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Paramedic FISDAP Final Questions & answers
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Paramedic FISDAP Final A 30 year old climber is experiencing sever shortness of breath after reaching an elevation of 12000feet. The PT is very anxious and has rales noted to all quadrants but is otherwise healthy. He is not accustomed to high altitudes. What should you do? - correct answer-Adm...

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  • April 10, 2024
  • 17
  • 2023/2024
  • Exam (elaborations)
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Paramedic
FISDAP
Final
A
3 0
y e a r
o l d
c l i m b e r
i s
e x p e r i e n c i n g
s e v e r
s h o r t n e s s
o f
b r e a t h
a f t e r
r e a c h i n g
a n
e l e v a t i o n
o f
1 2 0 0 0 f e e t .
T h e
P T
i s
v e r y
a n x i o u s
a n d
h a s
r a l e s
n o t e d
t o
a l l
q u a d r a n t s
b u t
i s
o t h e r w i s e
h e a l t h y .
H e
i s
n o t
a c c u s t o m e d
t o
h i g h
a l t i t u d e s .
W h a t
s h o u l d
y o u
d o ?
-
c o r r e c t
a n s w e r - A d m i n i s t e r
o x y g e n
w h i l e
d e s c e n d i n g
t o
a
l o w e r
a l t i t u d e .
A
2 6
y e a r
o l d
f e m a l e
d o e s
n o t
r e s p o n d
t o
v e r b a l
s t i m u l i
b u t
m o a n s
i n
r e s p o n s e
t o
p a i n .
A
f r i e n d
s t a t e s
t h e
p a t i e n t
h a s
i n g e s t e d
a p p r o x
1 5 0
a m i t r i p t y l i n e
t a b l e s .
V i t a l
S i g n s
a r e
B P
8 0
R 1 6 .
Y o u
e s t a b l i s h
I V
a c c e s s
a n d
a d m i n i s t e r
a
f l u i d
c h a l l e n g e .
E n
r o u t e
t o
t h e
h o s p i t a l
h e r
E C G
s h o w s
a
w i d e n i n g
Q R S .
Y o u
s h o u l d
a d m i n i s t e r
-
c o r r e c t
a n s w e r - S o d i u m
B i c a r b o n a t e .
Y o u
P T
e x p e r i e n c e d
t r a u m a
y e s t e r d a y
a n d
y o u
a r e
t r a n s f e r r i n g
h e r
t o
a
l a r g e r
f a c i l i t y .
S h e
h a s
b e e n
e x p e r i e n c i n g
p r o g r e s s i v e
h y p o x i a .
Y o u
n o t i c e
c o a r s e
c r a c k l e s
i n
a l l
l u n g
f i e l d s
o n
v e n t i l a t i o n .
V i t a l
s i g n s
a r e
B P
9 0
a n d
S P O 2
9 0 % .
Y o u
s h o u l d
-
c o r r e c t
a n s w e r - T r a n s p o r t
e m e r g e n c y
a n d
c o n t i n u e
v e n t i l a t i o n .
A n
a l e r t
2 2
y e a r
o l d
m a l e
w a s
j u s t
d i s e n t a n g l e d
f r o m
d e b r i s
i n
a
h o u s e
c o l l a p s e .
H e
d e n i e s
h e a d
o r
n e c k
p a i n ,
b u t
c o m p l a i n s
o f
s e r v e r
h i p
p a i n .
V i t a l
s i g n s
a r e
B P
8 0 .
P 1 2 0
R
1 6
y o u
s h o u l d
a d m i n i s t e r .
-
c o r r e c t
a n s w e r - s o d i u m
b i c a r b o n a t e
B r a x t o n
H i c k s
c o n t r a c t i o n s
-
c o r r e c t
a n s w e r - o c c u r
i n
t h e
s e c o n d
t r i m e s t e r
a n d
a r e
f a l s e
l a b o r .
A
4 0
y e a r
o l d
m a l e
c r a s h e d
h i s
m o t o r c y c l e .
H e
h a d
a
b r i e f
l o s s
o f
c o n s c i o u s n e s s ,
w o k e
u p
a n d
w a l k e d
h o m e .
