Exit Exam Alternative

Question 1

1. You have been called to a party for a 20 year old male who bystanders state had an episode of “Violent Shakes” before you arrived. The patient is conscious and agitated, BP 132/96, pulse 132, respirations are 28. He is diaphoretic and his pupils are dilated. Bystanders deny any drug or alcohol ingestion. What do you suspect?
   A) Grand mal seizure.
   B) Delirium tremens.
   C) Cocaine overdose.
   D) Heroin overdose.

Answer 1

Ans: A

Question 2

2. When a drug’s specific action is a negative Chronotropic effect, what effect will it have on the heart?
   A) Increased heart rate
   B) Decrease heart rate
   C) Increase force of muscular contractility
   D) Decrease force of muscular contractility

Answer 2

Ans: B

Question 3

3. A child has overdosed on ASA. You would expect all of the following except:
   A) Hypoventilation
   B) Metabolic acidosis
   C) Vomiting and dehydration
   D) Diaphoresis and fever

Answer 3

Ans: D

Question 4

4. The best possible score for a Glasgow coma scale
   A) Eye opening 4; verbal response 5; motor response; 6
   B) Eye opening 3; verbal response 4; motor response; 5
   C) Eye opening 6; verbal response 5; motor response; 4
   D) Eye opening 5; verbal response 5; motor response; 6

Answer 4

Ans: A

Question 5

5. Early signs of Lidocaine toxicity are:
   A) Seizures and hypertension
   B) Tremors & V Tachycardia
   C) Tremors and paresthesia
   D) Headache and seizures

Answer 5

Ans: D

Question 6

6. What position is JVD best observed:
   A) 30 degrees upright
   B) Fowlers
   C) Trendelenburg
   D) Supine

Answer 6

Ans: B

Question 7

7. ln addition to administering Pitocin to a patient experiencing postpartum hemorrhage, the Paramedic should also implement which of the following
   measures?
   A) IV volume expanders, antishock trousers, and EKG monitor.
   B) IV KVO, high-flow oxygen, and fundal massage.
   C) Massage fundus, IV Fluids, and allow newborn to breast feed.
   D) IV fluids, pack vagina and place mother in shock position.

Answer 7

Ans: C

Question 8

8. A patient who is hyperventilating may have which acid-base condition?
   A) Respiratory acidosis
   B) Respiratory alkalosis
   C) Metabolic acidosis
   D) Metabolic alkalosis

Answer 8

Ans: B

Question 9

9. A collection of the blood caused by a ruptured blood vessel that is enclosed in an organ, tissue or body space is a/an:
   A) Aneurysm
   B) Erythema
   C) Petichiae
   D) Hematoma

Answer 9

Ans: D

Question 10

10. You are transporting a 26-year-old multigravida whose last two babies were by Cesarean Section. She appears to be near full term and is having hard contractions 3-4 minutes apart. She suddenly complains of continuous lower abdominal pain, progressively worse, and gradually goes into shock. The most likely possibility is:
    A) Placenta previa
    B) Abruptio placenta
    C) Ruptured ectopic pregnancy
    D) Uterine rupture

Answer 10

Ans: B

Question 11

11. Cardiac output =
    A) Stroke volume x B/P
    B) Stroke volume + systolic B/P
    C) Heart Rate x Stroke volume
    D) Ejection Fraction x Contractile Force

Answer 11

Ans: C

Question 12

12. If a physician stops at the scene of your call and offers assistance, which of the following should you do before consenting to allow his/her assistance?
    A) Confirm that person is actually a medical doctor and not a Ph.D.
    B) Confirm that the physician is willing to come to the hospital with you and the patient.
    C) Let the physician speak to your medical control so they can work together.
    D) All of the above.

Answer 12

Ans: D

Question 13

13. A patient presents as follows: acting bizarre, skin is cool & clammy skin, slurred speech, and staggers. Vital signs are: Pulse 110 weak and thready, RR 24 regular and non-labored, BP 110/70, SA02 97% on RA, Glucose: LO. The diagnosis for this patient is:
    A) Hyperglycemia
    B) Diabetic Ketoacidosis
    C) Insulin Shock
    D) Brain Attack

Answer 13

Ans: C

Question 14

14. lf the heart rate increases, but the stroke volume remains the same, what happens to the cardiac output?
    A) Increases
    B) Decreases
    C) Remains the same
    D) The stroke volume must increase also

Answer 14

Ans: A

Question 15

15. The termination of a paramedic/patient care relationship before assuring that a health care provider of equal or higher training will continue care is called:
    A) False imprisonment
    B) Confidentiality.
    C) Malpractice.
    D) Abandonment.

Answer 15

Ans: D

Question 16

16. The pulmonary artery carries:
    A) Oxygenated blood to the lungs
    B) Deoxygenated blood to the lungs
    C) Oxygenated blood to the heart
    D) Deoxygenated blood to the heart

Answer 16

Ans: B

Question 17

17. lf a patient who is refusing care becomes unconscious, can the paramedic treat him?
    A) Yes, under the informed consent provision.
    B) Yes, under the emergency doctrine.
    C) Not without the police present.
    D) Not without permission of medical control.

