NREMT Paramedic Prep exam with correct verified answers 2024

You are called to assist an adult with chest pain. The patient has a cardiac history of two-posterior myocardial infarctions. He is conscious and alert, stating he is having a hard time breathing, and the chest pain worsens when he attempts to lay flat on his back. His skin is pale and hot, while auscultation of his lung sounds reveals mild crackles. He reports the pain worsens on deep inspiration and movement. Based on the patient's history, and signs and symptoms, which of the following should you suspect? A. Unstable angina pectoris B. Pericarditis C. Myocardial infarction D. Cardiomyopathy - correct answer B. You are the first ambulance to arrive on the scene of a single-car accident. As you approach the scene, you see four patients, two have been ejected from their vehicle, and two are still in the vehicle. What should be your next course of action? A. Call medical control, and advise them of the situation B. Request additional resources, such as fire rescue, and additional ambulances to respond to the scene C. Begin immediate triage and treatment of the two patients ejected first while awaiting fire department response D. Notify the local trauma center so they can prepare for the patients - correct answer B. A patient is experiencing a possible neurological emergency from a blunt force closed head injury. He is found to have abnormal pupillary reactions to light and has lost the ability to move his eyes from side to side to follow your finger movements. He is also unable to identify the number of fingers you are holding up. He reports he is able to see the fingers but is not able to focus enough to identify how many fingers are present. Which of the following cranial nerves should you suspect may be involved in his injury? A. Cranial nerves I, V, and VI B. Cranial nerves V and VII C. Cranial nerves IX and X D. Cranial nerves II, III, and IV - correct answer D. Simply put, shock is a state of hypoperfusion due to several different causes. Which one of the following types of shock would be considered distributive shock? A. Hypovolemic shock B. Cardiogenic shock C. Anaphylactic shock D. Toxic shock syndrome - correct answer C. Which of the following is responsible for initiating the sympathetic response to shock during a traumatic event? A. Increased oxygen level and increased PCO2 B. Increased peripheral vascular resistance and alkalosis C. Decreased perfusion and increased acidosis D. Peripheral vasodilation and increased capillary permeability - correct answer C. During which wave, complex, interval, or segment of an electrocardiogram tracing does the absolute refractory period take place in a normally functioning heart? A. S-T segment B. P-R interval C. P wave D. Q-T interval - correct answer D. You are preparing to perform synchronized electrical cardioversion with a biphasic defibrillator on your unstable adult patient who is experiencing supraventricular tachycardia at 160 beats per minute on the monitor. Which of the following initial energy settings would be recommended if he was exhibiting a narrow complex, regular supraventricular tachycardia, in which his palpable carotid pulse matches the rhythm on the monitor? A. Synchronized cardioversion at 50-100 joules B. Defibrillation at 100 joules C. Synchronized cardioversion at 360 joules D. Defibrillation at 360 joules - correct answer A. Other than a stroke, what is a common cause of one-sided facial droop and paralysis in an adult patient who exhibits no other neurological findings? A. Amyotrophic lateral sclerosis (ALS) B. Multiple sclerosis C. Huntington's disease D. Bell's palsy - correct answer D. You are on-scene with a patient who was struck by a car on her bicycle. She is conscious and alert but has a possible closed right mid-shaft femur fracture. The patient advises you that she is sixteen but does not need parental consent to be treated. Which of the following situations would make this statement true? A. She can be treated under implied consent because her injury may become life-threatening B. She is not an American citizen, visiting on a student visa C. She is an emancipated minor granted by the court D. She is an orphaned minor who lives alone - correct answer C. Your adult patient is showing signs and symptoms of being severely hyperkalemic. Medical control recommends the administration of a high-dose nebulized albuterol treatment as well as calcium chloride. Why is high-dose albuterol being recommended for this patient? A. To improve the patient's ventilatory status B. To assist with metabolic acidosis C. To increase the amount of available calcium at the cellular level D. To help lower dangerous potassium levels - correct answer D. When monitoring the electrical activity of a patient's heart, which standard limb lead records the difference in electrical potential between the left leg and the right arm when the left leg is positive and the right arm is negative? A. Augmented limb lead aVL B. Bipolar limb lead II (LII) C. Bipolar limb lead III (LIII) D. Bipolar limb lead I (LI) - correct answer B. You are evaluating a trauma patient who may have sustained a spinal cord injury. Which of the following would you expect to see in a trauma patient with a spinal cord injury with autonomic nervous system involvement? A. Bradycardia, hypotension, and a loss of sweating or shivering ability B. Bradycardia, hypertension, warm, dry skin, and numbness of fingertips C. Tachycardia, hypertension, one-sided paralysis, and amnesia D. Tachycardia, hypotension, diaphoresis, cool, and clammy skin - correct answer A. You are on-scene with an adult patient exhibiting unusual activity and appears to be intoxicated. He is anxious and hyperactive. His heart rate and respirations are fast, but his blood pressure remains within normal range for his age. The patient denies alcohol or drug consumption but reports he has diabetes. His blood glucose level is found to be 54 milligrams per deciliter. How would hypoglycemia cause the patient to present with the above findings? A. The low blood sugar levels stimulate the sympathetic nervous system to trigger the release of epinephrine into the bloodstream to promote liver glycogenolysis B. Low blood sugar levels mimic alcohol intoxication in the brain because of elevated insulin levels in the bloodstream C. The elevated heart rate and respirations stimulate the adipose tissue to increase glucose and fatty acid uptake in an attempt to correct the blood glucose level D. The heart rate and r - correct answer A. You are on scene at a motor vehicle accident, and your 20-year-old patient is entrapped. He is unconscious, unresponsive, and has a palpable carotid pulse that is weak and thready. His breathing is slow and shallow at four times a minute with equal chest wall expansion. There are no obvious deformity injuries or hemorrhage noted. Fire department on-scene has stabilized the vehicle and provided you and your partner a relatively safe environment to manage the entrapped patient. However, access is limited to the seated patient, and extrication is expected to take another twenty minutes. After having your partner maintain cervical spine stabilization, which of the following would be the best choice for securing the patient's airway? A. Insert a nasal airway and administer high-flow oxygen therapy B. Use nasotracheal intubation techniques to gain complete control of the patient's airway and assist ventilation C. Intub - correct answer D. You are on-scene with a 60-year-old COPD patient complaining of shortness of breath. During your exam, you note the presence of clubbed fingertips. Which of the following is most likely to cause this finding? A. Congestive heart failure especially left ventricular failure B. Long-term hypoxemia C. Hypocapnia resulting from low carbon-dioxide levels D. Hemoglobin saturated