phase 1 paramedic
Normal blood pH range
7.35-7.45
Which of the following statements is LEAST descriptive when documenting the events of a cardiac arrest call on your patient care report? A) "Followed ACLS protocols." B) "Intubated with a 7.5-mm ET tube." C) "Gave 1 mg of epinephrine at 1002." D) "Inserted 18-gauge IV in right forearm."
A) "Followed ACLS protocols."
Which of the following scenarios MOST accurately depicts abandonment? A) A patient with a possible fracture of the radius wishes to go to the hospital, but does not have transportation, so you arrange for a friend to take him to the emergency department the next day. B) While en route to the hospital with a patient experiencing chest pressure, you encounter a major motor vehicle accident, call the dispatcher to request assistance, and proceed to the hospital with your patient. C) During a mass-casualty incident involving a building collapse, a paramedic triages a patient as being low priority and instructs an EMT to observe the patient and inform the paramedic if the patient's condition deteriorates. D) A mentally competent adult with shortness of breath adamantly refuses to be transported to the hospital via EMS, so you arrange for a friend or family member to stay with the patient and call 9-1-1 if it becomes neces
A) A patient with a possible fracture of the radius wishes to go to the hospital, but does not have transportation, so you arrange for a friend to take him to the emergency department the next day.
Which of the following statements regarding ascites is correct? A) Ascites is a collection of fluid within the peritoneal cavity. B) Percussion of the abdomen will often yield hyperresonance. C) The most common cause of ascites is an acute splenic injury. D) The abdomen of a patient with ascites has a sunken appearance.
A) Ascites is a collection of fluid within the peritoneal cavity.
Which of the following is NOT a critical point addressed by the "White Paper" written in 1966 that was entitled "Accidental Death and Disability: The Neglected Disease of Modern Society"? A) Ensuring that paramedics responded to every call B) Participating in community-based prevention efforts C) Allocating adequate resources for medical direction D) Developing and pursuing a national EMS research agenda
A) Ensuring that paramedics responded to every call
Which of the following factors would likely NOT skew a pulse oximetry reading? A) Hypertension B) Cold temperature C) Carbon monoxide D)Sickle-cell disease
A) Hypertension
In which of the following situations is morphine sulfate associated with the greatest risk of bradycardia or AV heart block? A) Inferior wall MI B) Anterior wall MI C) Unstable angina D) Lateral wall MI
A) Inferior wall MI
Which of the following statements regarding isotonic solutions is correct? A) Isotonic solutions have almost the same osmolarity as bodily fluids. B) D5W becomes an isotonic solution once it is introduced into the body. C) Normal saline is the only isotonic solution used in the prehospital setting. D) Isotonic solutions expand the vascular space by shifting fluid from other compartments.
A) Isotonic solutions have almost the same osmolarity as bodily fluids.
Which of the following incident times is NOT commonly documented on the patient care report? A) Time of primary assessment B) Time of departure from the scene C) Time of arrival at the hospital D) Time of medication administration
A) Time of primary assessment
What are the three layers of the blood vessel, starting with the outer layer? A) Tunica adventitia, tunica media, tunica intima B) Tunica intima, tunica adventitia, tunica media C) Tunica media, tunica intima, tunica adventitia D) Tunica media, tunica adventitia, tunica intima
A) Tunica adventitia, tunica media, tunica intima
The vagus nerve releases _________________, which acts on _________________ receptors. A) acetylcholine, muscarinic-2 B) norepinephrine, alpha-1 C) epinephrine, beta-2 D) acetylcholinesterase, nicotinic
A) acetylcholine, muscarinic-2
At 5 to 10 mg/kg/min, dopamine: A) activates beta-1 receptor sites, causing an increased heart rate and increased cardiac contractility. B) activates dopaminergic receptor sites, causing renal and mesenteric artery vasodilation. C) no longer activates dopaminergic receptor sites and predominately activates alpha-1 receptor sites. D) has a negative chronotropic effect on the heart, but an increased inotropic effect.
A) activates beta-1 receptor sites, causing an increased heart rate and increased cardiac contractility.
it is MOST important to identify the age and sex of your patient because: A) age and sex can change how your patient presents. B) the differential diagnosis is modified for older patients. C) this is required information for the patient care report. D) the patient should be assessed by a medic of the same sex.
A) age and sex can change how your patient presents.
The catecholamine epinephrine (adrenaline) has an affinity for: A) alpha and beta receptors. B) alpha-1 receptors only. C) beta-1 receptors only. D) alpha-1 and beta-2 receptors.
A) alpha and beta receptors.
Ascites is defined as: A) an abnormal accumulation of fluid in the peritoneal cavity. B) lower extremity edema caused by lymphatic obstruction. C) fluid buildup in the lungs due to decreased cardiac function. D) fluid backup in the periphery due to right atrial dysfunction.