Answer 17

Ans: B

Question 18

18. Atropine works by:
    A) Stimulating the sympathetic nervous system
    B) Stimulating the parasympathetic nervous system
    C) Blocking the effects of the vagus nerve
    D) Stimulating the vagus nerve

Answer 18

Ans: C

Question 19

19. You are called to a home of a 23-year-old obese female approximately 8 months pregnant who has just had a Grand Mal seizure. You observe the patient is still having seizure activity. rapid pulse @ 145/min., BP -240/130,3+ edema of extremities. No history of epilepsy or head injury can be obtained. The most likely diagnosis is:
    A) Hypertensive crises
    B) CVA seizure
    C) Eclampsia
    D) Pre-eclampsia

Answer 19

Ans: C

Question 20

20. All of the following are elements of Cushing Triad except:
    A) Elevated BP
    B) Decreased pulse
    C) Irregular respirations
    D) Decreased peripheral vascular resistance

Answer 20

Ans: D

Question 21

21. You are unable to defibrillate a patient because the defibrillator doesn’t charge. The patient later dies, and the family learns that you failed to replace the battery -the morning according to your service’s routine procedures. You may be liable
    for:
    A) Negligence
    B) Malpractice
    C) Abandonment
    D) Wrongful death

Answer 21

Ans: A

Question 22

22. The principle of providing care equal to that of a similarly trained individual in the same or similar circumstances is called:
    A) Negligence
    B) Standard of care
    C) Duty to act
    D) The prudent person principle

Answer 22

Ans: B

Question 23

23. The pediatric patient that presents with sunken eyes, recent weight loss, and tachycardia should be evaluated to rule out:
    A) Polio
    B) Pertusis
    C) Anaphylaxis
    D) Dehydration

Answer 23

Ans: D

Question 24

24. You are called to the scene of a construction site accident. A 31-year-old male was working in a trench when the walls collapsed and he was completely
    covered by dirt. His coworkers have freed his abdomen, chest, and head, but he is still trapped from the waist down. The patient appears to be purple from the shoulders up and is having marked difficulty breathing. His eyes are bulging, and his lips appear swollen. You suspect:
    A) Myocardial infarction
    B) Tension pneumothorax
    C) Traumatic asphyxia
    D) Simple pneumothorax

Answer 24

Ans: C

Question 25

25. The normal PR interval is seconds
    A) 0.2 -0.4
    B) 0.4 -0.12
    C) 0.1 -0.20
    D) 0.12 -0.20

Answer 25

Ans: D

Question 26

26. The physician orders 5mcg/kg/min of dopamine for an 80 kg patient. You put
    400 mg of Dopamine in 250 ml D5W. What is the correct rate using a microdrip administration set?
    A) 15 gtts/min
    B) 30 gtts/min
    C) 40 gtts/min
    D) 120 gtts/min

Answer 26

Ans: A

Question 27

27. The APGAR score evaluates:
    A) Pulse, respirations, BP ,activity, color,
    B) Pulse, respirations, activity, color, grimace
    C) Pulse, reflex ability, appearance, BP
    D) BP, pulse, gestation, color, respiration

Answer 27

Ans: B

Question 28

28. The patient who is decorticate will move his hands and arms:
    A) Toward the body
    B) Over the head
    C) Extended away from the body
    D) None of the above

Answer 28

Ans: A

Question 29

29. A 60 y/o patient with a-fib develops signs of CVA. This is probably due to:
    A) Cerebral hemorrhage
    B) Pulmonary Hemorrhage
    C) Cerebral thromboembolus
    D) Cerebral embolus

Answer 29

Ans: C

Question 30

30. Select the answer which correctly arranges the stages of the grieving process in order.
    A) Denial- depression-anger-bargaining-acceptance
    B) Denial- anger-bargaining-depression-acceptance
    C) Bargaining -denial -anger -depression -acceptance
    D) Acceptance -depression -bargaining -denial -anger

Answer 30

Ans: B

Question 31

31. A 55 year old patient has a pulse rate of 50. There is a P for every QRS and the P-R interval is 0.16. The patient is cold and clammy and the BP is 70/50. Indicate the rhythm, and the initial treatment.
    A) Sinus bradycardia and Atropine 0.5 mg
    B) 1st. degree block and a fluid bolus
    C) Third degree block and Atropine 1 mg
    D) Sinus bradycardia and a Dopamine drip

Answer 31

Ans: A

Question 32

32. Arrange the below drug routes in order from quickest absorption to slowest.
33. Subcutaneous injection
34. Oral
35. Intravenous
36. Sublingual tablet
    A) 3-2-1-4.
    B) 1-3-4-2
    C) 3-4-1-2.
    D) 1-3-2-4

Answer 32

Ans: C

Question 33

33. You are treating a patient who is unconscious and hypotensive. His respiratory rate is 4bpm and his pupils are pinpoint. You note an empty syringe near his body. Treatment for this patient includes:
    A) Maintain airway, ventilate with 100% 02, EGG monitoring, nasal intubation.
    B) Maintain airway, ventilate with 100%02, EGG Monitoring, IV, Narcan.
    C) Maintain airway, EGG monitoring, IV, Narcan.
    D) Maintain airway, ventilate with 100% 02, EGG monitoring, IV, Epinephrine

Answer 33

Ans: B

Question 34

34. A Physician has ordered you to administer 1 mg / kg of Lasix to a 184 pound female. The pre-filled syringe is labeled 20 mg per ml. How many ml’s must you administer to obtain the proper dose:
    A) 2 ml.
    B) 3 ml.
    C) 4 ml.
    D) 4.5 ml.

