Paramedic FISDAP Final Exam Graded A+

1. 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? - ANSWER-Administer oxygen while descending to a lower altitude. 2. A 26 year old female does not respond to verbal stimuli but moans in response to pain. A friend states the patient has ingested approx 150 amitriptyline tables. Vital Signs are BP 88/50 R16. You establish IV access and administer a fluid challenge. En route to the hospital her ECG shows a widening QRS. You should administer - ANSWER-Sodium Bicarbonate. 3. You PT experienced trauma yesterday and you are transferring her to a larger facility. She has been experiencing progressive hypoxia. You notice coarse crackles in all lung fields on ventilation. Vital signs are BP 90/50 and SPO2 90%. You should - ANSWER-Transport emergency and continue ventilation. 4. An alert 22 year old male was just disentangled from debris in a house collapse. He denies head or neck pain, but complains of server hip pain. Vital signs are BP 88/40. P120 R 16 you should administer. - ANSWER-sodium bicarbonate 5. Braxton Hicks contractions - ANSWER-occur in the second trimester and are false labor. 6. A 40 year old male crashed his motorcycle. He had a brief loss of consciousness, woke up and walked home. You find him 2 hours later at home unconscious. You should suspect. - ANSWER-epidural hematoma 7. A 47 year old male who was found unconscious on the side of the road respond only to painful stimulus. When you attempt to establish IV access he stiffens his arms and legs. He has minor abrasions all over his body. Vital signs are BO 178/122 P56 R irregular ETCO2 30. What should you do? - ANSWER-Assist ventilations at 12 breaths per minHg. 8. A 28 year old female has a sudden onset of tightness in her chest and server difficulty breathing. Her tongue face and neck appear swollen and she has red itchy hives on her torso. Her signs are BP 80/40 P 130. You should administer - ANSWER-Epinephrine 0.3mg 9. You are asked to set up a patient treatment area after a box labeled "radio active" was found unattended in a park. Which of the following would be the best location. - ANSWER-Building in the park 10. You are at a house fire with multiple patients. Which patient should be transported First to a burn center? - ANSWER-52 year old with second degree burns to face and right hand 11. What is the most common cause of status epilepticus in adults. - ANSWER-Failure to take prescribed medications 12. A 58 year old male with history of renal failure complains of dizziness lethargy and difficulty breathing. He says he missed his last dialysis appointment. Vital signs are BP 160/90 P 100 R 28 with rales heard in the basses. SPO2 92% you should suspect. - ANSWER-Fluid Overload. 13. A 12 year old girl is seizing. Her mom tells you that her daughter has been feeling tired for days. Her skin is dry and she has been very thirsty. Vital signs are BP 118/80 P115 R26 you should suspect. - ANSWER-Diabetic ketoacidosis 14. A 42 year old female has fallen down a flight of stairs. She appears anxious her skin is cool and clammy her radial pulses are weak at 112 beats per min and she complains of abdominal pain in the left upper quadrant with radiation to the left scapula. You should suspect. - ANSWER-Torn or lacerated spleen. 15. Emergency medical responders are ventilating an apneic medical patient with a bag valve mask. You note abdominal distention and minimal chest rise. What should you do? - ANSWER-Reposition the head. 16. A 6 month old male was found lying face down in the crib. He is cyanotic and apneic. A weak brachial pulse is present. You are unable to see a chest rise with your second attempt at rescue breathing after repositioning the head. What should you do. - ANSWER-Start CPR 17. You have just been called to a dialysis clinic for a 58 year old male in cardiac arrest. The online physician may order you to administer which of the following medications. - ANSWER-Sodium Bicarbonate. 18. A 27 year old male has been assaulted with a pen in the supraclavicular area. He is anxious and pale and his vital signs are BP 80/42 P 128 R 32 and shallow. First responders have sealed the wound with a bandage. Assessment reveals lung sounds on the right and poor chest rise what should you do. - ANSWER-Burp dressing 19. A 50 pound child is unresponsive pulseless and apneic. The cardiac monitor displays ventricular fibrillations. CPR is in progress. The initial defibrillator should be at. - ANSWER-50 joules. 20. An 11 year old male has been skateboarding in 100 degrees temperature and has been drinking caffeinated soft drinks. He complains of palpations. The cardiac monitor displays a narrow QRS tachycardia at a rate of 160 beats. Vitals signs BP 110/60 P160 R 20 What should you do? - ANSWER-Transport the patient by ambulance monitor closely and administer fluids en route. 