1. What is the effect of oral glucose?
A. Lowers blood sugar
B. Raises blood sugar
C. Stimulates gluconeogenesis
D. Increases the rate of digestion
2. A 14 year old male is hot, dry and complaining of nausea and vomiting after mowing the lawn. What should you suspect?
A. Hypothermia
B. Heat exhaustion
C. Heat stroke
D. Hyperemesis
3. What occurs during compression of the inferior vena cava?
A. Preeclampsia
B. Supine hypotensive syndrome
C. Pregnancy induced hypertension
D. Eclampsia
4. An unresponsive 32 year old female was pulled from a frozen lake after 3 minutes of submersion. Vital signs are BP 90/70, P 24, R 8. Why is it important to handle her gently while transporting?
A. Any lung damage due to submersion is greatly reduced.
B. She could go into shock.
C. It prevents her from losing any limbs.
D. She could convert into V-Fib or V-Tach rhythm.
5. A 56 year old male complains of chest pain after shoveling the driveway.
He states that his pain was a 9/10, but it is now a 5/10 after rest and taking
2 of his nitroglycerin. Vital signs are BP 100/66, P 87, R 16. What should you do?
A. Apply high-flow oxygen.
B. Apply pulse oximetry.
C. Obtain a second set of vital signs.
D. Administer aspirin.
6. A 71 year old female is short of breath and has lower leg pain. She took 2 doses of her prescribed nitroglycerine and 324 mg aspirin 10 minutes ago. Vital signs are BP 160/90, P 88, R 24, SpO2 88%. What should you do?
A. Administer a third dose of nitroglycerin.
B. Apply oxygen by non-rebreather mask.
C. Administer an additional dose of aspirin.
D. Obtain a second set of vital signs.
7. A 66 year old female has shortness of breath and diffuse back pain. Auscultation of lungs reveal crackles in the bases. Vital signs are BP 170/110 and P 112. What should you do administer?
A. Adenosine
B. Furosemide
C. Albuterol
D. Nitroglycerin
Scenario:
8. An unresponsive 2 day old female is in respiratory distress. Her skin is cyanotic and vital signs are P 184, R 72. What should you do?
A. Assist her ventilations.
B. Administer albuterol.
C. Apply blow-by oxygen.
D. Asses for a blood pressure.
9. A 22 year old male complains of shortness of breath with diminished lung sounds on the right side. Vital signs are BP 130/90, P 86, R 24. What should you suspect?
A. Asthma attack
B. Pneumothorax
C. Tension pneumothorax
D. Exacerbation of COPD
10. An 66 year old female had a syncopal episode while attempting to stand up. She describes a history of COPD, CHF, and gout. Vital signs are BP 96/40, P 56, R 18. What should you suspect?
A. Rapid increase of insulin.
B. Increase in oxygen levels.
C. Decrease in cerebral blood flow.
D. Hypoglycemic event.
11. What is the best protection from contracting a communicable disease from a patient?
A. Frequent hand washing.
B. Changing clothes after run.
C. Wearing goggles during run.
D. Putting on a mask.
12. An anxious 55 year old male is severely short of breath and is coughing up pink frothy sputum. He is sitting upright and tells you that his “feet are more swollen than normal.” Vital signs are BP 202/112, P 110, R 36 with crackles. What should you do?
A. Obtain a detailed medical history.
B. Position him supine and apply high-flow oxygen.
C. Administer aspirin.
D. Assist his ventilations with a BVM.
13. A 34 year old male complains that people are “out to hurt me.” He thinks you are attempting to kill him with poison gas while applying a non-rebreather mask. What should you do?
A. Position the mask for blow-by oxygen.
B. Forcefully restrain him then apply the mask.
C. Switch to a nasal cannula.
D. Explain the benefits of oxygen.
14. What condition is caused by twisting of the spermatic cord, resulting in a sudden onset of severe scrotal pain?
A. Epididymitis
B. Urinary calculi
C. Priapism
D. Testicular torsion
15. How should you treat asystole in a patient?
A. Shock with an AED.
B. Provide positive pressure ventilation.
C. Provide chest compressions.
D. Administer high-flow oxygen.
16. A 45 year old female had a return of spontaneous circulatoin (ROSC) after
10 minutes in cardiac arrest. She is unresponsive. Vital signs are BP 96/40, P 88, R 18, SpO2 74%. What should you do?
A. Assist her ventilations with a BVM.
B. Continue to use the AED to analyze her pulse.
C. Position her in a recovery position and apply high-flow oxygen.
D. Provide low-flow oxygen by non-rebreather mask.
17. A 16 year old boy tells you that he “caught” his 40 year old mother “holding a handful of sleeping pills.” The son explains that she is depressed, and he is convinced that she meant to kill herself. She is extremely agitated and is refusing treatment. What should you do?
A. Carefully document the woman’s refusal and have her sign the form.
B. Request law enforcement assistance to transport the patient.
C. Contact social services to recommend they follow up on this family.
D. Encourage the patient to see a mental health professional that day.
18. A 76 year old female complains of chest pain on the right side directly above her 4th intercostal space. She states that she had a “hip replaced” a couple of weeks ago and that she is recovering well. What should you suspect?