Answer 34

Ans: D

Question 35

35. A class of drug that is designed to increase blood pressure is known as a(n):
    A) Antianginal
    B) Vasopressor
    C) Anticonvulsant
    D) Diuretic

Answer 35

Ans: B

Question 36

36. After receiving an intramuscular injection of Penicillin, a patient develops a rash all over his body, has difficulty in breathing, and is wheezing audibly. His blood pressure is 70/40, Pulse is 122 weak and thready with no radial pulse present, Respiratory rate is 28 per min labored. SAO2 89% and skin is pale and diaphoretic. Treatment for this patient includes:
    A) Epinephrine 1:1,000 0.3 -0.5 mg SQ injection
    B) Benadryl 100 mg IVP
    C) Epinephrine 1 :10,000 0.3 -0.5 mg IVP
    D) Benadryl 50 ml SQ injection

Answer 36

Ans: C

Question 37

37. Administration of Morphine Sulfate may cause:
    A) Respiratory depression or arrest
    B) Hypotension
    C) Unconsciousness
    D) All of the above

Answer 37

Ans: D

Question 38

38. You are evaluating a 31 y/o female who is complaining of dizziness and chest pain. Her blood pressure is 70/40 with a pulse of 230. Her EKG shows Supraventricular Tachycardia. Which of the following is appropriate?
    A) Synchronized cardioversion
    B) Lidocaine 1.5 mg / kg IVP
    C) Unsynchronized shock.
    D) Adenosine 6 mg rapid IVP.

Answer 38

Ans: A

Question 39

39. In a cardiac arrest situation, atropine is administered in doses of:
    A) 0.5 mg every 3 to 5 minutes, not to exceed 0.04 mg/kg or 3 mg.
    B) 1.0 mg every 3 to 5 minutes, not to exceed 0.4 mg/kg or 3mg.
    C) 1.0 mg every 3 to 5 minutes, not to exceed 0.5 mg/kg or 4 mg.
    D) 1.0 mg every 3 to 5 minutes, not to exceed 0.04 mg/kg or 3 mg.

Answer 39

Ans: D

Question 40

40. Mr. Webster is complaining of extreme fatigue and a headache, which has developed over the past 12 hours. His wife reports that he has been eating everything in sight and has been frequently urinating today. Upon exam, you note that is he is hypotensive and has deep, rapid respiration. You conclude that he is experiencing:
    A) Transient Ischemic Attack
    B) Insulin shock
    C) Thyrotoxicosis
    D) Diabetic Ketoacidosis.

Answer 40

Ans: D

Question 41

41. A narcotic poisoning may result in _____________ pupils.
    A) Unequal
    B) Dilated
    C) Constricted
    D) Fixed

Answer 41

Ans: C

Question 42

42. Once a tourniquet is applied, the decision may be that you will:
    A) Take it off once bleeding has been controlled.
    B) Lose the limb to save the life.
    C) Replace it with an air splint when one is available
    D) Loosen it when the patient experiences paresthesia

Answer 42

Ans: B

Question 43

43. A structure or area closer to the trunk than a given point of reference is considered to be
    A) Superficial
    B) Palmar
    C) Distal
    D) Proximal

Answer 43

Ans: D

Question 44

44. While ventilating an intubated patient with the bag-valve-mask device you notice that it becomes more and more difficult to compress the bag. This may indicate.
    A) Decreasing lung compliance
    B) An occlusion of the endotracheal tube.
    C) Endobronchial intubation.
    D) All of the above.

Answer 44

Ans: D

Question 45

45. Which of the following manual airway maneuvers is the preferred method for all but spine-injured patients?
    A) Head-tilt with chin-lift
    B) Chin-lift alone
    C) Head-tilt with jaw-thrust
    D) Jaw-thrust alone

Answer 45

Ans: A

Question 46

46. The curved laryngoscope blade is also called a:
    A) Macintosh
    B) MacBurnie
    C) Miller
    D) Magill

Answer 46

Ans: A

Question 47

47. Hypertensive emergencies are related to other emergencies such as intracranial hemorrhage, pulmonary edema, AMI and aortic dissection. When hypertension is associated with these conditions treatment should be directed at the:
    A) Hypertension.
    B) Pulmonary edema.
    C) AMI.
    D) Primary problem.

Answer 47

Ans: D

Question 48

48. A drug that influences the rate of the heart is referred to as being
    A) Isotropic.
    B) Phototropic.
    C) Inotropic
    D) Chronotropic

Answer 48

Ans: D

Question 49

49. The initial dose of adenosine is
    A) 6 mg rapid IVP (within 1 to 2 seconds).
    B) 6 mg slow IVP (over 30 seconds to 1 minute).
    C) 3 mg rapid IVP (within 1 to 2 seconds).
    D) 3 mg rapid IVP (over 30 seconds to 1 minute).

Answer 49

Ans: A

Question 50

50. Administration routes for sodium bicarbonate include
    A) IV only.
    B) ET only
    C) IV or ET
    D) IV,E.T, S.Q.

