Paramedic Final Exam Latest Updated Graded A+

For which of the following patients is nasotracheal intubation absolutely contraindicated? - ANSWER You are called for a young man choking. Upon arrival you find very scared parents trying to dislodge a piece of hot dog from their 10 year old child's airway by administering back blows and abdominal thrusts, The child is limp. As you take over you discover the child is able to move a minimal amount of air. You should: - ANSWER continue with back blow and abdominal thrusts until item becomes dislodged or obstruction becomes complete You have just intubated an adult patient. You believe you have been successful. You are listening for sounds in the epigastric area and hear nothing. What would you do? - ANSWER attach an ETCO2 monitoring device What changes in blood gases occur when a patient is hyperventilating? - ANSWER decreased CO2; increased PaO2 First responders are applying unusually long ventilations with an oxygen resuscitator to an apneic adult female. They are also not pausing between breaths. What negative effects can this increased pressure create? - ANSWER increased pulmonary elasticity?? Percutaneous transtracheal ventilation - ANSWER needle cricothyrotomy You are treating a cardiac arrest patient who you have successfully resuscitated. The patient is still unconscious, apneic, and he is endotracheally intubated. The patient suddenly becomes cyanotic and his SpO2 decreases from 98% to 82%. His heart rate decreases from 110 to 40. What caused these sudden changes? - ANSWER dislodged endotracheal tube What is the primary danger to the infant during a precipitous delivery? - ANSWER cerebral trauma You are treating a 26 year old male victim of an assault. The patient was struck in the chest and abdomen with a baseball bat. Vital Signs: P- 110, R- 6 with sonorous respirations. The patient is place on high flow O2. While attempting an oral airway the patient gags. The oral airway is removed. How are you attempting to secure his airway next? - ANSWER Place a nasopharyngeal airway and ventilate with a bag valve mask What effects does morphine sulfate have on the venous system? - ANSWER increases venous pooling, resulting in reduced preload and after load You are treating a 48 year old female with chest pain. On scene you administer oxygen, aspirin, and two nitro tablets. En route to the hospital your patient states her pain decreases to a 1 on a scale of 0-10. To provide the best care, you should... - ANSWER continue high flow oxygen and repeat vitals, consider 12 lead EKG if pain persists A 52 yom is compelling of constant, severe pain and pressure in his chest, which he says started about 4 hours ago. The patient has bilateral rales, and his skin is cool to the touch. Vital signs are: BP- 72/52, P- 124, R-28. No JVD or Edema in lower extremities. What condition is most likely responsible for his signs and symptoms. - ANSWER Myocardial infarction with cariogenic shock Which of the following patients has the best cerebral oxygenation? - ANSWER 45 yom, disoriented, BP 140/80, skin warm and dry What term best describes the ability of cardiac cells to spontaneously depolarize without being stimulated by a nerve? - ANSWER Automaticity A 72 yom with a history of atherosclerosis complains of a sudden onset of sharp pain in his right leg and foot which has grown worse over the past 2 hours. Objective data includes an anxious patient with vital signs: BP- 124/60, P-70, R-18. He has a pale, waxy, cool right leg. No pedal pulses are present in the right foot. The left leg is normal. What is the patients probable diagnosis? - ANSWER Acute arterial occlusion What is atherosclerosis? - ANSWER The gradual blockage of an artery due to cholesterol and hardened deposits Which of the following is the underlying cause of the pain associated with a sickle cell crisis? - ANSWER Tissue ischemia Which of the following best describes the term syncope? - ANSWER sudden temporary loss of consciousness The correct dose of naloxone for a 6lb 8oz neonate suffering respiratory depression secondary to in utero exposure to narcotics is - ANSWER 0.3mg Your patient is a 22 yof without a medical history. She was sitting at her office desk where she had an acute onset of dyspnea and pleuritic type chest pain. Presently she is awake but agitated. Upon exam you find she is pale, cool, and diaphoretic. Vital signs are: BP- 92/40, P-142, R-36 and shallow but clear bilaterally. Only medications are