with red blood cells - correct answer B. When involved in transporting a patient from the hospital (regardless of the destination), which of the following disease processes, along with HIV/AIDS, must be reported to the transporting crew members to prevent the accidental transmission of the disease? A. Shingles and pneumonia B. Hepatitis and tuberculosis C. ARDS and sepsis D. Syphilis and gonorrhea - correct answer B. Which of the following patients best fits the criteria for a critical burn? A. A 10-year-old patient with superficial burns over 60% of the body B. A 15-year-old patient with full-thickness burns on the left upper/lower arm, non-circumferential Which of the following patients best fits the criteria for a critical burn? A. A 10-year-old patient with superficial burns over 60% of the body B. A 15-year-old patient with full-thickness burns on the left upper/lower arm, non-circumferential C. A 60-year-old patient with partial-thickness burns across 25% of the body, not involving the hands, feet, face, or genitals D. A 20-year-old patient with partial-thickness burns on 25% of the body, not including the hands, feet, face, or genitals D. A 20-year-old patient with partial-thickness burns on 25% of the body, not including the hands, feet, face, or genitals - correct answer C. Which of the following common toxic substances is a colorless, flammable, and extremely hazardous gas that smells like rotten eggs and is capable of affecting several body systems, especially the nervous system? A. Hydrogen sulfide B. Methyl bromide C. Halogenated hydrocarbon D. Hydrogen cyanide - correct answer A. Your adult respiratory insufficiency patient's respirations are shallow and irregular at six times per minute. His SpO2 is 76 mm Hg, and you suspect carbon dioxide retention due to the decreased respiratory effort. Which of the following should you suspect? A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Metabolic alkalosis - correct answer B. You are assessing an adult patient experiencing sudden-onset chest pain and dyspnea. He quickly exhibits jugular vein distension and cool, clammy skin. His trachea is midline, but there are palpable air pockets under the skin on his upper chest on the left side that feel as though they pop or vanish when you palpate them. What is this abnormal finding? A. Subcutaneous emphysema B. Atelectasis C. Pitting edema D. Ascites - correct answer A. You are treating a 68-year-old cardiac history patient experiencing chest pain. If it is determined at the hospital that he experienced an acute myocardial infarction of the septal wall, which of the coronary arteries was most likely occluded? A. Circumflex artery B. Right main coronary artery C. Posterior descending artery D. Left main coronary artery - correct answer D. You are on-scene with a 70-year-old female who complains of being awakened in the middle of the night by sudden onset dyspnea and sweating. She is breathing 32 times per minute with inspiratory/expiratory wheezing and rales auscultated in all fields bilaterally, with an SpO2 of 88 percent on room air. Her heart rate is 136 beats per minute, showing an irregularly irregular sinus tachycardia on the monitor. Which of the following is most likely causing the patient's current signs and symptoms? A. Acute renal failure B. Chronic bronchitis C. Paroxysmal nocturnal dyspnea D. Acute respiratory distress syndrome - correct answer C. Your adult female postpartum patient delivered her newborn with the assistance of her husband five minutes prior to your arrival on the scene. The infant's Apgar score is 10, and the baby seems to be fine. However, the mother continues to bleed heavily after an adequate fundal massage and encouraging the infant to breastfeed. Her current heart rate is 125 bpm; her blood pressure is 108/60, and she is breathing 22 times a minute with an SpO2 of 97. After ensuring a second infant is not present, which of the following interventions would medical command most likely recommend? A. Continue fundal massage, and pack the vagina with sterile ABD or trauma pads B. Administer lactated Ringer's solution run wide open using macro-drip tubing under pressure C. Administer a fluid bolus of 1,000 mL of normal saline, and transport the patient in the Trendelenburg position D. Administer oxytocin infusion (1 unit per 100 mL of la - correct answer D. Which of the following operational modes used in EMS communication can transmit voice as well as telemetry simultaneously? A. Trunk system mode B. Multiplex mode C. Duplex mode D. Simplex mode - correct answer B. You are evaluating a 58-year-old who presented with sudden onset chest pain that radiates downward to his lumbar spine region. His peripheral pulses are present but unequal with a significant difference in blood pressure between his left and right arms. Which of the following conditions is most likely to cause the patient's presentation? A. A pulmonary embolus B. An aortic aneurysm dissection C. A cardiac tamponade D. A myocardial infarction - correct answer B. You are ordered to administer 3 mg/min of lidocaine via intravenous infusion to your cardiac patient who presents with a heart rate greater than 130 beats per minute as well as greater than 10 multifocal PVCs every minute. Therefore, you quickly but carefully mix 2 grams of the medication in 500 mL of normal saline and attach micro-drip tubing to the solution bag. Which of the following drip rates would effectively deliver the ordered dose of lidocaine? A. 15 gtts/min B. 30 gtts/min C. 60 gtts/min D. 45 gtts/min - correct answer D. You are ordered to administer 0.3 mL of epinephrine for a moderate allergic reaction. What is the preferred initial route of administration of epinephrine for an allergic reaction? A. Subcutaneous B. Intramuscular C. Intravenous D. Endotracheal - correct answer B. You are called to assist an adult diabetic who was found unconscious in bed. On arrival, your patient is unresponsive with snoring respirations and cool, clammy skin. Your glucometer will not power up, so blood glucose analysis is impossible at the present time. Which of the following would be most appropriate after controlling the patient's airway and delivering high-flow oxygen therapy? A. Administer glucagon to the patient intramuscularly in a large muscle group like the gluteal muscles B. Start an intravenous line, draw blood samples, and administer one amp of dextrose 50 percent (D50) C. Start an intravenous line, and draw blood samples before administering a glucose-containing IV fluid bolus D. Quickly establish an intravenous line, and transport the patient to the nearest hospital for blood glucose analysis prior to medication administration - correct answer B. You arrive on-scene to a two-vehicle MVA. One vehicle is already being attended to by another ambulance, so you head to the other car. Your patient is a 40-year-old male, standing outside of his car. Immediately, you can see your patient slightly swaying on his feet, and his breath smells of alcohol, but he has no noticeable injuries. There is slight crumpling on the driver's side of his car, and airbags have been deployed. Your patient adamantly says that he is not injured, but upon an assessment of his mental faculties, he is unsure of what month it is or what city he is in at the time. The patient does admit that he has only had two beers and is not inebriated. What C-Spine precautions, if any, should you take? A. Patient is ambulatory, and the lack of ability to remember the city he is in or what month it is can be attributed to the shock of the crash and his being inebriated B. Patient will need full C-spine - correct answer B. What can a paramedic expect to occur in a closed-head injury patient when the intracranial pressure increases and the mean arterial pressure decreases? A. The patient's cerebral blood flow decreases B. The patient has likely suffered