BLOCK 1 FINAL EXAM
Which of the following statements would be inappropriate when documenting your care of a patient with an emotional problem? Select one: A. "The patient's actions suggest the use of illicit drugs." B. "The patient was uncooperative during the exam." C. "There was no evidence of suicidal behavior." D. "The possible smell of ETOH was noted at the scene."
A. "The patient's actions suggest the use of illicit drugs."
A dose of 100 μg of fentanyl (Sublimaze) is equivalent to ____ mg of morphine. Select one: A. 10 B. 5 C. 0.5 D. 20
A. 10
Which of the following patients is NOT an emancipated minor? Select one: A. 17-year-old woman who goes to college and lives with her parents B. 16-year-old woman who is pregnant and lives with her boyfriend C. 17-year-old man who is a member of the U.S. armed forces D. 18-year-old woman who is pregnant and lives with her grandmother
A. 17-year-old woman who goes to college and lives with her parents
A severely burned patient requires 4,500 mL of isotonic crystalloid solution over 8 hours, so medical control orders you to begin the infusion in the field. If your administration set allows 10 gtts/mL, at how many gtts/min will you set the IV flow rate in order to deliver the ordered amount of fluid? Select one: A. 94 B. 88 C. 76 D. 84
A. 94
Which adrenergic receptor, when stimulated, inhibits norepinephrine release? Select one: A. Alpha-2 B. Alpha-1 C. Beta-1 D. Beta-2
A. Alpha-2
Which of the following clinical presentations warrants immediate transport? Select one: A. Chest discomfort; heart rate of 110 beats/min; systolic BP of 90 mm Hg B. Two days of vomiting; heart rate of 110 beats/min; warm, dry skin C. 38 weeks gestation; crowning; history of hypertension; tachycardia D. 250 mL external blood loss; systolic BP of 130 mm Hg; moderate pain
A. Chest discomfort; heart rate of 110 beats/min; systolic BP of 90 mm Hg
What physiologic reaction occurs when a person's blood sugar level falls? Select one: A. Glucagon production is increased. B. The pancreatic beta cells become hyperactive. C. The pancreas secretes more insulin. D. More glycogen is stored in the liver.
A. Glucagon production is increased.
Which of the following statements regarding the paramedic-physician relationship is correct? Select one: A. The paramedic will be held accountable for his or her own actions. B. The physician is not authorized to restrict the paramedic's practice. C. State EMS legislation is responsible for appointing medical directors. D. The physician is legally accountable for actions taken by an employer.
A. The paramedic will be held accountable for his or her own actions.
Which of the following directional terms describes the front surface of the body? Select one: A. Ventral B. Superior C. Inferior D. Dorsal
A. Ventral
Situational depression is: Select one: A. a reaction to a stressful event in a patient's life. B. a condition that usually requires inpatient care. C. ongoing and does not appear to have a cause. D. often characterized by violent bouts of rage.
A. a reaction to a stressful event in a patient's life.
The wrongful act that gives rise to a civil suit is called: Select one: A. a tort. B. damage. C. liability. D. negligence.
A. a tort.
Unlike Schedule I drugs, Schedule II drugs have: Select one: A. accepted medical uses. B. limited dependence potential. C. no accepted medical application. D. a higher abuse potential.
A. accepted medical uses.
Diazepam may be indicated for patients with: Select one: A. acute alcohol withdrawal. B. coma of unknown cause. C. myasthenia gravis. D. increased intracranial pressure.
A. acute alcohol withdrawal.
When assessing a patient who is under the influence of alcohol, it is MOST important to remember that: Select one: A. alcohol can mask any number of signs and symptoms. B. the amount of alcohol consumed is often overstated. C. the patient often gives a reliable and accurate history. D. suspicions of alcohol intoxication must be documented.
A. alcohol can mask any number of signs and symptoms
Diphenhydramine is primarily used for patients with: Select one: A. allergic reactions. B. bronchospasm. C. beta-blocker toxicity. D. status asthmaticus.
A. allergic reactions.
Although the technicalities of EMS DNR orders vary from state to state, they all: Select one: A. are designed to tell EMS providers when resuscitation is or is not appropriate. B. are completely irrevocable by the patient's immediate family members. C. must be renewed every 5 years or they will expire and become null and void. D. require the patient to wear a DNR insignia such as a bracelet or necklace.
A. are designed to tell EMS providers when resuscitation is or is not appropriate.
When your patient is a non-English-speaking person, his or her child is often able to function as an interpreter because: Select one: A. children quickly absorb a new language in school. B. the child is usually not as scared as his or her parent is. C. most children of non-English-speaking parents speak English. D. you can usually teach a child English quickly.
A. children quickly absorb a new language in school
Afterload is defined as the: Select one: A. degree of pressure against which the left ventricle pumps. B. volume of blood returned to the left and right atrium. C. volume of blood pumped ejected from the heart per minute. D. amount of blood pumped from the heart per contraction.
A. degree of pressure against which the left ventricle pumps.
Substances that release ions when dissolved in water are called: Select one: A. electrolytes. B. neutrons. C. exocytes. D. endocytes.
A. electrolytes.
Leakage of cerebrospinal fluid from the nose following severe head trauma suggests: Select one: A. fracture of the cribriform plate. B. damage to the nasal sinuses. C. fracture of the basilar skull. D. damage to the auditory canal.
A. fracture of the cribriform plate.
Glycogenolysis is the physiologic process in which: Select one: A. glycogen is converted to glucose. B. the kidneys produce additional glucose. C. glucose is converted to glycogen. D. the pancreas secretes glycogen.
A. glycogen is converted to glucose.
The process in which glucose is broken down to yield lactic or pyruvic acid is called: Select one: A. glycolysis. B. glycogenolysis. C. crenation. D. gluconeogenesis.
A. glycolysis.
The body's ability to spontaneously cease bleeding is called: Select one: A. hemostasis. B. thrombolysis. C. fibrinolysis. D. homeostasis.
A. hemostasis.
The fourth heart sound (S4): Select one: A. indicates increased pressure in the atria. B. represents increased left ventricular stretching. C. is normal in 25% of the population. D. occurs immediately before the S2 sound.
A. indicates increased pressure in the atria
By classification, digoxin is a(n): Select one: A. inotropic agent. B. sympathomimetic. C. catecholamine. D. anticholinergic.
A. inotropic agent.
A medication is used "off-label." This means that it: Select one: A. is used for a purpose not approved by the FDA, at doses different from the recommended doses, or by a route of administration not approved by the FDA. B. is administered in clinical trials while the manufacturer conducts further research and before the FDA has approved the medication for use. C. has been determined to be safe by a physician, and is used to treat a patient's illness before the medication has been approved by the FDA for any purpose. D. is administered in an extreme emergency situation, but only if initial clinical trials have determined that the medication will not cause harm to the patient.
A. is used for a purpose not approved by the FDA, at doses different from the recommended doses, or by a route of administration not approved by the FDA.
You respond to a skilled nursing facility for a patient who is not breathing. When you arrive, you assess the patient, a 78-year-old man, and confirm apnea. However, the patient has a rapid carotid pulse. The charge nurse advises you that, according to the patient's family, the patient is not to be resuscitated. You should: Select one: A. maintain the patient's airway, begin artificial ventilations, and transport the patient to the closest appropriate medical facility. B. remain at the scene, begin artificial ventilations, but discontinue if the family arrives and presents a valid DNR order. C. contact medical control and request authorization to provide palliative care only and transport the patient to the hospital. D. not attempt any form of resuscitation and ask the charge nurse to notify the patient's family immediately.
A. maintain the patient's airway, begin artificial ventilations, and transport the patient to the closest appropriate medical facility.
It is MOST important for the paramedic to exercise extreme care when using medical abbreviations because: Select one: A. many abbreviations have more than one meaning. B. medical abbreviations change frequently. C. even correctly used abbreviations often cause confusion. D. insurance companies do not pay if unapproved abbreviations are used.
