Paramedic Exam 2 Study Center > Simulated NREMT Tests > Paramedic Simulated Tests > Paramedic Exam 2 Step 1 of 49 2% When defibrillating an adult patient in ventricular fibrillation with a monophasic defibrillator, you should select which energy level?*360 J120 J300 J200 J A 26 year old female complains of a sudden onset of chest pain and shortness of breath. She tells you she recently delivered a baby by Caesarian section. She tells you that she is Rh- and was taking heparin until about a week ago. What is the probable cause of her symptoms?*Pulmonary embolismSpontaneous pneumothoraxNeoplasmARDS A 22 year old male struck a guide wire to a telephone pole while riding a snowmobile. You auscultate decreased breath sounds bilaterally and palpate an expanding area of subcutaneous emphysema across his upper chest. You should suspect a*simple pneumothorax.tension pneumothorax.pulmonary embolism.laceration in his trachea. Traction splints reduce the amount of internal blood loss from a displaced femur fracture by which of the following mechanisms?*Reduces the amount of space capable of holding bloodReduces the instance of the fractured bones lacerating the internal vasculatureTraction splints have little effect on bleeding from a femur fracture.Places the broken ends of the femur back into an inline position which tamponades the blood coming from the broken ends A febrile 45 year old male has been feeling ill for the last 2 days. Today he is having difficulty swallowing and breathing when he lays supine. You observe drooling and hear inspiratory stridor. You should suspect*epiglottitis.laryngotracheobronchitis.a foreign body airway obstruction.pneumonia. To determine the properties of the chemical that burned a patient, you should*match placard numbers to information in the Emergency Response Guidebook.ask the foreman for information about the chemical.Look for the NFPA 704 signage.obtain the SDS sheet. A 22 year old female is attempting to deliver a 35-week gestation infant. She is gravida 1, para 0. You observe the infant’s head repeatedly emerge and retract back into the vaginal canal with each contraction cycle. You should suspect*transverse lie.shoulder dystocia.en caul delivery.nuchal cord syndrome. You are assessing a 42 year old male who is continually coughing. He tells you he choked on a piece of steak and feels like the food is still lodged in his throat. You hear inspiratory stridor. You should suspect*vocal cord injury.esophageal stenosis.complete airway obstruction.partial airway obstruction.A 53 year old male complains of shortness of breath that worsened over the past hour. Two days ago he underwent a left lung biopsy. You auscultate decreased breath sounds at the left lower lobe, and his oxygen saturation is 93% on room air. You should suspect*pleural effusion.spontaneous pneumothorax.pulmonary embolism.tension pneumothorax. You set an automatic transport ventilator at a tidal volume of 600 mL and a rate of 10 breaths/minute. Based on this information, you estimate the alveolar minute ventilation to be*1500 mL.6000 mL.2400 mL.4500 mL. A 68 year old female had a syncopal episode witnessed by her family. She complains of weakness and lightheadedness. Her vital signs are P 44, R 22, BP 88/52, and SpO2 is 95% on room air. After administration of atropine, she remains hemodynamically unstable. You should next administer a/n*norepinephrine infusion at 2-20 mcg/minute.epinephrine infusion at 2-10 mcg/minute.epinephrine infusion at 2-10 mcg/kg/minute.norepinephrine infusion at 2-20 mcg/kg/minute. Which of the following best describes why the pain of angina pectoris is commonly relieved by rest?*Vasodilation around the occlusionDecreased oxygen demand from the myocardiumTime for the obstructing clot to passReversed vasospasm of the coronary artery An EtCO2 waveform that is prolonged and fin-shaped indicates*bronchoconstriction.hyperventilation.pulmonary embolism.respiratory failure. Which of the following mechanisms of injury is most commonly associated with diaphragmatic rupture?*Posterior thoracic trauma from a fallLateral thoracic trauma from a motor vehicle crashPenetrating trauma to the epigastric areaAnterior blunt force trauma from a high-velocity object A 29 year old male was working at a water treatment plant when he was exposed during an accidental chlorine gas release. Which of the following best describes how this patient would present?*Coughing, shortness of breath and pulmonary edemaShortness of breath and decreased tidal volumeRestlessness, shortness of breath, and false high SpO2 readingProfound hypoxia, unconsciousness, and clear lung sounds When treating a patient with excited delirium, you should*administer dextrose to maintain adequate blood glucose levels.avoid administration of benzodiazepines.restrain the patient in a prone position.consider early use of sedation. A 21 year old restrained female involved in a car crash complains of pain when you palpate her mid-epigastric and right hypochondriac region. You should suspect injury to which solid organ?*CecumIleumSpleenLiver You have intubated a neonate. Which of the following conditions would you most likely observe if ventilation and oxygenation are inadequate?