Y o u
f i n d
h i m
2
h o u r s
l a t e r
a t
h o m e
u n c o n s c i o u s .
Y o u
s h o u l d
s u s p e c t .
-
c o r r e c t
a n s w e r - e p i d u r a l
h e m a t o m a
A
4 7
y e a r
o l d
m a l e
w h o
w a s
f o u n d
u n c o n s c i o u s
o n
t h e
s i d e
o f
t h e
r o a d
r e s p o n d
o n l y
t o
p a i n f u l
s t i m u l u s .
W h e n
y o u
a t t e m p t
t o
e s t a b l i s h
I V
a c c e s s
h e
s t i f f e n s
h i s
a r m s
a n d
l e g s .
H e
h a s
m i n o r
a b r a s i o n s
a l l
o v e r
h i s
b o d y .
V i t a l
s i g n s
a r e
B O
1 7 2 2
P 5 6
R
i r r e g u l a r
E T C O 2
3 0 .
W h a t
s h o u l d
y o u
d o ?
-
c o r r e c t
a n s w e r - A s s i s t
v e n t i l a t i o n s
a t
1 2
b r e a t h s
p e r
m i n H g .
A
2 8
y e a r
o l d
f e m a l e
h a s
a
s u d d e n
o n s e t
o f
t i g h t n e s s
i n
h e r
c h e s t
a n d
s e r v e r
d i f f i c u l t y
b r e a t h i n g .
H e r
t o n g u e
f a c e
a n d
n e c k
a p p e a r
s w o l l e n
a n d
s h e
h a s
r e d
i t c h y
h i v e s
o n
h e r
t o r s o .
H e r
s i g n s
a r e
B P
8 0
P
1 3 0 .
Y o u
s h o u l d
a d m i n i s t e r
-
c o r r e c t
a n s w e r - E p i n e p h r i n e
0 . 3 m g
Y o u
a r e
a s k e d
t o
s e t
u p
a
p a t i e n t
t r e a t m e n t
a r e a
a f t e r
a
b o x
l a b e l e d
" r a d i o
a c t i v e "
w a s
f o u n d
u n a t t e n d e d
i n
a
p a r k .
W h i c h
o f
t h e
f o l l o w i n g
w o u l d
b e
t h e
b e s t
l o c a t i o n .
-
c o r r e c t
a n s w e r - B u i l d i n g
i n
t h e
p a r k
Y o u
a r e
a t
a
h o u s e
f i r e
w i t h
m u l t i p l e
p a t i e n t s .
W h i c h
p a t i e n t
s h o u l d
b e
t r a n s p o r t e d
F i r s t
t o
a
b u r n
c e n t e r ?
-
c o r r e c t
a n s w e r - 5 2
y e a r
o l d
w i t h
s e c o n d
d e g r e e
b u r n s
t o
f a c e
a n d
r i g h t
h a n d W h a t
i s
t h e
m o s t
c o m m o n
c a u s e
o f
s t a t u s
e p i l e p t i c u s
i n
a d u l t s .
-
c o r r e c t
a n s w e r - F a i l u r e
t o
t a k e
p r e s c r i b e d
m e d i c a t i o n s
A
5 8
y e a r
o l d
m a l e
w i t h
h i s t o r y
o f
r e n a l
f a i l u r e
c o m p l a i n s
o f
d i z z i n e s s
l e t h a r g y
a n d
d i f f i c u l t y
b r e a t h i n g .
H e
s a y s
h e
m i s s e d
h i s
l a s t
d i a l y s i s
a p p o i n t m e n t .
V i t a l
s i g n s
a r e
B P
1 6 0
P
1 0 0
R
2 8
w i t h
r a l e s
h e a r d
i n
t h e
b a s s e s .
S P O 2
9 2 %
y o u
s h o u l d
s u s p e c t .
-
c o r r e c t
a n s w e r - F l u i d
O v e r l o a d .
A
1 2
y e a r
o l d
g i r l
i s
s e i z i n g .
H e r
m o m
t e l l s
y o u
t h a t
h e r
d a u g h t e r
h a s
b e e n
f e e l i n g
t i r e d
f o r
d a y s .
H e r
s k i n
i s
d r y
a n d
s h e
h a s
b e e n
v e r y
t h i r s t y .
