PARAMEDIC READINESS EXAM 4 EXAM QUESTIONS & ANSWERS | AIRWAY, CARDIOLOGY, TRAUMA & EMS SCENARIOS COMPLETE WITH DETAILED RATIONALE

PARAMEDIC READINESS EXAM 4 EXAM QUESTIONS & ANSWERS | AIRWAY, CARDIOLOGY, TRAUMA & EMS SCENARIOS COMPLETE WITH DETAILED RATIONALE 1. A 58-year-old male with a history of COPD is in severe respiratory distress. He is sitting in a tripod position and has audible stridor. What is the most appropriate initial management? A. Administer nebulized albuterol B. Apply high-flow oxygen via non-rebreather mask C. Prepare for immediate endotracheal intubation D. Place the patient in a supine position Answer: B. Apply high-flow oxygen via non-rebreather mask Rationale: The tripod position and stridor indicate upper airway obstruction or severe respiratory distress. The first step is to administer high-flow oxygen. While intubation may be needed, it is not the initial action unless the patient is in immediate respiratory failure. ________________________________________ 2. What is the primary pathophysiological cause of hypotension in anaphylactic shock? A. Decreased cardiac contractility B. Increased capillary permeability C. Peripheral vasoconstriction D. Bradycardia Answer: B. Increased capillary permeability Rationale: In anaphylaxis, massive histamine release causes increased capillary permeability, leading to fluid shifting from the intravascular space to the interstitial space, resulting in relative hypovolemia and hypotension. ________________________________________ 3. A 45-year-old male is found unresponsive with snoring respirations after a fall from a ladder. Which airway maneuver should be performed first? A. Head-tilt chin-lift B. Jaw-thrust maneuver C. Insertion of an oropharyngeal airway D. Nasopharyngeal airway insertion Answer: B. Jaw-thrust maneuver Rationale: The jaw-thrust maneuver is the preferred initial airway maneuver for an unresponsive patient when cervical spine injury is suspected, as it minimizes cervical spine movement while opening the airway. ________________________________________ 4. A newborn is born with large amounts of meconium around the mouth and nostrils. The newborn has no movement and is cyanotic. What should you do first? A. Begin chest compressions B. Suction the lower airway C. Administer positive pressure ventilation D. Stimulate the newborn to cry Answer: B. Suction the lower airway Rationale: In a non-vigorous newborn with meconium-stained amniotic fluid, the priority is to suction the trachea under direct laryngoscopy to remove meconium from the lower airway before initiating positive pressure ventilation. ________________________________________ 5. A 23-year-old female presents with lower abdominal pain, purulent vaginal discharge, and low-grade fever after intercourse. She has a history of gonorrhea. What is the most likely diagnosis? A. Ectopic pregnancy B. Pelvic Inflammatory Disease C. Ovarian cyst D. Urinary tract infection Answer: B. Pelvic Inflammatory Disease Rationale: The combination of lower abdominal pain, purulent vaginal discharge, fever, and history of gonorrhea is classic for Pelvic Inflammatory Disease (PID), which is often caused by ascending infection from sexually transmitted organisms. ________________________________________ 6. A 60-year-old male is supine in bed, alert to painful stimuli, with clubbing of the fingers and on low-flow home oxygen. Vital signs: BP 170/90, P 110, R 30 and deep, SpO2 96%. Medications include lisinopril, Advair, and insulin. What should you suspect? A. Diabetic ketoacidosis B. Hyperventilation syndrome C. Pulmonary embolism D. Congestive heart failure Answer: B. Hyperventilation syndrome Rationale: The patient has a history suggesting COPD (clubbing, home O2, Advair) and is presenting with tachypnea and deep respirations with normal SpO2. Hyperventilation syndrome can occur in COPD patients, often related to anxiety or metabolic derangement. ________________________________________ 7. An 8-month-old female recently had a cold. She now has a low-grade fever with an occasional barking cough, hoarse cry, and is sitting up in her mother's arms. What is the most appropriate treatment? A. Nebulized epinephrine B. Oral corticosteroids C. Antibiotics D. High-flow oxygen Answer: A. Nebulized epinephrine Rationale: The presentation of barking cough, hoarse cry, and sitting upright is classic for croup (laryngotracheobronchitis). Nebulized epinephrine is the first-line treatment to reduce upper airway edema in moderate to severe croup. ________________________________________ 8. A 38-year-old male complains of shortness of breath after being stabbed in the left side of the chest. He has paradoxical chest wall movement and flat jugular veins. Vital signs: BP 94/40, P 130, R 26. What should you suspect? A. Tension pneumothorax B. Cardiac tamponade C. Hemothorax D. Pulmonary contusion Answer: C. Hemothorax Rationale: Flat jugular veins in the presence of hypotension and unilateral chest trauma suggest hemothorax rather than tension