Paramedic Exam 1 Study Center > Simulated NREMT Tests > Paramedic Simulated Tests > Paramedic Exam 1 Step 1 of 50 2% 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* administer mannitol. initiate rapid transport. establish vascular access. maintain a MAP below 80 mmHg. Which of the following conditions is a common cause of neonatal death as the result of decreased body temperature?* Hypovolemia Anemia Acidosis Hyperglycemia A 26 year old male has a tension pneumothorax. There is no improvement following needle decompression. You should next* repeat the procedure on the opposite side of his chest. intubate him and administer positive pressure ventilation. repeat the procedure with another needle placed adjacent to the first. transport the patient immediately without further intervention. Inability to initiate movement associated with Parkinson’s disease is* dystonia. bradykinesia. plastic rigidity. cogwheel rigidity. Which of the following findings is associated with the activation of histamine receptors in the bronchioles?* Rhonchi Wheezes Stridor Hoarse voice The production of adenosine triphosphate occurs in the* mitochondrion. vacuole. centriole. nucleus. Pulmonary edema associated with heart failure is most commonly the result of* decreased preload. diminished left ventricular function. diminished right ventricular function. decreased afterload. 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* potassium chloride. magnesium sulfate. sodium nitroprusside. calcium chloride. Hollow organ injuries present with which type of pain?* Parietal Somatic Referred Visceral 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* intubate her. establish IV access. administer a corticosteroid. administer a beta-2 agonist. 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. rising intracranial pressure. basilar skull fracture. Which of the following gases has a higher concentration at peak expiration as compared to newly inspired air?* Oxygen Carbon monoxide Carbon dioxide Nitrogen 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* central cord syndrome. anterior cord syndrome. Brown-Séquard syndrome. posterior cord syndrome. 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* pancreatitis. cholecystitis. diverticulitis. hepatitis. 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 failure. hyperventilation syndrome. respiratory alkalosis. respiratory distress. Which of the following should you suspect with an extremity injury that produces disproportional pain related to the injury?* Cushing’s syndrome Referred pain Visceral pain Compartment syndrome 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* decrease your ventilation rate. administer dopamine. resume chest compressions. begin transcutaneous pacing. 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. 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 corticosteroid. epinephrine. diphenhydramine. a bronchodilator. 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 rupture Pericardial tamponade Tension pneumothorax Aortic disruption 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* cardiovert at a higher joule setting. deliver an unsynchronized defibrillation. administer amiodarone. administer lidocaine. 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. apply a cold pack and assist her to the stretcher. apply a cervical collar and immobilize her to a long backboard. encourage her father to sign a refusal and transport her to an urgent care center. 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. Raynaud’s syndrome. sequestration crisis. An intended effect of CPAP is to* increase preload with its positive intrathoracic pressure. prevent the lungs from fully filling during exhalation. prevent the lungs from fully emptying during exhalation increase preload with its negative intrathoracic pressure. 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. Alzheimer’s disease. neoplasm. delirium. 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 (0.1mg/mL) 0.1 mg intravenous. epinephrine (1 mg/mL) 0.1 mg intravenous. epinephrine (0.1 mg/mL) 0.3 mg intramuscular. epinephrine (1 mg/mL) 0.3 mg intramuscular. 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* third-degree AV block. second-degree AV block, Type II. second-degree AV block, Type I. first-degree AV block. Pneumonia primarily affects the lungs via* pleural effusion. bronchoconstriction. inflammation of the alveoli. atelectasis. 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?* Lateral Anterior Septal Inferior 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* stabilize the flail segment with 3-inch tape. perform a needle decompression of the right chest. apply a bulky dressing to the right chest. administer oxygen by non-rebreather mask. 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?* Bronchospasm Disconnected circuit Extubation Cuff leak 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 a vagal maneuver. perform cardioversion. administer diltiazem. administer adenosine. Labetalol lowers blood pressure by* sodium channel blocking action. vasodilatory effect. alpha and beta-adrenergic blocking action. alpha blocking action. 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* massage her fundus. administer a fluid bolus. pack her vagina with absorbent pads. place her in the knee-chest position. 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?* Diabetes insipidus Hypervolemia Post-transplant renal failure Infection In a patient who has hepatic encephalopathy, rising ammonia levels result in* diminished nervous system function. a hyperreflexia state. alkalosis. osmotic diuresis. 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* croup. foreign body airway obstruction. asthma. bronchiolitis. 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. perform a needle cricothyrotomy. nasally intubate him. apply cricoid pressure. 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. wheezes and crackles sound the same in pediatric patients. sound is transmitted more readily in a pediatric patient’s lungs. wheezes may be normal due to his narrow air passages. 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* asthma. cystic fibrosis. bronchiolitis. pertussis. 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* myocardial infarction. cardiogenic shock. pleural effusion. pericarditis. 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* obstructive shock. distributive shock. cardiogenic shock. hypovolemic shock. In a spontaneously breathing patient, a shift to the right in the oxyhemoglobin dissociation curve will cause* hemoglobin to release oxygen less easily. a reduction in internal respiration. a decrease in SpO2 levels. hemoglobin to release oxygen more easily. 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* hypotonic fluid bolus. colloid fluid bolus. hypertonic fluid bolus. isotonic fluid bolus. Which of the following is the most likely cause of sudden death in traumatic asphyxia?* Vascular rupture in the head and neck Compression of the great vessels Massive intracerebral hemorrhage Compression of the lungs 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. parasympatholytic. corticosteroid. analgesic. 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?* Compensated respiratory acidosis Compensated metabolic acidosis Uncompensated metabolic acidosis Uncompensated respiratory acidosis A posterior pituitary gland tumor may cause* Graves’ disease. diabetes insipidus. Cushing syndrome. Hashimoto’s disease. 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* commotio cordis. diaphragmatic rupture. pulmonary contusion. blunt cardiac injury. Which of the following findings is specifically associated with the dissection of an acute aortic aneurysm?* Tearing pain Right shoulder pain Pain on inspiration Waxing and waning pain