V i t a l
s i g n s
a r e
B P
1 1 0
P 1 1 5
R 2 6
y o u
s h o u l d
s u s p e c t .
-
c o r r e c t
a n s w e r - D i a b e t i c
k e t o a c i d o s i s
A
4 2
y e a r
o l d
f e m a l e
h a s
f a l l e n
d o w n
a
f l i g h t
o f
s t a i r s .
S h e
a p p e a r s
a n x i o u s
h e r
s k i n
i s
c o o l
a n d
c l a m m y
h e r
r a d i a l
p u l s e s
a r e
w e a k
a t
1 1 2
b e a t s
p e r
m i n
a n d
s h e
c o m p l a i n s
o f
a b d o m i n a l
p a i n
i n
t h e
l e f t
u p p e r
q u a d r a n t
w i t h
r a d i a t i o n
t o
t h e
l e f t
s c a p u l a .
Y o u
s h o u l d
s u s p e c t .
-
c o r r e c t
a n s w e r - T o r n
o r
l a c e r a t e d
s p l e e n .
E m e r g e n c y
m e d i c a l
r e s p o n d e r s
a r e
v e n t i l a t i n g
a n
a p n e i c
m e d i c a l
p a t i e n t
w i t h
a
b a g
v a l v e
m a s k .
Y o u
n o t e
a b d o m i n a l
d i s t e n t i o n
a n d
m i n i m a l
c h e s t
r i s e .
W h a t
s h o u l d
y o u
d o ?
-
c o r r e c t
a n s w e r - R e p o s i t i o n
t h e
h e a d .
A
6
m o n t h
o l d
m a l e
w a s
f o u n d
l y i n g
f a c e
d o w n
i n
t h e
c r i b .
H e
i s
c y a n o t i c
a n d
a p n e i c .
A
w e a k
b r a c h i a l
p u l s e
i s
p r e s e n t .
Y o u
a r e
u n a b l e
t o
s e e
a
c h e s t
r i s e
w i t h
y o u r
s e c o n d
a t t e m p t
a t
r e s c u e
b r e a t h i n g
a f t e r
r e p o s i t i o n i n g
t h e
h e a d .
W h a t
s h o u l d
y o u
d o .
-
c o r r e c t
a n s w e r - S t a r t
C P R
Y o u
h a v e
j u s t
b e e n
c a l l e d
t o
a
d i a l y s i s
c l i n i c
f o r
a
5 8
y e a r
o l d
m a l e
i n
c a r d i a c
a r r e s t .
T h e
o n l i n e
p h y s i c i a n
m a y
o r d e r
y o u
t o
a d m i n i s t e r
w h i c h
o f
t h e
f o l l o w i n g
m e d i c a t i o n s .
-
c o r r e c t
a n s w e r - S o d i u m
B i c a r b o n a t e .
A
2 7
y e a r
o l d
m a l e
h a s
b e e n
a s s a u l t e d
w i t h
a
p e n
i n
t h e
s u p r a c l a v i c u l a r
a r e a .
H e
i s
a n x i o u s
a n d
p a l e
a n d
h i s
v i t a l
s i g n s
a r e
B P
8 2
P
1 2 8
R
3 2
a n d
s h a l l o w .
F i r s t
r e s p o n d e r s
h a v e
s e a l e d
t h e
w o u n d
w i t h
a
b a n d a g e .
A s s e s s m e n t
r e v e a l s
l u n g
s o u n d s
o n
t h e
r i g h t
a n d
p o o r
c h e s t
r i s e
w h a t
s h o u l d
y o u
d o .
-
c o r r e c t
a n s w e r - B u r p
d r e s s i n g
A
5 0
p o u n d
c h i l d
i s
u n r e s p o n s i v e
p u l s e l e s s
a n d
a p n e i c .
T h e
c a r d i a c
m o n i t o r
d i s p l a y s
v e n t r i c u l a r
f i b r i l l a t i o n s .
C P R
i s
i n
p r o g r e s s .
T h e
i n i t i a l
d e f i b r i l l a t o r
s h o u l d
b e
a t .
-
c o r r e c t
a n s w e r - 5 0
j o u l e s .