a brainstem herniation C. A marked increase in the patient's blood glucose level D. The formation of an intracranial abscess - correct answer A. When determining an estimated time of death on-scene, what is the terminology used to describe blood and fluid leaving the areas of the face, nose, and chin assisted by gravity and allowed to settle in the lowest parts of the body? A. Dependent lividity B. Cyanosis C. Rigor mortis D. Post-partum blood pooling - correct answer A. You are intubating a 26-year-old who is apneic. Once the endotracheal tube passes through the vocal cords, how much farther should the endotracheal tube be advanced before inflating the cuff and confirming proper placement? A. 0.5 to 1 inch B. Less than 1 cm C. 2 to 3 cm D. 1 to 2.5 inches - correct answer A. You are cleaning the back of the truck after transporting a trauma patient to the emergency department. Which of the following contaminated items should not be placed in a plastic biohazard bag? A. Plastic IV catheter B. Nasopharyngeal or oral airway C. French suction catheter D. Blood-soaked gauze pads - correct answer A. You suspect that your trauma patient may be experiencing the adverse effects of a crush injury after being entrapped under a fallen building for several hours before rescue. He is found to be wheezing with shortness of breath and hypotension with no obvious sign of chest wall/lung injury or blood loss. What is the most likely cause of these findings in a crush injury patient? A. Histamine release B. Atelectasis from the compressive forces C. Aortic dissection D. Thrombin formation - correct answer A. Your adult asthma patient is experiencing a severe attack characterized by inspiratory and expiratory wheezes with potential airway compromise due to laryngospasm. Which of the following interventions would be most appropriate after oxygen therapy is applied? A. 2.5 to 5 mg of albuterol solution mixed with 3 mL of 0.9 normal saline and nebulized with 6-8 lpm of oxygen B. Rapid sequence intubation with sedation C. 0.31 mg of levalbuterol nebulized with 6-8 lpm of oxygen D. 0.3-0.5 mL (1:1000) of epinephrine delivered IM/SC; repeat in 15 minutes if needed - correct answer A. You are preparing to perform fluid replacement on an adult trauma patient who lost a significant amount of his circulating blood volume when you note the presence of a drastic systolic blood pressure decline from 100 mmHg to 86 mmHg systolic after the patient's bleeding is controlled. The patient has no obvious new bleeding, but his abdomen is distended and is painful on palpation. There are no obvious masses, bruises, or deformity, and he has active bowel sounds over the epigastric region. Which of the following intravenous fluids would be most appropriate in this situation if the medical command physician recommends a fluid challenge? A. 0.9% normal saline B. 0.45% sodium chloride C. 0.45% normal saline with 5% dextrose D. Lactated Ringer's solution - correct answer D. What type of communication system operational mode is required for an EMS agency to be able to communicate simultaneously in both directions while also performing telemetry transmission? A. Multiplex mode B. Duplex mode C. Simplex mode D. Complex mode - correct answer A. You suspect your adult trauma patient has a potential complete spinal cord transection. If so, which of the following would you expect to find? A. Total loss of pain and sensation below the waist bilaterally with some loss of movement below the waist B. Bradycardia associated with loss in vascular tone C. Total absence of pain, sensation, and movement (paralysis) below the point of the transection (injury) D. Right-sided paralysis with decreased sensation on the opposite side of the body - correct answer C. You are on-scene with a patient who you suspect may be experiencing a myocardial infarction. He is conscious and alert, anxious, and has dilated pupils. He complains of substernal chest pain and admits to recent cocaine use. How does the use of cocaine increase the risk of experiencing an acute myocardial infarction? A. It speeds the heart rate to the point of asystole B. It causes the blood in the periphery to clot and travel to the coronary arteries C. It actually numbs the heart, making coronary perfusion difficult D. It causes coronary artery constriction and increases the chance of dislodging a thrombus or plaque - correct answer D. In which of the following situations would evaluating the ST segment elevation of a patient suffering from a suspected myocardial infarction not be indicated to determine if an infarction exists? A. When a pre-existing right bundle branch block is present B. When the patient is hypotensive C. In the presence of pulmonary edema D. In the presence of a left bundle branch block - correct answer D. If an adult patient is experiencing the signs and symptoms of a myocardial infarction with perfusing arrhythmias, which of the following pre-hospital interventions will help to reduce the patient's cardiac preload and afterload? A. The intravenous administration of 2-4 mg of morphine per a medical-control physician's order B. The administration of various medications and dosages to control the specific dysrhythmias such as procainamide, atropine, verapamil, and others C. The administration of sublingual nitroglycerin therapy D. The administration of high-flow oxygen therapy (15 liters per minute) via a non-rebreather mask - correct answer C. Your adult patient was entrapped by dirt up to his mid-abdominal area for a few hours while rescue crews worked to free him. Once on the cardiac monitor, why would tall, tented T waves become evident quickly? A. Hyperkalemia caused by the sudden influx of potassium B. Myocardial ischemia caused by decreased available oxygen for the myocardium C. Hypokalemia associated with the sudden release of the compressive force D. Cardiac tamponade associated with increased intrathoracic pressure and blood pressure - correct answer A. The alpha, beta-1, and beta-2 receptors are important in the maintenance of heart rate and respiratory function. What can we expect to occur if a patient's beta-1 receptors are stimulated? A. Decrease in the diameter of the bronchioles to help retain carbon dioxide when needed B. Increased heart rate and strength of contraction C. Increase in the diameter of the bronchioles to let more air in and out during ventilation D. Decrease in the heart rate and the size of the bronchioles - correct answer B. You are called to stage at a mass casualty incident involving exposure to possible chemical agents during the event. Knowing you will likely transport one or more patients from the scene that have been grossly decontaminated in the decontamination section, what measures can you take to minimize the possible contamination of your unit during the patient care/transport encounter? A. Use disposable equipment as much as possible, remove all equipment that will not likely be needed during transport, cover the patient and stretcher with plastic B. Patient should be transported in a full hazmat suit after gross decontamination to prevent infecting EMS and ER staff C. Cover the patient with sheets and blankets and administer oxygen via a non-rebreather mask to prevent spread of toxins D. Transport the patient on stretcher and treat appropriately. Decontamination has taken place so no further danger of contamination exist - correct answer A. You are monitoring the cardiac rhythm of your 60-year-old female patient with shortness of breath when you note the presence of a possible first-degree atrioventricular block in lead II on the EKG. Which of the following electrocardiogram abnormalities makes you think there is a first-degree AV block present? A. There are more than one P wave for each QRS complex B. A P-R interval greater than five small boxes (0.20 seconds) wide on the electrocardiogram tracing