Answer 50

Ans: A

Question 51

51. Nitroglycerin is indicated for all of the following situations except
    A) Angina
    B) Chest pain
    C) Pulmonary edema
    D) Cerebral edema.

Answer 51

Ans: D

Question 52

52. The lumbar spine consists of
    A) 3 to 5 vertebrae
    B) 5 vertebrae
    C) 7 vertebrae
    D) 12 vertebrae

Answer 52

Ans: B

Question 53

53. Paralysis of the lower extremities only is called
    A) Paraplegia
    B) Quadriplegia
    C) Hemiplegia.
    D) Paresis

Answer 53

Ans: A

Question 54

54. The phrase full-thickness burn may be applied to
    A) A first-degree burn.
    B) A second-degree burn.
    C) A third-degree burn.
    D) Both answers (a) and (b).

Answer 54

Ans: C

Question 55

55. You are called to the scene of a patient who was involved in an altercation at the local pool hall. You find one victim in the back alley anxious and screaming for your assistance. You notice immediately that he has clammy skin and a dusky appearance. He has a respiratory rate of 40 and his breathing is shallow. He tells you that he has been hit multiple times in the chest, abdomen, and back with a pool stick by “two big guys.” While assessing his chest you notice multiple contusions to the right side with diminished respirations on the right. What would you suspect?
    A) Cardiac tamponade
    B) Hemothorax
    C) Ruptured diaphragm
    D) Pneumothorax

Answer 55

Ans: D

Question 56

56. Off-line (indirect) medical control primarily relies on:
    A) Stop lines
    B) Protocols
    C) ACLS algorithms.
    D) Paramedic Judgement

Answer 56

Ans: B

Question 57

57. If you receive a copy of a valid DNR order after you have begun resuscitation attempts, you are ethically obligated to:
    A) continue resuscitation until ordered to stop by medical direction.
    B) continue resuscitation attempts until the patient is transported to an emergency department.
    C) check the patient’s breathing and pulse before ceasing resuscitation efforts.
    D) cease resuscitation efforts.

Answer 57

Ans: D

Question 58

58. Under the tongue, between the cheek and gums, the eyes, the nose, and the ear and ear canal are sites where medications can be absorbed into the body through the:
    A) arterioles.
    B) capillaries.
    C) venules.
    D) mucous membranes.

Answer 58

Ans: D

Question 59

59. Administering an oral medication to a patient who cannot support his airway may result in:
    A) poor absorption of the medication.
    B) the need to repeat the dose of medication.
    C) aspiration into the lungs.
    D) harmful substances after the drug is metabolized.

Answer 59

Ans: C

Question 60

60. An intramuscular injection is given at a:
    A) 15 degree angle.
    B) 45 degree angle.
    C) 90 degree angle.
    D) 100 degree angle.

Answer 60

Ans: C

Question 61

61. As the blood stagnates in the capillaries and the waste products build up, the red blood cells clump together, forming columns called:
    A) washout
    B) septic shock
    C) ischemia
    D) rouleaux

Answer 61

Ans: D

Question 62

62. The equipment or supplies required on every ambulance are known as:
    A) protocols
    B) standing orders
    C) indispensable supplies
    D) essential equipment

Answer 62

Ans: D

Question 63

63. An exaggerated response by the immune system to a foreign substance is called:
    A) an allergic reaction
    B) an allergy
    C) thyrotoxicolosis
    D) an immune response

Answer 63

Ans: A

Question 64

64. Scenario: Shortly after being stung by a bee, a patient experiences urticaria, stridor, and abdominal cramping. Which of the following signs or symptoms would probably also be present?
    A) bradycardia
    B) hypertension
    C) rhonchi
    D) wheezing

Answer 64

Ans: D

Question 65

65. Scenario: You are called to the scene of a 28-year-old male who is complaining of hoarseness, a scratchy sensation in the back of his throat, and palpitations. The symptoms began about 30 minutes ago and have grown steadily worse. The patient took prescribed penicillin one hour ago. Management of this patient should include all of the following EXCEPT:
    A) 0.3 mg epinephrine 1:1000 SQ.
    B) administration of a beta-blocker.
    C) IV of NS at KVO rate.
    D) supplemental oxygen via nonrebreather.

Answer 65

Ans: B

Question 66

66. Sublingual drugs are absorbed rapidly because the:
    A) patient chews them quickly.
    B) sublingual region is extremely vascular.
    C) drugs are typically smaller than in the oral route of administration.
    D) medication is given when the patient is awake and alert.

Answer 66

Ans: B

Question 67

67. Incidents that generate large numbers of patients and often make traditional EMS response ineffective because of special surrounding circumstances are known as a(n):
    A) MCI
    B) MIC
    C) CISM
    D) MVA

Answer 67

Ans: A

Question 68

68. Which level of trauma center commits resources to address all types of specialty trauma 24 hours a day, 7 days a week?
    A) Level I
    B) Level II
    C) Level III
    D) Level IV

Answer 68

Ans: A

Question 69

69. Careful, thorough documentation ________ frivolous lawsuits.
    A) encourages
    B) enables
    C) bolsters
    D) discourages

Answer 69

Ans: D

Question 70

70. Scenario: A patient presents with a normal sinus rhythm with occasional ectopic beats. The ectopic beats appear with absent P waves and a normal QRS complex. The ectopic beat is a premature _____ contraction.
    A) atrial
    B) bundle
    C) junctional
    D) ventricular

Answer 70

Ans: C

Question 71

71. An ECG rhythm that has no correlation between P waves and QRS complexes is known as a:
    A) 1st-degree AV Block.
    B) 2nd-degree AV Block Type
    C) 2nd-degree AV Block Type II.
    D) 3rd-degree AV Block.

