Paramedic Practice Test   1. Which of the following is a colloid solution? a. Ringers Lactate b. Normal Saline c. Dextran d. All of the above   2. A known diabetic who is unconscious, pale, clammy skin, with stable   vital signs is suffering from: a. CVA b. acute AMI c. diabetic coma d. insulin shock   3. Uncompensated shock produces which of the following: a. pre-capillary and post-capillary sphincter contraction b. pre- capillary sphincter contraction and post-capillary sphincter relaxation. c. pre-capillary sphincter relaxation and post-capillary sphincter contraction. d. pre-capillary and post- capillary sphincter dilation     4. Kinematics of trauma; How many collisions occur? a. one b. two c. three d. four   5. Dopamine has what effects when administered at 1-2 mcg/kg/min? a. renal and mesenteric dilation b. increased blood pressure c. increased heart rate d. decreased urine output   6. Decerebrate and decorticate posturing is an indication of: a. seizure b. cerebral focal cortex lesions c. diffuse cranial injury d. spine injury   7. The best possible score for a Glascow coma scale is: a. eye opening 4; verbal response 5; motor response; 6 b. eye opening 3; verbal response 4; motor response; 5 c. eye opening 6; verbal response 5; motor response; 4 d. eye opening 5; verbal response 5; motor response; 5     8. The beta cells of the pancreas produce: a. thyroxin hormone b. ACTH c. insulin hormone d. anti-diuretic hormone   9. The most significant sign of abdominal injury is: a. tenderness b. rigidity & guarding c. pain d. hematuria   10. Lidocaine is usually given for: a. ventricular tachycardia b. atrial fibrillation c. supraventricular tachycardia d. asystole   11. Before applying a PASG you must: a. insert an oral airway b. assess lung sounds c. measure the legs of the patient d. start an IV   12. Patient has high blood pressure in pregnancy: a. preeclampsia b. eclampsia c. toxemia d. uterine inversion   13. Anaphylaxsis following an insect sting is treated with: a. morphine sulfate b. epinephrine c. aminophylline d. benadryl   14. What device transmits specific tones that other receivers will recognize? a. repeater b. encoder c. modulator d. transponder   15. Who has the ultimate authority over the paramedic in the field? a. standing orders b. protocols c. on-line medical control d. scene physician   16. A deviation from the accepted standards of care is called: a. abandonment b. negligence c. incompetence d. malpractice   17. Which of the following is not a method of transmission of the Hepatitis virus? a. blood b. feces c. saliva d. sexual contact   18. An overdose of Oil of Wintergreen will present similar to: a. tricyclic antidepressants b. salicylates c. amphetamines d. opiate derivatives   19. Aminophylline is given: a. IV push rapidly b. IV over 20-30 minutes c. IV over 8-10 minutes d. IV push slowly   20. You have been called to a party for a 20 year old male who bystanders state had a seizure activity before you arrived. The patient is con- scious and agitated, BP 132/96, pulse 132, resp. 28. He is dia- phoretic and his pupils are dilated. He denies any drug or alcohol ingestion. What do you suspect? a. grand mal seizure b. delirium tremens c. cocaine d. heroin   21. Which of the following is NOT a predisposing factor to hypothermia? a. diabetes b. old age c. AMI d. alcoholism   22. Ions that carry a negative charge are: a. cations b. anions c. electrolytes d. megahertz     23. Verapamil has what effects on the myocardium? a. negative chronotropic b. positive inotropic c. negative inotropic d. positive chronotropic   24. What is the chief extracellular electrolyte? a. sodium b. potassium c. hydrogen d. calcium   25. The normal PR interval is _____ seconds a. 0.2-0.4 b. 0.4-0.12 c. 0.1-0.20 d. 0.12-0.20   26. The paramedic's best defense in the event of legal proceedings is: a. a detailed medical record b. professional liability insurance c. a lawyer d. the medical director   27. A paramedic in Missouri must complete relicensure requirements every: a. 1 year b. 2 years c. 3 years