C. The P-R intervals become progressively longer until a QRS complex is dropped altogether D. The P waves are present but bear no relationship to the QRS complexes - correct answer B. You are called to assist a 50-year-old cardiac history patient complaining of chest pain. On arrival, the patient rates his pain at an eight on the pain scale. His skin is cool, clammy, and diaphoretic with a SpO2 of 88 percent on room air. His respirations are at 33 per minute and shallow but clear. His heart rate is 40 beats per minute with a blood pressure of 90 systolic. Which of the following interventions would be inappropriate at this point? A. Intravenous access B. High-flow oxygen therapy C. Twelve-lead electrocardiogram analysis with continuous Lead II monitoring D. Nitroglycerin therapy - correct answer D. You are called to assist a 20-year-old male for a severe headache. On-scene, you learn the patient was involved in an accident that caused a potential closed head injury. However, at the time of the accident, the patient refused EMS care, stating he felt fine. Today, he is experiencing headache, confusion, and visual disturbances. Which of the following injuries is most likely to cause this type presentation? A. Coup-contra-coup injury B. Diffuse axonal injury C. Subdural hematoma D. Epidural hematoma - correct answer C. An adult trauma patient suffered a fall from greater than 15 feet. When predicting the injuries associated with this type injury, the paramedic should evaluate the distance fallen, the position of the body on impact, and which of the following? A. The type of landing surface involved B. The ambient temperature at the time of the fall C. The patient's neurological status D. The body parts that were struck with the most force - correct answer A. Negligence is divided into three categories. Which of the following is not one of the categories? A. Malfeasance B. Misfeasance C. Nonfeasance D. Milfeasance - correct answer D. You are assessing a patient with an altered mental status and has a diabetic history. Which of the following would most likely indicate the patient is suffering from diabetic ketoacidosis? A. Cool, moist skin, wet mucous membranes, normal pulses and blood pressure, shallow respirations, and family members report increasing hunger and then nausea in the patient before calling 9-1-1 B. Red hot skin, wet mucous membranes, weak tachycardic pulses, hypotension, shallow rapid respirations, and family members report that the patient spoke of a loss of appetite for several days before calling 9-1-1 C. Dry, doughy-looking skin that is cool to the touch, unresponsiveness, bradycardic pulse, normal blood pressure, slow, shallow respirations, and family members report that the patient spoke of increasing intolerance to cold for several days before calling 9-1-1 D. Dry skin, dry mucous membranes, hypotension, shallow rapid re - correct answer D. What can the paramedic expect to find when evaluating the pupillary response of a patient suspected of suffering from herniation? A. Bilateral pupil dilation B. A unilaterally, unequal and non-reactive pupil C. Bilaterally, unequal and non-responsive pupils D. Sluggish response, but equal pupils - correct answer B. In a trauma situation, it is acceptable to administer either normal saline or lactated Ringer's to your patient for volume replacement. What is the primary benefit of choosing lactated Ringer's? A. It will stay in the vascular system longer, promoting blood pressure B. It has the ability to carry red blood cells C. It helps decrease acidosis in a hypovolemic patient D. It helps increase acidosis in the hypovolemic patient - correct answer C. You are performing orotracheal intubation on an average-sized, apneic adult. At what depth marking should the airway be properly positioned 2 to 3 cm above the carina? A. 9 to 13 centimeters B. 29 to 32 centimeters C. 19 to 23 centimeters D. 32 to 36 centimeters - correct answer C. Opioid antagonists reverse the symptoms of an opioid overdose. Which of the following medications would be effective in reversing the adverse effects of a benzodiazepine overdose? A. Naltrexone B. Alprazolam C. Flumazenil D. Naloxone - correct answer C. You are working in a pre-hospital setting and are called for a 40-year-old male who was the victim of a stabbing. The patient has a blood pressure of 87/50 and a heart rate of 130. There is a large amount of blood on the scene. After applying direct pressure to the wound on the patient's arm and stopping the bleeding, of the following what would be the best intervention to mitigate the patient's blood pressure? A.Establish two large-bore IVs, and administer 2 liters of fluid B. Establish an IV, and administer a norepinephrine drip at 0.1-2mcg/kg/min, titrated to effect C. Establish an IV, and establish a dopamine drip to the patient at 5mcg/kg/min D. Establish an IV, and administer fluid to keep the patient's BP at or near 90 systolic - correct answer D. While on-scene with a 70-year-old complaining of chest pain, what is one of the first indicators that should alert the paramedic to the probability that an acute myocardial infarction is occurring? A. The relief to some degree of chest pain after the administration of nitroglycerin B. The presence of chest pain not changed or relieved by oxygen therapy alone C. The presence of persistent chest pain not relieved by nitroglycerin therapy D. Cyanosis around the patient's mouth, nose, and nail beds - correct answer C. Your 23-year-old diabetic patient was found unresponsive with increased respirations, hypotension, and bradycardia. Family members state he recently had a tooth pulled and was prescribed Vicodin. Which of the following is most likely to cause the patient's presentation? A. Myasthenia gravis B. Metabolic alkalosis C. Ketoacidosis D. Narcotic overdose - correct answer C. After assisting a full-term pregnant patient in the delivery of her newborn, the newborn remains bradycardic with a heart rate of 50 beats per minute and exhibits cyanosis around his mouth, nose, fingers, and toes. He is not responding well and appears lethargic following the five-minute APGAR assessment. What would be the best initial intervention at this point to increase his heart rate? A. Deliver adequate artificial ventilation after ensuring a definitive airway B. Administer epinephrine 1:10,000 at 0.1 mg/mL intravenously C. Administer a vasopressor agent intravenously per medical command recommendations D. "Fast and hard" chest compressions at more than 120 compressions per minute - correct answer A. You are working an adult cardiac arrest patient who is not responding to electrical therapy. According to ACLS guidelines, what is the appropriate concentration and dosage of epinephrine in a cardiac arrest patient? A. 1mg IV/IO every 3-5 minutes with a concentration of 1:10,000 B. 0.1mg IV/IO every 3-5 minutes with a concentration of 1:1,000 C. 1mg IV/IO every 1-3 minutes with a concentration of 1:10,000 D. 0.1mg IV/IO every 3-5 minutes with a concentration of 1:10,000 - correct answer A. While conducting an EKG on your post-myocardial infarction patient, you note the presence of consistently wide QRS complexes greater than 120 ms in duration. What does this most likely indicate? A. An intraventricular conduction delay or right/left bundle branch block B. A complete heart block indicating no relationship between the atria and ventricles C. The patient is likely suffering from a myocardial infarction currently D. The patient has a congenital heart defect and should not require emergency care - correct answer A. You are assessing a critical patient and considering the possibility of a reversible cause of his symptomatic slow heart rate. Which of the possibilities is most likely to cause a patient to present with a slow heart rate and associated signs/symptoms of bradycardia? A. Cardiac tamponade B. Hypoxia