A. many abbreviations have more than one meaning
The middle muscular layer of the heart is called the: Select one: A. myocardium. B. endocardium. C. pericardium. D. epicardium.
A. myocardium.
The mnemonic "OPQRST" is a tool that: Select one: A. offers an easy-to-remember approach to analyzing a patient's chief complaint. B. is used commonly to rule out conditions that are immediately life threatening. C. allows the paramedic to reach a field diagnosis quickly and initiate treatment. D. is only effective when assessing a patient who is experiencing severe pain.
A. offers an easy-to-remember approach to analyzing a patient's chief complaint
HIPAA mandates that: Select one: A. patient information shall not be shared with entities or persons not involved in the care of the patient. B. a penalty will be imposed for any release of any portion of a patient's personal information to any entity. C. patient information can only be shared with the receiving physician in the emergency department. D. a patient's personal information must be shared with the patient's immediate family members.
A. patient information shall not be shared with entities or persons not involved in the care of the patient
The presence of rhonchi during auscultation of the lungs is MOST suggestive of: Select one: A. pneumonia. B. toxic inhalation. C. pneumothorax. D. asthma.
A. pneumonia
In the bloodstream, _____________ reacts with the plasma protein angiotensinogen to form angiotensin I. Select one: A. renin B. sodium C. aldosterone D. testosterone
A. renin
At its worst, kyphosis can become a source of: Select one: A. restrictive lung disease. B. complete immobility. C. extremity paralysis. D. pathologic fractures.
A. restrictive lung disease
Contraindications for nitroglycerin include: Select one: A. severe bradycardia or tachycardia. B. a known allergy to salicylates. C. a systolic BP of less than 110 mm Hg. D. recent (within 24 hours) use of aspirin.
A. severe bradycardia or tachycardia.
Stimulation of the sympathetic nervous system causes: Select one: A. sweating. B. vasodilation. C. bradycardia. D. warm, moist skin.
A. sweating
Albuterol is a(n): Select one: A. sympathomimetic drug. B. beta-adrenergic blocker. C. parasympatholytic drug. D. selective beta-1 agonist.
A. sympathomimetic drug.
The gap that lies between each neuron is called the: Select one: A. synapse. B. terminal. C. vesicle. D. cleft.
A. synapse.
The BEST way for the paramedic to evaluate a patient's decision-making capacity is to: Select one: A. talk to the patient to determine if he or she understands what is happening. B. ensure that pulse oximetry and blood glucose readings are within normal limits. C. confirm that the patient is at least 18 years of age or otherwise emancipated. D. determine if the patient knows what care is appropriate for the situation.
A. talk to the patient to determine if he or she understands what is happening.
In addition to facilitating the uptake of sugar into the cells, insulin is responsible for: Select one: A. the chemical conversion of glucose to glycogen. B. the production of amino acids and carbohydrates. C. the chemical conversion of glycogen to glucose. D. stimulating the liver and kidneys to produce glucose.
A. the chemical conversion of glucose to glycogen.
A patient is generally considered to have orthostatic vital signs when: Select one: A. the heart rate increases by 20 beats/min or more when going from a supine to a standing position. B. he or she experiences chest pain and a rapid, irregular heart rate when going from a seated to a standing position. C. the systolic BP increases and the diastolic BP decreases when going from a lying to a sitting position. D. the respiratory rate becomes fast and the depth becomes shallow when he or she suddenly stands up.
A. the heart rate increases by 20 beats/min or more when going from a supine to a standing position.
When determining the most appropriate hospital to which to transport a patient, the paramedic's FIRST consideration should be: Select one: A. the patient's clinical condition. B. the wishes of the patient or family. C. traffic conditions and similar variables. D. whether or not the patient has insurance.
A. the patient's clinical condition.
If a patient has a potentially life-threatening illness or injury and there is any doubt as to his or her decision-making capacity, the paramedic should: Select one: A. treat and transport, even if it is against the patient's will. B. have the patient arrested and placed in protective custody. C. obtain consent from a family member to treat the patient. D. obtain a court order and then begin emergency treatment.
A. treat and transport, even if it is against the patient's will.
Side effects of albuterol may include: Select one: A. tremors, lightheadedness, and irritability. B. hypotension, bradycardia, and headache. C. dizziness, blurred vision, and dysphagia. D. wheezing, hypersalivation, and nausea.
A. tremors, lightheadedness, and irritability
If you make an error when completing a written patient care report, you should: Select one: A. use different colored ink when drawing a single line through the error. B. leave the error, but write the correct information in parentheses next to it. C. circle the error, initial it, and write the correct information next to it. D. not alter the original patient care report and write the correct information on an addendum.
A. use different colored ink when drawing a single line through the error.
Stimulation of alpha-1 receptors results in: Select one: A. vasoconstriction. B. glucagon secretion. C. insulin secretion. D. arterial dilation.
A. vasoconstriction.
Closure of the tricuspid and mitral valves occur during: Select one: A. ventricular contraction. B. the diastolic phase. C. atrial contraction. D. ventricular relaxation.
A. ventricular contraction.
All of the following are subjective findings, EXCEPT: Select one: A. visible blood in the ear canal. B. a feeling of impending doom. C. acute and severe nausea. D. a persistent dull headache.
A. visible blood in the ear canal
Other than overall patient appearance, the patient's __________ is/are the MOST objective data for determining his or her status. Select one: A. vital signs B. medical history C. chief complaint D. medications
A. vital signs
A patient's wife called 9-1-1 because the patient was complaining of a severe headache and nausea. The patient is conscious and alert, but obviously upset that his wife called 9-1-1 without consulting with him first. As you present the blood pressure cuff, the patient folds his arms and turns away from you. From this patient's actions, you should conclude that: Select one: A. you do not have consent to treat him. B. he will only consent to EMS transport. C. he is not mentally competent. D. consent to treat this patient is implied.
A. you do not have consent to treat him.
In general, +3 pitting edema is characterized by indentation of the skin to a depth of: Select one: A. ½ in to 1 in. B. greater than 1 in. C. 0 in to ¼ in. D. ¼ in to ½ in.
A. ½ in to 1 in
When assessing a hemodynamically stable child, the toe-to-head approach is generally indicated for children who are: Select one: A. younger than 12 months of age. B. 1 to 3 years of age. C. younger than 2 years of age. D. 4 to 5 years of age.
B. 1 to 3 years of age
A healthy person loses approximately ___ to ___ liters of fluid daily through urine output, through exhalation, and through the skin. Select one: A. 3, 4 B. 2, 2.5 C. 1, 1.5 D. 0.5, 1
B. 2, 2.5
0.2 mg equals: Select one: A. 0.02 g. B. 200 µg. C. 0.02 µg. D. 2,000 µg.
B. 200 µg
A 130-lb patient weighs ____ kg. Select one: A. 62 B. 59 C. 55 D. 49
B. 59
Which of the following statements regarding the harm element of a negligence lawsuit is MOST correct? Select one: A. Serious injury must have occurred in order for harm to be established. B. A loss of earning capacity is a form of harm that the patient may claim. C. The burden of proof for establishing harm rests with the defendant. D. Loss of income is the most common form of harm proven in a lawsuit.
B. A loss of earning capacity is a form of harm that the patient may claim.
Which of the following scenarios MOST accurately depicts abandonment? Select one: A. 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 necessary. B. 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. C. 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. D. 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.
