Paramedic Exam 1 Study Center > Simulated NREMT Tests > Paramedic Simulated Tests > Paramedic Exam 1 Step 1 of 50 2% A 62 year old female complains of severe upper right quadrant pain and tells you she can’t get comfortable. She tells you the pain came on suddenly after eating fried fish for dinner. She denies prior injury or recent illness. The most likely cause of her complaint is*hepatitis.diverticulitis.cholecystitis.pancreatitis. Which of the following conditions is a common cause of neonatal death as the result of decreased body temperature?*HypovolemiaAcidosisAnemiaHyperglycemia A 66 year old female complains of chest pain. After attaching the ECG, you observe an irregular, narrow complex bradycardia. The rhythm has a pattern of increasing P-R intervals preceding a dropped QRS complex. You should suspect*second-degree AV block, Type I.third-degree AV block.first-degree AV block.second-degree AV block, Type II. Which of the following is the most likely cause of sudden death in traumatic asphyxia?*Compression of the lungsCompression of the great vesselsMassive intracerebral hemorrhageVascular rupture in the head and neck Pulmonary edema associated with heart failure is most commonly the result of*diminished left ventricular function.decreased preload.decreased afterload.diminished right ventricular function. A 35 year old female complains of lightheadedness and feels her heart is racing. She tells you she is six months post renal transplant. Her vital signs are P 118, R 24, BP 90/40, and SpO2 is 95% on room air. Her blood glucose level is 350 mg/dL, and her temperature is 101.2˚ F. What is the likely cause of this presentation?*HypervolemiaDiabetes insipidusInfectionPost-transplant renal failure An 11 year old female complains of localized pain in her left shin after being kicked by another soccer player. You do not observe any deformity, swelling or bruising. She can move her leg. You should*splint her leg and transport for further evaluation.encourage her father to sign a refusal and transport her to an urgent care center.apply a cold pack and assist her to the stretcher.apply a cervical collar and immobilize her to a long backboard. A confused 70 year old male complains of chest pain. His vital signs are P 161, R 30, and BP 82/50. You attach the ECG and observe monomorphic ventricular tachycardia. The rhythm is refractory to cardioversion at 100 J. You should next*administer amiodarone.cardiovert at a higher joule setting.deliver an unsynchronized defibrillation.administer lidocaine. Which of the following should you suspect with an extremity injury that produces disproportional pain related to the injury?*Cushing’s syndromeReferred painCompartment syndromeVisceral pain An 88 year old female is not able to tell you what year it is and is unable to recall events that occurred earlier in the day. She does not appear to be in any distress. Her son tells you that this change occurred suddenly and that she is normally alert, active, and aware of her surroundings. You should suspect*dementia.delirium.Alzheimer’s disease.neoplasm. In a patient who has hepatic encephalopathy, rising ammonia levels result in*a hyperreflexia state.diminished nervous system function.alkalosis.osmotic diuresis. A 52 year old female pedestrian was struck by a car. She was briefly pinned between the car and a wall. You observe significant jugular venous distention, blood in the anterior surface of her eye, and cape cyanosis. You should first*initiate rapid transport.maintain a MAP below 80 mmHg.administer mannitol.establish vascular access. An 89 year old male complains of weakness, shortness of breath, and congestion with a productive cough. He has a previous history of atherosclerotic heart disease. You observe jugular venous distention and pitting pedal edema. His skin is mottled, cool, and clammy. His vital signs are P 132, respiration 16 and labored, BP 82/50 and SpO2 is 91% on room air. You should suspect*distributive shock.hypovolemic shock.cardiogenic shock.obstructive shock. The production of adenosine triphosphate occurs in the*nucleus.centriole.vacuole.mitochondrion. A 55 year old female has a history of chronic bronchitis. Her blood gas levels are pH of 7.36 PaCO2 46 mmHg PaO2 90 mmHg HCO3- 29 mEq/L Which of the following conditions would you suspect in this patient?*Uncompensated respiratory acidosisCompensated metabolic acidosisCompensated respiratory acidosisUncompensated metabolic acidosis A 27 year old female has just delivered the placenta after childbirth. You observe steady, moderate hemorrhage from her vagina that does not subside after 5 minutes. You should first*administer a fluid bolus.place her in the knee-chest position.massage her fundus.pack her vagina with absorbent pads. A 66 year old male complains of chest pain. You attach the 12-lead ECG and observe 2 mm ST elevation in leads V1 and V2. Which type of STEMI should you suspect?