d. 5 years   28. The range of a portable radio transmitter/receiver is somewhat limited. The range can be extended by the use of a(n): a. base station b. repeater c. amplifier d. telephone   29. The first action a paramedic takes after receiving a medication order over the radio is to: a. immediately administer the medication b. repeat the patients vital signs c. start an IV infusion d. repeat the medication order   30. Which of the following is a re-entry rhythm? a. sinus tachycardia b. junctional rhythm c. atrial tachycardia d. idioventricular   31. If a patients apical pulse is 130, and their radial pulse rate is 96, what is this referred to? a. pulse difference b. pulse deficit c. pulsis paradoxis d. circulatory gap   32. The presence of S3 heart sounds is associated with: a. bundle branch block b. congestive heart failure c. cardiac tamponade d. aortic aneurysm   33. The S1 heart sound is caused by closure of the: a. atrioventricular valves b. mitral valve & pulmonic valve c. tricuspid valve & aortic valve d. semilunar valves   34. A patient who is hyperventilating may have which acid-base condition? a. respiratory acidosis b. respiratory alkalosis c. metabolic acidosis d. metabolic alkalosis   35. If a radial pulse is present, systolic blood pressure is at least: a. 100 b. 80 c. 70 d. 60   36. What heart valve prevents the backflow of blood into the right atrium? a. mitral valve b. tricuspid valve c. bicuspid valve d. aortic valve   37. What is pH? a. the oxygen saturation b. the hemoglobin level c. the hydrogen ion concentration d. the phosphorus level   38. Which is the correct area for decompression of a tension pneumothorax? a. 3rd intercostal space, mid-axillary line b. 2nd intercostal space, mid-axillary line c. 4th intercostal space, mid-clavicular line d. 2nd intercostal space, mid-clavicular line   39. Airway obstruction can be caused by: a. lateral extension b. dorsal flexion c. ventral flexion d. ventral extension   40. Which aspect of the physical exam is least helpful in the field? a. pupillary response b. deep tendon reflex c. movement of extremities d. ability to follow simple commands   41. Which of the following is the earliest sign of shock? a. hypotension b. cyanosis c. cold clammy skin d. restlessness   42. A possible complication of the PASG is: a. reduced venous return to the heart b. gastric dilatation c. decreased ventilation d. increased bleeding under the suit   43. The joint action of two drugs where the combined effect is greater than the sum of their individual effect is called: a. antagonism b. potentiation c. synergism d. idiosycrasy   44. What is the action of insulin? a. stimulates alpha receptors b. produces glucagon c. transfers glucose into cells d. produces hemolysis of RBCs   45. The physician orders 5mcg/kg/min of dopamine for an 80 kg patient. You put 400mg of Dopamine in 250mls D5W. What is the correct rate using microdrip tubing? a. 15 gtts/min b. 30 gtts/min c. 40 gtts/min d. 120 gtts/min   46. Which drug must be given cautiously to patients currently taking Digitalis? a. CaCl b. D50 c. diazepam d. epinephrine   47. Which drug is contraindicated in asthma patients? a. digitalis b. CaCl c. Inderal d. epinephrine   48. The APGAR score evaluates: a. pulse, respirations, BP, activity, color b. pulse, respirations, activity, color, grimace c. pulse, reflex ability, appearance, BP d. BP, pulse, gestation, color, respiration   49. The signs of epiglottitis are: a. aphasia and fever b. fever and chills c. dysphagia and drooling d. rales and dyspnea   50. A patient has an IV established and suddenly goes into V-fib. You will: a. give lidocaine immediately b. defibrillate c. synchronized cardiovert d. begin CPR   51. A 30 y/o unconscious black female has an obstructed airway unrelieved by abdominal thrusts. The next therapy would be: a. direct laryngoscopy b. attempt to ventilate c. positive pressure ventilation d. cricothyrotomy   52. Painful bleeding in the third trimester of pregnancy is most likely: a. PID b. placenta previa c. abruptio placenta