A) an abnormal accumulation of fluid in the peritoneal cavity.
When oxygen does not reach the cell, the cell reverts to: A) anaerobic metabolism and produces lactic acid. B) aerobic metabolism and produces carbon dioxide. C) fat metabolism and begins producing ketoacids. D) anaerobic metabolism and produces bicarbonate.
A) anaerobic metabolism and produces lactic acid.
The purpose of a Volutrol (Buretrol) administration set is to: A) avoid inadvertent fluid overload. B) deliver large volumes of IV fluid. C) facilitate piggyback medication infusions D) deliver a maximum of 50 mL of IV solution.
A) avoid inadvertent fluid overload.
In order to cause a negative inotropic effect on the heart, you would have to administer a(n): A) beta-1 adrenergic antagonist. B) alpha-2 adrenergic agonist. C) beta-2 adrenergic agonist. D) alpha-1 adrenergic antagonist.
A) beta-1 adrenergic antagonist.
The primary buffer used in all circulating body fluids is: A) bicarbonate. B) phosphorus. C) potassium. D) magnesium.
A) bicarbonate.
Catecholamines and sympathomimetic medications should be administered with caution because they: A) can increase cardiac workload and myocardial oxygen demand. B) have an average duration of action of between 24 and 48 hours C) are associated with paradoxical bradycardia in younger patients. D) have a tendency to cause a significant decrease in cardiac output.
A) can increase cardiac workload and myocardial oxygen demand.
Unlike a nondepolarizing paralytic, a competitive depolarizing paralytic: A) causes muscle fasciculations. B) does not induce full paralysis. C) causes profound sedation. D) lowers serum potassium.
A) causes muscle fasciculations.
Hypertrophic cardiomyopathy is characterized by: A) enlargement or thickening of the heart muscle. B) progressive shrinking of the right side of the heart. C) a significant reduction of blood return to the atria. D) generalized thinning of the left and right ventricles.
A) enlargement or thickening of the heart muscle.
The MOST prominent clinical indicator of a pyrogenic reaction is: A) fever. B) nausea. C) a headache. D) vascular collapse.
A) fever.
When auscultating heart sounds, you should place your stethoscope at the: A) fifth intercostal space, over the apex of the heart. B) second intercostal space, over the base of the heart. C) third or fourth intercostal space, in the midaxillary line. D) sternal border at the second or third intercostal space.
A) fifth intercostal space, over the apex of the heart
Signs and symptoms of cumulative stress include: A) insomnia or hypersomnia. B) increased sexual function. C) bradycardia and hypotension. D)decreased interest in alcohol.
A) insomnia or hypersomnia.
A paramedic who is licensed in a particular state: A) is required to function under the guidance of a licensed physician. B) has complete autonomy and can function as an independent provider. C) must obtain more continuing education hours than a certified paramedic. D) is authorized to function as medical control for EMTs and advanced EMTs.
A) is required to function under the guidance of a licensed physician.
Patients with type 1 diabetes mellitus: A) need exogenous insulin to survive. B) are less likely to develop ketoacidosis. C) experience excessive cellular uptake of glucose. D) control their disease with dietary modification.
A) need exogenous insulin to survive.
A loss of normal sympathetic nervous system tone causes: A) neurogenic shock. B) obstructive shock. C) profound vasoconstriction. D)a reduced absolute blood volume
A) neurogenic shock.
The induction phase of the immune response begins when: A) part of the immune system recognizes an antigen. B) the body is initially exposed to a foreign substance. C) an antibody binds to a specific antigen and destroys it. D) biologic mediators release histamine and other chemicals.
A) part of the immune system recognizes an antigen.
The patient care report: A) provides for a continuum of patient care upon arrival at the hospital. B) is a legal document and should provide a brief description of the patient. C) should include the paramedic's subjective findings or personal thoughts. D) is only held for a period of 24 months, after which it legally can be destroyed.
A) provides for a continuum of patient care upon arrival at the hospital.
A patient experiences profound sedation when an opioid, such as fentanyl, is given together with a benzodiazepine, such as midazolam. This is an example of: A) synergism. B) summation. C) potentiation. D)antagonism.
A) synergism
A DNR order is MOST accurately defined as a: A) written order designed to tell health care providers when resuscitation is or is not appropriate. B) legal document that is executed by the patient while he or she still has decision-making capacity. C) written or oral directive that stipulates the care that a patient should receive at the end of his or her life. D) legal document signed by at least two physicians that prohibits resuscitative efforts in terminally ill patients.
A) written order designed to tell health care providers when resuscitation is or is not appropriate.
17. Compared to an EMT, an AEMT: A) can administer a variety of emergency medications. B) has a more advanced knowledge of pathophysiology. C) is trained and authorized to perform manual defibrillation. D) can legally transfer patient care to a provider of lesser training.
