SOE Paramedic Final Exam Questions and Answers|
Updated| Pass Guaranteed
1. A patient with long-standing COPD has chronic CO2 retention.
Which acid-base disturbance is most likely?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis only
Answer: C. Respiratory acidosis
Rationale: Failure to eliminate CO2 raises the carbonic acid level and
lowers pH. Chronic retainers partially compensate through the kidneys by
retaining bicarbonate.
2. An anxious patient is hyperventilating and complains of tingling
around the mouth and carpopedal spasm. What is the likely acid-base
state?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Normal acid-base balance
Answer: B. Respiratory alkalosis
Rationale: Blowing off CO2 raises pH, which lowers ionized calcium and
causes paresthesias and muscle spasm. Rule out serious causes such as
hypoxia, PE, and DKA before assuming anxiety.
SOE Paramedic Final Exam - Page 1
,3. According to the Frank-Starling mechanism, what happens as
preload increases within physiologic limits?
A. Stroke volume increases because the stretched myocardium contracts
more forcefully
B. Stroke volume always decreases
C. Heart rate falls to zero
D. Afterload disappears
Answer: A. Stroke volume increases because the stretched
myocardium contracts more forcefully
Rationale: Greater end-diastolic stretch improves the overlap of actin and
myosin and increases the force of contraction. Beyond a limit, as in failing
hearts, the relationship breaks down.
4. Which best defines afterload?
A. The volume of blood returning to the heart
B. The number of heartbeats per minute
C. The amount of blood in the veins
D. The resistance the ventricle must overcome to eject blood
Answer: D. The resistance the ventricle must overcome to eject blood
Rationale: Afterload is largely determined by systemic vascular resistance.
Vasoconstriction raises afterload and increases the heart's workload.
5. What is the mean arterial pressure (MAP) of a patient with a blood
pressure of 120/80 mmHg?
A. About 40 mmHg
B. About 100 mmHg
C. About 93 mmHg
D. About 200 mmHg
Answer: C. About 93 mmHg
Rationale: MAP equals diastolic plus one-third of the pulse pressure, or
(SBP + 2 x DBP) / 3. Here (120 + 160) / 3 is about 93.
SOE Paramedic Final Exam - Page 2
,6. A patient has a blood pressure of 90/70 mmHg. What does the
narrow pulse pressure suggest?
A. Excellent cardiac output
B. Reduced stroke volume, as in early shock or tamponade
C. Aortic regurgitation
D. Normal physiology
Answer: B. Reduced stroke volume, as in early shock or tamponade
Rationale: Pulse pressure is the systolic minus diastolic pressure (20
mmHg here). A narrowing pulse pressure reflects reduced stroke volume
and increased vascular tone.
7. Approximately what fraction of total body water is found inside
cells?
A. About two thirds
B. About one tenth
C. About one half of the plasma volume only
D. Nearly all in the blood vessels
Answer: A. About two thirds
Rationale: Intracellular fluid makes up roughly two thirds of total body
water, and the remaining third is extracellular, divided between interstitial
fluid and plasma.
8. What happens to a red blood cell placed in a hypotonic solution?
A. It shrinks
B. It stays unchanged
C. It turns into a white blood cell
D. It swells and may burst
Answer: D. It swells and may burst
Rationale: Water moves into the cell by osmosis because the solute
concentration inside is higher than outside.
SOE Paramedic Final Exam - Page 3
, 9. What is the maximum recommended time for a pulse check during
a cardiac arrest assessment?
A. 30 seconds
B. 1 minute
C. 10 seconds
D. 2 minutes
Answer: C. 10 seconds
Rationale: A prolonged pulse check delays compressions. If a pulse is not
definitely felt within 10 seconds, begin CPR.
10. Which finding is consistent with positive orthostatic vital signs?
A. A rise in systolic pressure of 20 mmHg
B. A drop in systolic pressure of 20 mmHg or more with symptoms on
standing
C. No change in heart rate or blood pressure
D. A fall in temperature only
Answer: B. A drop in systolic pressure of 20 mmHg or more with
symptoms on standing
Rationale: Orthostatic changes suggest volume depletion or autonomic
dysfunction. A heart rate rise of about 20 or more beats per minute is also
commonly used.
Section 2: Airway Management and Ventilation
11. Which mnemonic helps predict a difficult laryngoscopy and
intubation?
A. LEMON (Look, Evaluate 3-3-2, Mallampati, Obstruction, Neck mobility)
B. SAMPLE
C. OPQRST
D. DCAP-BTLS
Answer: A. LEMON (Look, Evaluate 3-3-2, Mallampati, Obstruction,
Neck mobility)
Rationale: Identifying a difficult airway ahead of time allows preparation of
backup devices and positioning. LEMON is widely used.