d. mittleschmertz   53. Bleeding in the third trimester of pregnancy without pain is most likely: a. spontaneous abortion b. placenta previa c. abruptio placenta d. prolapsed cord   54. While administering 6 liters of O2 to a COPD patient, the patient suddenly becomes apneic. You should: a. begin assisting ventilations with a BVM b. immediately intubate the patient c. discontinue the O2 therapy d. increase the O2 flow   55. A 35 y/o woman on bedrest got up and suddenly developed chest pain and severe dyspnea. Her lung sounds are clear and equal. What do you suspect? a. pulmonary embolism b. acute MI c. pneumonia d. spontaneous pneumothorax   56. Which drug is used as both an anti-arrythmic and an anti-convulsant? a. lidocaine b. phenytoin c. physostigmine d. diazepam   57. A radio's squelch should be adjusted: a. monthly b. before each transmission c. every time the radio is turned on d. when it is first installed   58. In a COPD patient the respiratory drive is triggered by? a. hypocarbia b. hypercarbia c. hypoxia d. hypovolemia   59. The waste product of anaerobic metabolism is: a. CO2 & H2O b. HCO3 c. lactic acid d. acetylcholine   60. What hormone is secreted by the female posterior pituitary gland and causes lactation and the contraction of the uterine smooth muscle? a. estrogen b. progesterone c. oxytocin d. evesterone   61. A normal, head first delivery is termed: a. breech b. transverse c. cephalic d. caudal   62. A heat exhaustion patient is suffering from what type of shock? a. metabolic b. hypovolemic c. cardiogenic d. neurogenic   63. Which of the following solutions is hypotonic? a. D5W b. 0.9% NSS c. 045% NSS d. D50W   64. Which of the following is NOT an endpoint to the administration of procainamide? a. hypotension develops b. QRS narrows by more than 50% c. the dysrhythmia is suppressed d. 1 gm has been administered   65. Which drug is a parasympathetic antagonist? a. lidocaine b. digoxin c. atropine d. dopamine   66. The paramedic should know that the administration of nitrous oxide? a. causes a decrease in intracranial pressure b. should be self administered by the patient only c. should not be used in trauma patients d. should not be used if patient has a suspected AMI   67. A patient receiving a unit of blood begins complaining of lower back pain substernal chest pain, dyspnea and a headache. What do you suspect? a. anaphylactic reaction b. hemolytic reaction c. pyrogenic reaction d. dehydration   68. Where is the femoral artery in relation to the inguinal ligament? a. posterior b. anterior c. medial d. lateral   69. Who would most likely suffer a painless, silent MI? a. drug abusers b. alcoholics c. diabetics d. elderly people   70. A 30 y/o pregnant patient is suffering from seizures. You have treated her with 5mg Valium IV push. You would give what drug next? a. 2-4 gms 10% solution of magnesium sulfate IV push b. 1 mg magnesium sulfate IM c. 2-4 mg 20% solution of magnesium sulfate IV push d. 250 mg dilantin at 25 mg/min   71. Normal tidal volume of the lungs of an adult is: a. 100 mls b. 200 mls c. 500 mls d. 800 mls   72. Which is not a symptom of anaphylaxsis? a. urticaria b. respiratory distress c. stomach cramps d. bradycardia   73. Which defines the relative refractory period: a. when a stimulus may occur during repolarization b. when no stimulus may occur during repolarization c. when a stimulus may occur during depolariztion d. when no stimulus may occur during depolariztion   74. What is "crack"? a. a CNS depressant b. a CNS stimulant c. muscle relaxant d. opiate derivative   75. The effective action of adrenalin is: a. sympathetic b. parasympathetic c. cholinergic d. antagonistic   76. A drug with predominantly alpha effects will cause: a. vasoconstriction b. vasodilation c. bronchodilation d. none of the above   77. Catecholamines are: a. sympathomimetic b. parasympathetic c. cholinergic d. none of the above   78. Ecchymosis over the mastoid bone is called: a. Cheyne stokes sign b. hemoptysis c. Battle's sign d. quadriplegia   79. Which injuries have the lowest