B
Which of the following statements regarding anaerobic metabolism is correct? A) The waste products of anaerobic metabolism are carbon dioxide and water. B) Anaerobic metabolism can be supported in most cells for only 1 to 3 minutes. C) The lactic acid produced by anaerobic metabolism is needed to make energy. D)Anaerobic metabolism is a normal process that occurs in the presence of oxygen.
B) Anaerobic metabolism can be supported in most cells for only 1 to 3 minutes.
Which of the following statements regarding isotonic crystalloid solutions is correct? A) You should infuse 1 mL of isotonic crystalloid solution for every 3 mL of estimated blood loss. B) Approximately two thirds of infused isotonic crystalloid solution will leave the vascular space within 1 hour. C) Isotonic crystalloids, such as normal saline, have the ability to carry and deliver oxygen to the body's cells. D) The ability of isotonic crystalloids to cross membranes and alter fluid levels makes them dangerous to use for fluid replacement.
B) Approximately two thirds of infused isotonic crystalloid solution will leave the vascular space within 1 hour
How does the body respond to hypoperfusion? A) Decreased preload, stroke volume, and heart rate B) Catecholamine release and increased systemic vascular resistance C) Splenic retention of red blood cells secondary to systemic hypoxia D) A compensatory decrease in cardiac output and cardiac oxygen demand
B) Catecholamine release and increased systemic vascular resistance
Which of the following statements regarding dobutamine is correct? A) The adult dose for dobutamine is 2 to 20 mg/kg/min, titrated to the desired clinical effect. B) Dobutamine increases myocardial contractility, but has minimal effect on the heart rate. C) Dobutamine is especially beneficial for patients who are in shock due to poisons or drugs. D) Patients with hypotension due to left ventricular failure should not be given dobutamine.
B) Dobutamine increases myocardial contractility, but has minimal effect on the heart rate.
What is the function of the lymphatic system? A) Prevention of viruses from entering the body B) Filtration of debris and bacteria from the blood C) Production of antibodies that destroy bacteria D) Secretion of hormones to regulate other body functions
B) Filtration of debris and bacteria from the blood
Increased myocardial contractility secondary to stretching of the myocardial walls is called the: A) Ernest-Henry effect. B) Frank-Starling effect. C) Beck-Cushing's reflex. D) Frank-Beck mechanism.
B) Frank-Starling effect.
You and your team are attempting to resuscitate a 50-year-old woman in a traumatic cardiac arrest. Your team consists of two EMTs and an AEMT. Which of the following tasks would be MOST appropriate to assign to the AEMT? A) Chest compressions B) IV therapy and fluid boluses C) Cardiac drug administration D) Emotional support for the family
B) IV therapy and fluid boluses
Which of the following statements regarding the EMT is correct? A) Manual defibrillation is a skill that all EMTs are required to learn and perform. B) In some states, EMTs are trained in advanced airway management and IV therapy. C) There are far more certified paramedics in the United States than there are EMTs. D) EMTs are licensed and can provide basic life support without medical direction.
B) In some states, EMTs are trained in advanced airway management and IV therapy.
During an allergic reaction, basophils release histamines and heparin. What respective roles do these chemicals play? A) Reduce inflammation and facilitate blood clotting B) Increase tissue inflammation and inhibit blood clotting C) Reduce inflammation and inhibit blood clotting D) Reduce tissue inflammation and inhibit blood clotting
B) Increase tissue inflammation and inhibit blood clotting
__________ entails gently striking the surface of the body, typically where it overlies various body cavities. A) Palpation B) Percussion C) Inspection D) Auscultation
B) Percussion
Which of the following processes occurs during multiple organ dysfunction syndrome (MODS)? A) MODS activates the kallikrein-kinin system, which stimulates the release of bradykinin, a potent vasoconstrictor B) The ischemic pancreas releases myocardial depressant factor, which impairs cardiac contractility C) Vascular endothelial damage causes depression of the coagulation system, which causes the blood to clot D) The liver produces too little of the enzymes aspartate aminotransferase and alanine aminotransferase
B) The ischemic pancreas releases myocardial depressant factor, which impairs cardiac contractility
Which of the following directional terms describes the front surface of the body? A) Dorsal B) Ventral C) Inferior D) Superior
B) Ventral
Percussion of the chest produces ____________ if the pleural space is full of blood. A) a hollow sound B) a dull sound C) a high-pitched note D) hyperresonance
B) a dull sound
An endogenous ligand is: A) any medication that binds to a receptor and causes a reaction. B) a molecule that is produced by the body and binds to a receptor. C) any molecule that is not naturally occurring in the human body. D) a synthetically made hormone that acts upon the endocrine system.
B) a molecule that is produced by the body and binds to a receptor
When oxygen levels are low or absent, the cells revert to a process of: A) aerobic metabolism. B) anaerobic metabolism. C) anaerobic anabolism. D) aerobic catabolism.