A. Pulmonary embolism
B. Acute coronary syndrome
C. Pnemothorax
D. Myocardial infarction
19. A 22 year old intoxicated male responds to voice by moaning. You note vomit in his airway, what should you do?
A. Insert a nasal airway.
B. Suction the mouth.
C. Manually stabilize c-spine.
D. Turn the patient on his side.
20. What is the movement of drugs in the body as they are absorbed, distributed, metabolized, and excreted called?
A. Pharmacodynamics
B. Pharmacokinetics
C. Biotransformation
D. The mechanism of action
Scenario:
21. A 32 year old female attempted to commit suicide by taking sleeping pills and cutting her wrists. She has dark red blood oozing from the wrist lacerations. Vital signs are BP 90/52, P 130 and weak, R 18. What type of bleeding and shock is she experiencing?
A. Venous bleeding with hypovolemic shock.
B. Arterial bleeding with hypovolemic shock.
C. Capillary bleeding with cardiogenic shock.
D. Venous bleeding with neurogenic shock.
22. What is a sign of an upper GI bleed?
A. Dark black emesis
B. Dry warm skin
C. High blood pressure and dizziness
D. Pain in the right shoulder
23. A 40 year old male was stung by a bee. His skin is pink and dry, his lung sounds are clear and he has equal chest rise. Vitals are BP 122/82, P 78, R 18, SpO2 98%. What should you do?
A. Administer high-flow oxygen by non-rebreather mask.
B. Assist with the administration of his EpiPen.
C. Contact poison control.
D. Perform a secondary assessment.
24. A 2 year old male is conscious after ingesting a small quantity of bleach. What should you suspect?
A. Hot, dry skin and diarrhea
B. Chemical burns around the mouth
C. Dilated pupils and labored breathing
D. Bright, red skin on child’s extremities
25. A 25 year old female is stung by a bee. She complains of shortness of breath, hives and has audible wheezes. What should you do?
A. Assist in the use of her metered dose inhaler.
B. Obtain an oxygen saturation reading.
C. Have family members confirm her bee allergy.
D. Remove the stinger using a credit card.
26. What signs and symptoms should make you suspect a heroin overdose?
A. Pinpoint pupils, coma, and respiratory depression
B. Hypertension, tachycardia, and urinary retention
C. Lacrimation, bradycardia, and hyperactivity
D. Dilated pupils, coma, and hyperpnea
27. What can rough handling of a patient with severe hypothermia cause?
A. Increased shivering
B. Decreased respirations
C. Ventricular fibrillation
D. Ventricular tachycardia
28. A 23 year old male complains of neck stiffness and flu symptoms for the past few days. He also describes a high fever with a severe headache, dizziness and blurred vision. What should you suspect?
A. Influenza
B. Meningitis
C. Migraine
D. Hemorrhagic stroke
29. A 27 year old pregnant female is complaining of extreme bouts of thirst, nausea and urination. What should you suspect?
A. Urinary tract infection
B. Pre-eclampsia
C. Early stage kidney failure
D. Gestational diabetes
30. A 34 year old female complains of an open sore on her leg that will not go away. She says that she cut her leg while shaving in the shower at her local gym 2 weeks ago. Her doctor prescribed antibiotics, but nothing has changed. What should you suspect?
A. Boils
B. MRSA
C. Varicose vein
D. Necrotizing fasciitis
31. What risk factor may cause the development of an esophageal varice?
A. Cirrhosis
B. Gastritis
C. Forceful vomiting
D. Anticoagulation therapy
32. What abdominal complaint is MOST concerning?
A. A sudden, tearing pain.
B. A dull, gradual-onset pain.
C. Pain that is relieved by rocking or movement.
D. Pain that increase with eating.
33. What medical term describes wheals on the skin during an allergic reaction?
A. Angioedema
B. Myxedema
C. Urticaria
D. Pruritus
34. What gland joins the nervous system with the endocrine system?
A. Hypothalamus
B. Thymus
C. Pituitary
D. Pineal
35. You assisted a 46 year old female with her prescribed nitroglycerin. She is now light-headed and feels dizzy. What should you do?
A. Contact medical control.
B. Check her blood sugar.
C. Perform a stroke assessment scale.
D. Position her supine.
36. A 20 year old male complains of nausea and headache after working on his car in the garage. Vital signs are BP 130/90, P 76, R 16. What should you suspect?
A. CO poisoning
B. Cholinergic poisoning
C. Migraine
D. Brain aneurysm
37. Lifeguards have rescued an unconscious 42 year old near-drowning victim from the water. What should be your most important treatment for this patient?
