Medical Practice Exam

Question 1

A 50-year-old man with diabetes has an altered mental status and is unable to tell you when he last ate or took his insulin. Your glucometer keeps malfunctioning and you are unable to determine his blood glucose level. Which of the following clinical signs would MOST likely lead you to the correct diagnosis?
Select one:
A. Restlessness and irritability
B. Hypotension and tachycardia
C. Deep and rapid breathing
D. Rapid and weak pulse

Answer 1

C. Deep and rapid breathing

Question 2

A 58-year-old man complains of chest discomfort and nausea. He is conscious and alert his blood pressure is 140/90 mm Hg, his pulse is 104 beats/min, and his respirations are 16 breaths/min. Your partner has applied supplemental oxygen. Prior to assisting the patient with one of his prescribed nitroglycerin tablets, you ask him if he takes medication to treat erectile dysfunction (ED) and he tells you that he does. You should:
Select one:
A. avoid giving him nitroglycerin and transport him at once.
B. recall that erectile ED drugs can cause significant hypertension.
C. ask him what he takes, how much, and when he last took it.
D. administer his nitroglycerin and then reassess his blood pressure.

Answer 2

C. ask him what he takes, how much, and when he last took it

Question 3

A 60-year-old man complains of chest pain. He is conscious and alert and denies shortness of breath. Which of the following questions would be the MOST appropriate to ask him?
Select one:
A. “Were you exerting yourself when the chest pain began?”
B. “Does the pain in your chest move to either of your arms?”
C. “Does the pain in your chest feel like a stabbing sensation?”
D. “Do you have any heart problems or take any medications?

Answer 3

D. Do you have any heart problems or take any medications?

Question 4

A 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 100/64 mm Hg. Her skin is hot and moist. You should be MOST suspicious that she is experiencing:
Select one:
A. pump failure.
B. a local infection.
C. decompensated shock.
D. septic shock.

Answer 4

D. septic shock

Question 5

A 71-year-old male is semiconscious following a sudden, severe headache. There is vomitus on his face and his respirations are slow and shallow. The EMT must immediately:
Select one:
A. apply oxygen via a nonrebreathing mask.
B. insert a nasopharyngeal airway.
C. perform oropharyngeal suctioning.
D. begin assisting the patient’s ventilations.

Answer 5

C. perform oropharyngeal suctioning

Question 6

A 73-year-old man presents with a generalized rash, which he thinks may have been caused by an antibiotic that he recently began taking. He has a history of coronary artery disease, hypertension, and emphysema. He is conscious and alert, his blood pressure is 144/94 mm Hg, and his pulse is 64 beats/min and regular. You auscultate his breath sounds and hear scattered wheezing, although he is not experiencing respiratory distress. You should:
Select one:
A. avoid the use of epinephrine because of his cardiac history, even if his symptoms become severe.
B. ask him if he has epinephrine and request approval from medical control to administer it to the patient.
C. begin transport and request to administer epinephrine if his systolic blood pressure falls below 110 mm Hg.
D. administer oxygen if needed, transport the patient, and monitor him for signs of deterioration.

Answer 6

D. administer oxygen if needed, transport the patient, and monitor him for signs of deterioration

Question 7

Abdominal thrusts in a conscious child or adult with a severe upper airway obstruction are performed:
Select one:
A. in sets of five followed by reassessment.
B. until he or she experiences cardiac arrest.
C. about 1 inch below the xiphoid process.
D. until he or she loses consciousness.

Answer 7

D. until he or she loses consciousness

Question 8

An absence seizure is also referred to as a:
Select one:
A. petit mal seizure.
B. grand mal seizure.
C. generalized motor seizure.
D. total body seizure.

Answer 8

A. petit mal seizure

Question 9

The left ventricle has the thickest walls because it:
Select one:
A. uses less oxygen than other chambers of the heart.
B. receives blood directly from the systemic circulation.
C. pumps blood into the aorta and systemic circulation.
D. pumps blood to the lungs to be reoxygenated.

Answer 9

C. pumps blood into the aorta and systemic circulation

Question 10

What is the alveolar minute volume of a patient with a tidal volume of 500 mL, a dead space volume of 150 mL, and a respiratory rate of 16 breaths/min?
Select one:
A. 5,600 mL
B. 8,000 mL
C. 6,000 mL
D. 7,400 mL

Answer 10

A. 5,600 mL

Question 11

When assessing an 80-year-old patient in shock, it is important to remember that:
Select one:
A. in older adults, it is especially common to observe a significant decrease in heart rate in response to shock.
B. it is common to see a more significant increase in heart rate than what would be expected in younger adults.
C. the patient’s cardiac output is able to increase by nearly 200% in response to the decrease in perfusion.
D. age-related changes in the cardiovascular system may make the patient less able to compensate for decreased perfusion.