Answer 71

Ans: D

Question 72

72. The inability of the heart to meet the metabolic needs of the body is termed:
    A) cardiogenic shock.
    B) hypovolemic shock.
    C) neurogenic shock.
    D) septic shock.

Answer 72

Ans: A

Question 73

73. Which of the following is NOT a medication commonly used during cardiac arrest resuscitation?
    A) adenosine
    B) atropine
    C) epinephrine
    D) Lidocaine

Answer 73

Ans: A

Question 74

74. What is the antagonist for an overdose of a Calcium-Channel blocker?
    A) adenosine
    B) atropine
    C) epinephrine
    D) calcium chloride

Answer 74

Ans: D

Question 75

75. Normal Lidocaine Drips should be initiated @ no less than _________ given that there are no precautions or contraindiations present.
    A) 1mg/min
    B) 2mg/min
    C) 3mg/min
    D) 4mg/min

Answer 75

Ans: B

Question 76

76. The initial dose for Lidocaine in a stable Ventricular Tachycardia is?
    A) 0.5 mg/Kg
    B) 1mg/Kg
    C) 1.5mg/Kg
    D) 3mg/Kg

Answer 76

Ans: B

Question 77

77. Scenario: A 62-year-old male fainted while going to the bathroom. His current vitals are blood pressure, 98/64; pulse, 42 and regular; and respirations, 24. His ECG displays a regular R-R complex, an abnormal P-R interval and wide QRS complex. Based on the information presented, the BEST treatment for this patient is:
    A) atropine 0.5 mg.
    B) epinephrine 1:10,000 1 mg.
    C) Isuprel 2-10 mcg/min.
    D) transcutaneous pacing.

Answer 77

Ans: D

Question 78

78. The most critical treatment that a paramedic can perform for a patient in an unwitnessed ventricular fibrillation cardiac arrest is:
    A) CPR.
    B) defibrillation.
    C) intubation.
    D) IV therapy.

Answer 78

Ans: A

Question 79

79. In PEA the first drug of choice would be:
    A) Epinephrine
    B) Atropine
    C) Lidocaine
    D) Oxygen

Answer 79

Ans: D

Question 80

80. One kilogram equals:
    A) 2 pounds.
    B) 2.1 pounds.
    C) 2.2 pounds.
    D) 2.3 pounds.

Answer 80

Ans: C

Question 81

81. In the START triage system, which of the following patients would be considered for immediate transport?
    A) an unconscious, breathing patient
    B) an unconscious, nonbreathing patient
    C) a patient with respirations of 24
    D) a patient with capillary refill of 2 seconds

Answer 81

Ans: A

Question 82

82. The thick middle tissue layer of the heart is the:
    A) endocardium.
    B) epicardium.
    C) myocardium.
    D) pericardium.

Answer 82

Ans: C

Question 83

83. The amount of blood ejected by the heart in one cardiac contraction is known as:
    A) Frank Starling Mechanism
    B) Ejection Fraction
    C) Cardiac Output
    D) Stroke volume

Answer 83

Ans: B

Question 84

84. The intrinsic rate of the _____ is 40-60 beats per minute.
    A) AV Node
    B) Bundle branches
    C) Purkinje system
    D) SA node

Answer 84

Ans: A

Question 85

85. The structure that conducts electrical impulses from the SA node to the AV junction is the:
    A) internodal pathways.
    B) bundle of His.
    C) Purkinje fibers.
    D) the bundle of branches

Answer 85

Ans: A

Question 86

86. A cell’s capability to self-depolarize is known as:
    A) automaticity.
    B) conductivity.
    C) contractility.
    D) excitability.

Answer 86

Ans: A

Question 87

87. All of the following electrolytes affect cardiac function EXCEPT:
    A) Ca++.
    B) Cl-.
    C) K+.
    D) Ph+.

Answer 87

Ans: D

Question 88

88. According to _____, the more the myocardial muscle is stretched, the greater its force of contraction will be.
    A) Boyle’s Law
    B) Henry’s Law
    C) Poiseuille’s Law
    D) Starling’s Law

Answer 88

Ans: D

Question 89

89. The rationale for ECG monitoring is to:
    A) determine cardiac output.
    B) determine stroke volume.
    C) evaluate the effectiveness of cardiac contractions.
    D) evaluate the heart’s electrical system for abnormalities.

Answer 89

Ans: D

Question 90

90. The upward deflection on the ECG paper represents:
    A) artifact.
    B) isoelectric impulse.
    C) negative impulse.
    D) positive impulse.

Answer 90

Ans: D

Question 91

91. The QRS complex represents:
    A) Atrial depolarization.
    B) Atrial repolarization.
    C) ventricular depolarization.
    D) ventricular repolarization.

