Paramedic Comprehensive Final Exam Practice

Following blunt trauma to the anterior chest, a 44-year-old woman presents with restlessness, respiratory distress, perioral cyanosis, and tachycardia. Further assessment reveals a midline trachea, engorged jugular veins, and absent breath sounds on the right side of her chest. You should: correct answerperform an immediate needle thoracentesis to the right side of the chest. A 40-year-old man presents with difficulty urinating, fever, and tremors. Which of the following should you suspect? correct answerProstatitis A 45-year-old unrestrained man was ejected from his small truck when it struck a tree. The patient is found approximately 20 feet from the wreckage. Your primary assessment reveals that he is unresponsive and has sonorous respirations and a rapid pulse. Your initial actions should include: correct answermanually stabilizing his head and opening his airway with the jaw-thrust maneuver. A 60-year-old man with crushing chest pain has 3 mm of ST elevation in leads V1 through V4. What should you suspect? correct answerLeft anterior descending artery occlusion A patient with a suppressed cough mechanism: correct answeris at serious risk for aspiration. You are caring for a 33-year-old woman who is 35 weeks pregnant and fell down a flight of stairs. Full spinal precautions have been taken, the patient is receiving high-flow oxygen, and a patent IV line is in place. During transport, you reassess her and note that she has become diaphoretic, tachycardic, and tachypneic. You should: correct answertilt the backboard to the left side. Which of the following is the MOST important consideration during a pandemic? correct answerPersonal protective equipment The door-to-balloon time for a patient with an ST elevation myocardial infarction is ___ minutes or less. correct answer90 When attempting resuscitation of a child with pulseless electrical activity, you should: correct answerattempt to identify an underlying cause of the arrest. Which of the following clinical findings would MOST likely differentiate a massive hemothorax from a tension pneumothorax? correct answerHemoptysis Which of the following clinical findings is the MOST consistent with hypertrophic cardiomyopathy? correct answerUnexplained syncope A 41-year-old woman attempted to kill herself by cutting her wrists. Law enforcement personnel are at the scene. You have controlled the bleeding with direct pressure and a pressure bandage. The patient's vital signs are stable and she is conscious and alert; however, she refuses to go to the hospital. Despite pleas from her family to go to the hospital, she still refuses. You should: correct answerremain with the patient, contact medical control, and request law enforcement intervention. Any time a patient with end-stage renal disease is found in cardiac arrest, the paramedic should strongly consider which of the following as the cause? correct answerKyperkalemia Which of the following statements regarding Grey Turner sign is correct? correct answerGrey Turner sign is characterized by flank bruising and indicates internal bleeding. Following decontamination, a patient is presented to you by rescue personnel for transport. The patient is conscious and alert, and is in no obvious respiratory distress. The patient is emitting a pungent odor and has an orange chemical on her clothing. You should: correct answeradvise the rescuers that the patient has not been adequately decontaminated. Epiglottitis in children: correct answeris uncommon because children are vaccinated against Haemophilus influenza type b. A young woman experienced massive facial trauma after being ejected from her car when it struck a tree. She is semiconscious, has blood draining from her mouth, and has poor respiratory effort. The MOST appropriate initial airway management for this patient involves: correct answersuctioning her airway until it is clear of blood and other secretions, administering a sedative and paralytic, and performing endotracheal intubation. Two MOST important underlying principles of National Incident Management System are: correct answerflexibility and standardization. The killing of pathogenic agents by directly applying a chemical made for that purpose is called: correct answerdisinfection. You are dispatched to the residence of a 19-year-old man who has a tracheostomy tube and is on a mechanical ventilator. According to the patient's mother, he began experiencing difficulty breathing about 30 minutes ago. Auscultation of his lungs reveals bilaterally diminished breath sounds, and his oxygen saturation is 80%. You disconnect the patient from the mechanical ventilator and begin bag-mask ventilations; however, you meet significant resistance. You should: correct answerremove the bag-mask device and suction his tracheostomy tube. A 48-year-old man with a history of hypertension presents with a severe headache, tinnitus, and blurred vision. He is conscious and alert and denies any other symptoms. His BP is 204/120 mm Hg, his pulse rate is 100 beats/min, and his oxygen saturation is 96%. The closest appropriate facility is 20 minutes away. You should: correct answermonitor his cardiac rhythm and transport. Your patient has a blood pressure of 80/60 mm Hg. What is his mean arterial pressure? correct answer66 mm Hg Which of the following factors would MOST likely produce a falsely normal pulse oximetry reading? correct answerCarboxyhemoglobin A 30-year-old man presents with jaw and neck stiffness and fever. During your assessment, he tells you that he cut his hand on a piece of metal about a week ago. You should suspect: correct answertetanus. If an EMS agency is providing relief to a neighboring community during a disaster, it is important to ensure that: correct answerit has enough coverage in its home area of responsibility. You respond to a residence for a possible overdose. The patient, a young man, is unresponsive with slow, snoring respirations. There are obvious needle track marks on his arms. Your FIRST action should be to: correct answermanually open his airway. Triage and emergency medical treatment should be performed: correct answerin the cold zone. If chest compressions and repositioning of the airway are unsuccessful in removing a severe airway obstruction in an unconscious patient, you should: correct answerperform laryngoscopy and use Magill forceps. A young female with experienced trauma to her genitalia and has profuse vaginal bleeding. She is hypotensive, tachycardic, and tachypneic. You should: correct answertransport immediately. Physiologic effects of histamine include all of the following, EXCEPT: correct answerincreased cardiac contractility A 33-year-old male presents with chest pain that is alleviated when he sits forward. The 12-lead ECG shows ST elevation of 2 to 3 mm in multiple leads. What should you suspect? correct answerPericarditis What 12-lead ECG finding