Answer 11

D. age-related changes in the cardiovascular system may make the patient less able to compensate for decreased perfusion

Question 12

When assessing for fluid collection in the lungs during auscultation of lung sounds, you should:
Select one:
A. note the presence of a high-pitched whistling sound, which is an indicator of fluid in the lungs.
B. start at the lower lung fields and determine at which level you start hearing clear breath sounds.
C. auscultate the posterior chest first and compare the apex of one lung to the base of the opposite lung.
D. pay special attention to the exhalation phase because this is when you will likely hear rales or rhonchi

Answer 12

B. start at the lower lung fields and determine at which level you start hearing clear breath sounds

Question 13

When gathering a patient's medications, you find the following: Isordil, Lasix, Nexium, and digoxin. Which of these medications can be obtained over-the-counter (OTC)?
Select one:
A. Digoxin
B. Lasix
C. Isordil
D. Nexium

Answer 13

D. Nexium

Question 14

Which of the following clinical signs is unique to anaphylactic shock?
Select one:
A. Dizziness
B. Hypotension
C. Wheezing
D. Pallor

Answer 14

C. Wheezing

Question 15

Which of the following medication routes has the slowest rate of absorption?
Select one:
A. Rectal
B. Oral
C. Sublingual
D. Inhalation

Answer 15

B. Oral

Question 16

Which of the following statements regarding gastrointestinal bleeding is correct?
Select one:
A. Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself.
B. In the majority of cases, bleeding within the gastrointestinal tract occurs acutely and is severe.
C. Lower gastrointestinal bleeding results from conditions such as Mallory-Weiss syndrome.
D. Chronic bleeding within the gastrointestinal tract is usually more severe than bleeding that occurs acutely.

Answer 16

A. Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself

Question 17

Which of the following statements regarding hepatitis A is correct?
Select one:
A. Although there is no vaccine against hepatitis A, treatment is usually successful.
B. Hepatitis A is primarily transmitted via contact with blood or other body fluids.
C. Hepatitis A can only be transmitted by a patient who has an acute infection.
D. Infection with hepatitis A causes chronic illness with a high mortality rate.

Answer 17

C. Hepatitis A can only be transmitted by a patient who has an acute infection

Question 18

Which of the following statements regarding smooth muscle is correct?
Select one:
A. Smooth muscle is under control of the voluntary nervous system.
B. A person has no voluntary control over smooth muscle.
C. Smooth muscle is found exclusively within blood vessels.
D. The biceps and quadriceps are examples of smooth muscle

Answer 18

B. A person has no voluntary control over smooth muscle

Question 19

Which of the following statements regarding ventricular fibrillation (V-fib) is correct?
Select one:
A. V-fib is a state of rapid ventricular contraction.
B. Defibrillation is only indicated for witnessed V-fib.
C. V-fib results in an absence of forward blood flow.
D. Most patients in V-fib have a weak carotid pulse.

Answer 19

C. V-fib results in an absence of forward blood flow

Question 20

You are assessing a 49-year-old man who, according to his wife, experienced a sudden, severe headache and then passed out. He is unresponsive and has slow, irregular breathing. His blood pressure is 190/94 mm Hg and his pulse rate is 50 beats/min. His wife tells you that he has hypertension and diabetes. He has MOST likely experienced:
Select one:
A. a ruptured cerebral artery.
B. a complex partial seizure.
C. acute hypoglycemia.
D. an occluded cerebral artery.

Answer 20

A. a ruptured cerebral artery

Question 21

You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. You should suspect:
Select one:
A. acute pulmonary embolism.
B. acute pulmonary edema.
C. spontaneous pneumothorax.
D. right-sided heart failure.

Answer 21

A. acute pulmonary embolism

Question 22

You are dispatched to a residence where a middle-aged man was found unconscious in his front yard. There are no witnesses who can tell you what happened. You find him in a prone position his eyes are closed and he is not moving. Your FIRST action should be to:
Select one:
A. open his airway with a jaw-thrust maneuver.
B. log roll him as a unit to a supine position.
C. palpate for the presence of a carotid pulse.
D. assess the rate and quality of his breathing.

Answer 22

B. log roll him as a unit to a supine position

Question 23

The process of exchanging oxygen and carbon dioxide between the alveoli and the blood of the capillaries is called:
Select one:
A. alveolar ventilation.
B. pulmonary ventilation.
C. cellular metabolism.
D. external respiration

Answer 23

D. external respiration

Question 24

To select the proper size oropharyngeal airway, you should measure from the:
Select one:
A. angle of the jaw to the center of the mouth.
B. corner of the mouth to the earlobe.
C. center of the mouth to the posterior ear.
D. corner of the mouth to the superior ear.