priority in the field? a. respiratory burns & abdominal trauma b. thoracic trauma & airway obstruction c. cardiac trauma & head injury d. spinal injury & open fractures   80. In a normal person, respiration is triggered by: a. oxygen level b. CO2 level c. HCO3 level d. CO level   81. If a rescuer inadvertently increases rate and depth while ventilating a patient it may result in: a. hypercarbia & respiratory alkalosis b. hypercarbia & metabolic acidosis c. hypocarbia & respiratory acidosis d. hypocarbia & metabolic alkalosis   82. The physician orders 8 mcg/min if isuprell for a 70 kg patient. You put 2 mg in 250 mls of D5W. What is the rate of microdrips? a. 30 gtts/min b. 60 gtts/min c. 90 gtts/min d. 120 gtts/min   83. Lidocaine toxicity may produce: a. ventricular fibrillation b. yellow vision c. asthma d. seizures/convulsions   84. Which valve prevents regurgitation of blood from the left ventricle to the left atrium? a. aortic valve b. tricuspid valve c. pulmonic valve d. mitral valve   85. In lead II what are you reading? a. +RA to -LL b. -RA to +LA c. -RA to +LL d. -LA to +LL   86. In AV junctional rhythms, the P wave is inverted because: a. the pacemaker is in the left atrium b. atria are depolarized retrogradely c. atria are depolarized simultaneously d. atria are depolarized spontaneously   87. Depolariztion is the: a. recovery of the cell b. electrical stimulus results in defibrillation c. electrical stimulus moves throughout the cell and results in cardiac muscle work d. the cell will not respond to strong stimulus   88. A diabetic with hypertension who experiences numbness of the left arm for 30 minutes has likely had: a. petit mal seizures b. focal seizures c. transient ischemic attacks d. conversion hysteria   89. The most significant problem resulting from hypoglycemia is: a. hunger b. loss of consciousness c. damage to the brain cells d. damage to the pancreas   90. The danger of thrombophebitis is that a clot may break loose and travel to the: a. brain b. lungs c. liver d. legs   91. Which is the correct placement of the paddles for defibrillation? a. cardiac apex and below clavicle, right of sternum b. cardiac apex and on sternum at Angle of Louis c. cardiac apex and on left of sternum d. cardiac apex and over center of sternum   92. The patient who is decorticate will move his hands and arms: a. toward the body b. over the head c. extended away from the body d. none of the above   93. A 5 y/o is leaning forward, drooling, stridorous, feverish, and has pain on swallowing. He most likely has: a. epiglottitis b. croup c. asthma d. bronchiolitis   94. A patient who is pacing, anxious, and blaming himself may be suffering from: a. depression b. conversion hysteria c. subdued mania d. schizophrenia   95. A woman watched her husband and son die in a domestic disturbance. She appears paralyzed, but no injury is found. What is she likely suffering from? a. psychogenic shock b. neurogenic shock c. conversion hysteria d. post-traumatic shock   96. Which statement is true of suicides? a. many have a history of psychiatric illness b. women are more successful than men c. many suicides isolate themselves d. most give no prior notice of what they will do   97. How much energy is used in initial defibrillation of a 70kg adult? a. 100-200 joules b. 200 joules c. 300 joules d. maximum output   98. For how long may you interrupt CPR to intubate? a. 5 seconds b. 10 seconds c. 30 seconds d. 45 seconds   99. A 60 y/o patient with a- fib develops signs of CVA. This is probably due to: a. cerebral hemorrhage b. cerebral embolism c. cerebral thrombosis d. pulmonary embolism   100. R on T phenomenon may result in: a. supraventricular tachycardia b. ventricular fibrillation c. premature atrial contractions d. atrial fibrillation   101. Defibrillation of an infant requires: a. 1 joule/kg b. 2-4 joules/kg c. 200 joules d. 5 joules/kg   102. Morphine is a schedule ____ narcotic medication. a. I b. II c. III d. IV   103. A farmer who had been spraying his crops calls EMS because he has a sudden onset