21. An 80 year old male in server respiratory distress. He has a history of hypertension and breathing problems. He takes inderal daily. Vital signs are BP 170/70 P72 and irregular R40 and extremely labored skin warm and diaphoretic. Lung sounds are diffuse bilateral crackles and wheezing. He coughs up blood tinged sputum. Which of the following is most important. - ANSWER-Decreasing preload 22. A 50 year old patient is found lying outside on the ground. The ambient temperature is 40 degrees F. You thermometer reads 20C 86F. He is in V-fib and pulseless and apneic. You should - ANSWER-Defibrillate once perform CPR intubate and transport rapidly. 23. To successfully accomplish nasotracheal intubation you should advance the endotracheal tube though the glottic opening to coincide with patient - ANSWER-Inhalation 25. An alert 23 year old male presents with a sudden onset of shortness of breath and chest pain after running upstairs. Breath sounds are diminished in the right side. The most likely cause is. - ANSWER-Spontaneous pneumothorax 26. First responders are treating an apneic adult female. You notice that they are applying frequent long ventilations with an oxygen resuscitator. What effects with their actions create. - ANSWER-Increased capillary elasticity. 27. You are called to a nursing home on a hot summer day for a 88 year old male. The nurse tells you he missed his dialysis appointment because he was complaining of nausea vomiting headache and running a fever. Which differential diagnosis should you consider first. - ANSWER-Sepsis and hyperkalemia 28. You have just administered adenosine to a 62 year old patient with narrow complex tach. The ECG shows an irregular rate of 50 then steadily climbs back to a rate of 169. What would should suspect - ANSWER-rapid atrial fibrillation. 29. A 63 year old male is having a diabetic emergency . He is unresponsive R12 glucometer 28. You cannot establish IV access. You should - ANSWER-administer glucagon IM 30. When setting up a night time landing zone for a helicopter what is the recommended area needed. - ANSWER-100x100 31. A 67 year old with hypo-tension and bradycardia has no responded to pacing or atropine. You should - ANSWER-administer dopamine infusion 32. A 19 year old male has suffered blunt trauma on his left chest. He complains of server dyspnea and pain over the affected area. Vital signs are BP 92/60 P 128 R 32. Breath sounds are very diminished over the left chest. You should - ANSWER-perform needle thoracostomy 33. A 44 year old patient has a persistent cough and occasional spits up bloody sputum . He has been living in a a shelter for the past three weeks and he smells like alcohol you should. - ANSWER-Put on N95 mask and eye protection. 34. While treating a patient with suspected TB. What type of personal protective equipment is essential - ANSWER-HEPA respirator 35. A 2 year old male has been sick over the last 48 hours with a low grade fever runny nose and upper respiratory infection. He has a seal bark cough. The patient is using accessory muscles to breath and appears fatigued his upper airway has stridours sounds. His lung sounds appear clear. SPO2 92% how would you treat the patient. - ANSWER-Oxygen nebulized racemic epinephrine transport. 36. 78 year old male lying unresponsive in his bed vital signs are BP unobtainable. R 12 and normal depth radial pulse rate matches ECG below ECG bradycardia - ANSWER-Perform transcutaneous pacing. 37. A 48 year old patient is chocking on a hot dog. He is unresponsive apneic and has a strong pulse. Chest compression are infective at relieving the obstruction. You should. - ANSWER-use lagosopy and magill forceps to remove the object. 38. 87 year male is complaining of dizziness. Physical exam revals pale cool and diaphoretic skin. Pulse matches ECG bradycardia. You should - ANSWER-administer atropine 39. A 14 year old patient was pulled form a indoor pool. She is pulseless and apneic. You should - ANSWER-perform CPR endotracheal intubation establish an IV and administer epinephrine 40. A trauma patient has lost approx 500ml of blood the amount of crystalloid solutions needed to replace this blood loss is - ANSWER-1500 ml of saline ( 3 to 1 rule) 41. A 43 year old female has been stuck in the chest with a baseball bat. There is a large bruise over her sternum. She is obversely in pain an states her heart feels like it is beating funny Vital signs are BP 109/80 P 124 and irregular R 22 The ECG show sinus tachycardia with ST elevation and frequent PVC's. You should suspect - ANSWER-myocardial contusion 42. A 28 year female is speaking very quickly and stating that she is going see the president of the united states after she buys all her family members a new car. She has not slept in four days because she does not need sleep. She usually takes lithium but ran out of her prescription about a week ago . vitals 144/88 P 128 R 28 you should suspect. - ANSWER-manic