FP-C

All of the following are considered to be primary objectives in open-water survival in the event of a medical air transport water landing except: A. Protecting against salt and sun exposure B. Protecting against the development of hypothermia C. Signaling to any potential rescuers D. Maintaining and caring for any life rafts used

A. Protecting against salt and sun exposure

Process of anaerobic metabolism

1. Glycolysis 2. Pyruvic acid 3. Lactic acid

During which phase of tylenol poisoning are liver enzymes at their peak? A. Second stage B. Third stage C. Fourth stage D. First stage

B. Third stage

Proper technique for cannulating umbilical cord

1. Cleanse the cord stump 2. Place a loop of umbilical tape around the cord adjacent to the skin 3. Cut the cord within 1 cm of the skin 4. Cannulate umbilical vein with a pre-flushed catheter

What is the correct dose for neonatal fluid resuscitation?

10 mL/kg

What is the normal heart rate for a neonate?

120-160 bpm

You are the flight paramedic caring for a patient suffering from decompression sickness. He is confused, has visual disturbances, and has had seizures prior to your arrival. What type of decompression sickness is the patient experiencing? A. Type 1 B. Type 2 C. Type 3 D. Type 4

B. Type 2

Normal oxygen extraction ratio

20-25%

35. Normal K lab value is:

3.5-4.5

Worrisome oxygen extraction ratio

30%

Oxygen extraction ratio that indicates anaerobic metabolism is starting

>40%

Which of the following is most appropriate for a patient in asystole? A. Epinephrine B. Synchronized cardioversion C. Atropine D. Transcutaneous pacing

A. Epinephrine

What type of hypoxia is caused by reduced oxygen carrying capacity in the blood? A. Hypemic hypoxia B. Stagnant hypoxia C. Hypoxic hypoxia D. Histotoxic hypoxia

A. Hypemic hypoxia

Three crew members of a medical air transport mission have survived an emergency open-water landing, during which the pilot and 2 other crew members were killed. Which of the following factors posed the greatest threat to the ongoing survival of the crew? A. Panic B. Injuries C. Contaminated water source D. Hypothermia

A. Panic

You are part of a medical air transport crew preparing to transport a patient that has experienced cardiogenic shock. All of the following ventricular assist devices (VADs) may be used to support left ventricular function in patients experiencing cardiogenic shock, EXCEPT: A. SynCardia B. Extracorporeal membrane oxygenation C. CentriMag Blood Pumping System D. Intraaortic balloon pump

A. SynCardia

18. In which sequence does blood flow through the heart valves? A. Tricuspid, pulmonic, mitral, aortic B. Tricuspid, mitral, pulmonic, aortic C. Tricuspid, aortic, mitral, pulmonic D. Mitral, pulmonic, tricuspid, aortic

A. Tricuspid, pulmonic, mitral, aortic "Toilet Paper My Ass"

During medical transport of a pregnant patient who is in the first stage of labor, the medical transport crew places the electronic fetal monitor (EFM) on the patient to monitor (EFM) on the patient to monitor the fetal heart rate (FHR) and notes the presence of variable decelerations. Which of the following is the most likely cause of this finding? A. Umbilical cord compression B. Compression of the fetal head on the cervix C. Uteroplacental insufficiency D. Fetal anemia

A. Umbilical cord compression

Which type of pelvic fracture carries the highest risk for massive hemorrhage? A. Vertical shear B. Open book C. All have equal risk D. Lateral

A. Vertical shear

12. Q waves present with ST elevation can indicate: A. Acute ischemia B. Acute injury C. Old infarction D. Right ventricular MI

B. Acute injury

The medical transport team that was called to the field scene of a motor vehicle accident was required to transport a patient discovered to have sustained cardiac tamponade as a result of penetrating trauma to the chest. The patient is exhibiting early signs of cardiac tamponade, which should be treated immediately during transport with which of the following interventions? A. Cautious administration of IV fluids B. Aggressive administration of IV fluids C. Pericardiocentesis D. Needle decompression

B. Aggressive administration of IV fluids

Which of the following statements regarding arterial lines is most accurate? A. The radial artery is most commonly chosen as the site for arterial line placement due to lower risk of injury at this site when compared to other potential insertion sites. B. Arterial lines must be set up with a pressure bag and a continuous flush device. C. Arterial line placement allows for assessment of the hemodynamics of the right heart D. Most members of a medical transport crew are able to place arterial lines

