia is present? 1) Glycogenolysis breaks glucagon down into glucose
2) Glucagon is released by the beta cells of the pancreas
3) Glycogen is released by the alpha cells of the pancreas
4) Gluconeogenesis produces glucose from non-sugar sources
4) Gluconeogenesis produces glucose from non-sugar sources
What is the correct volume of 10% Dextrose to administer at 1 gram/kg for a two-week-old infant weighing 4 kg?
1) 4 cc
2) 8 cc
3) 10 cc
4) 40 cc
4) 40 cc
You are ordered to administer 500 ml over a 60-minute time frame with a 15 gtts administration set. Which of the following represents the correct drip rate?
1) 63 gtts/min
2) 125 gtts/min
3) 250 gtts/min
4) 500 gtts/min
2) 125 gtts/min
The standard of care is used to:
1) Decide what skills are in a paramedic’s protocols
2) Delegate care from the physician to the paramedic
3) Measure the competence of a professional
4) Prove breach of duty
3) Measure the competence of a professional
Which organization is the federal agency with jurisdiction over EMS systems?
1) NHTSA
2) NAEMSP
3) NREMT
4) NAEMT
1) NHTSA
You and your partner are at the scene of an unresponsive patient when your partner suddenly clutches his chest, collapses and becomes unresponsive. Which of the following should you do NEXT?
1) Continue treating the pa”ent and begin treating your partner
2) Begin treating your partner and call for additional assistance
3) Call for additional assistance and continue treating the patient
4) Ask bystanders to treat your partner while you treat the patient
2) Begin treating your partner and call for additional assistance
During ventilation of an 8-month-old infant you determine the chest is not rising and falling properly. What should you do to improve ventilations with this age group?
1) Place a small towel roll under the shoulders
2) Tip the head back further until chest rise improvement
3) Lift the jaw forward until the ventilations are easier
4) Ventilate at a quicker pace to allow air to enter the chest
1) Place a small towel roll under the shoulders
What is the transfer of oxygen and carbon dioxide between the capillary red blood cells and the tissue cells called?
1) Pulmonary ventilation
2) Internal respiration
3) External respiration
4) Internal ventilation
2) Internal respiration
Two rescuers are assisting ventilations on an unconscious patient. If one rescuer compresses the bag-valve- mask, the other rescuer should:
1) Place his hands on the victim’s chest to assess rise and fall
2) Pinch off airflow to the patient’s nose
3) Hold the face mask in place
4) Auscultate lung sounds
3) Hold the face mask in place
Which of the following adult pa”ent would require ventilator assistance?
1) Tidal volume 300 cc, respiratory rate of 10
2) Tidal volume 325 cc, respiratory rate of 24
3) Tidal volume 500 cc, respiratory rate of 12
4) Tidal volume 700 cc, respiratory rate of 10
1) Tidal volume 300 cc, respiratory rate of 10
What does capnography measure?
1) Carbon dioxide levels in tissues
2) Oxygen levels in the lungs
3) Carbon dioxide levels in exhaled air
4) Oxygen levels in the blood
3) Carbon dioxide levels in exhaled air
What is the most accurate term used to describe the initial state of the cell’s condition during inadequate tissue perfusion (shock)?
1) Hypoxia
2) Necrosis
3) Hypocarbia
4) Hypoxemia
1) Hypoxia
From which part of the spine do the two phrenic nerves, responsible for moving the diaphragm, originate?
1) C3, C4, C5
2) C4, C5, C6
3) C1, C2, C3
4) T1, T2, T3
1) C3, C4, C5
Which of the following would be the correct dose, concentration and route of epinephrine for an adult patient experiencing an allergic reaction with respiratory distress?
1) 0.3 mg of 1:10,000 IV 2) 1.0 mg of 1:10,000 IV 3) 0.3 mg of 1:1000 SQ
4) 1.0 mg of 1:1000 IM
3) 0.3 mg of 1:1000 SQ
Which of the following MOST indicates a patient is experiencing pain from angina pectoris?
1) The pain associated with angina subsides with rest and nitroglycerin
2) The pain associated with angina is always associated with difficulty breathing
3) The pain associated with angina most often begins at rest
4) The pain associated with angina is exercise-induced
1) The pain associated with angina subsides with rest and nitroglycerin
Which of these is considered a major risk factor for cardiovascular disease?
1) Liver disease
2) Overall mental health
3) Individual response to stress
4) Diabetes mellitus
4) Diabetes mellitus
Possible pathogens that may lead to bacterial meningitis include which of the following?
1) Neisseria meningitides
2) Cryptococcus
3) Streptococcus monocytogenes
4) Listeria pneumonia
1) Neisseria meningitides
Which of the following ECG changes is present when the myocardium is actively infarcting?
1) ST segment elevation
2) P wave inversion
3) ST segment depression
4) Pathological Q wave
1) ST segment elevation
What is a sign of cardiac tamponade?
1) Bradycardia
2) Flat neck veins
3) Decreased venous pressure
4) Muffled heart tones
4) Muffled heart tones
According to the AHA (2015), which of these is the typical heart rate settng for transcutaneous pacing of the bradycardic patient?
1) 30 per minute
2) 50 per minute
3) 70 per minute
4) 100 per minute
3) 70 per minute
Which of the following is the MOST typical finding on right-sided myocardial infarction?
1) Hypertension
2) Hypotension
3) Flushed skin
4) Tachycardia
2) Hypotension
Your CHF patient takes a potassium supplement on a daily basis. Which of the following other drugs would you suspect this pa”ent also takes based on this information?
1) Magnesium Sulfate
2) Nitroglycerin
3) Lopressor
4) Furosemide
4) Furosemide
Which of the following would indicate possible pacemaker failure?
1) A pacemaker spike preceding the T-wave
2) A QRS complex duration of 0.20 seconds
3) Pacemaker spikes not followed by a QRS complex
4) Occasional QRS complexes without pacer spike
3) Pacemaker spikes not followed by a QRS complex
What disease occurs when the kidneys cannot respond to ADH or there is an inadequate release of ADH into the body? A) Type 1 Diabetes B) Diabetes mellitus C) Diabetes insipidus D) Type 2 diabetes
C) Diabetes insipidus