Tylenol and a BC pill. What conditions would you suspect? - ANSWER Pulmonary Embolism Which of the following best describes the term syncope? - ANSWER sudden temporary loss of consciousness Which vessel provides blood supply to the SA and AV nodes in most patients? - ANSWER right coronary artery Impulses that originate in both the atria and ventricles simultaneously, meeting somewhere in the heart, create a strange appearing complex. What is that complex known as? - ANSWER fusion beat Most common causes of premature atrial contractions? - ANSWER stimulants such as caffeine or tobacco Your 66 yom patient is experiencing crushing chest pain, and has a BP of 80/64. Your monitor shows him to be in VTACH at a rate of 176. How would you treat this patient? - ANSWER synchronized cardioversion at 100J A 20 yom presents to you complaining of diffuse chest pain that increases with deep inhalation but decreases when he leans forward. His 12 lead EKG shows changes in all leads. He recently had a viral infection. From this information, what is his most probable diagnosis? - ANSWER pericarditis What does Starling's Law state? - ANSWER The strength of a contraction of a muscle fiber is proportional to how far it is stretched Which of the following scenarios may best describe a patient experiencing an acute mi - ANSWER 79 yof gets in an argument with her sister. She begins feeling substernal pressure that is unrelieved by rest and nitro. An elderly female is found unresponsive by a neighbor. Your crew has initiate CPR. The cardiac monitor show VFib How would you treat this patient? - ANSWER continue CPR, then prepare to defibrillate at 360J What is the electrical axis of the heart? - ANSWER average of all depolarizations of the heart Under which conditions does a Type II AV block have a very serious prognosis? - ANSWER AV dissociation exists???? What are the primary causes of symptoms in patients experiencing tachydysrhythmias? - ANSWER decreased ventricular filling and stroke volume Your patient is a 58 yom with a history of alcoholism and and cirrhosis of the liver. The patient is vomiting copious amounts of blood. Which is most likely the cause? - ANSWER esophageal varices Correct bolus amount for a 44 lb child in hemorrhagic shock? - ANSWER 400 ml You are treating a 80 yom who complains of headache, blurred vision, and left sided weakness. He has a history of heart problems and takes digoxin. Which of these is the most likely cause of his symptoms? - ANSWER embolic stroke caused by afib You are caring for a patient with a heart rate of 50. He is alert and oriented. His BP is 126/72 and he denies chest pain or respiratory distress. How would you initially treat this patient? - ANSWER gather a complete history and physical assessment Which is the ion responsible for determining the resting membrane potential of a cardiac cell? - ANSWER potassium A 55 yom complains of sudden onset of acute shortness of breath. He denies chest pain and is alert and oriented but anxious. Skin is pale (with cyanosis), cool, and diaphoretic. BP 230/110, P 110, R 28. No JVD. Crackles are heard bilaterally. He has a hx of heart attack 5 years ago. The patient is most likely suffering from? Besides increasing oxygen levels, what is the next step for this patient? What medication and dosage would you use? - ANSWER left sided heart failure decrease preload nitroglycerin 0.4 Sally, a 72 yof, called EMS because of severe lower back pain that will not go away. She states that she has arthritis, but this is much worse. She has a hx of hypertension and takes medication for it. She is extremely pale and diaphoretic. BP- 90 by palpation, P- 104, R-24. After oxygen, how would you initially treat. What condition is most likely affecting the patient. - ANSWER rapid transport to the ED Abdominal Aortic Aneurysm Your patient is a 26 yo female Who has ingested 150 amitriptyline tablets. She responds to painful stimuli and has intact gag reflex, has a BP of 88/50, P 130, R 16. What medications would you consider using to treat this patient? - ANSWER Sodium bicarbonate 26 yo female ingested 150 amitryptaline tablets what would be your best thing to watch for changes? - ANSWER Cardiac monitoring Which of the following statements conserning elderly emergency medical care of the elderly is tru? - ANSWER Alcohol and drug use may be a cause if ams Which of the following statements concerning seizures is true? - ANSWER The post-ictal phase preceded the seizure in