*InferiorAnteriorLateralSeptal A 22 year old male who has head trauma is being mechanically ventilated during an interfacility transport. The high-pressure alarm sounds. What is the most likely cause?*BronchospasmDisconnected circuitExtubationCuff leak A 19 year old female was involved in a front-end car crash. You observe bulging of her intercostal muscles on the left anterior chest wall. You auscultate unequal breath sounds with hyperresonance on percussion on the left side of her chest. Her vital signs are P 110, R 24 and shallow, and BP 92/76. Her pulse oximetry reading has dropped to 90%. What has most likely caused these changes?*Diaphragmatic ruptureAortic disruptionPericardial tamponadeTension pneumothorax While assessing a 5 year old male, you auscultate diffuse wheezes. This finding may be misleading because*his bronchi are too narrow to produce wheezes.sound is transmitted more readily in a pediatric patient’s lungs.wheezes may be normal due to his narrow air passages.wheezes and crackles sound the same in pediatric patients. A 78 year old female complains of chest pain and weakness. She tells you that she recently had radiation treatment for breast cancer. You auscultate clear lung sounds and muffled heart tones. Her vitals are P 122 and weak, R 28, BP 108/90 and SpO2 is 95% on room air. You attach the 12-lead ECG and observe 2 mm ST elevation in all leads. You should suspect*pleural effusion.cardiogenic shock.pericarditis.myocardial infarction. An 18 year old male was ejected during a high-speed motor vehicle crash. He is confused and dyspneic. You observe paradoxical motion to his anterior right chest. You should first*apply a bulky dressing to the right chest.administer oxygen by non-rebreather mask.stabilize the flail segment with 3-inch tape.perform a needle decompression of the right chest. In a spontaneously breathing patient, a shift to the right in the oxyhemoglobin dissociation curve will cause*hemoglobin to release oxygen less easily.a decrease in SpO2 levels.hemoglobin to release oxygen more easily.a reduction in internal respiration. Cyanosis in dark-skinned individuals can best be assessed by examining*top of their foot.mucous membranes.pupil reaction to light.back of their hand. Labetalol lowers blood pressure by*sodium channel blocking action.alpha blocking action.alpha and beta-adrenergic blocking action.vasodilatory effect. A 45 year old female appears to be in respiratory distress and is having difficulty speaking. You auscultate wheezes. Her vital signs are P 104, R 28, BP 142/88 and SpO2 is 90% on room air. You should first*administer a corticosteroid.administer a beta-2 agonist.intubate her.establish IV access. Inability to initiate movement associated with Parkinson’s disease is*dystonia.bradykinesia.cogwheel rigidity.plastic rigidity. A drowsy 8 year old female has difficulty breathing and has audible wheezes. She speaks in one- to two-word sentences. Her vital signs are P 124, R 40, BP 100/60, SpO2 is 84% on room air, and her EtCO2 is 68 mmHg. You should suspect*respiratory distress.hyperventilation syndrome.respiratory failure.respiratory alkalosis. A posterior pituitary gland tumor may cause*Hashimoto’s disease.diabetes insipidus.Cushing syndrome.Graves’ disease. A 3 year old female presents with difficulty breathing and a spasmodic cough. You hear inspiratory stridor and her skin is warm to the touch. No drooling is evident. You should suspect*asthma.croup.bronchiolitis.foreign body airway obstruction. An unresponsive 44 year old male was ejected from his car. He is apneic, and because of severe hemorrhage from a Le Fort I fracture, you are unable to orally intubate him. You should next*insert a supraglottic airway.apply cricoid pressure.perform a needle cricothyrotomy.nasally intubate him. A 26 year old male was thrown from his snowmobile and now has paralysis in his lower extremities. Your assessment confirms that no motor function or sensation is present beneath his nipple line. His vital signs are P 70, respiration 16, and BP 76/34. You should first administer a/an*vasopressor.corticosteroid.analgesic.parasympatholytic. A 22 year old female has had a sudden onset of palpitations and shortness of breath. Her vital signs are P 210, respiration 28, BP 110/80. You observe a narrow, regular complex tachycardia. You should first*perform cardioversion.perform a vagal maneuver.administer diltiazem.administer adenosine. A 16 year old female has started a new prescription. Within 10 minutes of taking the first dose, she has audible wheezes and hives. Her