*PneumothoraxTachycardiaBradycardiaHypertension You are ventilating a 52 year old male using an ATV. His vital signs are P 94, R 12, BP 108/76, SpO2 93% and EtCO2 of 37 mmHg. You receive orders to increase the tidal volume and the rate. After 2 minutes, you should anticipate a/an*metabolic alkalosis.decrease in EtCO2.metabolic acidosis.increase in EtCO2. A 76 year old female complains of pain in her left lower leg. She tells you that she has been resting in bed for two days after hip surgery. You note swelling and point tenderness. You should transport her*with ice packs to her legs.in the Trendelenburg position.in the position of comfort.with her legs elevated. Hypoxemia in acute decompensated left heart failure is caused by difficulty*receiving blood from the peripheral circulation.pumping blood to the lungs.exchanging gases between the alveolus and capillary.maintaining pressure in the pulmonary circulation. Differentiating lightning strike from other heat-related or electrical causes can be done by identifying*significant destruction of tissue at the site of contact.full thickness burns.feathering burn pattern.cardiac arrest. A 65 year old female complains of palpitations. Her vital signs are P 132 and irregular, R 20, BP 142/82, and SpO2 is 99% on room air. Her medications are Metformin®, atenolol, and warfarin. Her cardiac rhythm is most likely*atrial fibrillation with a rapid ventricular response.paroxysmal supraventricular tachycardia.polymorphic ventricular tachycardia.sinus rhythm with frequent PVCs. Which of the following is an anticipated consequence of inadequate oxygen availability during the electron transport phase of metabolism?*Significantly diminished ATP productionReduced serum lactate levelsElevated body pHDecreased levels of circulating hydrogen ions Which of the following is a classic presentation of right-sided heart failure?*A 58 year old male who had a syncopal episode, has pitting edema in both lower extremities and right axis deviation on his 12-lead ECGA 72 year old female who complains of crushing chest pain, is bradycardic and has ST elevation in leads II, III, and aVF with reciprocal changesA 49 year old female who complains of chest discomfort and shortness of breath has diffuse crackles and is hypertensiveA 61 year old male who had a sudden onset of sharp chest pain has clear lung sounds and is hypoxic Why does fluid accumulate in the interstitial compartment of the lower extremities in a patient who has right ventricular failure?*Decreased oncotic pressureDecreased hydrostatic pressureIncreased oncotic pressureIncreased hydrostatic pressure A 52-year-old female called 911 after several near syncopal episodes at home. Her medications include Enalapril, Eliquis, and Verapamil. Assessment reveals an alert patient with no current complaints with vital signs P 32, R 20, BP 104/60, SpO2 97% and sinus bradycardia with 1st-degree heart block. After starting oxygen and an IV, you should*administer atropine 0.5 mg, a normal saline bolus, begin dopamine infusion, and transport.begin pacing the patient, administer pain control if time allows, and transport immediately.administer atropine 0.5 mg IV, reassess, and consider placing pacing pads before initiating transport.activate the CATH lab since the patient will most likely require a pacemaker and transport immediately. A 90 year old female complains of chest pain and nausea. You attach the ECG monitor and observe an irregular, narrow complex rhythm at 52 beats/minute. You note increasing PR intervals with an eventual dropped QRS complex. You should suspect*second degree AV block type I.bigeminal premature ventricular contractions.third degree heart block.second degree AV block type II. A full-term pregnant 38 year old female is in labor. You observed crowning, and she feels the need to push. She tells you that she is considered high risk because of her age and she developed gestational diabetes during the pregnancy. You should*transport immediately to a hospital with a NICU.contact medical direction prior to delivery.prepare to deliver the baby at the scene.move the patient to the ambulance and transport. During an assessment of a patient who was injured playing football, what finding would be lead you to suspect an injury to the spleen?*Lack of bowel sounds on auscultationPossible 9th and 10th rib fractures on the left sideLower left abdominal painRight upper quadrant ecchymosis A 36 year old female is having a severe asthma attack. After initial treatment, you note her breathing rate slows and she is still awake. She develops occasional, long pauses between breaths. You should suspect*respiratory failure.cor pulmonale.respiratory distress.cardiac asthma. Your partner is ventilating an apneic adult patient with a BVM. He tells you he is having trouble maintaining a face-mask seal despite the use of a BLS airway adjunct and positioning. You should*insert a nasogastric tube.intubate the patient.perform a needle decompression.hold the mask with two hands. A 75 year old female complains of pain and swelling her left ankle without signs of further injury. Her vital signs are P 54 R 16 BP 132/90 and SpO2 is 96% on room air. She tells you that she takes multiple medications and has a history of HTN, MI, and type II diabetes. What is the likely cause of her bradycardia?