Medical (Paramedic) Study Center > Diagnostic Tests > Paramedic Diagnostic Tests > Medical (Paramedic) Step 1 of 50 2% A 39 year old male complains of a four-day history of a cough and fever. He discloses to you that he has AIDS. Your exam finds diminished lung sounds in the left base and ronchi throughout all fields. His vital signs are P 88, R 24, BP 134/80. You should suspect*pneumonia.spontaneous pneumothorax.pleural effusion.tuberculosis. A 79 year old male complains of general illness over the last 6 days. He presents with lethargy and has severe pedal edema. You note a foul, fishy odor on his breath and tiny white crystals accumulated across his scalp. His vital signs are P 90, R 24, BP 190/100. You should suspect*end stage liver disease.chronic pancreatitis.left heart failure.chronic kidney disease. An 85 year old nursing home patient complains of a severe cough, fever and chills. Staff notes she has recently had a decrease in mental status. Staff further notes that “everyone in the facility has had a cough.” The patient presents with diminished lung sounds on the right side and rhonchi. Her vital signs are P 98, R 36, BP 160/80. These findings most likely point to*tension pneumothorax.acute pulmonary edema.exacerbation of COPD.pneumonia. Which of the following past medical histories is associated with a higher mortality rate in anaphylaxis?*AsthmaChronic kidney diseaseCoronary artery diseaseDiabetes A 24 year old female presents with altered mental status. Her family states she has had a severe fever since returning from her trip to South Africa. They note that today she was complaining of a severe headache and neck pain. You should first*obtain a blood glucose level.check for bite or sting marks.don personal respiratory protection.administer a bolus of normal saline. A 54 year old male has had an acute onset of altered mental status and threatening behavior. The patient now is hallucinating but not overtly violent. After completing a primary assessment, you should*apply soft restraints.move the patient to the lateral decubitus position.administer a chemical restraint such as ketamine.obtain a blood glucose level. A 39 year old woman complained of a “thunderclap headache” and was found by bystanders kneeling and clutching her head. She noted it was the “worst headache she ever had” and then passed out. You find her with signs of rising ICP. She is most likely suffering from a(n)*subarachnoid bleed.intracerebral hematoma.subdural hematoma.epidural hematoma. A 22 year old female complains of abdominal pain and severe vaginal bleeding over the last three hours. She notes no history of trauma and states, “it just came on all of a sudden.” You note she is pale and slightly diaphoretic. Her vital signs are P 116, R 24, BP 88/60. You should first*administer a bolus of normal saline.perform a fundal massage.initiate a magnesium sulfate infusion.administer high concentration oxygen. A 15 year old male developed anaphylaxis after being injected with IV dye. He is hypotensive. As your partner readies to administer epinephrine, you have been charged with administering a fluid bolus. Which of the following would be the most appropriate dose of normal saline to use for the initial bolus?*20 mL/kg10 mL/kg300 mL/hr150 mL/hr A 61 year old male has a new onset of difficulty speaking and visual disturbance. His family states that he was fine two hours prior and notes a long history of hypertension. The patient’s vital signs are P 100, R 24, BP 200/110. You should*administer 0.4 mg nitroglycerin.administer 25 mg diltiazem.initiate transport.administer 5 mg metoprolol. A 79 year old male presents with new onset expressive aphasia. His family states that he is having a harder time than usual getting up from the chair. The patient notes no specific pain and his vital signs are P 74, R 18, BP 190/88. His blood glucose is 58 mg/dL. You should first*administer dextrose 10%.assess waveform capnography.complete a detailed physical examination.obtain a 12 lead ECG. A 33 year old male has a suspected cocaine overdose. You have restrained the severely agitated patient and administered a sedative. The patient is now calm on your stretcher. You should next*move the patient to a Trendelenburg position.administer an analgesic.move the patient to a seated position.cover the patient’s face to prevent spitting. A 90 year old dementia patient has become progressively sicker after developing an upper respiratory infection one week ago. Staff notes that today they cannot even get her out of bed (she normally is an ambulatory patient). Her vital signs are P 114, R 32, BP 100/60 and her temperature is 97.9 F. (36.6 C). The patient’s mental status changes are most likely due to*hypothermia.hypoglycemia.sepsis.exacerbation of dementia. An 80 year old male complains of upper quadrant abdominal pain. He notes the pain is “tearing” in nature and radiates into his back. He discloses a history of hypertension. You should suspect*acute nephritis.abdominal aneurysmacute pancreatitis.incarcerated hernia. A 55 year old woman complains of new onset visual disturbance and an unsteady gait. She notes she was feeling fine prior to the onset and has only a history of hypothyroidism. Her vital signs are P 98, R 20, BP 140/94. You should suspect*thyroid storm.hypertensive crisis.stroke.hyperglycemia. A 90 year old woman presents with an inability to move the right side of her body. Her family states that the patient awoke from sleep with these symptoms. Her vital signs are P 60, R 24 and BP 178/102. Her blood glucose is 80 mg/dL and her oxygen saturation is 94%. You should*administer high concentration oxygen.administer dextrose 50%.administer metoprolol.activate the stroke alert. A 59 year old male has developed a high fever and confusion. His family note that his only history is recently being treated for a cutaneous infection on his leg. Your exam identifies the skin infection and you note he has a temperature of 101 F (38.8 C). His vital signs are P 132, R 40, BP 94/68. You should first*administer a dopamine infusion.administer a bolus of normal saline.administer dextrose 10%.begin a norepinephrine infusion. A 19 year old African American male complains of an acute onset of severe pain in his elbows, knees and lower back. He denies recent trauma and notes feeling fine prior to the onset. He notes similar episodes in the past that have resolved on their own. His vital signs are P 118, R 24, BP 140/80. You should suspect*osteoarthritis.a sickle cell vasoactive crisis.a deep vein thrombosis.fibromyalgia. Which of the following statements best describes the physiology of a dialysis fistula?