phase of bipolar disorder 43. A restrained 23 year old pregnant female is her third trimester was involved in a head on motor vehicle collision. She complains of abdominal pain. initial vital signs are BP 110/70 P 90 R 20. After rapid extrication and spinal immobilization via long spine board her vital signs are BP 90/40 P 110 R 28 what is the most likely explanation for her change in vitals. - ANSWER-Supine hypotensive syndrome 44. A 3 month old infant who weighs 6kg has a history of congenital heart disease. Vital signs are R60 the ECG hows a narrow complex tachycardia at a rate or 240 cyandic nail beds and spo2 at 88% what should you administer. - ANSWER-0.6 or adenosine IV 45. A 44 year old male fell from a ladder and is now complaining of pain in the middle of his back at the level of his shoulders blades. He responds to verbal stimulus and vitals signs are BP 70/50 P64 R 20. The patient is most likely suffering from - ANSWER-neurogenic shock 46. A 63 year old female chocked on a piece of steak and is apneic. You partner has visualized a partial obstruction in the trachea. He has been trying to grab it with forceps for more than 2 minutes. What should you advise him to do? - ANSWER-Remove the blade and attempt to ventilate. 47. An unconscious 13 year old patient has minor abrasion on his torso after being struck by a vehicle. The child's parents are not on scene law enforcement and an EMS supervisor are on scene You should? - ANSWER-transport the patent to hospital 48. A 38 year old female is crowing. You note the amniotic fluid contains a substance resembling pea soup. An apneic blue limp infant with a heart rate of 80 beats is delivers. How should you treat the infant. - ANSWER-Suction with a bulb syringe and ventilate. 49. A 56 year old female has a sudden onset of substernal chest pressure. She denies any shortness of breath or nausea. She has a history of arthrosporic heart disease and is talking verapamil. Vital signs are BP 160/90 pulse matches the ECG rhythm below R 16 skin warm and dry. and lungs clear bilateral. What should you do. - ANSWER-Nitroglycerin 50. A 64 year old is sitting in his living room in moderate distress. He is able to speak to you in full sentences but claims he is not feeling right. Vitals signs are BP 1110/64 R 16. Pulse matches monitor (super vertical tachycardia) what should you do. - ANSWER-vagal fluids adenosine. 51. Which I V will be able to administer the most fluid in the least amount of time. - ANSWER-14 gauge 1/2 inch IV catheter. 52. A 30 year old man is breathing fast and deep. He works at a preschool and believes that the children plan to harm him. Which of the following statement is most helpful when treating the patient. - ANSWER-I understand that you are concerned. Can you tell me more about why you fell this way. 53. A 67 year old man has collapsed and is on the floor. He is pale clammy and moaning with vomit around his mouth. Vital signs are BP 180/30 P110 and weak R28 and shallow. Oropharynx is clear and lungs are clear bilaterally. His ECG shows ventricular tachycardia. That should you do? - ANSWER-Synchronized cardio100J 54. You arrive at the scene of a single vehicle crash. A woman walks up to a your ambulance with a cut on her forehead. You should - ANSWER-determine if she is the only victim 55. A 73 year old male has several fractured ribs on his right side with unequal chest wall movement. He has dyspnea and diminished breath sounds on the right. Vital signs are BP 124/76 P124 R 26 and shallow. His trachea is mid line and neck veins are flat. Most likely has - ANSWER-a flail chest segment 56. You have just converted a 318 lb cardiac arrest patient into a normal sinus rhythm. She is hypotensive and you have been ordered to start the an epinephrine drip at 3mcg/min using a 60 drip set. You have mixed a 4:1 concentration of epinephrine and should set the drip rate at - ANSWER-45 drops/min (clock) 57. You are assisting with a deliver and the infants head has been deviled. You notice the umbilical cord is wrapped around the infants neck. You should - ANSWER-gently slip the cord over the infants head or clamp the cord in two places and cut between the clamps to release the cord. 58. A 50 year old male is complaining of a chronic cough. He has lost his appetite and has had hot flashes and periods of sweating during the night. He has noticed some red specks in his sputum when he coughs. You should suspect - ANSWER-Tuberculosis 59. A patient has surfaced rapidly from a deep dive and is now complaining of difficultly breathing and extreme muscle and joint pain. You should - ANSWER-Transport rapidly to the nearest hyperbaric chamber. 60. It is mid-December and a 13 month old child is awakened in the middle of the night with barking cough and inspiratory stridor. The child has been ill for a few days with chills and congestion. You should suspect - ANSWER-croup