A. Establish and maintain C-spine immobilization.
B. Immediately transport to the local hospital.
C. Perform a rapid primary survey.
D. Acquire information about what happened.
38. A 26 year old male has Kussmaul’s respirations. He has a diabetic alert bracelet. What should you suspect?
A. Diabetic ketoacidosis (DKA)
B. Hyperglycemic hyperosmolar nonketotic coma (HHNC)
C. Hypoglycemia
D. Insulin shock
39. A 46 year old male complains of difficulty breathing and a productive cough. He states that his cough began about 2 weeks ago. Lung sounds reveal coarse rhonchi in all fields. His skin color is ashen and he is diaphoretic. What should you do?
A. Don an N95 mask.
B. Obtain baseline vitals.
C. Apply oxygen by non-rebreather mask.
D. Assist with administration of his albuterol inhaler.
40. Possible splenic injury or ectopic pregnancy can have referred left shoulder pain called?
A. Kehr’s
B. Turner’s
C. Kernig’s
D. Hammain’s
41. Which of the following is NOT part of the Cincinnati Stroke Test?
A. Facial droop
B. Ability to walk
C. Slurred speech
D. Arm drift
Scenario:
42. A 32 year old male is presents with difficulty breathing. He has bilateral inspiratory and expiratory wheezing. Vital signs are BP 120/80, P 89, R 32, SpO2 93%. What should you suspect?
A. Emphysema
B. Asthma
C. Chronic bronchitis
D. Congestive heart failure
43. A 22 year old male working at a factory has recently inhaled a poison. After ensuring scene safety, what should you do?
A. Obtain a set of vital signs.
B. Move the patient to an area outside.
C. Administer high-flow oxygen.
D. Insert and oral airway.
44. A 19 year old male hides in his closet and thinks that aliens are coming to abduct him. What should you do?
A. Tell him that aliens don’t exist.
B. Acknowledge his fears as real.
C. Say you saw the aliens leave.
D. Tell him he should not be afraid.
45. A 47 year old male has a ROSC after 10 min of CPR, but remains unconscious. How should you transport him?
A. Prone with feet elevated 15 degrees
B. Left-lateral recumbent
C. Trendelendberg position
D. Semi-fowlers at 30 degrees
46. What can unequal pupils indicate?
A. Head injury
B. Heat emergency
C. Poisioning
D. Severe hypoxia
47. A 20 year old male has been exposed to cold temperatures for an unknown period of time. Where should you assess his skin temperature?
A. Abdomen
B. Armpit
C. Chest
D. Leg
48. How is nitroglycerin spray administered?
A. Topically.
B. Ingestion.
C. Injection.
D. Sublingually.
49. A 58 year old unconscious male has a return of spontaneous circulation (ROSC) after 10 minutes of CPR and 3 shocks from an AED. Vital signs are BP 90/60, P 54, R 4. What should you do?
A. Assist his ventilations with a BVM.
B. Remove the oral airway.
C. Continue CPR.
D. Discontinue interventions.
50. A 51 year old male with a history of COPD is having difficulty breathing. Vital signs are BP 136/74, R 22, P 100, SpO2 95%. What should you do?
A. Withhold oxygen to avoid decreasing the hypoxic drive.
B. Administer oxygen by nonrebreather mask.
C. Apply high-flow oxygen by bag-valve mask.
D. Apply low-flow oxygen by nasal cannula.
51. A 21 year old female was lost in the woods for several hours. The ambient temperature is 25 degrees Fahrenheit. She is lethargic and confused. The skin on her hands is waxy and white. What should you do?
A. Apply heat packs on her neck, armpits, and groin.
B. Place several heat packs on her legs and arms.
C. Gently wrap the patient in several dry blankets.
D. Vigorously rub the patient’s extremities.
52. What is the most common communicable disease contracted by blood-borne pathogen exposure?
A. AIDS
B. Hepatitis A
C. HIV
D. Hepatitis B
53. A 22 year old female was recently involved in a sexual assault. She wants to take a shower, what should you do?
A. Ask her to wait until she gets admitted to the hospital.
B. Allow her to do so after she places her clothing in an evidence bag.
C. Perform a thorough pelvic exam before letting her shower.
D. Advise her to speak to a police officer before showering.
54. An 80 year old male is confused and in his apartment on a hot summer day. Vital signs are BP 80/P, P 132 and regular, R 40 and shallow, skin is hot and dry. What should you suspect?
A. Hypoglycemia
B. Dementia
C. Heat exhaustion
D. Heatstroke
55. What is a contraindication for the administration of nitroglycerin?
A. Pain that radiates down the left arm
B. Recent use of erectile dysfunction medication
C. Blood pressure greater than 100 systolic
D. Diastolic blood pressure less than 90
56. A 12 year old is complaining of an “itchy throat” and stomach cramping after sharing a sandwich at school. What should you suspect?