*A central access catheter used to isolate a large arteryThe grafting of an artery and a vein to create a larger vesselA shunt used to reach the peritoneal cavityA peripheral catheter used to access venous flow A 44 year old female has overdosed on her tricyclic antidepressant. Poison control has recommended and you have administered the first dose of sodium bicarbonate. The patient is now semiconscious and her vital signs are P 100, R 36, BP 76/48. You should next*administer glucagon.administer a second dose of sodium bicarbonate.initiate a norepinephrine infusion.initiate transcutaneous pacing. A 17 year old male has had a sudden onset of altered mental status and hypotension. His mother states he has a history of Addison’s disease. This patient’s low blood pressure is most likely caused by*excessive production of aldosterone.diminished production of cortisol.decreased activity of the pituitary gland.excessive production of thyroid hormone. A 56 year old female patient has been diagnosed with a thyroid storm. Which of the following findings would be commonly associated with her condition?*Decreased body temperatureSevere hypertensionMild hypotensionRecent weight gain A 33 year old male complains of severe pain in his legs and flank pain after what he describes as a “heavy” introductory workout at the gym. He states he did leg exercises until he could barely stand. He notes he has been very weak since and called EMS after he developed flank pain and noticed that his urine had become dark and tea-colored. You should suspect*urinary tract infection.nephritis.rhabdomyolysis.routine muscle overuse pain. Which of the following findings would specifically exclude a stroke patient from receiving fibrinolytic therapy?*The patient is over 80 years oldCurrent anticoagulant therapyBlood glucose over 300 mg/dLPresent urinary tract infection A 44 year old female is having an asthma attack. Which of the following findings would best indicate that she has a high potential for a severe attack?A history of recent hospitalization for asthmaMultiple uses of a rescue inhaler without reliefA history of hypertensionA history of environmental allergies An 82 year old female was diagnosed with influenza one week ago. Since then she has had a persistent cough and has grown progressively weaker. Today she presents with altered mental status. Her vital signs are P 100, R 34, BP 80/60. After taking respiratory precautions, you should next*administer an inhaled beta agonist.prepare an infusion of norepinephrine.administer intravenous dextrose.initiate a fluid bolus with normal saline. A 69 year old male has new onset facial droop and is slurring his speech. He has a history of TIA. After completing your primary assessment, you should next*activate the stroke alert and initiate transport.complete a Cincinnati Stroke Checklist.obtain a blood glucose level.administer a complete neurological examination. A 51 year old male complains of dyspnea. The director of the group home in which he lives states that he has had a severe cough for the last 4 days and a fever. He notes all of his residents are sick. The patient is lethargic, coughing and has an audible wheeze when he breathes. His vital signs are P 130, R 44, BP 100/65, SpO2 84. You should first*administer 0.3 mg of epinephrine.administer 2.5 mg of albuterol via nebulizer.initiate supplemental oxygen.initiate positive pressure ventilation. A 50 year old male has had a hypoglycemic event and you have corrected his blood sugar using dextrose 10%. After therapy, he has returned to fully alert mental status. He notes he sometimes has these episodes when “he gets the flu” and says it’s difficult to predict since he began taking his oral antidiabetic medication. You should*assist the patient in preparing and eating a meal.recommend transport to the local hospital.recommend the patient follow up with his MD tomorrow.administer an additional dose of dextrose 10% as a buffer. A 29 year old female has developed an infection after breast augmentation surgery. She has a high fever and today has developed confusion. Her initial vital signs were P 140, R 44, BP 64/40. You have administered 20 mL/kg of normal saline and vitals have remained the same. You should next*initiate a norepinephrine infusion.initiate a dopamine infusion.administer a second bolus of normal saline.administer a corticosteroid. An 86 year old woman has grown increasingly ill since having a urinary catheter placed 5 days ago. She has altered mental status, fever and complains of abdominal pain. Her vital signs are P 116, R 30, BP 110/80. These findings most likely indicate*a blocked catheter.sepsis.a kidney infection.stroke. A 71 year old male patient with chronic kidney disease has missed his dialysis appointment. Given the missed dialysis, which of the following problems would be most likely?