Answer 24

B. corner of the mouth to the earlobe

Question 25

While providing CPAP to a patient in severe respiratory distress, you note that his heart rate has increased by 20 beats/min. He is conscious, but is no longer following verbal commands. You should: Select one: A. remove the CPAP device and ventilate him with a bag-valve mask. B. increase the amount of pressure that the CPAP device is delivering. C. remove the CPAP device and apply oxygen by nonrebreathing mask. D. decrease the amount of pressure that the CPAP device is delivering.

Answer 25

A. remove the CPAP device and ventilate him with a bag-valve mask

Question 26

You are ventilating a 40-year-old uninjured man who is apneic but has a pulse. When your partner reassesses his blood pressure, she notes that it has decreased significantly from previous readings. You should: Select one: A. perform a head-to-toe assessment to look for signs of bleeding. B. increase the rate at which you are ventilating and reassess his blood pressure. C. increase the volume of your ventilations and reassess his blood pressure. D. reduce the rate or volume of the ventilations you are delivering.

Answer 26

D. reduce the rate or volume of the ventilations you are delivering

Question 27

You are ventilating an apneic woman with a bag-valve mask. She has dentures, which are tight fitting. Adequate chest rise is present with each ventilation, and the patient's oxygen saturation reads 96%. When you reassess the patency of her airway, you note that her dentures are now loose, although your ventilations are still producing adequate chest rise. You should: Select one: A. remove her dentures at once and increase the rate and volume of your ventilations. B. leave her dentures in place, but carefully monitor her for an airway obstruction. C. remove her dentures, resume ventilations, and assess for adequate chest rise. D. attempt to replace her dentures so that they fit tightly and resume ventilations.

Answer 27

C. remove her dentures, resume ventilations, and assess for adequate chest rise

Question 28

Neurogenic shock occurs when: Select one: A. failure of the nervous system causes widespread vasodilation. B. massive vasoconstriction occurs distal to a spinal cord injury. C. there is too much blood to fill a smaller vascular container. D. the spinal cord is severed and causes massive hemorrhaging

Answer 28

A. failure of the nervous system causes widespread vasodilation

Question 29

``` You are transporting a 33-year-old male who was involved in a major motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should: Select one: A. repeat your secondary assessment. B. take his vital signs in 15 minutes. C. arrange for an ALS rendezvous. D. reassess his condition in 5 minutes. ```

Answer 29

D. reassess his condition in 5 minutes

Question 30

A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should: Select one: A. have her breathe into a paper or plastic bag. B. request a paramedic to give her a sedative. C. position her on her left side and transport at once. D. provide reassurance and give oxygen as needed.

Answer 30

D. provide reassurance and give oxygen as needed

Question 31

A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and with an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should: Select one: A. apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration. B. place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing. C. force fluid from his alveoli by hyperventilating him with a bag-valve mask at a rate of at least 20 breaths/min. D. place him in a supine position and assist his ventilations with a bag-valve mask and high-flow oxygen.

Answer 31

A. apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration

Question 32

Dyspnea is MOST accurately defined as: Select one: A. a marked increase in the exhalation phase. B. shortness of breath or difficulty breathing. C. a complete cessation of respiratory effort. D. labored breathing with reduced tidal volume.

Answer 32

B. shortness of breath or difficulty breathing

Question 33

You are dispatched to an apartment complex where a 21-year-old female has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should: Select one: A. insert an oropharyngeal airway and perform oral suctioning. B. insert a nasopharyngeal airway and begin assisted ventilation. C. apply oxygen via a nonrebreathing mask and transport at once. D. place her in the recovery position and monitor for vomiting.

Answer 33

B. insert a nasopharyngeal airway and begin assisted ventilation

Question 34

A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an automatic implanted cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do? Select one: A. Continue CPR and transport the patient to the closest appropriate hospital. B. Deliver the shock followed by immediate resumption of CPR. C. Avoid defibrillation as this will damage the patient's AICD. D. Contact medical control and request permission to defibrillate.

Answer 34

B. Deliver the shock followed by immediate resumption of CPR

Question 35

Acute coronary syndrome (ACS) is a term used to describe: Select one: A. a group of symptoms that are caused by myocardial ischemia. B. a severe decrease in perfusion caused by changes in heart rate. C. the warning signs that occur shortly before a heart attack. D. the exact moment that a coronary artery is completely occluded.

Answer 35

A. a group of symptoms that are caused by myocardial ischemia

Question 36

Cardiogenic shock following AMI is caused by: Select one: A. hypovolemia secondary to severe vomiting. B. widespread dilation of the systemic vasculature. C. a profound increase in the patient's heart rate. D. decreased pumping force of the heart muscle.

Answer 36

D. decreased pumping force of the heart muscle

Question 37

