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 answer-perform 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 answer-Prostatitis
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 answer-manually 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 answer-Left anterior descending artery occlusion
A patient with a suppressed cough mechanism: - correct answer-is 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 answer-tilt the backboard to
the left side.
Which of the following is the MOST important consideration during a pandemic? - correct
answer-Personal protective equipment
The door-to-balloon time for a patient with an ST elevation myocardial infarction is ___
minutes or less. - correct answer-90
When attempting resuscitation of a child with pulseless electrical activity, you should: -
correct answer-attempt 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 answer-Hemoptysis
Which of the following clinical findings is the MOST consistent with hypertrophic
cardiomyopathy? - correct answer-Unexplained 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 answer-remain 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 answer-Kyperkalemia
Which of the following statements regarding Grey Turner sign is correct? - correct
answer-Grey 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
answer-advise the rescuers that the patient has not been adequately decontaminated.
Epiglottitis in children: - correct answer-is 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 answer-suctioning 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 answer-flexibility and standardization.
The killing of pathogenic agents by directly applying a chemical made for that purpose is
called: - correct answer-disinfection.
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 answer-remove 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 answer-monitor his
cardiac rhythm and transport.
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 answer-perform 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 answer-Prostatitis
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 answer-manually 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 answer-Left anterior descending artery occlusion
A patient with a suppressed cough mechanism: - correct answer-is 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 answer-tilt the backboard to
the left side.
Which of the following is the MOST important consideration during a pandemic? - correct
answer-Personal protective equipment
The door-to-balloon time for a patient with an ST elevation myocardial infarction is ___
minutes or less. - correct answer-90
When attempting resuscitation of a child with pulseless electrical activity, you should: -
correct answer-attempt 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 answer-Hemoptysis
Which of the following clinical findings is the MOST consistent with hypertrophic
cardiomyopathy? - correct answer-Unexplained 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 answer-remain 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 answer-Kyperkalemia
Which of the following statements regarding Grey Turner sign is correct? - correct
answer-Grey 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
answer-advise the rescuers that the patient has not been adequately decontaminated.
Epiglottitis in children: - correct answer-is 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 answer-suctioning 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 answer-flexibility and standardization.
The killing of pathogenic agents by directly applying a chemical made for that purpose is
called: - correct answer-disinfection.
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 answer-remove 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 answer-monitor his
cardiac rhythm and transport.