B) anaerobic metabolism.
All of the following are endogenous catecholamines, EXCEPT: A) dopamine. B) atropine. C) epinephrine. D) norepinephrine.
B) atropine.
The sympathetic and parasympathetic nerves arise from the: A) somatic nervous system. B) autonomic nervous system. C) voluntary nervous system. D) adrenal nervous system.
B) autonomic nervous system.
In order to relieve the bronchospasm associated with an acute asthma attack, the paramedic would give a(n): A) alpha-1 agonist. B) beta-2 agonist. C) beta-1 agonist. D) alpha-2 agonist.
B) beta-2 agonist.
ACE inhibitor medications lower blood pressure by: A) selectively binding to alpha-1 and alpha-2 receptors. B) blocking the conversion of angiotensin I to angiotensin II. C) increasing cardiac afterload and reducing cardiac output. D) blocking the release of angiotensin I from the renal system.
B) blocking the conversion of angiotensin I to angiotensin II.
Distributive shock occurs when: A) central vasoconstriction forces blood from the core of the body. B) blood pools in expanded vascular beds and tissue perfusion decreases. C) microorganisms attack the blood vessels, resulting in vasodilation. D) a significant decrease in cardiac contractility causes decreased perfusion.
B) blood pools in expanded vascular beds and tissue perfusion decreases.
Edema in an upper extremity following a mastectomy is the result of: A) localized vasoconstriction. B) decreased lymphatic drainage. C) obstruction of a large blood vessel. D) surgery-induced inflammation.
B) decreased lymphatic drainage.
Unlike basophils, mast cells: A) do not release leukotrienes. B) do not circulate in the blood. C) circulate freely in the bloodstream. D)play a major role in allergic reactions
B) do not circulate in the blood.
The net effect of osmosis is to: A) balance the concentration of water on both sides of the cell wall. B) equalize solute concentrations on both sides of the cell membrane. C) utilize ATP to actively move solutes across the cell membrane. D) maintain a higher concentration of solutes outside of the cell.
B) equalize solute concentrations on both sides of the cell membrane
Glycogenolysis is the physiologic process in which: A) the pancreas secretes glycogen. B) glycogen is converted to glucose. C) glucose is converted to glycogen D) the kidneys produce additional glucose.
B) glycogen is converted to glucose
When you introduce yourself to your patient and ask why 9-1-1 was called, the patient looks at you, shakes your hand, and answers your questions appropriately. From these findings, you can gather that the patient: A) has not experienced a traumatic injury. B) has a Glasgow Coma Scale score of 15. C) will likely not require medication therapy. D) does not have a life-threatening condition.
B) has a Glasgow Coma Scale score of 15
A hypertonic solution has an osmolarity higher than that of serum, meaning that the solution: A) may cause the cells to expand and rupture due to the increased intracellular osmotic pressure exerted by the solution. B) has more ionic concentration than serum and pulls fluid and electrolytes from the intracellular and interstitial compartments into the intravascular compartment. C) contains high concentrations of proteins and can result in fluid overloading in patients with impaired cardiac function or renal insufficiency. D) has a lower ionic concentration than serum and pulls fluid and electrolytes from the intravascular compartment into the intracellular and interstitial compartments.
B) has more ionic concentration than serum and pulls fluid and electrolytes from the intracellular and interstitial compartments into the intravascular compartment.
The vestibulocochlear nerve is responsible for the functions of: A) facial and eye movements. B) hearing and balance perception. C) swallowing and gland secretion. D) tongue and neck movements.
B) hearing and balance perception.
A diabetic patient who failed to take his or her insulin and presents with peaked T waves on the cardiac monitor and muscle weakness is MOST likely: A) hypocalcemic. B) hyperkalemic. C) hypokalemic. D) hypoglycemic.
B) hyperkalemic.
It is MOST important to exercise caution when administering isotonic solutions to patients with: A) hypotension and severe hypovolemia. B) hypertension and congestive heart failure. C) dehydration secondary to excessive diarrhea. D)a history of insulin-dependent diabetes mellitus
B) hypertension and congestive heart failure.
Pyrogenic reactions can be largely avoided by: A) determining if the patient has any allergies. B) inspecting the IV solution carefully before use. C) premedicating the patient with 1 gram of acetaminophen. D) keeping the piercing spike sterile after it is exposed.
B) inspecting the IV solution carefully before use.
Carpopedal spasm that occurs during respiratory alkalosis is caused by a(n): A) decrease in arterial CO2. B) intracellular calcium shift. C) extracellular sodium shift. D) intracellular potassium shift.
B) intracellular calcium shift
Lactated Ringer's is a(n) __________ solution because its solute concentration is equal to that of the inside of the cell. A) colloid B) isotonic C) hypotonic D) crystalloid
B) isotonic
Fentanyl (Sublimaze) is the preferred opioid analgesic for patients in critical or unstable condition because: A) its effects last much longer than any other opioid. B) it is not as prone to causing hypotension as morphine. C) it only requires one small dose to achieve analgesia. D) it hyperstimulates mu (m) opioid receptor sites.