of dyspnea. On arrival you find him sitting in a chair complaining of nausea, substernal tightness, and abdominal cramps. He is sweating and in some respiratory distress. After placing him on high- flow O2 and starting an IV of NSS you would next give: a. atropine 1 mg b. epinephrine 0.3-0.5 sub-q c. atropine 5 mg IV push d. atropine 2 mg IM followed by 1 mg IV push   104. Why do you hyperventilate a patient with a head injury? a. to lower pCO2 below 40 torr b. to lower pCO2 below 100 torr c. to raise pCO2 above 40 mmHg d. none of the above   105. An infant with one leg burned on both sides has what % of body burned? a. 18% b. 13.5% c. 9% d. 12%   106. If you put 400mg of dopamine in 500 mls of D5W, how much dopamine is there per ml? a. 1250 mcg b. 800 mcg c. 1600 mcg d. 1.25 mg   107. What is described as the movement of a substance across the cell membrane against the osmotic gradient using energy? a. osmosis b. active transport c. diffusion d. facilitated transport   108. Procainamide administered too rapidly may cause: a. hypertension b. hypotension c. narrowing of the QRS complex d. V-tach   109. Theophylline and Theo-dur are both: a. sympathomimetics b. bronchodilators c. cardiac glycocides d. cholinergic   110. Which of the following is an emetic? a. ipecac liquid b. ipecac syrup c. activated charcoal d. atropine   111. 100 mls of 2% lidocaine contains how much lidocaine? a. 200 mg b. 2000 mg c. 2000mcg d. 20 gm   112. A 30 y/o female has just taken 100 tablets of Tylenol. What should you administer? a. 60 mls ipecac syrup b. 30 mls ipecac water c. 30 mls ipecac syrup d. 50 gms activated charcoal   113. A widened QRS complex is a sign of: a. slowed impulses through the atria b. atropine overdose c. conduction defect of the ventricles d. wandering pacemaker   114. You have put restraints on a patient who shows signs of violence. How do you explain this to him? a. We put these on everyone. b. These are to keep you from hurting yourself and others. c. the law says we must restrain all OBS patients. d. We like doing this!   115. To secure the airway in a trauma patient, you should: a. place an ET tube while your partner maintains in-line immobiliza- tion b. place an EOA and hyperextend the neck c. place an ET tube putting the head in a sniffing position d. use only an oropharyngeal airway   116. What is usually true in GI bleeding? a. never bright red in color b. peptic ulcer is most common cause c. duodenal ulcer is most common cause d. never dark red in color   117. A 20 y/o male fractured his leg one week ago. He has taken aspirin for pain. He gets up and becomes short of breath. He probably suffered a(n) a. acute MI b. pulmonary embolism c. thrombosis d. angina attack   118. A 27 y/o male involved in a MVA is complaining of chest pain. You would treat this patient as having a(n): a. angina attack b. MI c. pulmonary embolism d. thrombosis   119. You suspect a patient is having an MI. You base this on: a. vital signs b. appearance of patient c. Hx of the acute illness d. opinion of base hospital physician   120. Tension pneumothorax causes: a. cardiac tamponade effect b. lack of blood return to the atria c. pulmonary embolism d. thrombosis   121. In tension pneumothorax the patient has: a. ruptured spleen b. tracheal deviation away from affected side c. tracheal deviation toward affected side d. over inflation of the lung   122. Ischemia is defined as: a. lack of oxygen to the cells b. lack of CO2 to the cells c. deficient blood supply d. deficient iron supply   123. You started an IV in the external jugular. As you attach the tubing you note blood pulse back up into the tubing. You will: a. D/C the IV, withdraw the catheter and apply pressure for 5 minutes b. Tape the IV in place, clamp the tubing and start another c. slow the IV to KVO rate d. attach a blood filter   124. Principles of restraining patients include all of the following EXCEPT a. have adequate numbers of people b. restrain all extremities c. restrain as a last resort d. free the restraints after the patient displays