Answer 91

Ans: C

Question 92

92. A normal QRS complex lasts:
    A) between 0.08 and 0.42 seconds.
    B) between 0.04 and 0.12 seconds.
    C) between 0.12 and 0.20 seconds.
    D) between 0.33 and 0.42 seconds.

Answer 92

Ans: B

Question 93

93. Changes in the S-T segment might indicate any of the following EXCEPT:
    A) ischemia.
    B) injury.
    C) infarct.
    D) inotropy.

Answer 93

Ans: D

Question 94

94. Scenario: A 72-year-old male is complaining of difficulty breathing. You attach him to the ECG and notice a rhythm of 42 with a corresponding pulse, a P-R interval of 0.16, and normal R-R intervals. Vitals are blood pressure of 90/52, respirations of 42. The patient also states that he feels very nauseated and dizzy. Treatment for this patient should include:
    A) atropine 0.5 mg IVP
    B) epinephrine 1:1000 0.3 mg SQ
    C) epinephrine 1:10,000 1 mg IVP
    D) Isuprel 2-10 mcg/min IVP

Answer 94

Ans: A

Question 95

95. Which ECG is characterized by a P-R interval greater than 0.20 and a regular R-R interval?
    A) 1st-degree AV block
    B) 2nd-degree Type I AV block
    C) 2nd-degree Type II AV block
    D) 3rd-degree AV block

Answer 95

Ans: A

Question 96

96. Scenario: A patient presents with a normal sinus rhythm with occasional ectopic beats. The ectopic beats appear with P waves and a QRS complex width of 0.10. The ectopic beat is a premature _____ contraction.
    A) Atrial
    B) Ectopic
    C) Junctional
    D) Ventricular

Answer 96

Ans: A

Question 97

97. Scenario: You are managing a patient in the ED with symptomatic bradycardia and multifocal PVCs. Suddenly your patient slumps unconscious and goes into ventricular fibrillation. You check your defibrillator/monitor and all connections. You then confirm that your patient is pulseless. After activating the code team, your next action would be to:
    A) administer Lidocaine 1.5 mg/kg.
    B) begin CPR.
    C) cardiovert at 200 joules.
    D) defibrillate at 200 joules.

Answer 97

Ans: D

Question 98

98. You are managing a patient in cardiac arrest the ECG shows ventricular fibrillation. Which of the following is the correct medication of choice and dose?
    A) Lidocaine @ .05 mg/kg IVP
    B) Atropine 1 mg IVP
    C) Lidocaine @ 1.5 mg/kg IVP
    D) Procainamide 50 mg/kg IVP

Answer 98

Ans: C

Question 99

99. Scenario: A 58-year-old patient is experiencing chest pain and shortness of breath. ECG shows a sinus tachycardia at 126; pulse is weak, and blood pressure is 92/52. Which pharmaceutical agent and dose would be MOST appropriate for this patient?
    A) Dopamine 2-20 mcg/kg/min
    B) Lasix 40 mg
    C) Morphine sulfate 5 mg
    D) Nitrostat 0.4 mg SL

Answer 99

Ans: A

Question 100

100. All of the following Dysrhythmia’s are typically seen in cardiac arrest EXCEPT:
     A) asystole.
     B) pulseless ventricular tachycardia.
     C) atrial fibrillation.
     D) ventricular fibrillation.

Answer 100

Ans: C

Question 101

101. The time an impulse takes to travel from the atria to the ventricles is known as the:
     A) P-R interval.
     B) QRS interval.
     C) QT interval.
     D) S-T segment.

Answer 101

Ans: A

Question 102

102. An ECG rhythm that has a constant prolonged P-R interval and regular R-R interval with QRS complexes less than 0.12 seconds and occasional dropped QRS complexes is known as a
     A) 1st-degree AV Block.
     B) 2nd-degree AV Block Type
     C) 2nd-degree AV Block Type II.
     D) 3rd-degree AV Block.

Answer 102

Ans: C

Question 103

103. Scenario: A patient is experiencing severe chest pain and is hemodynamically unstable. ECG shows a ventricular rate of 40. P-R interval is 0.24 and is constant for conducted QRS complexes. However, every 4th P wave does not conduct a QRS. Immediate management for this patient should include:
     A) adenosine 6 mg.
     B) atropine 1 mg.
     C) Lidocaine 1 mg/kg.
     D) transcutaneous pacing.

Answer 103

Ans: D

Question 104

104. Which of the following is NOT an assessment priority when evaluating a patient suspected of suffering an AMI?
     A) blood pressure
     B) breath sounds
     C) ECG
     D) pupilary response

Answer 104

Ans: D

Question 105

105. Scenario: Your patient is a 42 y/o male who was involved in a head on collision. He presents with JVD, distant heart sounds, S.O.B and a BP of 162/84 on the Rt arm and 142/76 on the left arm. What condition can be suspected?
     A) Tension pneumothorax
     B) Neurogenic Shock
     C) Pericardial tamponade
     D) Abdominal aortic aneurysm

Answer 105

Ans: C

Question 106

106. Scenario: A 6 year old child presents in a tripod position with drooling. He has an axillary temperature reading of 104.4 degrees fahrenheit. You suspect:
     A) Epiglottitis
     B) Croup
     C) Bronchiolitis
     D) Asthma