A. Anaphlyaxis
B. Food poisoning
C. Allergic reaction
D. Foreign body airway obstruction
57. What cardiac dysrhythmia will an AED defribrillate?
A. Pulseless electrical activity
B. Ventricular tachycardia
C. Bradycardia
D. Asystole
58. What are the names of the four valves in the heart?
A. Left Atrial, Right Atrial, Septal, Ventricular
B. Ventral, Caudal, Transverse, Lateral
C. Mitral, Tricuspid, Pulmonic, Aortic
D. Mitre, Trigeminal, Pulmonary, Aorta
59. A 67 year old female is undergoing dialysis treatment for renal failure. Which of her organs is compromised?
A. Liver
B. Lungs
C. Kidneys
D. Pancreas
60. An unresponsive 64 year old male has a stoma. He is supine and apneic. What should you do?
A. Assist his ventilations with an adult bag-valve mask and cover the stoma.
B. Apply a cervical collar and perform a jaw thrust maneuver.
C. Place a pediatric sized BVM over the stoma and ventilate.
D. Obtain a set of vital signs and apply an AED.
61. What chemical substance, released by a gland, controls processes in other glands or body systems?
A. Hormone
B. Glucocorticoid
C. Catecholamine
D. Steroid
62. Excessive urination is known by what medical term?
A. Polyphagia
B. Polyuria
C. Polydipsia
D. Glycosuria
63. Which of the following is NOT a communicable disease?
A. HIV/AIDS
B. Cancer
C. Tuberculosis
D. Hepatitis B
64. A 23 year old female has ingested an unknown poison. She is crying uncontrollably and begging you to save her life. What should you do?
A. Contact medical direction and transport rapidly.
B. Administer activated charcoal.
C. Position patient to anticipate vomiting.
D. Obtain a second set of vital signs while preparing to transport.
65. What is the most common complaint of patients with cardiac compromise?
A. Hypertension
B. Leg pain
C. Hypotension
D. Dyspnea
66. An elderly patient has left-sided heart failure. What lung sounds should you suspect to hear?
A. Wheezing
B. Ronchi
C. Stridor
D. Crackles
67. A 84 year old female becomes unconscious while eating her breakfast. Her home-care nurse states that she was “fine one minute and then complained of a bad headache” before losing consciousness. Vital signs are 178/120, P 62, R 10 and irregular. What should you suspect?
A. Hemorrhagic stroke
B. Hypoglycemia
C. Transient ischemic attack
D. Myocardial infarction
68. What is the primary action of insulin?
A. Facilitate glucose transport into cells.
B. Add a functional group during gluconeogenesis.
C. Reduce the glucose consumption of the cells.
D. Increase blood glucose levels.
69. A 45 year old male has chest pain. What should you determine before administering a dose of nitroglycerin?
A. His blood pressure
B. A pulse oximetry reading
C. Recent use of blood thinners
D. Recent use of an inhaler
70. You have assisted with the administration of an Albuterol inhaler. The patient’s heart rate begins to increase. What should you do?
A. Obtain an additional set of vitals and transport to the hospital.
B. Administer a single dose of nitroglycerin.
C. Discontinue administration and apply low-flow oxygen.
D. Listen to lung sounds and obtain a SAMPLE history.
71. A 32 year old male has ingested an unknown quantity of gasoline in an attempt to kill himself. What should you do?
A. Administer 75 grams of activated charcoal by mouth.
B. Administer 30 mL of syrup of ipecac followed by a glass of water.
C. Apply high-flow oxygen and transport immediately.
D. Ask him if he plans on hurting others.
72. You are called to a bar for a 52 year old male who has slurred speech and difficulty sitting upright. He is unable to follow your commands and refuses to leave the bar. Which of the following should you consider LAST?
A. Stroke
B. Diabetic reaction
C. Seizure
D. Alcohol intoxication
73. A 64 year old male is unresponsive. Bystanders tell you he has been down for 10-15 minutes and resuscitation efforts have not been attempted. What should you do?
A. Assess a carotid pulse.
B. Apply and AED.
C. Ventilate him with a BVM.
D. Request ALS intercept.
74. A systolic blood pressure is less than 90. What should this indicate?
A. Hypertension
B. Hypotension
C. Tachycardia
D. Bradycardia
75. Which type of shock presents itself with respiratory distress, crackles and chest pain?
A. Hypovolemic
B. Anaphylactic
C. Cardiogenic
D. Neurogenic
76. A 87 year old female has bilateral rales. What should you suspect?
A. Pulmonary edema
B. Abdominal edema
C. Sacral edema
D. Pedal edema
77. A 24 year old female complains of a sudden onset of lower quadrant abdominal pain. She is pale and has a rapid, weak pulse. What should you ask her?
A. “How many sexual partners do you have?”
B. “Are you on birth control?”
C. “Are you sexually active?”
D. “Is there any possibility you are pregnant?”
78. What is a hazardous, odorless gas resulting from incomplete combustion?
A. Carbon dioxide
B. Nitrogen
C. Sarin
D. Carbon monoxide
79. Which statement about suicide is correct?
A. There is a high correlation between suicide and alcohol use.
B. People who talk about suicide rarely act on it.
C. All suicidal people are mentally ill.
D. The suicide rate is lowest during holiday seasons.
80. What condition presents with a fruity, acetone-like odor on the breath?
A. Diabetic ketoacidosis (DKA)
B. Hyperosmolar hyperglycemic nonketotic coma (HHNC)
C. Hypoglycemia
D. Hyperglycemia
81. A 21 year old male complains of dark colored urine. His eyes and nail beds have a yellow discoloration. He has general weakness and has upper right quadrant discomfort. What should you suspect?