B. Arterial lines must be set up with a pressure bag and a continuous flush device

9. Which of the following is characteristic of the 12-lead ECG for a patient with a history of WPW? A. J point B. Delta wave C. Osborne wave D. Q wave

B. Delta wave

4. Which of the following references can be used to determine ST elevation, ST depression, or QRS duration on the ECG tracing? A. Delta wave B. J point C. Osborne wave D. Z point

B. J-point

Which of the following statements is most accurate regarding industry standards for pregnant medical air transport crew members? A. Pregnant crew members are required to follow the recommendations of the transport program's medical consultants regarding their individual ability to participate in air transport. B. Medical air transport programs are responsible for establishing their own policies regarding pregnant crew members. C. Medical air transport programs are required to incorporate established industry standards regarding pregnant crew members into their individual program policies. D. Industry standards prohibit flight participation of pregnant crew members beginning in the second trimester.

B. Medical air transport programs are responsible for establishing their own policies regarding pregnant crew members.

You are providing for a patient with pancreatitis who is complaining of severe, persistent epigastric pain. All of the following medications are recommended as first-line pharmacologic treatment for this patient's complaint of pain, EXCEPT: A. Indomethacin B. Morphine C. Meperidine D. Ketamine

B. Morphine

A chest x-ray has just been completed to confirm correct placement of an endotracheal tube. All of the following x-ray findings indicate successful placement of an ETT except: A. Murphy's eye can be visualized where the clavicles meet B. Murphy's eye can be seen in the upright position C. The distal tip of the ETT can be seen at the level of the T3 to T4 vertebrae D. The distal tip of the ETT is located 4 to 5 cm above the carina

B. Murphy's eye can be seen in the upright position

A previously healthy pregnant patient who intentionally overdosed on phenytoin has been diagnosed with diabetes insipidus (DI). From which of the following types of DI is this patient most likely experiencing the DI effects? A. Gestagenic B. Neurogenic C. Nephrogenic D. Dipsogenic

B. Neurogenic

As part of the medical air transport crew, you are preparing to retrieve a bariatric patient for transport. All of the following accommodations potentially necessary to meet the needs of this patient should be made except: A. Obtain seat belt extenders B. Obtain an extraproximal length endotracheal tube C. Obtain a laryngeal mask airway D. Obtain intraosseous infusion supplies

B. Obtain an extraproximal length endotracheal tube

31. A patient with a history of tricyclic antidepressant overdose can exhibit which of the following on the ECG tracing? A. Short PR interval B. Peaked or tented T waves C. Prolonged QT interval D. Prolonged PR interval

B. Prolonged Q-T interval

Which of the following is not a self imposed stressor of flight? A. Alcohol B. Thermal changes C. Hypoglycemia D. Exhaustion

B. Thermal changes

Which ABG represents partially compensated respiratory acidosis? A. pH- 7.30, CO2- 55, HCO3- 24 B. pH- 7.30, CO2- 55, HCO3- 28 C. pH- 7.55, CO2- 30, HCO3-20 D. pH- 7.40, CO2- 40, HCO3- 24

B. pH- 7.30, CO2- 55, HCO3- 28

43. During transport you note rust-colored "flakes" in the IABP tubing. This indicates:

Balloon rupture

During transport of a motorcycle accident victim, your partner alerts you to fluid draining from the patient's ear. The patient has most likely sustained a:

Basal skull fracture

41. Your IABP begins to purge during ascent. The triggering mechanism for this function was initiated as a result of which gas law?

Boyle's law

You are called to a rural hospital for the transport of a 57-year-old male to a higher level of care facility. The patient was brought to the ER by EMS after a large, heavy piece of farm equipment fell and pinned him underneath. The patient's nurse reports that the patient was trapped for several hours before heavy rescue was able to free the patient. As the flight paramedic, which of the following conditions should you be concerned the patient may have? A. DIC B. Pneumonia C. Sepsis D. Rhabdomyolysis

D. Rhabdomyolysis

11. ST depression can indicate all of the following, except: A. Ischemia B. Old injury C. Acute injury D. Digitalis toxicity

C. Acute injury

You are providing medical air transport for a patient who is experiencing thyroid storm. Which of the following interventions is of critical importance and should be performed first? A. Administer steroids B. Administer beta blockers C. Administer intravenous fluids D. Administer acetaminophen