A n
1 1
y e a r
o l d
m a l e
h a s
b e e n
s k a t e b o a r d i n g
i n
1 0 0
d e g r e e s
t e m p e r a t u r e
a n d
h a s
b e e n
d r i n k i n g
c a f f e i n a t e d
s o f t
d r i n k s .
H e
c o m p l a i n s
o f
p a l p a t i o n s .
T h e
c a r d i a c
m o n i t o r
d i s p l a y s
a
n a r r o w
Q R S
t a c h y c a r d i a
a t
a
r a t e
o f
1 6 0
b e a t s .
V i t a l s
s i g n s
B P
1 1 0
P 1 6 0
R
2 0
W h a t
s h o u l d
y o u
d o ?
-
c o r r e c t
a n s w e r - T r a n s p o r t
t h e
p a t i e n t
b y
a m b u l a n c e
m o n i t o r
c l o s e l y
a n d
a d m i n i s t e r
f l u i d s
e n
r o u t e .
A n
8 0
y e a r
o l d
m a l e
i n
s e r v e r
r e s p i r a t o r y
d i s t r e s s .
H e
h a s
a
h i s t o r y
o f
h y p e r t e n s i o n
a n d
b r e a t h i n g
p r o b l e m s .
H e
t a k e s
i n d e r a l
d a i l y .
V i t a l
s i g n s
a r e
B P
1 7 0
P 7 2
a n d
i r r e g u l a r
R 4 0 a n d
e x t r e m e l y
l a b o r e d
s k i n
w a r m
a n d
d i a p h o r e t i c .
L u n g
s o u n d s
a r e
d i f f u s e
b i l a t e r a l
c r a c k l e s
a n d
w h e e z i n g .
H e
c o u g h s
u p
b l o o d
t i n g e d
s p u t u m .
W h i c h
o f
t h e
f o l l o w i n g
i s
m o s t
i m p o r t a n t .
-
c o r r e c t
a n s w e r - D e c r e a s i n g
p r e l o a d
A
5 0
y e a r
o l d
p a t i e n t
i s
f o u n d
l y i n g
o u t s i d e
o n
t h e
g r o u n d .
T h e
a m b i e n t
t e m p e r a t u r e
i s
4 0
d e g r e e s
F .
Y o u
t h e r m o m e t e r
r e a d s
2 0 C
8 6 F .
H e
i s
i n
V - f i b
a n d
p u l s e l e s s
a n d
a p n e i c .
Y o u
s h o u l d
-
c o r r e c t
a n s w e r - D e f i b r i l l a t e
o n c e
p e r f o r m
C P R
i n t u b a t e
a n d
t r a n s p o r t
r a p i d l y .
T o
s u c c e s s f u l l y
a c c o m p l i s h
n a s o t r a c h e a l
i n t u b a t i o n
y o u
s h o u l d
a d v a n c e
t h e
e n d o t r a c h e a l
t u b e
t h o u g h
t h e
g l o t t i c
o p e n i n g
t o
c o i n c i d e
w i t h
p a t i e n t
-
c o r r e c t
a n s w e r - I n h a l a t i o n
A n
a l e r t
2 3
y e a r
o l d
m a l e
p r e s e n t s
w i t h
a
s u d d e n
o n s e t
o f
s h o r t n e s s
o f
b r e a t h
a n d
c h e s t
p a i n
a f t e r
r u n n i n g
u p s t a i r s .
B r e a t h
s o u n d s
a r e
d i m i n i s h e d
i n
t h e
r i g h t
s i d e .
T h e
m o s t
l i k e l y
c a u s e
i s .
-
c o r r e c t
a n s w e r - S p o n t a n e o u s
p n e u m o t h o r a x
F i r s t
r e s p o n d e r s
a r e
t r e a t i n g
a n
a p n e i c
a d u l t
f e m a l e .
Y o u
n o t i c e
t h a t
t h e y
a r e
a p p l y i n g
f r e q u e n t
l o n g
v e n t i l a t i o n s
w i t h
a n
o x y g e n
r e s u s c i t a t o r .
W h a t
e f f e c t s
w i t h
t h e i r
a c t i o n s
c r e a t e .
-
c o r r e c t
a n s w e r - I n c r e a s e d
c a p i l l a r y
e l a s t i c i t y .