A. Hepatitis
B. Pancreatitis
C. Splenic injury
D. Kidney failure
82. Which of the following is a contraindication for Nitroglycerin?
A. Renal failure.
B. Hypotension.
C. MAO Inhibitors.
D. Pulmonary hypertension.
83. A 43 year old male complains of a stiff neck, persistent cough, and fever for the past week. He states he has been in and out of homeless shelters for the past 5 months. What should you do?
A. Put on eye protection and a surgical mask.
B. Have the patient wear a HEPA mask.
C. Apply oxygen by non-rebreather mask.
D. Use gloves, gown, and HEPA mask.
84. What condition is NOT commonly associated with sickle cell anemia?
A. Musculoskeletal pain
B. Excessive bleeding
C. Abdominal pain
D. Renal disease
85. What is status epilepticus?
A. When the patient sees an aura prior to a seizure
B. A seizure affecting one area of the body
C. Two or more continuous seizures
D. A seizure that occurs during a fever
86. A 70 year old male complains of shortness of breath and has wheezing. Vitals signs are BP 126/90, P 74, R 22, SpO2 92%. What should you do?
A. Assist his ventilations with a bag-valve mask.
B. Apply oxygen by nasal cannula at 2 lpm.
C. Apply oxygen by non-rebreather mask at 15 lpm.
D. Administer albuterol
87. A 26 year old female is supine and only responding to voice with unintelligible gurgling noises. Her husband tells you she is an epileptic. She had a seizure during which he was able to gently assist her to the ground. What should you do?
A. Apply a c-collar and place her on a long backboard.
B. Load the patient on a stretcher and apply soft restraints.
C. Roll the patient onto her side and suction the airway.
D. Perform a thorough trauma assessment and patient history.
88. What type of drug abuse is characterized by the pateint “seeing” or “hearing” things that are not present?
A. Volatile chemicals
B. Downers
C. Hallucinogens
D. Uppers
89. You are transporting a 44 year old male complaining of chest pain when he becomes unconscious, pulseless, and stops breathing. What should you do?
A. Contact another unit for help.
B. Contact medical control for direction.
C. Ask your partner to go with lights and siren to the hospital.
D. Begin CPR and attach the AED.
90. What does the body use for fuel in diabetic ketoacidosis?
A. Ketones
B. Fats
C. Acids
D. Glucose
91. What statement is used to gain information about the “P” in OPQRST? What were you doing when the pain began?
A. Do you have any past history of this complaint?
B. Did the pain begin suddenly or gradually?
C. Is there anything that worsens or relieves the pain?
92. A 56 year old male has intercostal retractions and is in the tripod position. Vital signs are BP 116/78, P 90, R 32. What should you do?
A. Assist his ventilations.
B. Administer oxygen by nasal cannula.
C. Administer albuterol.
D. Apply a non-rebreather mask at 15 lpm.
93. What is the phase after a generalized seizure called?
A. Psychosis
B. Translucent
C. Aura
D. Postictal
94. An 18 month infant is pulseless and apneic. What should you do?
A. Two minutes of CPR
B. Administer 2 rescue breaths
C. Call medical control
D. Defibrillate
95. When should you obtain a blood glucose level?
A. Every patient
B. For all adults over 65
C. Patients with an altered mental status
D. When your local protocols dictate
96. A 30 year old female is having an asthma attack. She has taken several inhaler treatments without relief. Vital signs are P 160, R 40. What should you do?
A. Administer 15 lpm oxygen via non-rebreather mask.
B. Administer 6 lpm oxygen by nasal cannula.
C. Assist her ventilations with a bag valve mask.
D. Administer another dose of albuterol.
97. The ability of the heart to generate it’s own muscle contractions is known as?
A. Cardiac contractility
B. Myocardial automaticity
C. Involuntary muscle movement
D. Spontaneous muscle contraction
98. An 18 year old male presents with symptoms of hypoglycemia. What criteria must be met for him to receive oral glucose?
A. His blood glucose analysis must be between 70 and 95 mg/dL.
B. He must have a prescription for oral glucose.
C. He must be conscious, with a patent airway.
D. He must have a history of type 1 diabetes.
99. A 55 year old female is unconscious, apneic and pulseless. What should you do?
A. Determine the absence of a pulse and call ALS.
B. Apply AED and deliver three consecutive shocks.
C. Begin CPR, and apply the AED.
D. Apply AED, and follow directions.
Scenario:
100. A 42 year old female is unconscious and apneic. What should you do?
A. Assess the carotid pulse.
B. Perform a jaw thrust maneuver.
C. Insert oralpharyngeal airway.
D. Open the airway with a head-tilt.
101. How does the blood flow through the heart?
A. Left atrium to left ventricle to lungs to right atrium to right ventricle
B. Right atrium to right ventricle to lungs to left atrium to left ventricle
C. Right ventricle to right atrium to lungs to left ventricle to left atrium
D. Left ventricle to left atrium to lungs to right ventricle to right atrium
102. What should you do when the automated external defibrillator (AED) performs its rhythm analysis?
A. Perform chest compressions.
B. Administer 2 rescue breaths.
C. Remain clear of the patient.
D. Check for carotid pulse.
103. When administering nitroglycerin to a patient with angina, to which structures are you hoping to alleviate ischemia?