rational behavior   125. You put 1 gm of lidocaine in 250 mls of D5W. You are told to administer 2mg/min. How many gtts/min is this? a. 15 gtts b. 30 gtts c. 45 gtts d. 60 gtts   126. By what process does a solute move through a semi-permiable membrane? a. osmosis b. diffusion c. activity d. magic   127. What do you call a coarse rub or bark on expiration? a. rales b. rhonchi c. wheezes d. croup   128. The effective action of acetylcholine is: a. sympathetic b. parasympathetic c. antagonistic d. adrenergic   129. A drug with beta effects will cause: a. vasoconstriction b. bronchoconstriction c. increased heart rate d. none of the above   130. Which area reflects the central venous pressure? a. right atrium b. aorta c. radial artery d. pulmonary artery   131. Hypovolemic shock produces: a. increased preload b. decreased preload c. increased afterload d. increased CVP   132. How do you know your treatment for shock is effective? a. return of spontaneous ventilation b. cyanosis is gone c. blood pressure rises d. 2 liters of fluid has been given   133. What would you not use in neonatal resuscitation? a. high flow O2 by demand valve b. epinephrine c. CPR d. endotracheal intubation   134. Initial therapy for a child with a high fever,drooling,and anxiety is: a. direct laryngoscopy b. humidified O2 by mask c. prepare for intubation d. administer racemic epinephrine   135. You are treating a 35 y/o male who was the driver in a MVA. He is complaining of chest pain and shows steering wheel imprints on the chest. Lung sounds are equal bilaterally. Patient is hypertensive but has bilateral decreased femoral pulses. Which is the most likely Diagnosis? a. rib fractures b. dissected aorta c. tension pneumothorax d. fractured sternum   136. A person who acts in a less developed form of behavior is demonstrating: a. paranoia b. regression c. agoraphobia d. Travis laws   137. You respond to find an unconscious 69 y/o male on the bathroom floor. During your exam the patient awakens and tells you he was attempting to move his bowels. His most likely difficulty is: a. vertigo b. vasovagal response c. cardiac syncope d. postural syncope   138. You have an unconscious patient who was complaining if chest pain prior to collapse. BP is 88/45, pulse 46, and respirations 12. The patient is likely suffering from: a. an AMI b. anaphylaxsis c. cardiogenic shock d. CVA   139. Which is a common reason in having to treat a diabetic: a. medication noncompliance b. lack of knowledge about insulin c. hidrosis d. hirsutism   140. The difficulty in transmission of radio waves is related to the fact that radio waves: a. go through dense foliage b. are reflected by metal objects c. are scattered by irregular metal objects d. are absorbed by the ground   141. Which of the following is the best definition to "phobia": a. tortured as a child b. a normal fear c. great fear of wide open spaces d. an unrealistic fear   142. You respond to a 27 y/o male complaining of sudden onset of stabbing chest pain on inspiration. Vital signs are stable and the lung sounds are clear and equal bilaterally. Which is the most likely diagnosis? a. Spontaneous pneumothorax b. pleurisy c. pneumonia d. hemothorax   143. The amount of blood pumped by the heart in one minute is referred to as: a. cardiac output b. stroke volume c. PVR d. afterload   144. Acetylcholine is usually associated with: a. alpha sympathetic system b. beta sympathetic system c. parasympathetic system d. adrenergic system   145. You respond to an elderly female found in the snow. The outside temperature is -2 degrees Farenheight. The vital signs are depressed. Important to know in treatment is: a. support the patients BP b. rewarm the patient quickly c. apply hot packs in axilla and wrap in blankets d. CPR may be ineffective until the patient is rewarmed   146. A patient is unconscious and you suspect a neck injury. Which assessment is NOT done? a. palpate the neck for deformities b. observe respiratory effort c. check for "dolls eyes" phenomenon d. observe trachea for mid-line position   