B. 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.
Prior to administering nitroglycerin to a patient with chest pain, the patient denies the use of erectile dysfunction (ED) drugs when asked, even though he took an ED drug a few hours earlier. After being given the nitroglycerin, the patient experiences severe hypotension and almost dies. Which of the following could the paramedic use as a potential defense if the patient attempts to sue? Select one: A. Qualified immunity B. Contributory negligence C. Plausible deniability D. Patient incompetence
B. Contributory negligence
A patient is found to have a high blood sugar level (hyperglycemia). What is a cause of this? Select one: A. Hyperactivity of the pancreatic beta cells B. Deficient insulin levels in the blood C. Decreased production of glucagon D. Excessive insulin levels in the blood
B. Deficient insulin levels in the blood
Which of the following statements regarding a psychiatric patient who is refusing transport is MOST correct? Select one: A. Medical control has the authority to order paramedics to forcibly restrain and transport any psychiatric patient. B. If the patient's life is not in danger, only a police officer can authorize paramedics to restrain and transport the patient. C. It is generally agreed that any psychiatric patient should be transported against his or her will for evaluation by a psychiatrist. D. Family members can authorize involuntary commitment, including forcibly transporting the patient against his or her will.
B. If the patient's life is not in danger, only a police officer can authorize paramedics to restrain and transport the patient.
Which of the following is an example of slander? Select one: A. Asking a patient if he or she is under psychiatric care B. Telling the receiving facility that a patient is drunk C. Asking a family member if the patient uses drugs D. Documenting that you noted the possible smell of alcohol
B. Telling the receiving facility that a patient is drunk
Which of the following is NOT a required element needed to prove negligence? Select one: A. The paramedic committed a breach of duty. B. The patient's condition was life threatening. C. The paramedic or EMS system had a duty to act. D. An act of omission was the cause of the patient's injury.
B. The patient's condition was life threatening.
The term affinity, as it applies to pharmacology, is MOST accurately defined as the: Select one: A. ability of a medication to bind to a receptor. B. strength of the bond between a medication and its receptor. C. blocking of a receptor site by a particular medication. D. process of a medication binding to a receptor.
B. ability of a medication to bind with its receptor. *
The peak of a medication's effect depends on _____________, whereas the duration of effect depends on ______________. Select one: A. elimination, absorption B. absorption, metabolism C. metabolism, distribution D. distribution, absorption
B. absorption, metabolism
Movement of an extremity toward the midline of the body is called: Select one: A. abduction. B. adduction. C. supination. D. pronation.
B. adduction.
A solution of water with 0.9% sodium chloride is: Select one: A. of minimal value in expanding the vascular space. B. also called normal saline and is an isotonic solution. C. capable of carrying oxygen when it is infused. D. hypotonic until it is introduced into the body.
B. also called normal saline and is an isotonic solution
Atropine sulfate is classified as a(n) __________________ medication. Select one: A. sympatholytic B. anticholinergic C. adrenergic D. sympathomimetic
B. anticholinergic
The most inferior portion of the heart is called the: Select one: A. volar. B. apex. C. base. D. dorsum.
B. apex.
If a physician insists that you perform an intervention that you are not properly trained to perform, it would be MOST appropriate to: Select one: A. refuse to perform the intervention and follow your protocols. B. ask the physician if he or she can suggest another alternative. C. perform the ordered intervention to the best of your ability. D. ask the physician to talk you through the procedure over the phone.
B. ask the physician if he or she can suggest another alternative.
A medication that has a narrow therapeutic index: Select one: A. should not be given to patients over 50 years of age. B. can be given, but not without close patient monitoring. C. should not be given because its effects are too harmful. D. is safe to give because the chance of toxicity is remote.
B. can be given, but not without close patient monitoring.
An opaque black area against the red reflex of the eye is indicative of: Select one: A. conjunctivitis. B. cataracts. C. retinitis. D. macular degeneration.
B. cataracts
If a patient's trigeminal nerve is intact, he or she should be able to: Select one: A. maintain balance. B. clench his or her jaw. C. frown. D. swallow without difficulty.
B. clench his or her jaw
A paramedic gives a woman with chronic pain an injection of sterile saline and tells her that it is a narcotic analgesic. The paramedic's action: Select one: A. demonstrates compassion and empathy. B. could result in criminal prosecution. C. will likely be of therapeutic benefit. D. is acceptable under the circumstances.
B. could result in criminal prosecution.
The movement of a solute from an area of higher concentration to an area of lower concentration is called: Select one: A. exocytosis. B. diffusion. C. osmosis. D. endocytosis.
B. diffusion.
A patient who complains of double vision has: Select one: A. anisocoria. B. diplopia. C. hyperopia. D. ptosis.
B. diplopia
Before asking a patient to sign a refusal form, the paramedic must: Select one: A. ask a police officer to determine if the patient is competent. B. ensure the patient is aware of the risks of his or her refusal. C. tell the patient that he or she will die without treatment. D. ask an impartial observer to sign the refusal form first.
B. ensure the patient is aware of the risks of his or her refusal.
The ongoing process by which red blood cells are made is called: Select one: A. diapedesis. B. erythropoiesis. C. hematopoiesis. D. phagocytosis.
B. erythropoiesis.
When auscultating heart sounds, you should place your stethoscope at the: Select one: A. third or fourth intercostal space, in the midaxillary line. B. fifth intercostal space, over the apex of the heart. C. sternal border at the second or third intercostal space. D. second intercostal space, over the base of the heart.
B. fifth intercostal space, over the apex of the heart.
The brain and spinal cord are connected through a large opening at the base of the skull called the: Select one: A. lamboid suture. B. foramen magnum. C. vertebral foramen. D. mastoid process.
B. foramen magnum.
A patient is placed in the Fowler's position. In this position, the body is: Select one: A. on its side with the head elevated. B. in a semireclining position. C. supine with the legs elevated. D. on its side with the head lowered.
B. in a semireclining position.
Bruising in the periumbilical area is indicative of: Select one: A. a leaking aortic aneurysm. B. intraperitoneal hemorrhage. C. ruptured ectopic pregnancy. D. a ruptured urinary bladder.
B. intraperitoneal hemorrhage
Insulin and glucagon are produced in specialized groups of cells in the pancreas known as the: Select one: A. medullary cortex. B. islets of Langerhans. C. adrenal islets. D. adrenal medulla.
B. islets of Langerhans.
Dysfunction of the mitral valve may cause backflow of blood into the: Select one: A. right atrium. B. left atrium. C. left ventricle. D. right ventricle.
B. left atrium.
Documenting a false statement that injures a person's good name or reputation constitutes: Select one: A. gross negligence. B. libel and defamation. C. assault and battery. D. slander and defamation.
B. libel and defamation.
If a patient does not respond to a question within a couple of seconds, he or she: Select one: A. must be assumed to have an altered mental status until proven otherwise. B. may be deciding if he or she can trust you enough to answer the question. C. should have the question repeated back to him or her using different terms. D. should immediately be asked another question to facilitate gathering data.
B. may be deciding if he or she can trust you enough to answer the question
The reticular activating system is located in the __________ and regulates: Select one: A. occipital lobe, sight. B. midbrain, consciousness. C. cerebellum, motor function. D. brainstem, breathing.
B. midbrain, consciousness.
If you must deviate from your protocols because of unusual circumstances, you should FIRST: Select one: A. document the event. B. notify medical control. C. apprise the receiving hospital. D. advise the patient.
B. notify medical control.
Patient autonomy is MOST accurately defined as the: Select one: A. court's support and upholding of the rights of a patient with regard to health care decisions. B. patient's right to direct his or her own care and to decide how end-of-life care should be provided. C. inability of the patient to refuse medical treatment once he or she has given appropriate consent. D. right of the patient to determine which medications the paramedic should administer for a given situation.
B. patient's right to direct his or her own care and to decide how end-of-life care should be provided.
A patient who is absolutely still and resists any movement should be suspected of having: Select one: A. kidney stones. B. peritonitis. C. a bowel obstruction. D. intra-abdominal bleeding.
B. peritonitis
If you receive another call before completing the patient care report accurately for the previous call: Select one: A. your patient care report must be completed within 36 hours after the call. B. pertinent details about the previous call may be omitted inadvertently. C. you should submit what you have completed to the receiving facility. D. you should ask the dispatcher to send another paramedic crew to the call.
