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1.
You respond to a 58-year-old male seated upright on his couch complaining of
crushing substernal chest pain radiating to his left arm. He is pale and diaphoretic.
Vital signs: BP 146/88, HR 102, RR 18, SpO₂ 96% on room air. He denies
allergies and has not taken any medications today. What is the most appropriate
initial medication intervention?
A. Nitroglycerin
B. Aspirin
C. Oxygen via nonrebreather
D. Morphine
Correct Answer: B
Rationale: Aspirin should be administered early in suspected acute coronary
syndrome to inhibit platelet aggregation, provided there are no contraindications.
,2.
A 22-year-old female is found sitting on the curb after a motor vehicle collision.
She is alert, oriented, and states she cannot feel her legs. She denies pain. Vital
signs are stable. What is the most appropriate spinal management?
A. Full spinal immobilization with backboard
B. Allow patient to self-extricate
C. Manual stabilization and rapid transport
D. Cervical collar only
Correct Answer: A
Rationale: Neurologic deficits following trauma require full spinal motion
restriction to prevent secondary spinal cord injury.
3.
A 4-year-old child is in respiratory distress with audible wheezing, nasal flaring,
and intercostal retractions. The mother reports a history of asthma. The child’s
inhaler is empty. What is the most appropriate intervention?
A. High-flow oxygen via nonrebreather
B. Bag-valve-mask ventilation
C. Assist with a nebulized bronchodilator
D. Place in recovery position
Correct Answer: C
Rationale: Wheezing and increased work of breathing in an asthmatic child
indicates bronchoconstriction, best treated with inhaled bronchodilators.
,4.
You are treating a 71-year-old female who suddenly became confused and
developed slurred speech 20 minutes prior to arrival. Which finding most strongly
supports a stroke alert?
A. Unequal pupils
B. Blood glucose of 110 mg/dL
C. Facial droop on one side
D. History of hypertension
Correct Answer: C
Rationale: Unilateral facial droop is a key finding in stroke screening tools and
suggests acute neurologic compromise.
5.
A patient with a known peanut allergy is experiencing difficulty breathing,
widespread hives, and swelling of the lips. Blood pressure is 88/60. What is the
priority treatment?
A. Oxygen via nasal cannula
B. Epinephrine auto-injector
C. Oral antihistamine
D. IV fluid bolus
Correct Answer: B
Rationale: Epinephrine is the first-line treatment for anaphylaxis due to its
bronchodilatory and vasoconstrictive effects.
, 6.
A 45-year-old diabetic patient is confused and diaphoretic. Blood glucose reads 42
mg/dL. He is conscious but unable to swallow. What is the most appropriate
intervention?
A. Oral glucose gel
B. Encourage sugary beverage
C. Assisted ventilations
D. Rapid transport only
Correct Answer: A
Rationale: Oral glucose may be administered to conscious patients who cannot
reliably self-administer but still have protective airway reflexes.
7.
During the primary assessment of an unresponsive patient, you find shallow
breathing at 6 breaths per minute and a weak carotid pulse. What is the next
immediate action?
A. Apply AED
B. Begin chest compressions
C. Assist ventilations with BVM
D. Administer oxygen via nonrebreather
Correct Answer: C
Rationale: Inadequate respirations with a pulse require assisted ventilations to
correct hypoxia and hypercapnia.