C. Pulmonary embolus D. Hypovolemia - correct answer B. You are treating a COPD patient for mild shortness of breath when you note the presence of pursed lips and sighing-type respirations at 26/minute. Why would the patient present with pursed lips and frequent sighing? A. In an attempt to expel foreign bodies or irritants from the lower airway B. To prevent atelectasis from occurring at the end of exhalation C. To prevent pleural friction rub that is associated with pleurisy and pain D. To increase the size of the air sacs of the lungs to improve oxygenation - correct answer B. You suspect your unconscious adult trauma patient may have increased intracranial pressure from a closed head injury. Due to the compression forces of increased intracranial pressure, at what level of brain injury would be expected if the patient is exhibiting Cheyne-Stokes respirations and is presenting with increasing blood pressure readings and a decreasing, reactive pulse rate? A. Cortex and upper brainstem B. Midbrain region C. Medulla oblongata D. Lower portion of the brainstem - correct answer A. You are called to assist a pregnant female in the 24th week gestation period according to her due date. The pale 26-year-old patient is found supine in bed, complaining of dizziness/weakness with extreme nausea. The patient denies vaginal bleeding, amniotic fluid leakage, or abdominal pain. There are no signs of imminent birth or active labor. She reports receiving normal prenatal care with no associated problems found during the pregnancy. Her heart rate is 126-130 beats per minute; her blood pressure is 80 mmHg systolic while her skin is cool and pale. Which of the following conditions is most likely to cause the patient's presentation? A. Uterine rupture B. Spontaneous abortion C. Supine hypotension D. Placenta previa - correct answer C. You are dispatched to the scene of a one-vehicle motor collision. Upon your arrival at the scene, you note that the vehicle struck a tree on the driver side. The driver is the only patient, and she is still sitting in the driver seat of the vehicle. The vehicle is stable and has moderate damage noted to the driver side, which prevents the driver side door from opening. Which of the following would be the most appropriate way to extricate the patient from the vehicle? A. Break the driver side window and attempt to remove the patient through the window B. Open the rear driver side door and extricate the patient through the backseat C. Use a crowbar and pry open the driver door D. Open the passenger side door and extricate through the passenger side - correct answer D. You are on-scene with a patient suspected of taking a large amount of meperidine hydrochloride. Which of the following interventions may be effective in reversing the adverse effects of the ingested medication? A. Activated charcoal B. Atropine C. Romazicon D. Naloxone - correct answer D. Meperidine is an Opiate Analgesic Your adult status asthmaticus patient requires rapid sequence intubation due to rapidly increasing airway constriction. Which of the following would be most appropriate following tube placement confirmation? A. 3 mg of levalbuterol administered directly down the ET tube B. 2-5 mg of albuterol administered directly down the ET tube C. 2.5 mg of albuterol in 3-mL solution, nebulized and delivered with ventilation D. 1.25 mg of levalbuterol in 3-mL solution, nebulized and delivered with ventilation - correct answer C. Several minutes after sealing your adult trauma patient's sucking chest wound with an occlusive dressing secured on three sides, he begins to experience increasing shortness of breath, jugular vein distension, decreasing unilateral breath sounds on the affected side, and his blood pressure is less than 90 systolic and falling. Repeated attempts to relieve the pressure at the occlusive dressing have proven ineffective. At this point, which of the following should be initiated? A. Remove the occlusive dressing and pull sucking chest wound open gently to allow air to escape the chest B. Translaryngeal Jet Ventilation using a 10- or 14-gauge catheter that is an inch to an inch-and-a-half long C. Endotracheal intubation and positive pressure ventilations via forced air ventilator D. Immediate needle decompression using a 10- or 14-gauge catheter that is at least 2 or 2.5 inches long - correct answer D. When treating an adult patient for a mild allergic reaction, with no respiratory distress or dyspnea, which medication is routinely administered either IM or IV for the treatment of an allergic reaction? A. Epinephrine B. Methylprednisolone C. Albuterol D. Diphenhydramine - correct answer D. Epinephrine is effective in helping reverse the adverse effects of anaphylaxis. It is the drug of choice because it causes bronchodilation and vasoconstriction to improve respiratory effort and improve blood pressure. What other effect does epinephrine have on the patient's body during an anaphylactic reaction? A. It reduces the release of chemical mediators from the mast cells B. It is effective in reducing the inflammatory response of the reaction C. Increases the heart rate to improve peripheral perfusion D. It causes peripheral vasoconstriction to reduce the itching associated with the reaction - correct answer A. What is the name of the legal document in which an individual specifies what medical treatments should and should not be done for him in the event he is unable to make his own medical care decisions? A. A do not resuscitate order (DNR) B. A will C. An advanced directive D. A personal directive - correct answer C. You are preparing to initiate a rapid sequence intubation on a pediatric patient who is exhibiting a borderline hypotensive state with a decreased level of consciousness and hypoventilation. He is quickly becoming hypoxic with a SpO2 of 77% and a delayed capillary refill. Which medication would be most effective in sedating this patient for the procedure? A. Succinylcholine B. Midazolam C. Ketamine D. Propofol - correct answer C. You are preparing to intubate an apneic patient and decide to use a Macintosh blade. When using a curved blade on an adult, where should the tip of the laryngoscope blade be placed? A. Directly under the epiglottis B. Space below the vallecula C. Directly into the vallecula D. Directly on the epiglottis - correct answer C. You have a 70-year-old female patient in cardiac arrest. Your partner begins compressions, and another paramedic on-scene begins ventilating with an OPA and BVM. You look over to the fridge and find the patient's DNR orders that state the patient does not want any life-saving procedures and looks to be signed and valid. However, the patient has many pictures of her family on the fridge, and pictures drawn for her by her grandchildren. There is no family on-scene. What are the next steps that you should take? A. Continue basic CPR and airway control, and transport to the hospital so they can determine whether or not to continue resuscitation B. Discontinue all resuscitation measures, and take the next steps of notifying your dispatch and/or local medical coroner, as laid out by protocol C. Follow full ACLS protocols for at least two minutes to assess whether the patient can be resuscitated, as the patient looks to - correct answer B. You are on-scene assisting another crew with a childbirth call that quickly turned into a neonatal resuscitation. The newborn does not have a palpable brachial pulse, but muffled heart tones and the monitor confirm a sluggish heart rate of 55 beats per minute. After reassessing him after a few minutes of high-quality chest compressions and effective ventilations with 100% oxygen concentration, the patient's heart rate fails to respond. Which of the following would be considered a class IIa intervention for this patient? A. 0.1 mg/mL of a 1:10,000 concentration of epinephrine delivered