``` Common side effects of nitroglycerin include all of the following, EXCEPT: Select one: A. hypertension. B. severe headache. C. hypotension. D. bradycardia. ```

Answer 37

A. hypertension

Question 38

``` Common signs and symptoms of AMI include all of the following, EXCEPT: Select one: A. pain exacerbated by breathing. B. shortness of breath or dyspnea. C. irregular heartbeat. D. sudden unexplained sweating. ```

Answer 38

A. pain exacerbated by breathing

Question 39

You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. After applying high-flow oxygen, you expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should: Select one: A. ask him if the nitroglycerin patch he is wearing has improved his chest pressure, complete your secondary assessment, and transport promptly. B. immediately remove the nitroglycerin patch, apply the AED in case he develops cardiac arrest, and transport to the closest hospital. C. move the nitroglycerin patch to the other side of his chest in case you need to apply the AED, keep him warm, and transport without delay. D. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport.

Answer 39

D. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport

Question 40

You are dispatched to a convenience store for a patient who passed out. Upon arriving at the scene, you find two off-duty EMTs performing CPR on the patient, a 58-year-old male. Your initial action should be to: Select one: A. quickly attach the AED and push the analyze button. B. request a paramedic unit and quickly attach the AED. C. feel for a pulse while compressions are ongoing. D. have the EMTs stop CPR and assess for a pulse.

Answer 40

C. feel for a pulse while compressions are ongoing

Question 41

``` You are dispatched to a residence for a 56-year-old male with an altered mental status. Upon arrival at the scene, the patient's wife tells you that he complained of chest pain the day before, but would not allow her to call EMS. The patient is semiconscious has rapid, shallow respirations and has a thready pulse. You should: Select one: A. apply a nonrebreathing mask. B. begin ventilatory assistance. C. attach the AED immediately. D. obtain baseline vital signs. ```

Answer 41

B. begin ventilatory assistance

Question 42

Kussmaul respirations are an indication that the body is: Select one: A. compensating for decreased blood glucose levels. B. attempting to eliminate acids from the blood. C. severely hypoxic and is eliminating excess CO2. D. trying to generate energy by breathing deeply.

Answer 42

B. attempting to eliminate acids from the blood

Question 43

To which of the following diabetic patients should you administer oral glucose? Select one: A. An unconscious 33-year-old male with cool, clammy skin B. A semiconscious 40-year-old female without a gag reflex C. A conscious 37-year-old female with nausea and vomiting D. A confused 55-year-old male with tachycardia and pallor

Answer 43

D. A confused 55-year-old male with tachycardia and pallor

Question 44

When assessing an unresponsive diabetic patient, the primary visible difference between hyperglycemia and hypoglycemia is the: Select one: A. rate of the patient's pulse. B. patient's mental status. C. rate and depth of breathing. D. presence of a medical identification tag.

Answer 44

C. rate and depth of breathing

Question 45

``` If a woman with vaginal bleeding reports syncope, the EMT should assume that she: Select one: A. is in shock. B. is pregnant. C. has an infection. D. has an ectopic pregnancy. ```

Answer 45

A. is in shock

Question 46

When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she: Select one: A. has formed a general impression of the patient. B. has obtained a complete set of vital signs. C. ascertains if the patient was ever pregnant. D. has gathered patient history information.

Answer 46

D. has gathered patient history information

Question 47

Whenever possible, a female sexual assault victim should be: Select one: A. encouraged to take a shower and change her clothes. B. asked to provide a brief description of the perpetrator. C. thoroughly assessed, even if no signs of injury exist. D. given the option of being treated by a female EMT.

Answer 47

D. given the option of being treated by a female EMT

Question 48

``` A young male is unresponsive after overdosing on an opioid. He is not breathing and his pulse is weak. The EMT should immediately: Select one: A. request an ALS ambulance. B. begin chest compressions. C. administer naloxone. D. ventilate with a BVM. ```

Answer 48

D. ventilate with a BVM

Question 49

``` If gastric distention begins to make positive-pressure ventilation difficult, you should: Select one: A. insert an oropharyngeal airway. B. suction the patient's oropharynx. C. reposition the patient's airway. D. increase the rate of ventilation ```

Answer 49

C. reposition the patient's airway

Question 50

The MOST appropriate treatment for a patient with a mild upper airway obstruction includes: Select one: A. performing five back blows and five abdominal thrusts. B. visualizing the airway and removing the obstruction. C. advising the patient not to make any attempts to cough. D. administering oxygen and transporting immediately.

Answer 50

D. administering oxygen and transporting immediately