vital signs are P 136, R 36 and labored, BP 88/46 and SpO2 is 90% on room air. You should first administer*epinephrine (0.1 mg/mL) 0.3 mg intramuscular.epinephrine (1 mg/mL) 0.1 mg intravenous.epinephrine (0.1mg/mL) 0.1 mg intravenous.epinephrine (1 mg/mL) 0.3 mg intramuscular. Pneumonia primarily affects the lungs via*pleural effusion.atelectasis.bronchoconstriction.inflammation of the alveoli. An intended effect of CPAP is to*prevent the lungs from fully filling during exhalation.prevent the lungs from fully emptying during exhalationincrease preload with its negative intrathoracic pressure.increase preload with its positive intrathoracic pressure. A bedridden 66 year old male complains of fatigue and joint pain. He tells you that his room has been hot for the last three days. His vital signs are P 110, R 26, BP 90/60, and SpO2 is 94% on room air. You attach the 12-lead ECG and observe decreased amplitude P waves, an intraventricular conduction delay, and T waves that are 15 mm tall in all leads. You should administer*calcium chloride.potassium chloride.magnesium sulfate.sodium nitroprusside. Which of the following gases has a higher concentration at peak expiration as compared to newly inspired air?*Carbon dioxideNitrogenOxygenCarbon monoxide Hollow organ injuries present with which type of pain?*VisceralSomaticReferredParietal A 56 year old male was thrown 20 feet after an explosion. He complains of chest pain and nausea. His skin is diaphoretic and you observe JVD. His vital signs are P 40, R 30, and BP 82/40. The most likely cause of his complaint is*diaphragmatic rupture.pulmonary contusion.blunt cardiac injury.commotio cordis. Which of the following findings is associated with the activation of histamine receptors in the bronchioles?*StridorWheezesRhonchiHoarse voice A 33 year old female who has type 1 diabetes tells you she has had elevated blood glucose levels for the last 4 days despite adjusting her insulin. Her vital signs are P 90, R 22 and deep, BP 114/56, and she has a blood glucose level of 459 mg/dL. You should administer a/an*hypertonic fluid bolus.hypotonic fluid bolus.isotonic fluid bolus.colloid fluid bolus. An alert 60 year old female was knocked down by an explosion inside a movie theater. She is speaking loudly and is having difficulty hearing your triage questions. You should suspect*compression of cranial nerve I.ruptured tympanic membranes.basilar skull fracture.rising intracranial pressure. A 26 year old male has a tension pneumothorax. There is no improvement following needle decompression. You should next*intubate him and administer positive pressure ventilation.repeat the procedure on the opposite side of his chest.transport the patient immediately without further intervention.repeat the procedure with another needle placed adjacent to the first. A 14 year old male complains of severe back pain and a painful erection that started 3 hours ago. He tells you that he has a history of depression and sickle cell disease. His skin is pink, warm, and dry and you auscultate clear breath sounds. His vital signs are P 128, R 24 and shallow, BP 146/94, and SpO2 is 95% on room air. You should suspect*psychogenic reaction.testicular torsion.sequestration crisis.Raynaud’s syndrome. A febrile 3 month old male has dyspnea. His mother tells you he has had a runny nose for 24 hours and that everyone in the house has been sick. You observe moderate respiratory distress and auscultate wheezes in all fields. You should suspect*bronchiolitis.cystic fibrosis.asthma.pertussis. A 25 year old male has had an acute onset of respiratory distress. He tells you he frequently has these attacks, but today it seems to be worse. You observe accessory muscle use and auscultate wheezes. His vital signs are P 108, R 30, BP 128/88, and SpO2 is 95% on room air. You should first administer*a bronchodilator.a corticosteroid.diphenhydramine.epinephrine. You are ventilating a 63 year old male after achieving ROSC. His vital signs are P 34, R 10 with good chest rise, and BP 76/44. His SpO2 is 99% and his EtCO2 is 45 mmHg. You observe a third-degree block on the ECG monitor. You should first*administer dopamine.begin transcutaneous pacing.resume chest compressions.decrease your ventilation rate. Which of the following findings is specifically associated with the dissection of an acute aortic aneurysm?*Tearing painPain on inspirationWaxing and waning painRight shoulder pain A 22 year old male was shot in the back. He has loss of motor function on his left side below the level of the injury and loss of pain sensation on his right side below the level of the injury. You should suspect*anterior cord syndrome.posterior cord syndrome.central cord syndrome.Brown-Séquard syndrome.