via the intraosseous route B. 0.01 mg/mL of a 1:1,000 concentration of epinephrine delivered via the intramuscular route C. 0.25 mg/mL of a 1:1,000 concentration of epinephrine delivered via the endotracheal tube route D. 0.1 mg/mL of a 1:10,000 concentration of epinephrine delivered intravenously - correct answer D. Your adult trauma patient may be experiencing the adverse effects of a crush injury that triggered the sudden release of high levels of histamine. What would this usually cause? A. Bronchoconstriction and vasodilation B. Irregular, shallow respirations and a normotensive blood pressure C. Increased spontaneous respiration and unequal blood pressure readings in arms and legs D. Bronchodilation and vasoconstriction - correct answer A. While evaluating the twelve-lead electrocardiogram tracing of your 66-year-old cardiac history patient for the possibility of an acute myocardial infarction, you note the presence of deep symmetrically inverted T waves. Which of the following is most likely the cause of this abnormal finding? A. Necrosis B. Ischemia C. Hyperkalemia D. Hypokalemia - correct answer B. You are treating a 50-year-old male with a cardiac history currently complaining of chest pain. He is breathing at 20 times a minute, has an irregular heart rate of 136 beats per minute, and a blood pressure of 120/60. His twelve-lead-tracing indicates the presence of an ST-elevation myocardial infarction (STEMI). What makes the ST-elevation infarction treatment different from a non-STEMI patient's treatment? A. A non-ST elevation infarction may respond to fibrinolytics, so destination is important for this patient B. ST-elevation infarctions may respond to fibrinolytics, so time and destination are critical for this patient C. ST-elevation patients will need a fluid bolus to maintain an adequate blood pressure D. Nothing, both types will respond to fibrinolytic therapy equally - correct answer B. Which of the following respiratory patterns is most likely to be present with an adult patient suffering the adverse effects of diabetic ketoacidosis? A. Bradypnea B. Central neurogenic hyperventilation C. Kussmaul respirations D. Cheyne-Stokes respirations - correct answer C. Your adult patient presents with shortness of breath and chest pain. She reports the pain began last night and has worsened. She is breathing 28 times per minute with a SpO2 of 96 percent on room air. She reports the pain worsens when asked to take a deep breath. Lung sounds are equal with a grating sound heard on inhalation. The patient's heart rate and blood pressure are normal. She is showing a sinus rhythm with a first-degree atrioventricular block present in lead II on the ECG. Which of the following is most likely the cause of her complaints? A. Pleurisy B. Asthma C. Acute myocardial infarction D. Bronchitis - correct answer A. Your 49-year-old COPD patient is unconscious and exhibiting ineffective respirations. You quickly decide to attempt to control his airway and provide positive pressure ventilations. Which airway adjunct has a large distal end with an inflatable cuff that presses against the patient's esophageal sphincter while the proximal border of the airway device rests against the patient's tongue? A. King LTD airway B. Esophageal-Tracheal Combi-tube C. Laryngeal Mask Airway (LMA) D. Nasotracheal intubation - correct answer C. Your adult patient has suffered a prolonged cardiac arrest interval and is receiving advanced cardiac life-support interventions. When administering medications intravenously, why should calcium chloride and sodium bicarbonate not be administered through the same IV line? A. Calcium chloride will precipitate/crystallize when mixed with sodium bicarbonate B. Calcium chloride will antagonize the effects of sodium bicarbonate C. Sodium bicarbonate will cause a rebound acidosis when mixed with calcium chloride D. Sodium bicarbonate will act as an agonist to the calcium chloride causing hypercalcemia - correct answer A. To combat increasing ICP in a head injury, the body utilizes this principle: A. Monro-Kellie Principle B. Bernicke Principle C. Fick Principle D. Bernoulli's Principle - correct answer A. Your adult patient called for help after he began to vomit bright red blood. On arrival, the patient is found to be tachycardic and bleeding freely from his mouth. His respirations are shallow, and his skin is cool with a blood pressure is 68 systolic. His only history involves liver disease from chronic alcoholism. He denies drinking recently. What should be the goal of your pre-hospital intervention with this patient after ensuring his airway and applying oxygen therapy? A. Fluid resuscitation to maintain a systolic blood pressure of 80-90 systolic B. Fluid resuscitation to maintain a blood pressure of at least 100 systolic C. To control the hemorrhage with pharmacologic intervention D. Maintaining a high blood oxygen saturation to continue perfusion at the cellular level - correct answer A. Your adult patient presents with dyspnea that developed over the last few days and worsened today. During auscultation of the patient's lungs, his vocal sounds become louder over the left lower lobe of his lung. What does this likely indicate? A. Consolidation (fluid, mucus) is present in the left lower lobe of the patient's lung B. Consolidation (clear lung sounds) is present everywhere but in the left lower lobe of the patient's lung C. A pneumothorax likely exists in the left lower lobe of the patient's lung D. The patient is likely experiencing an acute asthma attack - correct answer A. Your adult patient was involved in a structure fire and received possible airway burns. The patient complains of shortness of breath, but there are no obvious burns noted in his oropharynx. However, his dyspnea fails to improve after several minutes of high-flow oxygen therapy, and his lung sounds reveal a grating sound during equal inspiration/exhalation. Which of the following should you suspect? A. A loss of pulmonary surfactant B. Bronchoconstriction C. Fluid accumulation in the small airways D. Associated rib fracture - correct answer A. You are treating a post femoral fracture patient with suspected deep vein thrombosis in his right upper thigh. What should be the main concern while treating and transporting the patient to the hospital? A. Immobilize the right leg and apply hot packs to the suspected occlusion site to improve distal circulation B. Allow the patient to assume a position of comfort and monitor closely for a pulmonary embolism C. Fully immobilizing the patient and monitoring distal circulation, sensation, and heart tones D. Immobilizing the right leg and making sure it stays lower than the heart while assessing distal pulses - correct answer B. You are on-scene with a cardiac history patient experiencing unstable ventricular tachycardia that is not responding well to prehospital interventions. The patient and family want the patient transported to a hospital across town; however, there is a facility more capable of handling the cardiac event much closer. Which of the following would be most appropriate? A. Transport the patient to the closer facility, then explain to the patient and family on arrival at the appropriate facility B. Transport the patient to the facility of his or her choice, regardless of medical condition C. Explain the situation to the patient and family, then transport him to the closer facility to benefit the patient D. Tell the patient and family they have no choice and transport the patient to the closer facility - correct answer C. Thyroid storm is caused by the acute hyperfunction of the thyroid gland and is a true medical emergency that requires emergent hospital intervention. Which of the following signs and symptoms would a paramedic expect a patient experiencing a thyroid storm to exhibit? A. Tachycardia, bradypnea, hypothermia, gastrointestinal