A. Jugular veins
B. Pulmonary veins
C. Carotid arteries
D. Coronary arteries
Scenario:
104. A 62 year old female complains of chest pain and shortness of breath. She is extremely anxious. Vital signs are BP 80/56, P 118, R 24 with crackles, SpO2 87%. What is the most likely cause?
A. Cardiogenic shock
B. Hypovolemic shock
C. Pulmonary embolus
D. Right-sided heart failure
105. A 3 year old male has inspiratory wheezes. After assisting wth his inhaler you now hear both inspiratory and expiratory wheezing. What should you do?
A. Document the respiratory improvement.
B. Assist ventilations with a bag-valve mask.
C. Call medical control to indicate deterioration.
D. Position him on his back and administer oxygen.
106. Which of the following is NOT a sign of heatstroke?
A. Flushed skin
B. Unconsciousness
C. Diaphoresis
D. Dilated pupils
107. Which of the following is NOT a definitive sign of death?
A. Rigor mortis
B. Absence of breath sounds
C. Dependent lividity
D. Putrefactation
108. What symptom would a person who overdosed on barbiturates have?
A. Rapid eye movement
B. Sluggish movements
C. Pupillary constriction
D. Anxiousness
109. A 57 year old female complains of difficulty breathing. She has jugular vein distension (JVD), pedal edema and fatigue. What chamber of the heart should you suspect is weakened?
A. Right ventricle
B. Left atrium
C. Left ventricle
D. Right atrium
110. A euphoric patient states that she can save the world while sitting on the roof of her house. What should you suspect?
A. Psychosis
B. Neurosis
C. Delusion
D. Hysteria
Scenario:
111. A 33 year old male has respirations of 22 per minute. How should you administer oxygen to him?
A. Simple rebreather mask at 4 lpm.
B. Non-rebreather mask at 15 lpm.
C. Bag-valve mask at 8 lpm.
D. Venturi mask at 8 lpm.
112. Which of the following is a common side effect of nitroglycerin?
A. Bleeding
B. Hypotension
C. Bronchospasm
D. Heartburn
113. Where are the first electrical impulses stimulating the heart located?
A. Left atrium
B. Myocardium
C. Right atrium
D. Aorta Valve
114. An apneic 79 year old female is found lying unconscious on the floor. Vital signs are P 45, R 0. What should you do?
A. Manually immobilize her c-spine.
B. Provide ventilations with a BVM.
C. Check for a medical alert bracelet or card.
D. Open the airway with a head-tilt chin-lift.
115. A 56 year old male complains of “squeezing” chest pain after doing yard work. He states the pain has subsided slightly with rest. What should you do?
A. Assess his vital signs
B. Administer oxygen
C. Assist with his prescribed nitroglycerin
D. Administer aspirin
116. Where does the electrical impulse in the heart begin?
A. AV node
B. SA node
C. Bundle of His
D. Purkinje fibers
117. After assisting your patient with the self-administration of their prescribed metered-dose inhaler medication, what should you do?
A. Wait for the patient’s condition to alleviate.
B. Discontinue high-flow oxygenation of the patient.
C. Ensure the medication belongs to the patient.
D. Gather an additional set of vital signs.
118. A 60 year old female has a history of type 2 diabetes and complains of nausea and weakness. You notice a sharp, fruity odor on her breath. What should you suspect?
A. Hypoglycemia
B. Diabetic ketoacidosis
C. Hyperglycemia
D. Hyperglycemic hyperosmolar nonketotic syndrome
119. A 59 year old female missed her weekly renal dialysis appointment. She is feeling weak and unable to care for herself. What should you suspect?
A. Fluid overload
B. Polyuria
C. Hypokalemia
D. Anemia
120. A 57 year old male complains of chest pain. He is slightly pale, but warm and dry. He has a 20 year cardiac history and is taking metoprolol. Vital signs are BP 86/64, P 84, R 22. What should you do?
A. Administer 324 mg aspirin.
B. Assist him in taking nitroglycerin.
C. Place him in the Trendelenburg position.
D. Apply oxygen by non-rebreather mask.
121. A 14 year old male is recovered from a 30F pond after falling through the ice 10 minutes ago. How should he be moved to the ambulance?
A. Gently on a backboard
B. Dragging slowly by his torso
C. Sliding him across the ice in a stokes basket
D. Fireman’s carry
122. An unrestrained 47 year old female is in cardiac arrest after car crash on the freeway. She has been pulseless for 20 minutes and CPR was withheld. What should you do?