C. Administer intravenous fluids

Your patient has irregular wide-complex tachycardia, at a ventricular rate of 140/min and BP of 110/70 mmHg. He is asymptomatic and reports a history of angina. What is the next best step? A. Synchronized cardioversion B. Adenosine 6 mg IV bolus C. Contact medical direction D. Lidocaine 1.5 mg IV bolus

C. Contact medical direction

A police officer is shot while on duty after being directed to a robbery in progress at a liquor store where the perpetrator used a 9mm handgun to hold up the store clerk. Which of the following types of injury forces is the police officer most likely to sustain as a result of being shot with the 9mm handgun? A. Blunt injury force B. Shearing injury force C. Crushing injury force D. Compression injury force

C. Crushing injury force

49. Which of the following is the most potentially harmful IABP timing error? A. Early deflation B. Early inflation C. Late deflation D. None of the above

C. Late deflation

46. Inadvertent migration of the IAB may cause which of the following, EXCEPT: A. Loss of renal perfusion B. Loss of flow to subclavian artery C. Loss of flow to the carotid vein D. Loss of flow to the renal arteries

C. Loss of flow to the carotid vein

Which of the following is the most useful for estimating the extent of a burn in a pediatric patient? A. Palmar surface method B. Child-Pugh score C. Lund and Browder chart D. Rule of Nines

C. Lund and Browder chart

Which of the following items should be carried in the medical air transport personnel's personal survival kit in the event of emergency crash landing? A. Cooking kit B. Insect repellant C. Nylon cord D. Water purification tablets

C. Nylon cord

The medical transport team that is transporting a patient who has ingested ethylene glycol is unable to obtain fomepizole to treat the patient. Which of the following agents can be used as an alternative to treatment with fomepizole? A. IV administration of physostigmine B. Oral administration of glucagon C. Oral administration of ethanol D. IV administration of pralidoxime

C. Oral administration of ethanol

Initial management of respiratory distress in a pediatric patient includes: A. Endotracheal intubation B. Blind finger-sweep of oropharynx C. Perform a rapid assessment D. Placing the child in the left-lateral decubitus position

C. Perform a rapid assessment

A patient undergoing dialysis treatment begins to hemorrhage through her shunt. Bleeding is not controlled by direct pressure. All of these are considered best choices in managing this patient EXCEPT: A. Application of a hemostatic dressing B. Placement of a proximal tourniquet C. Placement of a sandbag over the dialysis shunt site D. Administration of a loading dose of tranexamic acid

C. Placement of a sandbag over the dialysis shunt site

2. Which of the following coronary arteries supplies the majority of circulation to the inferior portion of the heart? A. Left coronary B. Left ascending C. Right coronary D. Circumflex

C. Right coronary

26. On 12-lead ECG, posterior wall MIs manifest as: A. ST elevation in II, III, AVF B. ST depression in II, III, ACF C. ST depression in V1-V4 with abnormally tall R waves D. ST elevation in V1-V4 with abnormally tall R waves

C. ST depression in V1-V4 with abnormally tall R waves

7. Hyperkalemia >7.0 can exhibit which of the following changes on the ECG tracing? A. Inverted T waves B. U waves C. Tented or peaked T waves D. Flattened T waves

C. Tented T-waves (typically greater than 5mm)

Which of the following statements regarding the use of renal-dose dopamine is most accurate? A. Renal-dose dopamine is defined as doses under 5 mcg/kg/min B. The use of renal-dose dopamine in critical care medicine is considered standard of care C. The use of renal-dose dopamine has been found to cause harm D. Renal-dose dopamine affords renal protection in patients experiencing shock

C. The use of renal-dose dopamine has been found to cause harm

A patient with esophageal varices and portal hypertension is being transported by medical air transport. A review of the patient's chart reveals a history of alcoholism. Which of the following potential complications is this patient at risk for due to his specific history? A. Clotting problems B. Bleeding C. Hypotension D. Seizures

D. Seizures

During a night medical air transport mission, an experienced member of the medical crew becomes concerned that the (new) pilot is not flying at correct altitude for the mission route. All of the following actual statements of communicating concern in this scenario are correct and appropriate except: A. I'm concerned that we are flying at too low of an altitude B. There's a mountain ridge over there that we're going to slam into if you don't bring us up to a higher altitude C. We need to get this flight turned around or get to a higher altitude or we're all going to die tonight D. If you are unfamiliar with this flight path, I am asking you to abort the mission and turn back to avert a disaster.