upset, and listlessness B. Bradycardia, tachypnea, hypothermia, palpitations, and lethargy C. Tachycardia, tachypnea, hyperthermia, palpitations, and delirium D. Bradycardia, bradypnea, hyperthermia, confusion, and delirium - correct answer C. Your adult hemodialysis patient is in cardiac arrest one hour after completing a dialysis treatment. He is found to be apneic and asystolic with adequate CPR in progress. Which of the following should be administered during the resuscitation attempt? A. Sodium bicarbonate and magnesium sulfate B. Amiodarone and magnesium sulfate C. Sodium bicarbonate and calcium chloride D. Potassium and dopamine - correct answer C. After assisting a pregnant patient to deliver her full-term newborn at home, you quickly dry the infant and open his airway to help begin spontaneous respiration. However, after a few seconds, you realize the newborn has copious secretions in his airway preventing effective spontaneous respiration. Which of the following should you do to safely and effectively clear the infant's airway? A. Use a portable suction machine with a rigid suction catheter to suction his posterior airway B. Use a bulb syringe to suction his nose first and his mouth second C. With assistance, use two bulb syringes to suction his mouth and nose simultaneously D. Use a bulb syringe to suction his mouth first and then his nose second - correct answer D. You are called to assist an adult female with a possible allergic reaction. You arrive to find a 22-year-old patient who is just beginning to have difficulty breathing. She has itching, urticaria, and hives after a bee-sting. During the possible allergic reaction, what is occurring at the cellular level? A. The mast cells are retaining the vasoactive amines, resulting in a localized response to the sting B. The cells begin a hypermetabolic state associated with the patient's increased activity level after the sting C. An anaerobic metabolism has begun at the local level and is now moving into the vasculature D. The mast cells have degranulated, releasing serotonin and histamines into the general circulation - correct answer D. If the city council in your area enacts a law concerning the classification of first responders, what type of law allows this to occur in the US? A. Civil law B. Legislative law C. Administrative law D. Common law - correct answer B. You are treating a 20-year-old patient who sustained a full-thickness burn to his entire right lower leg. During your evaluation, it is quickly determined the patient has no sensation or distal pulses peripherally in the affected limb. If circulation is not quickly returned to the extremity, which of the following is most likely to occur? A. Crush injury syndrome B. Burn shock syndrome C. Compartment syndrome D. Lactic acidosis syndrome - correct answer C. You are called to assist a 50-year-old patient with rapid-onset pain in his right lower calf. The patient denies trauma but has a past medical history of hypertension and heart disease. The right lower leg is cool and pale, and the patient reports cramp-like pain in the area that began while he was sitting. His left leg remains asymptomatic. Which of the following conditions should be suspected until proven otherwise? A. Acute femoral artery occlusion B. Acute iliac artery occlusion C. Acute abdominal aorta occlusion D. Acute mesenteric artery occlusion - correct answer A. You are responding to a possible assault call. You choose to park down the block from the house, as police have not yet made the scene safe. However, you see what looks to be a patient in distress in the upper story window. What would be the safest approach in this situation? A. Wait for responding police to control the situation and say that it is safe for EMS B. Wait for police to arrive, then grab your gear and go in with police to treat the patient C. Drive up to the driveway to get a better view of the patient's condition D. Head into the house to treat the patient since he could be critically hurt - correct answer A. You are orally intubating a patient experiencing spasmodic closure of the vocal cords from laryngeal spasm. What is the best way to get the cords to allow the passage of the ET tube in this situation? A. Applying a copious amount of lubrication on the tube and vocal cords B. Apply steady cricoid pressure throughout the intubation C. Allow the tip of the stylet to exit the end of the tube to serve as a guide through the narrow opening D. A forceful upward pull of the jaw to reposition the airway - correct answer D. Which of the following is not a cause of shock? A. Inability of RBCs to deliver oxygen to the tissues B. Decreased systemic vascular resistance C. Increased systemic vascular resistance D. Inadequate cardiac output - correct answer C. Which of the following is considered a solution that contains molecules, such as proteins, that are too large to pass through the capillary membrane? A. Hypertonic solution B. Hypotonic solution C. Crystalloid solution D. Colloid solution - correct answer D. Which of the following conditions is most likely to cause a patient to present with potentially reversible pulseless electrical activity on the monitor? A. Traumatic asphyxia B. Wolf Parkinson White syndrome C. The R-on-T phenomenon D. Tension pneumothorax - correct answer D. An adult patient who experiences the loss of his/her gag reflex following a closed-head and suspected spinal injury may have suffered an injury to which of the following cranial nerves? A. Cranial nerve X (vagus) B. Cranial nerve III (oculomotor) C. Cranial nerve XII (hypoglossal) D. Cranial nerve IX (glossopharyngeal) - correct answer A. Your adult patient sustained a right index finger amputation at work. On arrival, first responders have the bleeding controlled with sterile dressings, and the patient is conscious, alert, and oriented. What is the best way to manage the patient's amputated finger during transport to the hospital? A. Do not wrap the finger. Gently place it in a sealed plastic bag, and place it on a towel in ice. B. Wrap the finger in gauze (moistened with normal saline), and seal the finger in a plastic bag before placing it on ice C. Rinse the gauze-wrapped finger using water, and place it in a plastic bag with ice D. Wrap it in gauze, and place the finger in close proximity to the patient's core to maintain the appropriate body temperature for re-attachment - correct answer B. You are on-scene with a patient in cardiac arrest. You turn the monitor/defibrillator on and attach the pads to the patient. When it begins to analyze the patient's cardiac rhythm, it signals "low battery" and then shuts off. You have no other batteries available, and an electrical plug is not available. The patient subsequently dies despite adequate CPR and advanced airway and ventilation during transport. Which of the following could result? A. Manslaughter charges could be brought against the paramedic in charge of the unit B. Negligence charges could be brought against the paramedic in charge of the unit C. Battery charges could be brought against the entire service D. Defamation charges could be brought against the entire crew on scene - correct answer B. A patient suffering from an ST-elevation myocardial infarction or a presumably new-onset left bundle branch block may benefit from the use of fibrinolytic therapy if the agent is given promptly. How long does a patient have to receive the first fibrinolytic agent to salvage ischemic heart tissue? A. Within 12 hours of symptoms onset B. Within the first 90 minutes from symptom onset C. Within 24 hours of symptoms onset D. Within the first hour ("golden hour") from symptom onset - correct answer A. You are working a 55-year-old patient in cardiac arrest. When it comes time to push amiodarone for ventricular fibrillation, you note that your stock of the preferred medication