SOE Paramedic Final Exam - Page 4
Updated| Pass Guaranteed
1. A patient with long-standing COPD has chronic CO2 retention.
Which acid-base disturbance is most likely?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis only
Answer: C. Respiratory acidosis
Rationale: Failure to eliminate CO2 raises the carbonic acid level and
lowers pH. Chronic retainers partially compensate through the kidneys by
retaining bicarbonate.
2. An anxious patient is hyperventilating and complains of tingling
around the mouth and carpopedal spasm. What is the likely acid-base
state?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Normal acid-base balance
Answer: B. Respiratory alkalosis
Rationale: Blowing off CO2 raises pH, which lowers ionized calcium and
causes paresthesias and muscle spasm. Rule out serious causes such as
hypoxia, PE, and DKA before assuming anxiety.
SOE Paramedic Final Exam - Page 1
,3. According to the Frank-Starling mechanism, what happens as
preload increases within physiologic limits?
A. Stroke volume increases because the stretched myocardium contracts
more forcefully
B. Stroke volume always decreases
C. Heart rate falls to zero
D. Afterload disappears
Answer: A. Stroke volume increases because the stretched
myocardium contracts more forcefully
Rationale: Greater end-diastolic stretch improves the overlap of actin and
myosin and increases the force of contraction. Beyond a limit, as in failing
hearts, the relationship breaks down.
4. Which best defines afterload?
A. The volume of blood returning to the heart
B. The number of heartbeats per minute
C. The amount of blood in the veins
D. The resistance the ventricle must overcome to eject blood
Answer: D. The resistance the ventricle must overcome to eject blood
Rationale: Afterload is largely determined by systemic vascular resistance.
Vasoconstriction raises afterload and increases the heart's workload.
5. What is the mean arterial pressure (MAP) of a patient with a blood
pressure of 120/80 mmHg?
A. About 40 mmHg
B. About 100 mmHg
C. About 93 mmHg
D. About 200 mmHg
Answer: C. About 93 mmHg
Rationale: MAP equals diastolic plus one-third of the pulse pressure, or
(SBP + 2 x DBP) / 3. Here (120 + 160) / 3 is about 93.
SOE Paramedic Final Exam - Page 2
,6. A patient has a blood pressure of 90/70 mmHg. What does the
narrow pulse pressure suggest?
A. Excellent cardiac output
B. Reduced stroke volume, as in early shock or tamponade
C. Aortic regurgitation
D. Normal physiology
Answer: B. Reduced stroke volume, as in early shock or tamponade
Rationale: Pulse pressure is the systolic minus diastolic pressure (20
mmHg here). A narrowing pulse pressure reflects reduced stroke volume
and increased vascular tone.
7. Approximately what fraction of total body water is found inside
cells?
A. About two thirds
B. About one tenth
C. About one half of the plasma volume only
D. Nearly all in the blood vessels
Answer: A. About two thirds
Rationale: Intracellular fluid makes up roughly two thirds of total body
water, and the remaining third is extracellular, divided between interstitial
fluid and plasma.
8. What happens to a red blood cell placed in a hypotonic solution?
A. It shrinks
B. It stays unchanged
C. It turns into a white blood cell
D. It swells and may burst
Answer: D. It swells and may burst
Rationale: Water moves into the cell by osmosis because the solute
concentration inside is higher than outside.
SOE Paramedic Final Exam - Page 3
, 9. What is the maximum recommended time for a pulse check during
a cardiac arrest assessment?
A. 30 seconds
B. 1 minute
C. 10 seconds
D. 2 minutes
Answer: C. 10 seconds
Rationale: A prolonged pulse check delays compressions. If a pulse is not
definitely felt within 10 seconds, begin CPR.
10. Which finding is consistent with positive orthostatic vital signs?
A. A rise in systolic pressure of 20 mmHg
B. A drop in systolic pressure of 20 mmHg or more with symptoms on
standing
C. No change in heart rate or blood pressure
D. A fall in temperature only
Answer: B. A drop in systolic pressure of 20 mmHg or more with
symptoms on standing
Rationale: Orthostatic changes suggest volume depletion or autonomic
dysfunction. A heart rate rise of about 20 or more beats per minute is also
commonly used.
Section 2: Airway Management and Ventilation
11. Which mnemonic helps predict a difficult laryngoscopy and
intubation?
A. LEMON (Look, Evaluate 3-3-2, Mallampati, Obstruction, Neck mobility)
B. SAMPLE
C. OPQRST
D. DCAP-BTLS
Answer: A. LEMON (Look, Evaluate 3-3-2, Mallampati, Obstruction,
Neck mobility)
Rationale: Identifying a difficult airway ahead of time allows preparation of
backup devices and positioning. LEMON is widely used.
SOE Paramedic Final Exam - Page 4