147. An abnormal, high pitched, musical inspiratory sound caused by obstruction in the trachea or larynx is called: a. stridor b. rales c. rhonchi d. wheezing   148. The best definition of extrication from a vehicle? a. dismemberment b. disentanglement c. removal d. removification   149. How many milligrams of lidocaine are contained in 1 ml of a 2% soln.? a. 2 mg b. 20 mg c. 200 mg d. 20 gm   150. A patient who is suicidal usually: a. does not transmit their intentions b. tends to feel isolated c. doesn't really mean it d. is also homicidal   151. A patient who is listless, slovenly, unkempt, is most likely suffering from: a. paranoia b. depression c. mania d. anorexia   152. For every unit of blood lost in trauma, how much crystalloid must be infused? a. twice as much b. equal amount c. three times the amount d. half as much   153. A 30 y/o female is in a MVA and is complaining of chest pain, should be treated as a patient with: a. an MI b. COPD c. CVA d. TIA   154. A patient complaining of chest pain who is showing multifocal PVCs on the monitor should be treated with: a. 1 mg/kg lidocaine bolus b. 1 mg/kg bretylium bolus c. 2-4 mcg/kg lidocaine infusion   155. Vasopressors may be indicated in which type of shock? a. hypovolemic b. neurogenic c. respiratory d. metabolic   156. Treatment of neurogenic shock should include: a. oxygen, IV, PASG, consider vasopressors b. oxygen, IV, aramine, Trendelenberg position c. IV, aramine, lidocaine infusion d. oxygen, IV, valium   157. A patient with a history of seizures is most likely to take which medications: a. dilantin and phenobarbitol b. theo-dur and lanoxin c. lasix and lanoxin d. inderal and digitalis   158. A patient presents with vomiting, headache, and yellow vision. The monitor shows rapid atrial fib with frequent PVCs. The patient states that she takes a heart pill. She is most likely suffering from: a. lidocaine toxicity b. lasix overdose c. lanoxin toxicity d. influenza   159. The preferred site for intraosseous needle placement in the field is: a. distal tibia b. proximal tibia c. distal femur d. midshaft femur   160. The most common cause of airway obstruction in the unconscious victim of an unwitnessed collapse is: a. food b. mucous c. dentures d. tongue   161. A pregnant patient suffering from edema, hypertension and increased muscle tone is likely suffering from: a. PMS b. postural hypotension c. preeclampsia d. ecclampsia   162. The problem with communication of the elderly is most often due to: a. hearing loss b. confusion c. senility d. organic brain syndrome   163. The term that which describes normal respirations is: a. orthopnea b. dyspnea c. eupnea d. bradypnea   164. The rate of adult compressions in CPR is: a. 80-100 b. 100 plus per minute c. 15-1 d. 5-2   165. The death which occurs at the moment the heart stops is: a. biological death b. clinical death c. irreversible death d. DRT   166. The proper rate for rescue breathing for an adult is: a. 5 breaths/minute b. 8 breaths/minute c. 12 breaths/minute d. 20 breaths/minute   167. The rescuer's initial ventilation of a requiring CPR should be: a. one quick breath b. four quick breaths c. two full breaths d. five full breaths   168. Your 27 y/o female patient is complaining of vaginal discharge and abdominal pain which increases with intercourse. The patient relates that she may have been exposed to gonorrhea. The patient is most likely suffering from: a. uterine rupture b. ectopic pregnancy c. AIDS d. PID   169. What is the name for alveolar collapse? a. tension pneumothorax b. pneumonia c. atelectasis d. pulmonary edema   170. A 31 y/o female is involved in a MVA. Vital signs are 90/68, 100, and 40. Trachea is deviated to the right, breath sounds are absent on the left, hyperresonance is noted on the left side on percussion. What is most likely the problem? a. simple pneumothorax b. hemothorax c. pericardial tamponade d. tension pneumothorax   171. The first priority in management an open pneumothorax is to: a. deliver high flow O2 b. check both lung fields c. insert an