Answer 106

Ans: A

Question 107

107. Which of the following medications will cause the pupils to dilate?
     A) adenosine
     B) atropine
     C) epinephrine
     D) Lidocaine

Answer 107

Ans: B

Question 108

108. What is the antagonist for an overdose of a benzodiazapine?
     A) narcan
     B) mag sulfate
     C) romazicon
     D) labatelol

Answer 108

Ans: C

Question 109

109. Which of the following medications should be pushed slowly?
     A) Adenosine
     B) Morphine
     C) Atropine
     D) Epinepherine

Answer 109

Ans: B

Question 110

110. One of the contra indications for the administration of Cardizem is:
     A) Administer with Supraventricular Tachydysrhythmias
     B) Administer with Systolic blood pressure < 90 mm Hg.
     C) Administer to decrease re-absorption of Calcium in the Myocardium
     D) Administer for rates exceeding 150 Beats per minute.

Answer 110

Ans: B

Question 111

111. What class of medication is Calcium Chloride?
     A) Narcotic
     B) Antidysrhythmic
     C) Electrolyte
     D) Beta blocker

Answer 111

Ans: C

Question 112

112. The subsequent dose for Lidocaine in a stable Ventricular Tachycardia is?
     A) 0.5 mg/Kg IVP
     B) 1mg/Kg IVP
     C) 1.5mg/Kg IVP
     D) 0.5mg/Kg SQ

Answer 112

Ans: A

Question 113

113. Scenario: A 62-year-old male fainted while going to the bathroom. His current vitals are blood pressure, 108/64; pulse 62 and irregular; respirations, 24. His ECG displays an irregular rhythm with normal P-R interval and QRS complex. The MOST likely cause of the patient’s syncopal episode is:
     A) AV-node ischemia.
     B) digitalis toxicity.
     C) excessive vagal tone.
     D) fibrotic disease.

Answer 113

Ans: C

Question 114

114. All of the following might cause pulseless electrical activity EXCEPT:
     A) cardiac tamponade.
     B) electrocution.
     C) hypovolemia.
     D) tension pneumothorax

Answer 114

Ans: B

Question 115

115. Scenario: You are arrival on a MVA that involves a school bus full of children and an SUV with 5 patients. The first patient you contact has a distal pulse of 42bpm/regular/strong and cap refill of 2 seconds, RR 20bpm/non-labored, and he is AAOx3 with a laceration to his forehead. Using the START triage system, this patient would be tagged with a ___________ ribbon.
     A) Green
     B) Yellow
     C) Red
     D) Black

Answer 115

Ans: B

Question 116

116. Implanted pacemakers that sense and fire only when the heart rate drops below a set rate are known as:
     A) AV sequential pacemakers.
     B) demand pacemakers.
     C) dual-chambered pacemakers.
     D) fixed-rate pacemakers.

Answer 116

Ans: B

Question 117

117. Which of the following regimens is NOT recommended for the CHF patient?
     A) ECG evaluation
     B) IV of NS wide open
     C) Morphine sulfate
     D) Positive pressure ventilation

Answer 117

Ans: B

Question 118

118. The condition in which excess fluid accumulates between the visceral and parietal pericardium is known as:
     A) cardiac tamponade.
     B) cor pulmonale.
     C) hemothorax.
     D) 3rd-space edema.

Answer 118

Ans: A

Question 119

119. Scenario: A patient presents with a history of myocardial infarction, paroxysmal nocturnal dyspnea, and pedal edema. It would be safe to conclude that this patient is experiencing:
     A) cardiogenic shock.
     B) hypovolemic shock.
     C) neurogenic shock.
     D) septic shock.

Answer 119

Ans: A

Question 120

120. The most critical treatment that a paramedic can perform for a patient in an witnessed cardiac arrest showing ventricular fibrillation is:
     A) CPR.
     B) defibrillation.
     C) intubation.
     D) IV therapy.

Answer 120

Ans: B

Question 121

121. When presented with asystole, the paramedic should perform all of the following EXCEPT:
     A) take a 12-lead ACG.
     B) check for a pulse.
     C) check for lead placement.
     D) confirm rhythm in more than one lead.

Answer 121

Ans: A

Question 122

122. The process of passing an electrical current through the heart during the R wave of the cardiac cycle to terminate tachydysrhythmias is known as:
     A) defibrillation.
     B) rapid synchronized pacing.
     C) synchronized cardioversion.
     D) transcutaneous pacing.