Y o u
a r e
c a l l e d
t o
a
n u r s i n g
h o m e
o n
a
h o t
s u m m e r
d a y
f o r
a
8 8
y e a r
o l d
m a l e .
T h e
n u r s e
t e l l s
y o u
h e
m i s s e d
h i s
d i a l y s i s
a p p o i n t m e n t
b e c a u s e
h e
w a s
c o m p l a i n i n g
o f
n a u s e a
v o m i t i n g
h e a d a c h e
a n d
r u n n i n g
a
f e v e r .
W h i c h
d i f f e r e n t i a l
d i a g n o s i s
s h o u l d
y o u
c o n s i d e r
f i r s t .
-
c o r r e c t
a n s w e r - S e p s i s
a n d
h y p e r k a l e m i a
Y o u
h a v e
j u s t
a d m i n i s t e r e d
a d e n o s i n e
t o
a
6 2
y e a r
o l d
p a t i e n t
w i t h
n a r r o w
c o m p l e x
t a c h .
T h e
E C G
s h o w s
a n
i r r e g u l a r
r a t e
o f
5 0
t h e n
s t e a d i l y
c l i m b s
b a c k
t o
a
r a t e
o f
1 6 9 .
W h a t
w o u l d
s h o u l d
s u s p e c t
-
c o r r e c t
a n s w e r - r a p i d
a t r i a l
f i b r i l l a t i o n .
A
6 3
y e a r
o l d
m a l e
i s
h a v i n g
a
d i a b e t i c
e m e r g e n c y
.
H e
i s
u n r e s p o n s i v e
R 1 2
g l u c o m e t e r
2 8 .
Y o u
c a n n o t
e s t a b l i s h
I V
a c c e s s .
Y o u
s h o u l d
-
c o r r e c t
a n s w e r - a d m i n i s t e r
g l u c a g o n
I M
W h e n
s e t t i n g
u p
a
n i g h t
t i m e
l a n d i n g
z o n e
f o r
a
h e l i c o p t e r
w h a t
i s
t h e
r e c o m m e n d e d
a r e a
n e e d e d .
-
c o r r e c t
a n s w e r - 1 0 0 x 1 0 0
A
6 7
y e a r
o l d
w i t h
h y p o - t e n s i o n
a n d
b r a d y c a r d i a
h a s
n o
r e s p o n d e d
t o
p a c i n g
o r
a t r o p i n e .
Y o u
s h o u l d
-
c o r r e c t
a n s w e r - a d m i n i s t e r
d o p a m i n e
i n f u s i o n
A
1 9
y e a r
o l d
m a l e
h a s
s u f f e r e d
b l u n t
t r a u m a
o n
h i s
l e f t
c h e s t .
H e
c o m p l a i n s
o f
s e r v e r
d y s p n e a
a n d
p a i n
o v e r
t h e
a f f e c t e d
a r e a .
V i t a l
s i g n s
a r e
B P
9 0
P
1 2 8
R
3 2 .
B r e a t h
s o u n d s
a r e
v e r y
d i m i n i s h e d
o v e r
t h e
l e f t
c h e s t .
Y o u
s h o u l d
-
c o r r e c t
a n s w e r - p e r f o r m
n e e d l e
t h o r a c o s t o m y
A
4 4
y e a r
o l d
p a t i e n t
h a s
a
p e r s i s t e n t
c o u g h
a n d
o c c a s i o n a l
s p i t s
u p
b l o o d y
s p u t u m
.
H e
h a s
b e e n
l i v i n g
i n
a
a
s h e l t e r
f o r
t h e
p a s t
t h r e e
w e e k s
a n d
h e
s m e l l s
l i k e
a l c o h o l
y o u
s h o u l d .
-
c o r r e c t
a n s w e r - P u t
o n
N 9 5
m a s k
a n d
e y e
p r o t e c t i o n .
W h i l e
t r e a t i n g
a
p a t i e n t
w i t h
s u s p e c t e d
T B .
W h a t
t y p e
o f
p e r s o n a l
p r o t e c t i v e
e q u i p m e n t
i s
e s s e n t i a l
-
c o r r e c t
a n s w e r - H E P A
r e s p i r a t o r

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