B) it is not as prone to causing hypotension as morphine.
The left main coronary artery rapidly divides into the: A) posterior descending and left ventricular arteries. B) left anterior descending and circumflex arteries. C) left posterior descending and acute marginal arteries. D)circumflex and right anterior descending arteries
B) left anterior descending and circumflex arteries
In general, alpha-adrenergic receptor antagonists: A) decrease the heart rate. B) lower the blood pressure. C) are used for hypotension. D) increase vascular resistance.
B) lower the blood pressure.
Dopamine is commonly used in the prehospital setting as the primary medication for: A) right-sided heart failure. B) nonhypovolemic hypotension. C) severe intracranial hemorrhage. D)vagal-induced bradycardia
B) nonhypovolemic hypotension.
Apoptosis is defined as: A) hypoxic cell death. B) normal cell death. C) pathologic cell death. D) premature cell death.
B) normal cell death.
If a patient is able to sense smell, his or her __________ nerve is intact. A) abducens B) olfactory C) trigeminal D) trochlear
B) olfactory
Radio transmission distances from a mobile transceiver are reduced: A) by fog or light rain. B) over mountainous areas. C) over water or flat terrain. D) with greater than 7.5 W of power.
B) over mountainous areas.
During your assessment of a patient, you note that he is bradycardic, hypotensive, and salivating. These clinical findings suggest: A) sympathetic nervous system stimulation. B) parasympathetic nervous system stimulation. C) sympathetic nervous system depression. D) parasympathetic nervous system depression.
B) parasympathetic nervous system stimulation.
Chronic stress: A) has actually been shown to lower one's risk for cancer. B) places the body in a continuous, unrelieved state of alert. C) most commonly results from a single acute stress reaction. D)is preferentially treated with a benzodiazepine medication
B) places the body in a continuous, unrelieved state of alert.
Stimulation of alpha-2 receptors: A) constricts the vascular smooth muscle. B) suppresses the release of norepinephrine. C) causes profound systemic hypertension. D) increases the release of norepinephrine.
B) suppresses the release of norepinephrine.
Burnout is MOST accurately defined as: A) an acute reaction to an overwhelming situation. B) the exhaustion of physical or emotional strength. C) cynicism after being a paramedic for many years. D) a person's emotional reaction to a stressful event.
B) the exhaustion of physical or emotional strength.
The accuracy of your patient care report depends on all of the following factors, EXCEPT: A) including all pertinent event times. B) the severity of the patient's condition. C) the thoroughness of the narrative section. D) documenting any extenuating circumstances.
B) the severity of the patient's condition.
The hormones tetraiodothyronine and triiodothyronine are synthesized by the: A) adrenal glands. B) thyroid gland. C) pituitary gland. D) parathyroid glands.
B) thyroid gland.
The shoulders and hips are examples of __________ joints. A) biaxial B) triaxial C) monoaxial D) diarthrotic
B) triaxial
The ability of multiple agencies or systems to share the same radio frequency is called: A) a duplex. B) trunking. C) patching. D) telemetry.
B) trunking.
Stimulation of alpha-1 receptors results in: A) insulin secretion. B) vasoconstriction. C) arterial dilation. D) glucagon secretion.
B) vasoconstriction.
Anaphylactic shock is characterized by: A) labored breathing and hypertension. B) wheezing and widespread vasodilation. C) intracellular hypovolemia and hives. D) a deficiency of circulating histamines.
B) wheezing and widespread vasodilation.
A dose of 100 mg of fentanyl (Sublimaze) is equivalent to ____ mg of morphine. A) 0.5 B) 5 C) 10 D) 20
C) 10
What is the Glasgow Coma Scale score of a patient who opens her eyes when you call her name, is confused when she speaks, and points to her area of pain? A) 10 B) 11 C) 12 D) 13
C) 12
Which adrenergic receptor, when stimulated, inhibits norepinephrine release? A) Beta-1 B) Alpha-1 C) Alpha-2 D) Beta-2
C) Alpha-2
The first EMT textbook, Emergency Care and Transportation of the Sick and Injured, was published in 1971 by the: A) National Association of EMS Educators (NAEMSE). B) American College of Emergency Physicians (ACEP). C) American Academy of Orthopaedic Surgeons (AAOS). D) American Association of Critical Care Nurses (AACN).
C) American Academy of Orthopaedic Surgeons (AAOS).