C. We need to get this flight turned around or get to a higher altitude or we're all going to die tonight.

Which of the following statements regarding emergency locator transmitters (ELT) on emergency medical services (EMS) aircraft is most accurate? A. The Federal Aviation Administration (FAA) requires that the ELT transmit its distress signal on frequency 405 MHz, which provides information about the aircraft's global positioning system (GPS) location B. The ELT is automatically activated in response to an impact of 3 Gs or less C. The ELT transmission is broadcast on distress frequency 121.5 MHz which is monitored by the COSPAS-SARSAT search and rescue satellite system D. The ELT can be activated manually or automatically

D. The ELT can be activated manually or automatically

You are the flight paramedic caring for a patient who called EMS complaining of sudden onset of chest pain. Patient's EKG showed ST elevation in V2-V6. Initially, patient was alert and oriented but during transport, the patient begins to show signs of altered mental status. Patient's skin is cool and clammy. Patient's blood pressure is 80/40 and pulses are thready. Which condition is the patient most likely experiencing?

Cardiogenic shock

A patient who is being transport by medical air transport begins complaining of pruritus and knee pain during ascent which persists once the fixed-wing aircraft has reached its traveling altitude. The patient is most likely experiencing which of the potential complications of air travel? A. The chokes and syncope B. The staggers and the creeps C. The bends and the chokes D. The creeps and the bends

D. The creeps and the bends

Which of the following statements regarding medical transport of a pregnant patient experiencing third-trimester bleeding is most accurate? A. The patient may be safely transported by a general transport team B. The patient should be transported by a team consisting of both maternal and neonatal specialists C. The patient should be transported by a specialized maternal transport team D. The patient may be safely transported by a general transport team that has received high-risk obstetrical training

D. The patient may be safely transported by a general transport team that has received high-risk obstetrical training

When planning to utilize administration of packed red blood cells (PRBCs) as part of treatment for severely anemic critical care patients, transfusion to what hemoglobin level (Hb) has demonstrated most improvement in patient status? A. 10 g/dL B. 9 g/dL C. 8 g/dL D. 7 g/dL

D. 7 g/dL

The medical air transport team has retrieved a 26-year-old female who ingested an unknown quantity of acetaminophen chewable tablets 9 hours ago, and is transporting her to a tertiary care center for intensive treatment. The team prepares to administer an intravenous dose of N-acetylcysteine (NAC) during the flight which is slated to take 2.5 hours. What loading dose of NAC should they administer? The patient weighs 60 kg. A. 8,400 mg B. 3,000 mg C. 6,000 mg D. 9,000 mg

D. 9,000 mg

You respond to the scene where the adult patient reportedly overdosed to cause self harm. The patient is hyperventilating, complains of ringing in her ears, and is sweating. Of the following, which is most likely the drug ingested?

D. Aspirin

The communication center for a busy medical air transport program is in need of hiring a communications specialist (CS) for the site. According to the Commission on Accreditation of Medical Transport Systems (CAMTS) recommendations, which of the following statements is most accurate in regard to CS applicants? A. CS applicants may not be related to other program employees B. CS applicants must have medical field experience C. CS applicants must have previous communications center experience D. CS applicants should be encouraged to obtain emergency medical technician (EMT) certification

D. CS applicants should be encouraged to obtain emergency medical technician (EMT certification

50. During transport you experience a complete IABP failure. You should: A. Withdraw the IABP to 10cm B. Cycle the balloon manually timing with EKG visually C. Cycle the balloon manually timing with the A-line visually D. Cycle the balloon manually every thirty minutes regardless of timing

D. Cycle the balloon manually every thirty minutes regardless of timing when managing IABP failure.

What are the signs and symptoms of a person in the compensatory phase of hypoxia? A. Person will not exhibit signs B. Slurred speech, cyanosis, sleepiness, decreased muscle coordination C. Mental confusion followed by unconsciousness D. Increased heart rate, increased respirations, slowed thinking

D. Increased heart rate, increased respirations, slowed thinking

You are called to the scene by ground EMS for a 21-year-old male involved in a motorcycle accident. You determine the scene is safe. The paramedic states that your patient was traveling at an unknown rate of speed when he ran off the road and collided with a tree. The patient is responsive to painful stimuli only. Initial assessment shows a patent airway, respirations at 8 and shallow. Breath sounds are absent on the left side, and you note tracheal deviation. The patient's pulses are rapid and thready, capillary refill is delayed more than 4 seconds. Which is the most appropriate intervention? A. Warming the patient B. Bilateral IV access C. Intubation D. Needle decompression