absence (petit mal) seizures Your Patient is a 41 year old female who is 3 days postoperative, recovering from an abdominal hysterectomy. She smokes and is about 40 pounds overweight. She is taking hormone replacement therapy, an antidepressant, and an antibiotic. She has a sudden onset of sharp left-sides chest pain With dyspnea and near syncope. She is not responsive only two painful stimulus, her school skin is cool and diaphoretic, and she is cyanotic. BP 90/50, P 122 weak but regular, Are 36. Which of the following is most likely the cause of her presentation? - ANSWER Massive Pulmonary Embolism 17 yo m ingested 20 diazepam tablets, unresponsive to all stimuli and has snoring respiration's at 6 per min. What is the best treatment? - ANSWER Insert a NPA and BVM Which of the following does not need to be proven by the plaintiff with a malpractice case against a medic? - ANSWER A duty to act 22 yo female vetinary student, ingested tick killer and is presenting with SLUDGE what med does she need? - ANSWER Atropine 70 yo male in a bar fell off a stool, responds to verbal has slurred speech and has flank pain and head pain. How would you treat this Pt? - ANSWER Oxygen, IV 0.9% sodium chloride The correct placement for a needle throacostomy would be - ANSWER The second intercostal space, over the third rib, midclavicular line. What is the most common cause of pulmonary embolism? - ANSWER deep leg vein thrombosis You are treating a 6 yo who weighs 40lbs. He is unresponsive with a weak pulse, delayed capillary refill. His vital signs are BP 60/0, P240, R6. EKG shows a narrow complex tachycardia at a rate of 250. What is your initial treatment? - ANSWER Synchronous at 20 joules What is the most common cause of death in children over the age of 1 year? - ANSWER Trauma Which of the following has the greatest potential to prevent pediatric deaths? - ANSWER Car seats, seat belts, and seat belt positioning boosters When assessing the mental status of an 8 month old child, which of the following is expected behavior in a patient with a normal mental state? - ANSWER Recognizes familiar caretakers Which of the following is the most common concern to the adolescent trauma patient? - ANSWER Parental reprimand Which of the following is the recommended location for assessment of the pulse in an unresponsive 6 month old child? - ANSWER Brachial artery When responding to the scene of an injured 5yo child, child abuse should be expected in which of the following circumstances? - ANSWER Injury pattern does not match the history of the mechanism of injury A 5yo boy who awoke with a sore throat and fever is found sitting at the kitchen table. He appears quite ill and is leaning forward with his head in his hands. His voice is muffled and he is drooling. What illness do you suspect the child is suffering from? - ANSWER Epiglottitis How can you reduce gastric distention during ventilation? - ANSWER The patient is ventilated slow with large volumes of oxygen Which of the following pulse rates would be cause for concern in an 18 month old child? - ANSWER Options: 90,100,120,150 Answer: 150? Which of the following is true concerning pediatric febrile seizures? - ANSWER Febrile seizures are more likely to occur when the temp raises rapidly Which isn't the correct location for placement of an IO needle in a pediatric patient? - ANSWER Proximal tibia You are treating a pregnant woman in her third trimester. She is suffering from a headache. Her vitals, BP 220/108, P 80, R18. She tells you her ankles are more swollen than normal. What illness is most likely causing her signs and symptoms? - ANSWER Preeclampsia 23 yo female is complaining of diffuse Lower abdominal pain, unusual vaginal discharge, and a low-grade fever. Her symptoms began 2 days ago, toward the end of her period, which was otherwise normal. What is the most likely explanation for her symptoms? - ANSWER PID Oxytocin is indicated for the management of which of the following conditions? - ANSWER Postpartum hemorrhage You are assisting with a normal cephalon delivery. The infants head has been delivered. To assist with the delivery of the upper shoulder you should? - ANSWER Assist the infants head downward What stage of labor begins with cervical dilation and ends with delivery of the infant? - ANSWER Second Your Pt is G3P2Ab0. 38 weeks began having contractions 2.5 hours ago. Contractions are 2.5 mins apart and regular. The patient states that her water has not yet broken. In