A. Look for signs of occult bleeding.
B. Provide chest compressions for 2 minutes then apply the AED.
C. Apply the AED and start CPR simultaneously.
D. Start CPR and contact medical control to terminate efforts.
123. What is the normal rate of breathing for an adult?
A. 12 to 20 breaths per minute.
B. 22 to 26 breaths per minute.
C. 28 to 36 breaths per minute.
D. 6 to 10 breaths per minute.
124. A 19 year old male complains of sudden difficulty breathing on his right side after sneezing vigorously. He has diminished breath sounds on his right side. What should you suspect?
A. Spontaneous pneumothorax
B. Pericardial tamponade
C. Pulmonary edema
D. Traumatic asphyxia
125. Which structure contains the vocal cords?
A. Sternum
B. Pharynx
C. Trachea
D. Larynx
126. What is the normal range for blood sugar? A. 80 – 120
B. 60 – 70
C. 130 – 140
D. 200 – 300
127. A 42 year old male complain of hives and itching on his lower right leg immediately after mowing the lawn. Vital signs are BP 146/84, P 92, R 16. What should you suspect?
A. Eczema
B. Anaphylaxis
C. Allergic reaction
D. Insecticide poisoning
128. A 75 year old male describes sharp, tearing pain in his abdomen and back. Blood pressures are 114/ in his left arm 60/0 in his right arm. He is cool, pale and diaphoretic. What should you suspect?
A. Simple pneumothorax
B. Aortic dissection
C. Pulmonary embolism
D. Acute mycardial infarction
129. What treatment is NOT correct when caring for a patient with severe hypothermia?
A. Remove wet clothing.
B. Wrap in warm blankets.
C. Provide high flow oxygen.
D. Active rewarming.
130. What does a pulsating mass in the abdomen suggest?
A. Ruptured ectopic pregnancy
B. Abdominal aortic aneurysm
C. Perforated ulcer
D. Hernia
131. What are agonal respirations?
A. Shallow, rapid, and regular panting breaths.
B. Shallow, slow, and irregular gasping breaths.
C. Deep, very slow and irregular breaths.
D. Deep, rapid, and regular breaths.
132. A 45 year old male is supine and unconscious. His wife states he came in from mowing the lawn and had slurred speech, followed complaints of the “worst headache of his life.” What should you suspect?
A. Ischemic stroke
B. Pericardial tamponade
C. Hemorrhagic stroke
D. Acute myocardial infarction
133. Why is diabetic ketoacidosis (DKA) associated with a fruity smelling breath?
A. Excessive amounts of glucose molecules in their blood.
B. Salivary amylase creates an increase in glucose digestion.
C. Elevated insulin levels.
D. An increase in ketone levels.
134. An alert 45 year old female is pale and cyanotic. Her vitals are BP 180/104, P 102 and irregular, R 28 with bilateral crackles. What is the most likely cause of her shortness of breath?
A. Simple pneumothorax
B. Asthma
C. Anaphylaxis
D. Pulmonary edema
Scenario:
135. A 26 year old male is leaning over the toilet vomiting a steady stream of bright, red blood. He is a chronic alcoholic. What should you do?
A. Immobilze the patient and transport.
B. Transport in a position of comfort.
C. Position him supine and suction his airway.
D. Apply a non-rebreather mask.
136. What division of the autonomic nervous system is responsible for the “fight-or-flight” response?
A. Sympathetic
B. Central
C. Peripheral
D. Parasympathetic
137. What is homeostasis?
A. The body’s ability to maintain a temperature equal to the external temperature.
B. The relative stability and constancy of the body’s internal environment.
C. The liver’s ability to convert glycogen to glucose.
D. The control mechanism known as a negative feedback loop.
138. How many vertebrae make up the cervical spine?
A. Twelve
B. Ten
C. Seven
D. Five
139. What gland secretes chemical substances directly into the blood and is also called a ductless gland?
A. Adrenocorticotropic
B. Sebaceous
C. Endocrine
D. Exocrine
140. What are the structures that branch off from the trachea called?
A. Arterioles
B. Bronchi
C. Carina
D. Alveoli
141. A 35 year old man is pulseless and apneic. He was found in a lake after falling through the ice. His wife says he left the house 3 hours ago. What should you do?
A. Provide chest compressions.
B. Contact the medical examiner.
C. Tell the wife that her husband has died.
D. Begin active rewarming techniques.
142. A 36 year old male and his 34 year old wife complain of severe headaches, confusion, and dizziness. He also complains of chest pain. Both are short of breath. What type of poisoning should you suspect?
A. Carbon dioxide
B. Ammonia
C. Carbon monoxide
D. Organophosphate
143. At a mass gathering several hundred people suddenly began to experience severe salivation, lacrimation, urination, and vomiting. What should you do?
A. Evacuate all of the patients from the premises.
B. Contact the Department of Homeland Security.
C. Alert the Center for Disease Control.
D. Set up a command post and ensure scene safety.
144. A 26 year old male underwent a recent surgery. He has fever, altered mental status, and decreased urine output. What should you suspect?