Which of the following clinical effects would you expect to observe in a patient who is receiving dopamine in a dosing range of 2 to 4 mg/kg/minute? A) Increased heart rate B) Increased vascular resistance C) Increased urine output D) Increased cardiac contractility
C) Increased urine output
During a crisis, the paramedic is able to focus and function, but afterwards, he or she may be left with nervous, excited energy that continues to build This is indicative of: A) burnout. B) an acute stress reaction. C) a delayed stress reaction. D) a cumulative stress reaction.
C) a delayed stress reaction.
. Conducting EMS research studies on critically ill or injured patients without their informed consent is: A) inappropriate. B) ethically acceptable. C) a true ethical dilemma. D) legal under the law of implied consent.
C) a true ethical dilemma.
The MOST common cause of cardiogenic shock is: A) untreated hypertension. B) blunt force chest trauma. C) acute myocardial infarction. D) sustained pulmonary hypertension.
C) acute myocardial infarction.
The MOST significant problem associated with making up your own medical abbreviations and documenting them on the patient care report is: A) insurance denial. B) a potential lawsuit. C) an error in patient care. D) confusion at the hospital.
C) an error in patient care.
Although the technicalities of EMS DNR orders vary from state to state, they all: A) are completely irrevocable by the patient's immediate family members. B) require the patient to wear a DNR insignia such as a bracelet or necklace. C) are designed to tell EMS providers when resuscitation is or is not appropriate. D) must be renewed every 5 years or they will expire and become null and void.
C) are designed to tell EMS providers when resuscitation is or is not appropriate.
Blood pressure is the product of: A) stroke volume and heart rate. B) left ventricular ejection fraction and afterload. C) cardiac output and peripheral vascular resistance. D) right atrial preload and ventricular stroke volume.
C) cardiac output and peripheral vascular resistance.
Abandonment occurs when: A) a patient is released and did not require further medical care. B) an emergency nurse takes a verbal report from a paramedic. C) care of a patient was terminated without his or her consent. D) a patient refuses care and subsequently dies of his condition.
C) care of a patient was terminated without his or her consent.
Severe, prolonged stress: A) is frequently a direct cause of death. B) results in the destruction of cholesterol and fat. C) causes the body to lose its ability to fight disease. D) results in chronically low levels of cortisol.
C) causes the body to lose its ability to fight disease.
If a patient's trigeminal nerve is intact, he or she should be able to: A) frown. B) maintain balance. C) clench his or her jaw. D) swallow without difficulty.
C) clench his or her jaw.
For the EMS provider, the process of collecting and analyzing data regarding injury prevention begins with: A) following up on the patient's outcome. B) retrospective research of severe injuries. C) completing a legible prehospital care report. D)his or her initial paramedic training program
C) completing a legible prehospital care report.
All of the following are functions of the parasympathetic nervous system, EXCEPT: A) constriction of the pupils. B) lowering of the blood pressure. C) decreased gastrointestinal function. D) mediating arousal in males and females.
C) decreased gastrointestinal function
Beginning with the outermost layer, the three meningeal layers of the central nervous system are the: A) dura mater, pia mater, and arachnoid. B) arachnoid, pia mater, and dura mater. C) dura mater, arachnoid, and pia mater. D) pia mater, dura mater, and arachnoid.
C) dura mater, arachnoid, and pia mater
Hypotonic solutions: A) include normal saline and lactated Ringer's solution. B) draw fluid from the cells and into the vascular space. C) hydrate the cells while depleting the vascular compartment. D) are the preferred solutions to use in patients with head trauma.
C) hydrate the cells while depleting the vascular compartment.
In decompensated shock, systolic blood pressure is: A) less than 90 mm Hg in adult males. B) less than 80 mm Hg in adult females. C) less than the fifth percentile for the age. D) usually undetectable due to vasodilation.
C) less than the fifth percentile for the age.
If too much water enters a cell during osmosis, it will burst. This process is called: A) diffusion. B) crenation. C) lysis. D)viscosity.
C) lysis
If nonencapsulated bacteria enter the body: A) exogenous antibiotic therapy is not effective. B) antibodies coat them so phagocytosis can occur. C) macrophages begin to destroy them immediately. D) antibodies are not produced and released into the blood.
C) macrophages begin to destroy them immediately.
Phagocytosis is the process by which: A) phagocytes are produced. B) phagocytes are destroyed. C) monocytes digest microbes. D)microbes destroy monocytes
C) monocytes digest microbes
The FIRST thing you should do if you think you are beginning to experience symptoms of burnout is: A) take at least 3 weeks off from work and go on a vacation B) see a psychologist and try to identify the underlying cause. C) reexamine your beliefs and your ways of responding to stress. D) request to work at a busier station to keep your mind occupied.
C) reexamine your beliefs and your ways of responding to stress.
The resistance stage of the stress reaction is characterized by: A) an immediate release of the catecholamines epinephrine and norepinephrine, which causes the fight-or-flight response B) a reduction of cortisol in the body, which predisposes the person to acute inflammatory processes. C) stimulation of the adrenal glands to secrete hormones that increase blood glucose levels and maintain blood pressure. D) adrenal gland depletion, which leads to decreased blood glucose levels, physical exhaustion, and immunocompromise.