D. Needle decompression

16. Your patient is exhibiting ST elevation in leads II, III, and AVF. ST depression is noted in V1-V3. Which of the following may prove hazardous? A. Isotonic fluid bolus B. Heparin C. GII/BIIIa inhibitors D. Nitroglycerin

D. Nitroglycerin

In addition to its analgesic properties, ketamine also has which of the following properties? A. Paralytic B. Vasodilator C. Vasoconstrictor D. Potent bronchodilator

D. Potent bronchodilator

The transport team is using the maternal fetal triage index in preparation for the planned transport of a pregnant patient. According to this triage tool, a patient who is 34 weeks pregnant and is experiencing regular contractions and who has herpes simplex lesions is considered to have what level of transport need? A. Urgent/Priority 2 B. Stat/Priority 1 C. Nonurgent/Priority 4 D. Prompt/Priority 3

D. Prompt/Priority 3

You are monitoring a vented patient during medical air transport when the low pressure alarm sounds. All of the following may cause the low pressure alarm to sound except: A. Chest tube leak B. Accidental disconnect from ventilator C. Hypovolemia D. Reduced lung compliance

D. Reduced lung compliance

45. The primary trigger used for most IABP operations is the:

ECG R wave

Occurs as a result of poisoning or metabolic disorders such as cyanide, ETOH, or CO poisoning

Histotoxic hypoxia

Reduction in the oxygen carrying ability in the blood due to hemorrhage, anemia, and certain drugs

Hypemic hypoxia

21. The ECG may show peaked P waves, flattened/slurred Ts, and appearance of U waves, which may indicate:

Hypokalemia

Deficiency in alveolar oxygen exchange

Hypoxic hypoxia

Four types of hypoxia

Hypoxic hypoxia Hypemic hypoxia Histotoxic hypoxia Stagnant hypoxia

The physiologic requirements during positive pressure breathing are as follows:

Inhale passively > pause > exhale actively > pause

A trauma patient received massive blood transfusions in the first 12 hours following his accident. Which lab study is most likely to be abnormally low?

Ionized calcium

30. ST elevation in leads I, aVl, V5, and V6 are indicative of injury to which area of the heart?

Lateral wall

42. The balloon has dislodged when treating your IABP patient. Which is the most common site that will be affected?

Left radial artery (occlusion)

The transport team's highest priorities in caring for a neurological trauma patient are:

Maintaining airway Maintaining oxygenation Preventing hypotension

6. ST elevation seen on the ECG tracing can indicate:

Myocardial injury

What is a concern regarding the transmission of sensitive radio traffic

News media may intercept patient information communication being transmitted to a receiving hospital

PO2

O2 partial pressure of oxygen in the environment

47. When timing the IABP, inflation should initiate in synchronization with:

Onset of ventricular diastole (dicrotic notch on arterial waveform)

PAO2

Partial pressure of oxygen in the alveoli

PaO2

Partial pressure of oxygen in the blood

A patient presenting with muffled heart tones, narrowed pulse pressures, jugular vein distention, and pulses alternans on EKG would benefit from which procedure?

Pericardiocentesis

Most commonly administered initial treatment for neonatal seizure activity

Phenobarbital

What is considered the best method of translation or interpretation when providing international transport of ill or injured patients?

Phone line medical professional translator

A flight paramedic is transporting a patient that has a depressed skull fracture that affected the patient's sinuses. What should the flight paramedic be concerned for?

Pneumocephalus

Which electrolyte should the flight paramedic be most concerned with when treating a patient with rhabdomyolysis?

Potassium

3. V1-V6 chest leads are categorized as:

Precordial/unipolar

When is the use of magnesium indicated during cardiac arrest?

Pulseless ventricular tachycardia-associated torsades de pointes

23. Inferior wall MI is caused by an occlusion of which coronary artery?

Right coronary artery

34. What changes in the ECG would a patient presenting with an inferior wall MI most likely have?

ST elevation in leads II, III, and aVf

38. Diagnosis of a right ventricular MI includes:

ST elevation in right-sided V4 lead.

Reduced cardiac output (Q) or pooling of blood such as heart failure, PE, or shock states

Stagnant hypoxia

DO2

The amount of oxygen delivered to the tissues each minute

CaO2

The content of O2 in the arteries

CvO2

The content of O2 in the venous system (consumption)

True or false: Hyperlactatemia mortality directly relates to stress response

True