B. pertinent details about the previous call may be omitted inadvertently
The action of the body in response to a medication is called: Select one: A. pharmacology. B. pharmacokinetics. C. pharmacodynamics. D. biotransformation.
B. pharmacokinetics.
When dealing with a patient who has multiple symptoms, the MOST effective way to develop an appropriate care plan is to: Select one: A. perform a complete head-to-toe exam. B. prioritize the patient's complaints. C. address all complaints simultaneously. D. assume that all complaints are linked.
B. prioritize the patient's complaints
Serial vital signs: Select one: A. establish a baseline to which further vital signs are compared. B. provide comparative data regarding the patient's condition. C. provide definitive information about the patient's problem. D. are of no value unless they are repeated every 5 minutes.
B. provide comparative data regarding the patient's condition
After inserting the needle during an intramuscular or subcutaneous injection, but before delivering the medication, you should: Select one: A. ensure that you stretch the skin taut. B. pull back on the plunger to aspirate for blood. C. look in the barrel of the syringe for blood. D. inquire about any medication allergies.
B. pull back on the plunger to aspirate for blood.
A 40-year-old man presents with bizarre behavior. His speech is slurred and he is very belligerent. His blood glucose level is 35 mg/dL. The patient tells you to get out of his house. You should: Select one: A. monitor the patient's condition for 15 minutes and then begin emergency treatment if he does not improve. B. remain professional and advise the patient that he is not legally capable of refusing EMS treatment. C. utilize law enforcement to help restrain the patient so that you can start an IV line and give him dextrose. D. administer oxygen only until you can obtain a court order to start an IV and administer dextrose.
B. remain professional and advise the patient that he is not legally capable of refusing EMS treatment.
"Track marks" along the course of a patient's vein are usually a sign of: Select one: A. multiple thromboses deep within the vein. B. sclerosis caused by frequent cannulation. C. small vein rupture caused by hypertension. D. numerous one-way valves inside the vein.
B. sclerosis caused by frequent cannulation.
Etomidate is a: Select one: A. long-acting benzodiazepine that is useful for patients with severe anxiety. B. short-acting hypnotic that acts at the level of the reticular activating system. C. short-acting barbiturate that induces sedation and retrograde amnesia. D. long-acting narcotic analgesic that stimulates opioid receptor sites in the body.
B. short-acting hypnotic that acts at the level of the reticular activating system
An accurate and legible patient care report: Select one: A. provides immunity to the paramedic if the patient decides to pursue legal action against the paramedic. B. should be complete to the point where anyone who reads it understands exactly what transpired on the call. C. is not possible on every call, especially if there is more than one patient or the patient is critically ill or injured. D. is a relatively reliable predictor of the quality of care that the paramedic provided to the patient during the call.
B. should be complete to the point where anyone who reads it understands exactly what transpired on the call.
A drug that is contraindicated for a particular patient: Select one: A. should be given with extreme caution. B. should not be administered to the patient. C. will likely result in immediate death. D. is usually given at half its usual dose.
B. should not be administered to the patient.
A composition of dissolved elements and water is called a(n): Select one: A. solvent. B. solution. C. electrolyte. D. solute.
B. solution
A reasonable paramedic should follow the same ______________ that another paramedic in a similar situation would. Select one: A. scope of practice B. standard of care C. medical practice act D. wishes of the family
B. standard of care
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: Select one: A. summation. B. synergism. C. antagonism. D. potentiation.
B. synergism.
The husband of a terminally ill woman called 9-1-1 because he thinks his wife is about to die. The patient has a valid living will and an out-of-hospital DNR order. You should: Select one: A. ask the husband why he called EMS if his wife is not to be resuscitated. B. treat the husband and his wife with respect and provide emotional support. C. contact medical control and request permission to provide emergency care. D. assume that the husband has revoked the DNR order and begin treatment.
B. treat the husband and his wife with respect and provide emotional support.
The correct dose of aspirin for a patient with cardiac-related chest pain is: Select one: A. 81 to 162 mg, enteric. B. up to 325 mg, chewable. C. up to 160 mg, chewable. D. 81 to 324 mg, enteric.
B. up to 325 mg, chewable
Cerebrospinal fluid is manufactured in the: Select one: A. subarachnoid space. B. ventricles of the brain. C. posterior pituitary gland. D. anterior pituitary gland.
B. ventricles of the brain.
100 mL is equal to: Select one: A. 0.01 L B. 0.0001 L C. 0.1 L D. 0.001 L
C. 0.1 L
A 2-year-old girl in cardiac arrest requires epinephrine at a dose of 0.01 mg/kg. The mother tells you that her daughter weighs about 25 lb. How much epinephrine will you administer? Select one: A. 0.01 mg B. 0.15 mg C. 0.1 mg D. 0.2 mg
C. 0.1 mg
1 mg is equal to ______ µg. Select one: A. 100 B. 10,000 C. 1,000 D. 10
C. 1,000
A hypoglycemic patient requires IV dextrose. Medical control orders you to administer 25 mL. You have a prefilled syringe of 50% dextrose that contains 25 g/50 mL. How much dextrose will you give? Select one: A. 500 mg B. 5,000 mg C. 12.5 g D. 50 g
C. 12.5 g
Which of the following patients is NOT an emancipated minor? Select one: A. 18-year-old woman who is pregnant and lives with her grandmother B. 17-year-old man who is a member of the U.S. armed forces C. 17-year-old woman who goes to college and lives with her parents D. 16-year-old woman who is pregnant and lives with her boyfriend
C. 17-year-old woman who goes to college and lives with her parents
A 5-mL prefilled syringe of lidocaine contains 100 mg. How many mg/mL are present? Select one: A. 30 B. 50 C. 20 D. 10
C. 20
An elderly man with congestive heart failure and shortness of breath requires an IV line in case medication administration is necessary. Which of the following IV catheters is MOST appropriate to use when starting the IV? Select one: A. 18 gauge, 2 ¼″ B. 14 gauge, 2 ¼″ C. 20 gauge, 1 ¼″ D. 16 gauge, 1 ¼″
C. 20 gauge, 1 ¼″
Which of the following situations is an example of an act of commission? Select one: A. An EMT fails to splint a possible leg fracture. B. The paramedic charges for his or her services. C. A paramedic sutures a patient's lacerated arm. D. A physician transfers patient care to a paramedic.
C. A paramedic sutures a patient's lacerated arm.
Which of the following scenarios MOST accurately depicts abandonment? Select one: A. 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. 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. 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. 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 necessary.
C. 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 scenarios is considered by most states to be a medical examiner case? Select one: A. Death of a person under 45 years of age B. Any patient who dies outside the hospital C. Any violent or unexpected death D. Death of a criminal who is on probation
C. Any violent or unexpected death
Which of the following reassessment findings is MOST significant in a patient with penetrating chest trauma? Select one: A. Symmetrical chest rise and fall B. Heart rate of 78 beats per minute C. Blood pressure of 90/76 mm Hg D. Loud heart tones to auscultation
C. Blood pressure of 90/76 mm Hg
Which of the following statements regarding certification is correct? Select one: A. Certification is a process in which a certifying entity attests to the fact that the health care provider has mastered a certain skill set. B. Unlike a licensed health care provider, a certified health care provider is not required to obtain continuing education hours. C. Certification is evidence that an individual has a certain level of credentials based on hours of training and examination. D. A certified health care provider has been granted the authority and privilege to practice medicine in a certain municipality.
C. Certification is evidence that an individual has a certain level of credentials based on hours of training and examination.
Which of the following statements regarding pharmacology is correct? Select one: A. Evidence-based guidelines, while helpful, are not the primary factor that drives medication administration. B. The action of the human body in response to a particular medication is called pharmacology. C. Despite the advanced science of pharmacology, adverse reactions are commonplace. D. The selection and administration of most medications are based largely on anecdotal research.