C) stimulation of the adrenal glands to secrete hormones that increase blood glucose levels and maintain blood pressure.
All of the following are endocrine glands, EXCEPT the: A) adrenal glands. B) thymus gland. C) sweat glands. D) pituitary gland.
C) sweat glands.
Lactated Ringer's (LR) solution may be beneficial to patients who have lost large amounts of blood because: A) it takes less LR to effectively expand the intravascular compartment than any other isotonic solution. B) LR has the ability to carry oxygen and can maintain cellular perfusion until the patient receives definitive care. C) the lactate contained within LR is converted to bicarbonate in the liver and can help combat intracellular acidosis. D) the likelihood of causing acute circulatory overload is minimal relative to other hypertonic solutions.
C) the lactate contained within LR is converted to bicarbonate in the liver and can help combat intracellular acidosis.
Osmosis occurs when: A) water moves from an area of higher solute concentration to an area of lower solute concentration. B) solutes move from an area of lower water concentration to an area of higher water concentration. C) water moves from an area of lower solute concentration to an area of higher solute concentration. D) solutes move from an area of higher water concentration to an area of lower water concentration.
C) water moves from an area of lower solute concentration to an area of higher solute concentration.
In general, +3 pitting edema is characterized by indentation of the skin to a depth of: A) 0 in to ¼ in. B) ¼ in to ½ in. C) ½ in to 1 in. D) greater than 1 in.
C) ½ in to 1 in.
Which of the following statements regarding basophils is correct? A) Basophils release chemicals that destroy parasitic invaders. B) Basophils account for approximately 70% of the leukocytes. C) Basophils travel to the tissues, where they become macrophages. D) Basophils release histamine and other chemicals that dilate blood vessels.
D) Basophils release histamine and other chemicals that dilate blood vessels.
Which of the following conditions would be the LEAST likely to cause hyperventilation? A) Ketoacidosis B) Severe infection C) Aspirin overdose D) Metabolic alkalosis
D) Metabolic alkalosis
What type of shock occurs when blood flow becomes blocked in the heart or great vessels? A) Cardiogenic B) Peripheral C) Distributive D) Obstructive
D) Obstructive
What are the functions of the pancreas? A) Production of renin and regulation of blood pressure B) Storage and movement of food into the small intestine C) Concentration and storage of bile until it is needed for digestion D) Production of insulin and certain enzymes that aid in digestion
D) Production of insulin and certain enzymes that aid in digestion
Which of the following statements regarding fentanyl (Sublimaze) is correct? A) The adult dose of fentanyl is 25 to 50 mg. B) Fentanyl has a duration of action of 10 minutes. C) Fentanyl should be given over 10 to 20 seconds. D) The peak effect of fentanyl is 3 to 5 minutes.
D) The peak effect of fentanyl is 3 to 5 minutes.
Approximately 20 minutes after starting an IV on a 40-year-old man, he begins complaining of a backache and chills. You should be MOST suspicious of: A) an air embolus. B) an allergic reaction. C) circulatory overload. D) a pyrogenic reaction.
D) a pyrogenic reaction.
Phenothiazine medications exert their antiemetic properties by: A) promoting the secretion of hormones in the brain that depress the function of the medulla oblongata. B) antagonizing dopaminergic receptor sites in the brain, which suppresses the function of the hypothalamus. C) blocking histamine-2 receptors, which inhibits gastric acid production and slows peristalsis. D) activating dopaminergic receptors in the brain and releasing hormones that depress the reticular activating system.
D) activating dopaminergic receptors in the brain and releasing hormones that depress the reticular activating system
A major distinction between a paramedic and an EMT is that the paramedic: A) is more likely to be sued for negligence. B) is held to a higher professional standard. C) can function independently of a physician. D) carries out advanced pharmacologic skills.
D) carries out advanced pharmacologic skills.
Efferent nerves of the peripheral nervous system are responsible for: A) carrying impulses from the body to the brain. B) sensations such as pain, temperature, and pressure. C) involuntary functions such as breathing and heart rate. D) carrying commands from the brain to the muscles.
D) carrying commands from the brain to the muscles.
At 15 mg/kg/min, dopamine: A) reduces cardiac contractility. B) antagonizes alpha-1 receptors. C) activates beta-2 receptor sites. D) causes vigorous vasoconstriction.
D) causes vigorous vasoconstriction.
Burnout is a consequence of: A) a high call volume. B) many years in EMS. C) underlying depression. D) chronic, unrelieved stress.
D) chronic, unrelieved stress.
Naloxone (Narcan) reverses the central nervous system depressant effects of drugs such as morphine and fentanyl by: A) stimulating narcotic receptor sites. B) facilitating excretion by the renal system. C) agonizing opiate receptor sites. D) competitively inhibiting opiate receptor sites.