Answer 122

Ans: C

Question 123

123. Which of these conditions can be caused by either ischemic or hermorrhagic lesions to a portion of the brain?
     A) seizure
     B) sepsis
     C) spina bifida
     D) stroke

Answer 123

Ans: D

Question 124

124. One of the most common causes of PEA is?
     A) Pneumothorax
     B) Hyperkalemia
     C) Hypovolemia
     D) Drug Overdose

Answer 124

Ans: C

Question 125

125. The majority of ischemic strokes are caused by:
     A) Thromboembolism
     B) Atherosclerotic occlusion
     C) Aneurysmal rupture
     D) Acute hypertension

Answer 125

Ans: A

Question 126

126. Which of the following statements regarding stroke are true?
     A) It is the leading cause of death in the USA
     B) Paramedics must be prepared to administer fibrinolytics promptly in the field
     C) It is the leading cause of disability in the USA
     D) Approximately 2/3 of patients die who suffer an acute stroke

Answer 126

Ans: C

Question 127

127. The on-scene prehospital stroke examination consists of:
     A) Speech, facial symmetry, arm strength
     B) Speech, facial symmetry, reflexes
     C) Speech, reflexes, arm strength
     D) Reflexes, facial symmetry, arm strength

Answer 127

Ans: A

Question 128

128. Which of the following is NOT a risk factor for ischemic stroke?
     A) Cigarette smoking
     B) Hypertension
     C) Diabetes mellitus
     D) Chronic obstructive pulmonary disease

Answer 128

Ans: D

Question 129

129. Each of the following is a correct statement regarding asprin, EXCEPT:
     A) Should be chewed for rapid effect
     B) Decreases platelet stickiness
     C) Promotes bleeding
     D) Lyses blood clots

Answer 129

Ans: D

Question 130

130. An acute ST-elevation myocardial infarction, regardless of the degree of coronary artery atherosclerosis, is mainly the result of:
     A) Plaque formation
     B) Thrombotic occlusion
     C) Coronary artery spasm
     D) Ventricular aneurysm

Answer 130

Ans: B

Question 131

131. Which of the following is the most typical result of an acute right coronary artery occlusion?
     A) Ventricular tachycardia
     B) Sinus tachycardia
     C) Anterior wall infarction
     D) Inferior wall infarction

Answer 131

Ans: D

Question 132

132. Which of the following conditions would cause a false reading on the SAO2 monitor?
     A) Multiple sclerosis
     B) Sickle cell crisis
     C) Cyanide poisoning
     D) Carbon monoxide poisoning

Answer 132

Ans: D

Question 133

133. Where does decontamination begin in a hazardous material incident?
     A) Cold zone
     B) Warm zone
     C) Hot zone
     D) Neutral zone

Answer 133

Ans: B

Question 134

134. The tissue that connect bone to muscle is known as:
     A) Fascia
     B) Tendon
     C) Ligament
     D) Epicondyle

Answer 134

Ans: B

Question 135

135. The maximum amount of fluid given to a trauma patient should be no more than_____.
     A) 500 ml’s
     B) 1000 ml’s
     C) 2000 ml’s
     D) 3000 ml’s

Answer 135

Ans: D

Question 136

136. Which of the following personnel are ultimately responsible for the scene of a multiple casualty incident?
     A) Incident commander
     B) Triage officer
     C) Operations Chief
     D) Staging officer

Answer 136

Ans: A

Question 137

137. Which of the following can not penetrate paper and is dangerous if ingested?
     A) Alpha rays
     B) Beta rays
     C) Gamma rays
     D) Radio Isotopes

Answer 137

Ans: A

Question 138

138. Scenario: Your patient is a 23 y/o patient that was involved in a shallow water diving accident. He presents with shallow respirations at a rate of 4 times per minute and a heart rate of 84. His lung sounds are clear and his SAO2 is 84 percent. Patient tells you he is having a really hard time breathing and can not feel his arms or legs. Pt. has no movement from the shoulders down. What location do you suspect the spinal injury has occured?
     A) C-1
     B) C-3
     C) C-7
     D) T-1

Answer 138

Ans: B

Question 139

139. The ligament that suspends the liver and can cause massive bleeding in trauma known as the:
     A) Ligimentum arteriosum
     B) Ligimentum venosum
     C) Ligimentum teres
     D) Ligimentum liverosum

Answer 139

Ans: C

Question 140

140. In any hazmat incident, your vehicle and crew should always be ___________ from the incident.
     A) Uphill, Upwind
     B) Uphill, Downwind
     C) Downhill, Upwind
     D) Downhill, Downwind

Answer 140

Ans: A

Question 141

146. The best way to prevent infection is:
     A) Proper BSI while dealing with patients
     B) Taking antibiotics prophylatically
     C) One baby asprin a day
     D) Handwashing

Answer 141

Ans: D

Question 142

147. Surfactant is:
     A) A lubricating substance that increases alveolar surface tension during breathing
     B) Produced by the mucous cells of the left and right mainstem bronchi
     C) A proteinaceous substance that decreases surface tension on the alveolar walls
     D) Quickly destroyed in patients who have a severe upper airway obstruction

Answer 142

Ans: C

Question 143

148. Laryngeal spasm and edema would MOST likely result from:
     A) Croup
     B) Inhalation injury
     C) Viral pharyngitis
     D) A mild asthma attack

Answer 143

Ans: B

Question 144

149. The nasal cannula is of MOST benefit of patients:
     A) Who require high oxygen concentrations
     B) With an exacerbation of emphesema
     C) With mild hypoxemia and claustrophobia
     D) Who are hypoxic and are mouth breathers

Answer 144

Ans: C

Question 145

150. Murphy’s eye, an opening on the distal side of ET tube allows ventilation to occur:
     A) Whether the tube is in the trachea or in the esophagus
     B) Even if the tip of the tube is occluded by blood or mucus
     C) If the tube is inserted into the right mainstem bronchus
     D) Even if the ET tube does not enter the patient’s trachea fully

Answer 145

Ans: B