A. Neurogenic shock
B. Anaphylactic shock
C. Septic shock
D. Hypovolemic shock
145. How many times faster does heat loss occur during water immersion as compaired to air exposure?
A. 50
B. 25
C. 2
D. 100
146. Which of the following capillary refill times is considered normal?
A. 2 seconds
B. 6 seconds
C. 3 seconds
D. 4 seconds
147. You have completed your initial assessment of a ten year old unresponsive medical patient. How should you start your focused assessment?
A. A SAMPLE history from family members.
B. A history of childhood illnesses from family members.
C. A physical exam of head and chest.
D. A rapid physical exam.
148. What condition can present with paranoia, delusions, and auditory hallucinations?
A. Schizophrenia
B. Organic brain syndrome
C. Obsessive-compulsive disorder
D. Bi-polar disorder
149. What does the “O” in the OPQRST mnemonic stand for?
A. Observe
B. Oral intake
C. Occult injury
D. Onset
150. What type of procedure does a patient with chronic renal failure undergo?
A. Peritoneal hemolysis
B. Renal dialysis
C. Renal calculi
D. Renal hemolysis
151. What environmental emergency is life-threatening?
A. Chilblains
B. Heat stroke
C. Frostbite
D. Heat exhaustion
Scenario:
152. A 45 year old male has fallen down a flight of stairs. He is unresponsive and has diminished breath sounds bilaterally with subcutaneous emphysema around the base of his neck. What should you suspect?
A. Fractured treachea
B. Pneumothorax
C. Flail chest
D. Hemothorax
153. A 65 year old male complains of circumferential burns around his hands and wrists. His homecare nurse says that he burned himself while helping cook dinner that evening. What should you suspect?
A. Psychosis
B. Dementia
C. Neglect
D. Abuse
154. An 84 year old man is in cardiac arrest in the passenger seat of a vehicle following a single car crash. The driver tells you that his passenger had complained of chest pain prior to the car crash. What should you do?
A. Contact the patient’s personal physician.
B. Treat the other patients while attempting to contact medical control.
C. Establish an incident command post.
D. Start CPR and call for additional ambulances.
155. A 6 year old male with sudden onset stridor and drooling is seated upright. His skin is hot and he is lethargic to respond. Vital signs are BP 80/54, P 140, RR 32. What should you do?
A. Insert an oral thermometer.
B. Transport supine and suction.
C. Transport in fowler’s position.
D. Insert an oropharyngeal airway.
156. What is the name of the leaf shaped valve that prevents food from entering the trachea?
A. Bronchi
B. Pharynx
C. Epiglottis
D. Larynx
157. A 21 year old male was involved in a motor vehicle collision. He has a puncture wound to the neck that is actively bleeding. What should you apply?
A. An occlusive dressing.
B. A sterile bulky dressing.
C. A gloved hand for direct pressure.
D. A c-collar with sterile dressing underneath.
158. Why do patients with cardiac compromise have chest pain?
A. The heart rate increases too rapidly.
B. Blood supply is diminished to the lung tissue.
C. There is not enough oxygen to the heart.
D. The patient is working too hard to breathe.
159. A 22 year old female complains of body aches, severe headache and blurred vision. She admits to having large amounts of alcohol the night before. What diagnosis you should consider LAST?
A. Meningitis
B. Cerebral vascular accident
C. Hangover
D. Migraine headache
160. Which of the following MOST accurately defines an allergic reaction?
A. An exaggerated immune system response to any substance.
B. A release of erythrocytes in response to a foreign substance.
C. Destruction of the immune system by an external substance.
D. A direct negative effect on the body by an external substance.
161. A patient with AIDS vomited blood during transport. How should you disinfect your ambulance?
A. Using universal precautions, spray a bleach-based cleaning solution and carefully wipe down the stretcher.
B. Place the ambulance out of service until a full OSHA cleaning can be completed.
C. Soak the mattress pad for 20 minutes in disinfectant, then let the mattress stand for 6 hours before use.
D. Replace the mattress and throw out the sheets.
162. A 17 year old female has a tick embedded in her scalp. How should you remove the tick?
A. Burn the tick with the head of a burnt match.
B. Gently pull the tick straight out.
C. Pop the tick with your fingernails, then pull it out.
D. Pull the tick out with a twisting motion.
163. After your combative patient has been placed in restraints, what should you do?
A. Perform a primary survey.
B. Contact law enforcement.
C. Check distal functions.
D. Contact medical control.
164. How often should you reassess vital signs in an unstable patient?
A. 15 minutes
B. 3 minutes
C. 10 minutes
D. 5 minutes
165. What mechanism does the body lose the majority of heat?
A. Convection
B. Evaporation
C. Radiation
D. Conduction
166. Which of the following effects of anaphylaxis will be fatal if not treated immediately?
A. Bronchoconstriction
B. Diffuse uticaria
C. Systemic vasodilation
D. Severe hypotension
167. What chamber of the heart pumps oxygenated blood to the peripheral body systems?
A. Right ventricle
B. Left atrium
C. Left ventricle
D. Right atrium
168. What term describes away from or being the farthest from a point of origin.
A. Proximal
B. Superficial
C. Distal
D. Deep