Question 1

A supervisor senses that an EMS crew that has just conducted a very dramatic, but unsuccessful, rescue of a drowned child may be experiencing very intense emotions about the incident. Which of the following is an appropriate supervisory action?

Accepted Answer

A)  Do nothing unless the providers become obviously distressed. 
B)  Refer all crew members to psychiatric help at the end of the shift. 
C)  Minimize any effects by keeping a low-key attitude about the incident. 
D)  Initiate a "resiliency based care" program to care for the mental health of the crew.

Question 2

Tricyclic antidepressants achieve their therapeutic effect by:

Accepted Answer

A)  prolonging the duration of norepinephrine and serotonin at the receptor sites. 
B)  enhancing degradation of norepinephrine and serotonin at the synapse. 
C)  blocking the release of norepinephrine and serotonin at the synapse. 
D)  blocking the release of acetylcholine at the synapse.

Question 3

Which of the following practices, when done regularly, can help reduce back injuries during lifting?

Accepted Answer

A)  Gaining body weight to "anchor" the lift 
B)  Keeping the palms up when possible while lifting the cot 
C)  Using traditional sit-ups to strengthen lower back muscles during exercise routines 
D)  Counterbalance the lift by moving your center of gravity away from the load

Question 4

An essential component of good documentation is the appropriate use of:

Accepted Answer

A)  subjective opinions. 
B)  administrative research. 
C)  medical terminology. 
D)  medical metaphors.

Question 5

Which of these is NOT an issue facing EMS providers, according to Emergency Medical Services: At the Crossroads?

Accepted Answer

A)  Insufficient coordination 
B)  Disparities in response times 
C)  Limited evidence base 
D)  Medical malpractice

Question 6

If you were to administer an antiarrhythmic drug that was a complete sodium channel blocker, which of the following would you expect?

Accepted Answer

A)  It would prevent the efflux (outflow) of calcium from within the cell. 
B)  It would impede the sodium-potassium pump from replacing the ions to their original locations. 
C)  It would cause excessive muscular contraction, because sodium is the principal cation in myofibril contraction. 
D)  It would prevent the development of phase 0, thereby inhibiting depolarization.

Question 7

Rules or standards that govern the conduct of members of a particular group or profession are called:

Accepted Answer

A)  regulations. 
B)  ethics. 
C)  morals. 
D)  statutes.

Question 8

Which of the following diseases is characterized by hypersecretion of adrenocorticotropic hormone leading to hyperglycemia, obesity, hypertension, and electrolyte imbalances?

Accepted Answer

A)  Cushing's disease 
B)  Gigantism 
C)  Hashimoto's disease 
D)  Addison's disease

Question 9

Which of the following sites on the body is NOT used for an intradermal injection?

Accepted Answer

A)  Abdomen 
B)  Upper back 
C)  Upper chest 
D)  Inside of middle forearm

Question 10

Gastric tubes may be gently placed in patients who have gastric or esophageal varices unless they have undergone a banding or cautery procedure within the past:

Accepted Answer

A)  month. 
B)  week. 
C)  six weeks. 
D)  two weeks.

Question 11

Which of the following statements about the physiological changes associated with aging is TRUE?

Accepted Answer

A)  There is a 25 to 30 percent increase in kidney mass due to hypertrophy. 
B)  Impaired insulin use and glucose metabolism result in weight loss. 
C)  Decreased elasticity of the lung tissue results in a smaller lung volume. 
D)  Blood vessel walls thicken, reducing blood flow to end organs and causing blood pressure to rise.

Question 12

During a respiratory assessment, the absence of breath sounds may indicate:

Accepted Answer

A)  a pneumothorax. 
B)  a pulmonary embolism. 
C)  flail chest. 
D)  bronchitis.

Question 13

What is one of the emerging roles and responsibilities of a paramedic in the 21st century?

Accepted Answer

A)  Third-party biller 
B)  Managed health care 
C)  Health promotion 
D)  Internet education

Question 14

Which of the following mechanisms buffers the acidity of the blood the fastest?

Accepted Answer

A)  Increased hydrogen ion elimination in the urine 
B)  Protein buffering system 
C)  The carbonic acid-bicarbonate buffer system 
D)  Increased respiratory rate

Question 15

Which of the following best describes the paramedic's professional obligation?

Accepted Answer

A)  Acceptance and adherence to a code of professional ethics and etiquette 
B)  Placing the system's well-being above that of the patient 
C)  Absolute adherence to medical protocols 
D)  Following long-standing traditions in practice

Question 16

Your patient weighs 22 pounds and is to receive 0.02 mg/kg of atropine IV push. You have a multidose vial of atropine containing 20 mL at a concentration of 0.04 mg/mL. What volume (in mL) of medication is to be injected?

Accepted Answer

A)  0.5 
B)  2.5 
C)  0.25 
D)  5

Question 17

You are seeing a 69-year-old female patient complaining of fatigue and nausea. She has a history of heart failure and two previous myocardial infarctions. She reports having blurred vision with halos around objects. Her blood pressure is 144/88 mmHg, her pulse is 110 and irregular, and her ventilations are 16. What should you suspect is causing her symptoms?

Accepted Answer

A)  Impaired cerebral perfusion secondary to heart failure 
B)  Acute closed-angle glaucoma 
C)  Toxic blood levels of digoxin 
D)  Cerebral embolus secondary to atrial fibrillation

Question 18

The subjective narrative includes information that is elicited:

Accepted Answer

A)  during history taking. 
B)  from public records. 
C)  by observing the patient's actions. 
D)  from dispatch information.

Question 19

You are providing end-of-life care to a patient in the last stages of a terminal illness. She appears to be at peace and speaks animatedly about her upcoming funeral. She is in which stage of loss?

Accepted Answer

A)  Acceptance 
B)  Denial 
C)  Bargaining 
D)  Depression

Question 20

Which of the following mechanisms is responsible for hypoxemia in the patient with a pulmonary embolism?

Accepted Answer

A)  Pulmonary shunting 
B)  Pulsus paradoxus 
C)  Lower airway obstruction 
D)  Atelectasis

Exam 1: Introduction to Paramedicine