C. Despite the advanced science of pharmacology, adverse reactions are commonplace.
Which of the following statements regarding the IM route of medication administration is correct? Select one: A. IM-administered medications are subject to first-pass metabolism in the liver. B. Any medication given by the IV route can be given by the IM route. C. Medications have a bioavailability of 75% to 100% following IM administration. D. Muscle perfusion has minimal effect on the absorption of IM-administered drugs.
C. Medications have a bioavailability of 75% to 100% following IM administration.
For which of the following conditions is diphenhydramine contraindicated? Select one: A. Phenothiazine toxicity B. Severe motion sickness C. Narrow-angle glaucoma D. Acute dystonic reaction
C. Narrow-angle glaucoma
Which of the following is NOT a function of the skin? Select one: A. Protection from the environment B. Transmission of information to the brain C. Production of antibodies to foreign organisms D. Temperature regulation
C. Production of antibodies to foreign organisms
While attempting to resuscitate a middle-aged woman in cardiac arrest, you perform effective CPR but do not evaluate the patient's cardiac rhythm until 10 minutes into the resuscitation attempt. When the cardiac monitor is finally applied, the patient is in asystole. The patient is transported but is pronounced dead upon arrival at the hospital. Which of the following statements regarding this scenario is correct? Select one: A. Although there was a delay in applying the cardiac monitor, you cannot be held liable, because effective CPR was performed throughout the resuscitation attempt. B. Your inaction reflects gross negligence and it easily could be established that the patient would have survived if the cardiac monitor had been applied earlier. C. The delay in evaluating the patient's cardiac rhythm constitutes a breach of duty and could be proven to be the proximate cause of her death. D. Simple negligence can be established because of the delay in applying the cardiac monitor, but your inaction did not proximately cause her death.
C. The delay in evaluating the patient's cardiac rhythm constitutes a breach of duty and could be proven to be the proximate cause of her death.
Conducting EMS research studies on critically ill or injured patients without their informed consent is: Select one: A. legal under the law of implied consent. B. inappropriate. C. a true ethical dilemma. D. ethically acceptable.
C. a true ethical dilemma.
The catecholamine epinephrine (adrenaline) has an affinity for: Select one: A. beta-1 receptors only. B. alpha-1 and beta-2 receptors. C. alpha and beta receptors. D. alpha-1 receptors only.
C. alpha and beta receptors.
The hypoxic drive, a backup system to control breathing, is stimulated when: Select one: A. arterial PaO2 levels increase. B. arterial PaCO2 levels increase. C. arterial PaO2 levels decrease. D. arterial PaCO2 levels decrease.
C. arterial PaO2 levels decrease.
A 39-year-old man with severe dehydration requires IV fluid therapy to treat his condition. The patient is conscious, alert, and oriented to person, place, time, and event. You should: Select one: A. start the IV to quickly restore his body fluid balance and then explain to the patient why you started the IV line. B. tell the patient that you are going to start an IV on him in order to replenish his body with lost fluid and electrolytes. C. ask him if you can start an IV and explain the reason for the IV as well as the potential risks of IV therapy. D. establish the IV line based on the law of implied consent, because his condition has impaired his decision-making capacity.
C. ask him if you can start an IV and explain the reason for the IV as well as the potential risks of IV therapy.
The first and second cervical vertebrae are called the: Select one: A. axis and dens. B. odontoid and axis. C. atlas and axis. D. dens and atlas.
C. atlas and axis.
The percentage of an unchanged medication that reaches the systemic circulation is referred to as: Select one: A. drug interference. B. pharmacodynamics. C. bioavailability. D. peak plasma level.
C. bioavailability.
Furosemide (Lasix) increases urinary output by: Select one: A. alkalinizing the urine, which promotes hydrogen ion excretion via the renal system. B. promoting the movement of fluid from the intracellular space to the extracellular space. C. blocking sodium absorption at the distal and proximal tubules and the loop of Henle. D. drawing glucose from the cells into the vascular compartment, which induces diuresis.
C. blocking sodium absorption at the distal and proximal tubules and the loop of Henle
The presence of rales during auscultation of the chest indicates all of the following conditions, EXCEPT: Select one: A. heart failure. B. toxic inhalation. C. bronchospasm. D. pulmonary edema.
C. bronchospasm
You would NOT expect to encounter decreased breath sounds in a patient with: Select one: A. pulmonary edema. B. opiate intoxication. C. cardiac tamponade. D. status asthmaticus.
C. cardiac tamponade
Efferent nerves of the peripheral nervous system are responsible for: Select one: A. sensations such as pain, temperature, and pressure. B. carrying impulses from the body to the brain. C. carrying commands from the brain to the muscles. D. involuntary functions such as breathing and heart rate.
C. carrying commands from the brain to the muscles.
If a conflict arises between a paramedic and a physician bystander in the field, the paramedic should: Select one: A. become subordinate to the physician. B. politely ask the physician to leave the scene. C. contact medical control to seek resolution. D. involve law enforcement in the incident.
C. contact medical control to seek resolution.
A drug is assigned a pregnancy category "A" if: Select one: A. there is evidence of fetal risk based on human experience, and the risk of using the drug in pregnant women clearly outweighs any possible benefit. B. studies in animals have revealed adverse effects on the fetus and there are no controlled studies in women, or studies in women and animals are not available. C. controlled studies in women fail to demonstrate a risk to the fetus in the first trimester, there is no evidence of risk in later trimesters, and the possibility of fetal harm appears remote. D. there is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the documented risk.
C. controlled studies in women fail to demonstrate a risk to the fetus in the first trimester, there is no evidence of risk in later trimesters, and the possibility of fetal harm appears remote.
Examples of steroid hormones are: Select one: A. oxytocin and growth hormone. B. epinephrine and prolactin. C. cortisol and testosterone. D. norepinephrine and antidiuretic hormone.
C. cortisol and testosterone.
A microdrip administration set: Select one: A. does not contain a needlelike orifice in its drip chamber. B. should be used when patients need fluid replacement. C. delivers 1 mL for every 60 drops. D. allows 10 or 15 drops per milliliter.
C. delivers 1 mL for every 60 drops
The projection of the neurons that receives electrical impulses from other neurons is called a(n): Select one: A. axon. B. neuroglia. C. dendrite. D. motor fiber.
C. dendrite.
Indications for magnesium sulfate include: Select one: A. increased intracranial pressure. B. second- or third-degree AV block. C. digitalis-induced dysrhythmias. D. calcium channel blocker toxicity.
C. digitalis-induced dysrhythmias
A hypertonic solution has an osmolarity higher than that of serum, meaning that the solution: Select one: A. has a lower ionic concentration than serum and pulls fluid and electrolytes from the intravascular compartment into the intracellular and interstitial compartments. B. contains high concentrations of proteins and can result in fluid overloading in patients with impaired cardiac function or renal insufficiency. C. has more ionic concentration than serum and pulls fluid and electrolytes from the intracellular and interstitial compartments into the intravascular compartment. D. may cause the cells to expand and rupture due to the increased intracellular osmotic pressure exerted by the solution.
C. has more ionic concentration than serum and pulls fluid and electrolytes from the intracellular and interstitial compartments into the intravascular compartment.
After administering Fentanyl, a controlled medication, to a patient for severe pain, you should: Select one: A. properly dispose of any remaining medication and ask your partner to sign as the person who wasted the medication. B. discard any medication that was not used and document the amount you wasted on the patient care report. C. have your partner or a supervisor witness you properly disposing of any of the unused medication and then sign as a witness. D. ensure that any unused medication is disposed of properly and then have the patient's family member sign as a witness.