D) competitively inhibiting opiate receptor sites.
Stimulation of beta-1 adrenergic receptors would produce all of the following effects, EXCEPT: A) an increase in heart rate. B) increased renin secretion. C) increased cardiac electrical conduction. D) decreased myocardial contractility.
D) decreased myocardial contractility.
Unlike bacteria, viruses: A) are unable to replicate. B) are treated effectively with antibiotics. C) do not produce an immune response. D) do not produce exotoxins or endotoxins.
D) do not produce exotoxins or endotoxins.
The MOST common type of exogenous hypovolemic shock is: A) severe diarrhea. B) internal hemorrhage. C) excess plasma loss. D) external bleeding.
D) external bleeding.
In general, paramedics who do not experience burnout are those who: A) regularly see a psychiatrist or psychologist. B) have been paramedics for fewer than 10 years. C) consider the patient's needs before their own. D) have learned to value and respect themselves.
D) have learned to value and respect themselves.
Enlargement of the left ventricle due to chronically elevated blood pressure is called: A) atrophy. B) dysplasia. C) hyperplasia. D) hypertrophy.
D) hypertrophy.
Administering large amounts of an isotonic crystalloid solution to a patient with internal bleeding would MOST likely: A) expand the vascular space and improve systemic perfusion. B) cause acute hypotension as fluid is drawn from the vascular space. C) change the ratio of hemoglobin and red blood cells. D) increase the severity of internal bleeding by interfering with hemostasis.
D) increase the severity of internal bleeding by interfering with hemostasis
Distention of the jugular veins indicates: A) a state of hypovolemia. B) left-sided heart failure. C) decreased venous pressure D) increased venous capacitance.
D) increased venous capacitance.
The thyroid gland is responsible for the: A) release of TSH. B) breakdown of glycogen. C) production of glucose. D) metabolic rate.
D) metabolic rate.
Rocuronium bromide (Zemuron) is classified as a: A) depolarizing neuromuscular blocker. B) nondepolarizing neuromuscular agonist. C) depolarizing neuromuscular agonist. D) nondepolarizing neuromuscular blocker.
D) nondepolarizing neuromuscular blocker.
Fentanyl citrate (Sublimaze) is a(n): A) opiate antagonist. B) sedative-hypnotic. C) Schedule I narcotic. D) opioid analgesic.
D) opioid analgesic.
Lower extremity shortening and/or internal or external rotation are findings often associated with: A) pelvic fractures. B) mid-shaft femur fractures. C) pathologic fractures of the hip. D) proximal lower extremity injury.
D) proximal lower extremity injury.
Cardiac output is equal to: A) systole minus diastole. B) blood pressure multiplied by heart rate. C) heart rate minus systolic blood pressure. D) stroke volume multiplied by heart rate.
D) stroke volume multiplied by heart rate.
Biotelemetry is MOST accurately defined as: A) linking two frequencies together so that the paramedic and physician can converse directly. B) a common radio frequency assigned to EMS by the Federal Communications Commission. C) the ability of more than one public safety agency to share the same radio frequency during a crisis. D) the capability of measuring vital signs and ECG tracings and transmitting them to a distant terminal.
D) the capability of measuring vital signs and ECG tracings and transmitting them to a distant terminal.
Lactated Ringer's (LR) solution should not be given to patients with liver problems because: A) LR is a hypertonic solution and cannot be metabolized by the liver. B) the lactate contained within LR can cause necrosis of the liver tissue. C) patients with liver disease commonly experience renal insufficiency. D) the liver cannot metabolize the lactate in the solution.
D) the liver cannot metabolize the lactate in the solution.
All of the following are adventitious breath sounds, EXCEPT: A) rales. B) rhonchi. C) wheezes. D) vesicular sounds.
D) vesicular sounds.
General guidelines for preventing burnout include: A) avoiding stress-relieving techniques while you are on duty. B) taking a mild sedative to help get adequate sleep each night. C) discussing your shift with your spouse or other family members. D)engaging in social activities with people not involved in EMS
D)engaging in social activities with people not involved in EMS
The parathyroid glands produce and secrete a hormone that: A) regulates the body's basil metabolic rate. B) converts glycogen produced in the liver to glucose. C) controls the function of all other endocrine glands. D)maintains normal levels of calcium in the blood
D)maintains normal levels of calcium in the blood
Prior to administering dopamine to a patient, the paramedic must ensure that the patient is: A) awake and alert. B) not bradycardic. C) tracheally intubated. D)not hypovolemic.
D)not hypovolemic
Blood enters the right atrium of the heart from the: A) vena cava and aorta. B) aorta and coronary sinus. C) pulmonary vein and aorta. D)vena cavae and coronary sinus
D)vena cavae and coronary sinus