has been depleted on a previous call. What medication can be safely used in place of amiodarone in this situation? A. Epinephrine B. Cardizem C. Lidocaine D. Procainamide - correct answer C. EMS communication over open airways is normally conducted through two-way radios of varying frequencies and controlled by the FCC. Of the frequency bands listed below, which one is strictly assigned to two-way communication or one-way paging, operating in the simplex mode? A. Very High Frequency (VHF), low and high bands between 32-170 MHz B. Ultra High Frequency (UHF) bands between 450-470 MHz C. Ultra High Frequency (UHF) bands up to 400 MHz D. Very High Frequency, low band (VHF) between 20-30 MHz - correct answer A. Which of the following medications is used to prevent blood clot formation in patients with a-fib or pulmonary embolism, and decrease the risk of MI in patients with atherosclerosis as well as reduce the risk of stroke? A. Nitroglycerin B. Lotensin C. Losartan D. Streptokinase - correct answer D. Which of the following medical conditions or injuries is most likely to cause problems with both the internal and external processes of normal respiration? A. Lung cancer B. Chronic hypertension C. Congestive heart failure D. Emphysema - correct answer D. You are ordered to administer a dopamine infusion to your 62-year-old, 75 kg, hypotensive, cardiac patient. The ordered dose is 10 mcg/kg/min, and you plan to use a micro-drip tubing set with the standard dopamine mixture of 800 mg in a 500 mL normal saline infusion bag. How many drops per minute will it take to deliver the ordered dose of dopamine properly? A. 28 gtts/min B. 42 gtts/min C. 14 gtts/min D. 56 gtts/min - correct answer A. Which of the following medications may be effective in reversing the signs and symptoms of dystonia? A. Promethazine B. Morphine sulfate C. Lidocaine D. Diphenhydramine - correct answer D. Due to automaticity, a cardiac cell can initiate electrical impulses. The more superior its location, the more intrinsic beats it is able to produce per minute. Which of the following is known as the chief pacemaker of the heart? A. Sinoatrial node B. Purkinje fibers C. Bundle of His D. Atrioventricular node - correct answer A. Which of the following would be your most appropriate action after the administration of 1mg of atropine fails to increase the heart rate of your symptomatic bradycardic patient's heart rate and cardiac output? A. Transcutaneous pacing (TCP) B. Synchronized cardioversion at 50 joules C. Repeat with another one-mg dose of atropine after 3-5 minutes D. Administer one mg of epinephrine intravenously - correct answer A. How does nitroglycerin relieve ischemic cardiac chest pain? A. By increasing cardiac preload B. By increasing peripheral vascular resistance C. By reducing cardiac preload D. By decreasing myocardial oxygen consumption - correct answer C. You arrive on-scene of a seizure call to find a 22-year-old patient actively seizing. Family on scene reports the patient has an epileptic seizure disorder that sometimes causes seizures that last a minute or two. Today, the seizure has lasted for longer than fifteen minutes prior to your arrival without a break in the tonic-clonic phase. Your attempts to gain IV access are restricted due to the ongoing seizure activity. Which of the following is the drug of choice for intramuscular injection to control the prolonged seizure in this situation? A. Thiamine B. 50 percent dextrose (D50) C. Lorazepam D. Etomidate - correct answer C. What condition is most likely to cause an adult female patient to present with non-traumatic lower abdominal quadrant pain reported as severe, agonizing, and often radiates to the patient's shoulders? A. Renal calculi B. Ovarian cyst rupture C. Ectopic pregnancy rupture D. Splenic rupture - correct answer C. Which of the following is characterized by sudden onset malaise, weakness, anorexia, intermittent nausea, vomiting, and jaundiced skin? A. Peptic ulcer B. Cholecystitis C. Renal calculi D. Hepatitis - correct answer D. Your unconscious closed head injury patient presents with a widened pulse pressure and bradycardia. Her pupils are sluggish to react, and she is exhibiting abnormal extension posturing. Her signs and symptoms lead you to believe she is experiencing increased intracranial pressure from the injury. What area of the brain is most likely impacted by the increase in pressure? A. Medulla B. Pons C. Midbrain D. Cortex - correct answer C. Pericardial tamponade and hemorrhagic shock present very similarly in the pre-hospital environment. What is the best way, of those listed, to distinguish between the two diagnoses? A. Pericardial tamponade presents with jugular vein distension, and hemorrhagic shock normally does not cause jugular vein distension B. Pericardial tamponade patients present with cyanosis to the face, neck, and upper chest while hemorrhagic shock presents with core cyanosis C. Hemorrhagic shock presents with hypotension, and pericardial tamponade presents with hypertension D. The presence of narrow complex tachycardia with hemorrhagic shock and wide complex tachycardia with pericardial tamponade - correct answer A. After attempting to slow the bleeding associated with natural childbirth by non-invasive means, your patient continues to bleed significantly. Per medical direction, after ensuring a second fetus is not present, which of the following would be the most appropriate intervention for the new mother? A. Rapidly administer a 2-3 liter glucose-containing IV solution such as D5W using a pressure infusion B. Place ice packs on the abdomen and at the opening of the birth canal to promote clotting C. Mix 10 units of oxytocin to 1 liter of lactated Ringer's solution and run at 20-30 gtts/min D. Apply firm, direct pressure to the area above the pubic bone while inserting a sterile ABD pad into the opening of the birth canal - correct answer C. Your newborn patient is in need of a fluid bolus to return his circulating blood volume to a near normal level after a bleeding injury has occurred, but the bleeding is now controlled. What is an acceptable fluid bolus amount for the newborn patient? A. 10 milliliters per kilogram of body weight over 5-10 minutes B. 25 milliliters per kilogram of body weight over an hour C. 100 milliliters total over 1-3 minutes and can be repeated twice D. 40 milliliters of normal saline delivered over one minute - correct answer A. Your pediatric patient has been ill for several days leading you to suspect he may be dehydrated. Once on the electrocardiogram, it is evident the patient has an accelerated heart rate and abnormally flattened T waves. What is the most likely cause of this finding? A. Hyperglycemia B. Hyperkalemia C. Hypoglycemia D. Hypokalemia - correct answer D. Your cardiac patient has an unstable angina history and is suspected of experiencing an ischemic event. He presents with chest pain, cool and clammy skin, and diaphoresis. If the event is being caused by unstable angina pectoris, which medication may be used to prevent an increase in the size of a thrombus if one is present? A. Nitroglycerin B. Morphine C. Aspirin D. Streptokinase - correct answer C What is the benefit of inducing mild hypothermia to a post-arrest patient who has a return of spontaneous circulation? A. Hypothermia reduces the body's need for stored energy (sugar) to maintain homeostasis B. Hypothermia increases blood flow to the brain and heart while reducing blood flow to the peripheral tissues C. It reduces intracranial pressure, the cerebral metabolic rate, and the brain's demand for oxygen D. It reduces the amount of oxygen and blood circulation needed to supply the tissues of the periphery - correct answer C. Your adult patient is experiencing lightheadedness and shortness of breath. He is found to be bradycardic with a second-degree type II AV heart block on the