C. have your partner or a supervisor witness you properly disposing of any of the unused medication and then sign as a witness
If a paramedic receives an order from a physician that he or she feels is detrimental to the patient's best interests, the paramedic should: Select one: A. tell the patient that the physician's order is appropriate for him or her. B. not carry out the order and discuss the issue with the physician later. C. immediately discuss with the physician why the paramedic feels that way. D. carry out the order, but factually and carefully document the event.
C. immediately discuss with the physician why the paramedic feels that way.
Distention of the jugular veins indicates: Select one: A. a state of hypovolemia. B. decreased venous pressure. C. increased venous capacitance. D. left-sided heart failure.
C. increased venous capacitance
Contraindications to fibrinolytic therapy include: Select one: A. an allergy to salicylates. B. any long bone fracture. C. intracranial surgery within 3 months. D. systolic BP greater than 150 mm Hg.
C. intracranial surgery within 3 months
For anaphylactic shock, epinephrine should be given via the _____________ route. Select one: A. intramuscular B. endotracheal C. intravenous D. subcutaneous
C. intravenous
A medication undergoes first-pass metabolism in the: Select one: A. stomach. B. bone marrow. C. liver. D. spleen.
C. liver.
A poorly written patient care report: Select one: A. often indicates that the paramedic was too busy providing patient care. B. generally results in a lawsuit, even if the patient outcome was favorable. C. may raise questions by others as to the paramedic's quality of patient care. D. is unavoidable during a mass-casualty incident and is generally acceptable.
C. may raise questions by others as to the paramedic's quality of patient care
Newer medications are designed to target only specific receptor sites on certain cells in an attempt to: Select one: A. reduce their therapeutic effect. B. treat more than one condition. C. minimize the adverse effects. D. eliminate all side effects.
C. minimize the adverse effects.
Tidal volume is MOST effectively assessed by: Select one: A. noting the patient's respiratory rate. B. looking for accessory muscle use. C. observing for rise and fall of the chest. D. auscultating breath sounds.
C. observing for rise and fall of the chest
A paramedic who was trained and certified to perform a surgical cricothyrotomy successfully performs the procedure on a patient in the field. However, because the EMS system's medical director does not permit paramedics to perform a needle cricothyrotomy, the paramedic: Select one: A. did not follow the national standard of care. B. has committed an act of gross negligence. C. performed outside his or her scope of practice. D. will likely be sued by the medical director.
C. performed outside his or her scope of practice.
Glucagon is used in the treatment of beta-blocker overdose because it: Select one: A. blocks alpha-2 receptors and increases blood pressure. B. activates beta-1 receptors and increases the heart rate. C. produces positive inotropic and chronotropic effects. D. causes vasoconstriction and increases blood pressure.
C. produces positive inotropic and chronotropic effects.
The BEST legal protection for the paramedic is to: Select one: A. always transport the patient to the hospital of the patient's choice, regardless of the patient's clinical condition. B. treat all patients with respect and remain aware that patients' cultural beliefs may differ from those of the paramedic. C. provide a detailed patient assessment and appropriate medical care, followed by complete and accurate documentation. D. routinely obtain more than the minimum number of continuing education credits required by the state department of health.
C. provide a detailed patient assessment and appropriate medical care, followed by complete and accurate documentation.
After inserting an 18-gauge over-the-needle catheter into the hand vein of a 30-year-old woman and securing the IV line in place, you note edema at the catheter site despite continued flow of the IV. The woman complains of pain and tightness around the IV site. You should: Select one: A. discontinue the IV and circumferentially wrap a dressing around the extremity. B. apply direct pressure to the venipuncture site and elevate her extremity. C. recognize that infiltration has occurred and immediately discontinue the IV. D. reapply the proximal constricting band to reduce edema at the catheter site.
C. recognize that infiltration has occurred and immediately discontinue the IV.
The rectal route is preferred over the oral route for certain emergency medications because: Select one: A. the vasculature of the rectal mucosa allows for slow drug absorption. B. bioavailability of rectal medications does not exceed 50 percent. C. rectal medications are usually not subject to first-pass metabolism. D. rectal medications are altered significantly by first-pass metabolism.
C. rectal medications are usually not subject to first-pass metabolism.
Health care powers of attorney are also called "durable" powers of attorney because they: Select one: A. do not require anyone to make decisions on the patient's behalf. B. must be in the patient's possession at all times. C. remain in effect once a patient loses decision-making capacity. D. can only be revoked by the patient's personal physician.
C. remain in effect once a patient loses decision-making capacity.
The antihypertensive properties of labetalol (Normodyne) are due to its: Select one: A. nonselective dopaminergic and selective alpha-adrenergic blocking effects. B. selective alpha and selective beta-adrenergic blocking effects. C. selective alpha and nonselective beta-adrenergic blocking effects. D. nonselective alpha and selective beta-1 adrenergic blocking effects.
C. selective alpha and nonselective beta-adrenergic blocking effects
Glucagon increases the blood glucose level by: Select one: A. facilitating glucose entry into the cell. B. agonizing the effects of insulin. C. stimulating glycogenesis. D. inhibiting gluconeogenesis.
C. stimulating glycogenesis.
All of the following are peripheral veins, EXCEPT the: Select one: A. lower extremity veins. B. veins of the hand. C. subclavian vein. D. external jugular vein.
C. subclavian vein
Ethics is MOST accurately defined as: Select one: A. behavior that is consistent with the law and an attitude that society in general expects. B. a code of conduct that can be defined by society, religion, or a person, affecting character, conduct, and conscience. C. the philosophy of right and wrong, of moral duties, and of ideal professional behavior. D. the professional behavior that a person's peers as well as the general public expect.
C. the philosophy of right and wrong, of moral duties, and of ideal professional behavior.
Decreased efficacy or potency of a medication when taken repeatedly by a patient is called: Select one: A. addiction. B. immunity. C. tolerance. D. habituation.
C. tolerance.
If the body is sliced so the result is a top and bottom portion, this is referred to as the: Select one: A. cross section. B. midsagittal plane. C. transverse plane. D. body's midline.
C. transverse plane.
Flushed skin is commonly seen as a result of all the following, EXCEPT: Select one: A. fever. B. superficial burns. C. vasoconstriction. D. heat exposure.
C. vasoconstriction
In response to shock or stress, sympathetic nervous system stimulation causes: Select one: A. increased gastrointestinal function. B. shunting of blood to the body's periphery. C. vasoconstriction. D. slowing of the heart rate
C. vasoconstriction.
Blood enters the right atrium of the heart from the: Select one: A. vena cava and aorta. B. aorta and coronary sinus. C. vena cavae and coronary sinus. D. pulmonary vein and aorta.
C. vena cavae and coronary sinus.
Atropine is supplied in 10-mL prefilled syringes that contain 1 mg. What is the concentration per milliliter? Select one: A. 10 mg/mL B. 1 mg/mL C. 0.01 mg/mL D. 0.1 mg/mL
D. 0.1 mg/mL
1 cc is equal to _____ mL. Select one: A. 10 B. 1,000 C. 100 D. 1
D. 1
The correct adult IV/IO dose and concentration of epinephrine for cardiac arrest is: Select one: A. 1 mg, 1:1,000 every 3 to 5 minutes. B. 0.01 mg/kg, 1:10,000 every 3 minutes. C. 0.1 mL/kg, 1:1,000 every 5 minutes. D. 1 mg, 1:10,000 every 3 to 5 minutes.
D. 1 mg, 1:10,000 every 3 to 5 minutes.
The correct dose of IV dextrose for an adult is: Select one: A. 500 mg/kg of a 25% solution. B. 100 mL of a 50% solution. C. 2 to 4 g/kg of a 50% solution. D. 12.5 to 25 g of a 50% solution.