*Her medicationOccult head injuryProlonged sitting positionParasympathetic reaction to painWhich of the following can cause a petechial rash that does not blanch?*Meningococcal meningitisAseptic meningitisViral meningitisMeningitis vaccine A 52 year old female complains of a sudden onset of weakness and lightheadedness. You note that she has a sudden drop in her pulse rate. She tells you that she had a heart transplant 2 years ago. Her palpated pulse of 44 matches the rate on the ECG monitor. You should first*administer atropine.administer dopamine.begin transcutaneous pacing.administer epinephrine. Which of the following is most suggestive of commotio cordis in an unconscious 14 year old female?*Cape cyanosis, diminished lung sounds, and difficulty ventilating herBruising to her flank and a rigid abdomenDiscoloration around her eyes and behind the ears after head traumaBruising to her chest after being struck by a baseball Which of the following would best describe why referred back pain is associated with a dissecting descending aortic aneurysm?*A tear in the artery is widening as blood leaks out of the vessel.The bulging artery is tearing away from its tethers.Swelling in the vessel applies pressure on spinal nerves.A hole in the diaphragm is torn as the bulging artery passes through. A febrile 3 year old male has nasal congestion and a barking cough. He is alert and consolable, breathing normally with clear lung sounds. His vital signs are P 108, R 28, BP 92/60, and SpO2 is 97% on room air. You should next*transport him.administer nebulized epinephrine.administer humidified oxygen.establish IV access. An unresponsive 34 year old male is breathing irregularly at a rate of 6/minute. How should you improve his alveolar minute volume?*Assist his ventilation with a BVMApply CPAPAdminister oxygenPlace him in the recovery position In an open-book pelvic fracture, the primary benefit of applying a pelvic binder is to*minimize the pain.decrease the internal pelvic volume.enable easier movement.stabilize the pelvis. A 58 year old male complains of feeling sick for 3 weeks. He has a history of type 2 diabetes. His vital signs are P 108, R 18, BP 100/78, and SpO2 is 94% on room air. His blood glucose level is greater than 500 mg/dL. You should suspect*hyperosmolar hyperglycemic syndrome.diabetic ketoacidosis.sepsis.pancreatic tumor. The cells of the alveoli that secrete surfactant are*thrombocytes.lymphocytes.pneumocytes.leukocytes. A 69 year old male with a history of left heart failure has severe difficulty breathing and a productive cough. You auscultate coarse crackles halfway up both lungs. His vital signs are P 120 and irregular, R 22, BP 156/96, and SpO2 88% on room air. His temperature is 98.2˚F. You should initially*apply CPAP.assist his ventilations.intubate him.administer furosemide. What procedure best explains the passive flow of oxygen into the alveoli during intubation?*Dead space perfusionApneic oxygenationFacilitated diffusionActive diffusion When assisting ventilations of a tachypneic 38 year old male, you should initially*attach a PEEP device to override his inspiratory effort.provide one ventilation every six seconds.provide a tidal volume higher than normal based on his age.assist his ventilation at the rate he is breathing. Which of the following is the most reliable indicator of apnea in an unresponsive patient?*Absence of extremity movementUnable to feel breath on your cheekCircumoral cyanosisLack of chest wall movement An 8 year old male was struck in the face with a baseball. He did not lose consciousness but complains of pain on the right side of his face. He also tells you that he has double vision. You should suspect a/an*orbital fracture.Le Fort fracture.detached retina.epidural hematoma. A 6 month old female is cyanotic. She responds to her parents who tell you she is underweight and is awaiting surgery for tetralogy of Fallot. You should*administer oxygen and establish intraosseous access.transport her without interventions to the nearest trauma center.administer oxygen, establish IV access, and transport her.administer blow-by oxygen and transport her. Why does fluid accumulate in the interstitial compartment of the lower extremities in a patient who has right ventricular failure?*Increased oncotic pressure.Decreased oncotic pressure.Increased hydrostatic pressure.Decreased hydrostatic pressure. An 88 year old female has a sudden onset of pleuritic chest pain and shortness of breath. Pertinent physical findings include clear breath sounds and a swollen, tender left calf. Her vital signs are P 120, R 32, BP 96/50, and SpO2 86% on room air. You should suspect*pulmonary embolism.angina pectoris.acute chest syndrome.acute heart failure. An unconscious 32 year old female whose GCS is 10 (E-2, V-3, M-5) has multiple gunshot wounds to her abdomen and pelvis. During transport, your partner is treating her wounds. You have inserted a nasopharyngeal airway and administered oxygen 15 L/minute by non-rebreather mask. Her vital signs are P 144, R 30, BP 68/34, and SpO2 is 72%. You should next*perform a cricothyroidotomy.decompress her chest.endotracheally intubate her.nasotracheally intubate her.