*Increased ammonia levelsHypoxiaHypotensionIncreased urea levels You have activated a stroke alert for a 70 year old male. Transport has been initiated and you have obtained a normal blood glucose level. You should next*complete the fibrinolytic screening checklist.obtain intravenous access.obtain a baseline set of vital signs.obtain the “last seen normal.” A 90 year old female has fallen in her apartment after returning from her dialysis appointment. She complains of shortness of breath and vertigo. Your assessment finds her skin to be pale. Her vital signs are P 88, R 22, BP 80/60. You should next*administer high concentration oxygen.place the patient in the Trendelenburg position.begin an albuterol nebulizer treatment.administer a 500 mL fluid bolus. A 22 year old female was found with a blood glucose of 20 mg/dL. Dextrose 10% was administered, but 15 minutes later she still has an altered mental status and her blood glucose remains at 38mg/dL. You should next*administer 1 mg glucagon.instill a tube of oral glucose.administer 25 g of dextrose 50%.ask the patient’s family to turn off her insulin pump. A 79 year old female complains of abdominal pain. She states she had diverticulitis surgery 2 weeks ago but has been feeling better since. Today she complains of waxing and waning pain across her lower two abdominal quadrants. You should suspect*bowel obstruction.Crohn’s disease.gastritis.cholecystitis. A 69 year old female complains of diffuse upper quadrant abdominal pain. She notes she has been weak for 2 days and has been vomiting all morning. She discloses a history of GERD. Her vital signs are P 110, R 28, BP 96/50. You should first*administer a fluid bolus.apply high concentration oxygen.administer an H2 blocker.administer an antiemetic. A 35 year old female has a known allergy to peanuts and was accidentally exposed. She denies difficulty breathing. Your physical examination notes no evidence of skin signs or rash. Her vital signs are P 100, R 20, BP 86/60. You should first administer*IM epinephrine.a bolus of normal saline.IV diphenhydramine.high concentration oxygen. A 77 year old female has developed sepsis secondary to an infection around an indwelling catheter. She has altered mental status and tachycardia. Which of the following findings would you also expect given her presentation of sepsis?*A high blood pressureA high blood glucose levelA slow respiratory rateA low lactate level A 22 year old male is found in the fetal position with pain due to a “sickle cell crisis.” He notes the pain began two hours ago and rates the pain a 10 on a 1-10 scale. The patient’s vital signs are P 120, R 20, BP 110/70. You should first*provide a bolus of normal saline.immobilize the patient to a long spine board.administer midazolam.administer diphenhydramine. You have administered an intranasal dose of naloxone to an unconscious heroin overdose patient. Over the last 5 minutes the patient’s respiratory rate has increased from 4/minute to 16/minute, however, the patient remains unconscious. You should next*administer a second dose of intranasal naloxone.administer a dose of intravenous naloxone.monitor and transport the patient.continue positive pressure ventilation. Which of the following diseases would be commonly associated with a living environment infested by mice or rats?*MRSAHantavirusTuberculosisTetanus A 69 year old female has had a syncopal episode. She complains of vertigo and her vital signs are P 110, R 24, BP 82/60. She denies any recent trauma but notes she recently stopped taking her prescribed corticosteroid. You should suspect*myxedema coma.Cushing’s syndrome.adrenal insufficiency.thyroid storm. A 55 year old intoxicated female has been secured to your stretcher using soft restraints. She is still quite agitated and is fighting fiercely. After ensuring she is safely restrained, you should next*initiate intravenous access.administer oxygen.initiate priority transport to the hospital.administer a sedative. A 62 year old female had an acute onset of right-sided hemiplegia that resolved by itself shortly after your arrival. At this point she is symptom-free. She has a past medical history of hypertension, high cholesterol, and atrial fibrillation. She also takes medication for depression. The most likely cause of today’s episode would be*a stroke.a TIA.a new onset atrial fibrillation.an anxiety attack. Which of the following endocrine disorders is commonly associated with a swelling of the eyes and a lumpy reddish thickening of the skin?*Grave’s diseaseAddison’s diseaseAcute pancreatitisCushing’s syndrome A 70 year old female fell to the floor and was unable to get up. She was trapped on the floor for three days and was unable to take her oral antidiabetic medications. She is currently comatose and her vital signs are P 130, R 40, BP 100/78. Her blood glucose reads “HI.” The most likely cause of her altered mental status would be*syncope.HHNS.stroke.hypoglycemia. A 42 year old male has had an acute onset of altered mental status. Family notes he went from being confused to “barely conscious” over the course of 30 minutes. You find the patient responsive to pain only and snoring. His blood glucose level reads “LO” on the glucometer. You should first*initiate immediate transport.administer 25 g of dextrose 50% intramuscularly.administer 250 mL of dextrose 10% solution intravenously.administer a tube of oral glucose into the buccal space. Which of the following findings would most likely be associated with chronic liver disease?*Rebound tendernessJaundicePolyuriaUremic frost A 66 year old female complains of severe upper left quadrant abdominal pain. She notes she has had pain for the last few weeks, but that today the pain is significantly worse. She also discloses a history of peptic ulcers. Her vital signs are P 116, R 24, BP 88/60. You should first administer*normal saline.an analgesic.aspirin.an antiemetic.