D. 12.5 to 25 g of a 50% solution.
An 80-kg patient weighs ____ lb. Select one: A. 182 B. 179 C. 185 D. 176
D. 176
A prefilled syringe of lidocaine contains 100 mg/5 mL of volume. How many milligrams per milliliter (mg/mL) are present in the syringe? Select one: A. 10 B. 25 C. 5 D. 20
D. 20
The correct second dose of adenosine for a 50-pound child is: Select one: A. 6 mg. B. 12 mg. C. 2.3 mg. D. 4.6 mg.
D. 4.6 mg
A patient with a core body temperature of 35° on the Celsius scale has a core body temperature of ____ on the Fahrenheit scale. Select one: A. 96° B. 97° C. 94° D. 95°
D. 95°
Which of the following scenarios reflects a violation of EMTALA? Select one: A. An emergency department provides stabilization care only. B. A registration clerk asks you if the patient has insurance. C. Paramedics transport a woman in labor to the closest hospital. D. A hospital transfers an unstable patient to another facility.
D. A hospital transfers an unstable patient to another facility.
Which of the following statements regarding emergency vehicle laws is correct? Select one: A. An ambulance must use its lights and siren when transporting any acutely ill or injured patient. B. The Star of Life insignia permits an ambulance to run a red light or stop sign if it is safe. C. Most states allow an emergency vehicle to exceed the speed limit by 20 MPH if it is safe to do so. D. All state statutes require emergency vehicles to be operated in a safe and prudent manner.
D. All state statutes require emergency vehicles to be operated in a safe and prudent manner.
Which of the following statements regarding ascites is correct? Select one: A. Percussion of the abdomen will often yield hyperresonance. B. The abdomen of a patient with ascites has a sunken appearance. C. The most common cause of ascites is an acute splenic injury. D. Ascites is a collection of fluid within the peritoneal cavity.
D. Ascites is a collection of fluid within the peritoneal cavity.
Which of the following is the MOST practical method of assessing for gross neurologic deficits during your assessment of a patient? Select one: A. Check deep tendon reflexes with a reflex hammer or similar object. B. Ask the patient to lift both legs and hold them up for 20 to 30 seconds. C. Assess capillary refill time at the forehead and the fingernails and toenails. D. Ask the patient if he or she can feel and move his or her fingers and toes.
D. Ask the patient if he or she can feel and move his or her fingers and toes
Which of the following medications is derived from a plant source? Select one: A. Insulin B. Lithium C. Heparin D. Digoxin
D. Digoxin
Which of the following significant mechanisms of injury is unique to the infant and child? Select one: A. Penetrating injury to the head B. Vehicle-pedestrian collision C. Ejection from a car's back seat D. Fall from greater than 10 ft
D. Fall from greater than 10 ft
Which of the following statements regarding ethics in the workplace is correct? Select one: A. EMS has long been recognized and funded in the same manner as the other health care professions. B. Paramedics are accountable only to the EMS system's medical director and to the director of EMS operations. C. Acknowledging a patient's cultural beliefs is a low priority if he or she is critically ill or injured. D. Off-duty misconduct on the part of the paramedic may lessen the public's confidence in EMS in general.
D. Off-duty misconduct on the part of the paramedic may lessen the public's confidence in EMS in general.
When is aspirin indicated for the treatment of a stroke? Select one: A. Within the first 15 minutes after the onset of symptoms B. Immediately upon arrival at the emergency department C. Only if the patient is prescribed antiplatelet medications D. Only after an intracranial hemorrhage has been ruled out
D. Only after an intracranial hemorrhage has been ruled out
For which of the following is midazolam (Versed) indicated? Select one: A. To potentiate the effects of barbiturates B. Analgesia for orthopaedic trauma C. Paralysis induction for intubation D. Sedation prior to cardioversion
D. Sedation prior to cardioversion
Which of the following is NOT a required element needed to prove negligence? Select one: A. An act of omission was the cause of the patient's injury. B. The paramedic committed a breach of duty. C. The paramedic or EMS system had a duty to act. D. The patient's condition was life threatening.
D. The patient's condition was life threatening.
Proximate cause is MOST accurately defined as: Select one: A. a direct relationship between the mechanism of injury and the patient's injury. B. an action on the part of the paramedic that improved the patient's condition. C. an act of ordinary or gross negligence that resulted in further harm to the patient. D. a link between the paramedic's improper action and the patient's injury.
D. a link between the paramedic's improper action and the patient's injury.
The movement of a substance against a concentration or gradient that requires energy is called: Select one: A. facilitated diffusion. B. endocytosis. C. osmotic pressure. D. active transport.
D. active transport.
A/an __________________ agent is used to increase the pH of the serum or urine? Select one: A. anticoagulant B. antihistamine C. antacid D. alkalinizing
D. alkalinizing
A medication that initiates or alters a cellular activity by attaching to receptor sites and prompting a cell response is said to be: Select one: A. a competitive binder. B. an antagonist. C. synergistic. D. an agonist.
D. an agonist.
A 60-year-old woman with acute chest discomfort requires 0.4 mg of sublingual nitroglycerin. Prior to administering the medication, you should: Select one: A. determine to which hospital she wishes to be transported. B. assess her mucous membranes to ensure they are dry. C. ensure that her systolic BP is greater than 120 mm Hg. D. ask her if she wears a transdermal nitroglycerin patch.
D. ask her if she wears a transdermal nitroglycerin patch
An appropriately sized blood pressure cuff should: Select one: A. cover at least one third of the patient's upper arm. B. completely encompass the entire upper arm. C. cover at least two thirds of the patient's upper arm. D. be one half to two thirds the size of the upper arm.
D. be one half to two thirds the size of the upper arm
A 77-year-old man with end-stage COPD and renal failure is found unresponsive by his daughter. Your assessment reveals that the patient is apneic and pulseless. The daughter presents you with an out-of-hospital DNR order; however, the document expired 3 months ago. You should: Select one: A. realize that the patient cannot be resuscitated and notify the coroner. B. begin full resuscitative efforts because the DNR order is no longer valid. C. confirm that the order has expired before initiating any patient treatment. D. begin CPR only and contact medical control for further guidance.
D. begin CPR only and contact medical control for further guidance.
The ilium is defined as the: Select one: A. lower portion of the small intestine. B. structure that overlies the bladder. C. ligament that overlies the femoral vessels. D. bony prominences of the pelvis.
D. bony prominences of the pelvis.
A(n) ___________ is a substance that can absorb or donate hydrogen. Select one: A. acid B. ion C. base D. buffer
D. buffer
Blood pressure is the product of: Select one: A. stroke volume and heart rate. B. left ventricular ejection fraction and afterload. C. right atrial preload and ventricular stroke volume. D. cardiac output and peripheral vascular resistance.
D. cardiac output and peripheral vascular resistance
The amount of medication, expressed in milligrams, grams, or grains, that is present in an ampule or vial is called the: Select one: A. yield. B. desired dose. C. volume. D. concentration.
D. concentration
During the attempted resuscitation of a 79-year-old man in cardiac arrest, a young man arrives at the scene and asks you to cease resuscitative efforts. He further tells you that the patient has entrusted him to make all of his medical decisions. You should: Select one: A. advise the man that, because he does not have valid documentation that he is authorized to make decisions for the patient, you must continue resuscitation. B. cease all resuscitative efforts, contact medical control, and advise medical control that a surrogate decision maker is present and has requested you to stop. C. limit your resuscitative efforts to basic life support only and cease resuscitation altogether if the man can present a valid advance directive. D. continue full resuscitative efforts and ask the man if the patient has a living will and if he has documentation naming him as the person authorized to make decisions.
D. continue full resuscitative efforts and ask the man if the patient has a living will and if he has documentation naming him as the person authorized to make decisions.
The substance that contains all the cellular contents between the cell membrane and the nucleus is called the: Select one: A. Golgi apparatus. B. endoplasmic reticulum. C. protoplasm. D. cytoplasm.
D. cytoplasm.
The physiologic effects of nitroglycerin when given to patients with cardiac-related chest pain include: Select one: A. coronary vasoconstriction and increased preload. B. increased myocardial oxygen consumption. C. increased afterload and peripheral vasodilation. D. decreased preload and coronary vasodilation.
D. decreased preload and coronary vasodilation.
When a medication alters the velocity of the conduction of electricity through the heart, it is said to have a(n) _____________ effect. Select one: A. inotropic B. chronotropic C. alpha agonistic D. dromotropic
D. dromotropic
The first portion of the small intestine that receives food from the stomach is the: Select one: A. jejunum. B. ilium. C. ileum. D. duodenum.
D. duodenum.
Beginning with the outermost layer, the three meningeal layers of the central nervous system are the: Select one: A. dura mater, pia mater, and arachnoid. B. pia mater, dura mater, and arachnoid. C. arachnoid, pia mater, and dura mater. D. dura mater, arachnoid, and pia mater.
D. dura mater, arachnoid, and pia mater.
The Babinski sign, grasping, and sucking are: Select one: A. abnormal findings in infants. B. voluntary motor responses. C. signs of nervous system dysfunction. D. examples of primitive reflexes.
D. examples of primitive reflexes
During a 20-minute transport of a critical patient, you should make a concerted effort to reassess the patient ___ times. Select one: A. one B. three C. two D. four
D. four
If an initial dose of adenosine is ineffective for a 130-pound patient, you should: Select one: A. give a second dose after 10 minutes. B. give the second dose more slowly. C. give 6 mg rapid IV/IO push. D. give 12 mg after 1 to 2 minutes.
D. give 12 mg after 1 to 2 minutes
One of the major differences between laws and ethics is that laws: Select one: A. are reflective of a person's moral responsibilities. B. allow a person to determine right from wrong. C. are usually broken because of an unethical act. D. have sanctions for violation that are enforceable.
D. have sanctions for violation that are enforceable.
You would MOST likely encounter bilateral dependent edema in a patient with: Select one: A. deep vein occlusion. B. diabetes mellitus. C. arterial occlusion. D. heart failure.
D. heart failure
Indications for epinephrine include all of the following, EXCEPT: Select one: A. mild or severe allergic reactions. B. atropine-refractory bradycardia. C. bradycardia-induced hypotension. D. hypothermic cardiac arrest.
D. hypothermic cardiac arrest.
If too much water enters a cell during osmosis, it will burst. This process is called: Select one: A. viscosity. B. crenation. C. diffusion. D. lysis.
D. lysis.
The parathyroid glands produce and secrete a hormone that: Select one: A. controls the function of all other endocrine glands. B. converts glycogen produced in the liver to glucose. C. regulates the body's basil metabolic rate. D. maintains normal levels of calcium in the blood.
D. maintains normal levels of calcium in the blood.
For purposes of refusing medical care, a patient's mental status may be considered impaired if he or she: Select one: A. is not sure of the exact time. B. makes a derogatory comment. C. is notably frightened. D. makes nonsensical statements.
D. makes nonsensical statements
While off duty and outside of your jurisdiction, you encounter a motor vehicle crash. You can see one patient lying motionless on the ground near her overturned vehicle. As an off-duty paramedic, you: Select one: A. have a legal responsibility to stop and render aid. B. should call 9-1-1 but not stop to provide care. C. should stop if you have an EMS decal on your car. D. may feel an ethical obligation to stop and assist.
D. may feel an ethical obligation to stop and assist.
Additions or notations added to a completed patient care report by someone other than the original author: Select one: A. must be initialed by the original author or the patient care report will be deemed null and void. B. are generally acceptable, provided the additions are made by a paramedic. C. are not legal and may result in criminal action against the original author. D. may raise questions about the confidentiality practices of the EMS agency.
D. may raise questions about the confidentiality practices of the EMS agency
The topographic term used to describe the location of body parts that are closer to the midline is: Select one: A. lateral. B. midclavicular. C. midaxillary. D. medial.
D. medial.
Normal inhalation is the result of: Select one: A. air passively entering the lungs. B. positive pressure in the thoracic cavity. C. diaphragmatic relaxation. D. negative pressure in the thoracic cavity.
D. negative pressure in the thoracic cavity.
A pathologic fracture occurs when: Select one: A. abnormal forces are applied to normal bone structures. B. abnormal forces are applied to abnormal bone structures. C. normal forces are applied to normal bone structures. D. normal forces are applied to abnormal bone structures.
D. normal forces are applied to abnormal bone structures
During your assessment of a patient, you note that he is bradycardic, hypotensive, and salivating. These clinical findings suggest: Select one: A. sympathetic nervous system stimulation. B. sympathetic nervous system depression. C. parasympathetic nervous system depression. D. parasympathetic nervous system stimulation.
D. parasympathetic nervous system stimulation.
Bulging of a child's anterior fontanelle is: Select one: A. suggestive of significant dehydration. B. benign if the child is not flailing around. C. suggestive of an intracerebral hemorrhage. D. pathologic when observed in a quiet child.
D. pathologic when observed in a quiet child
Abdominal guarding is MOST commonly encountered in patients with: Select one: A. acute renal failure. B. intra-abdominal bleeding. C. chronic liver inflammation. D. peritoneal irritation.
D. peritoneal irritation
The most important nerve of the cervical plexus, which innervates the diaphragm, is the: Select one: A. vagus nerve. B. abducens nerve. C. trochlear nerve. D. phrenic nerve.
D. phrenic nerve.
Decreased levels of antidiuretic hormone (ADH) result in: Select one: A. increased fluid retention. B. oliguria and dehydration. C. anuria and diabetes mellitus. D. polyuria and diabetes insipidus.
D. polyuria and diabetes insipidus.
Freshly oxygenated blood is returned to the left atrium through the: Select one: A. superior vena cava. B. pulmonary arteries. C. inferior vena cava. D. pulmonary veins.
D. pulmonary veins.
The concept of consent refers to all of the following, EXCEPT the: Select one: A. patient's ability to make rational decisions. B. patient's age. C. patient's mental capacity. D. severity of the patient's injury.
D. severity of the patient's injury.
The diameter of a patient's pupils and their reactivity to light provide information about the: Select one: A. amount of vitreous humor. B. level of carbon dioxide in the brain. C. intactness of the first cranial nerve. D. status of cerebral perfusion.
D. status of cerebral perfusion
The term inotropy refers to the: Select one: A. control of electrical conduction. B. rate of cardiac contraction. C. degree of ventricular irritability. D. strength of myocardial contraction.
D. strength of myocardial contraction.
Cardiac output is equal to: Select one: A. systole minus diastole. B. heart rate minus systolic blood pressure. C. blood pressure multiplied by heart rate. D. stroke volume multiplied by heart rate.
D. stroke volume multiplied by heart rate.
If a paramedic is attacked by a violent patient: Select one: A. the paramedic will not be held legally accountable if the attack was the result of patient provocation. B. the law allows the paramedic to use a knife or firearm as a means of self-defense against the attacker. C. the paramedic is legally permitted to defend himself or herself with the use of deadly force. D. the paramedic may respond with force that is equal to or slightly greater than the force offered by the patient.
D. the paramedic may respond with force that is equal to or slightly greater than the force offered by the patient.
A paramedic's actions are considered to be grossly negligent if he or she: Select one: A. does not consult with online medical control first. B. makes a simple mistake that causes harm to the patient. C. only provides basic life support to a critical patient. D. willfully or wantonly deviates from the standard of care.
D. willfully or wantonly deviates from the standard of care.
Components of a thorough patient refusal document include: Select one: A. notification of the patient's physician to apprise him or her of the situation. B. assurance by the paramedic that the patient's ability to pay is of no concern. C. documentation of a complete assessment, even if the patient refused assessment. D. willingness of EMS to return to the scene if the patient changes his or her mind.
D. willingness of EMS to return to the scene if the patient changes his or her mind.