oral airway d. cover and seal the wound   172. Uncompensated shock is evidenced by: a. falling blood pressure b. rising temperature c. cold, clammy skin d. rising pulse rate   173. In some people, congenitally weakened areas of the lungs may rupture causing: a. alveolar pneumonia b. hemothorax c. pulmonary edema d. spontaneous pneumothorax   174. Which is the most important in evaluating a patient with an illness causing abdominal pain? a. appearance of the patient b. patient history c. palpitation d. vital signs   175. Insulin is secreted by the: a. adrenal glands b. gall bladder c. islets of Langerhans d. superior testines   176. What is the primary drug given to correct ventricular fibrillation? a. inderal b. atropine c. lidocaine d. lasix   177. The usual dose of isuprell when given as a drip is: a. 20 mg in 500 ml of D5W b. 1 mg in 1000 ml of D5W c. 0.2 mg in 500 ml of D5W d. 2 mg in 500 ml D5W   178. The fluid portion of blood is the: a. leukocyte b. erythrocyte c. plasma d. albumin   179. Which of the following is a result of a serious insulin deficit? a. respiratory alkalosis b. metabolic acidosis c. respiratory acidosis d. metabolic acidosis   180. The purkinge system has an intrinsic firing rate of: a. 10-20 min b. 20-40 min c. 40-60 min d. 60-70 min   181. You have been ordered to give a patient 7 mcg/min of isuprell. Mix 1 mg in 250 ml of D5W and use a microdrip. What drip rate is needed? a. 28 gtts/min b. 90 gtts/min c. 105 gtts/min d. 210 gtts/min   182. The proper dose of pediatric epinephrine 1:1000 for an asthma attack would be: a. 10 mg/kg b. 0.1 mg/kg c. .01 mg/kg d. .001 mg/kg   183. Stimulation of the beta receptors causes: a. decreased cardiac oxygen consumption b. increased heart rate and force of contraction c. increased vascular resistance and vasoconstriction d. bronchial constriction and tachycardia   184. You are attempting to intubate a pediatric patient. Your best guide in choosing the correct size tube is: a. the patient's general appearance b. the patient's little finger c. the patient's ring finger d. the patient's weight   185. Which factor is common to all forms of shock? a. hypovolemia b. tachycardia c. tachypnea d. inadequate tissue perfusion   186. When a myocardial fiber is at rest the charge within the cell is: a. polarized b. negative c. positive d. depolarized   187. A hypotonic solution is defined as a solution having: a. a concentration the same as that in the cells b. a concentration higher than that in the cells c. a concentration lower than that in the cells d. none of the above adequately defines the term   188. Which of the following is primarily an extracellular electrolyte? a. potassium b. calcium c. sodium d. nitrogen   189. Injuries that result in partial tearing of a ligament are called: a. dislocations b. sprains c. strains d. fractures   190. In a posterior dislocation of the hip, the leg will appear: a. shortened and rotated inward b. lengthened and rotated outward c. flexed to about 90 degrees d. abducted and slightly flexed   191. Lactated Ringer's solution is a(n): a. isotonic solution b. hypotonic solution c. hypertonic solution d. isotonic balanced buffered electrolyte solution   192. Sudden infant death syndrome (SIDS) is usually caused by: a. overheating the infant b. underfeeding the infant c. suffocation d. the cause is unknown   193. The most common cause of seizures in the child is: a. ventricular fibrillation b. elevated temperature c. bronchitis d. inadequate tissue perfusion   194. What is the first step in the secondary survey? a. check for hemorrhage b. head to toe survey c. obtain a set of vital signs d. check for open fractures   195. Your patient is unconscious and in apparent respiratory distress. The permission to treat her is given by the concept of: a. applied consent b. implied consent c. replied consent d. actual consent   196. 23 y/o Tim has a history of seizures. You find him having recurrent seizures without return to consciousness. His color is poor and he is suffering arrythmias. Tim is suffering from: a. petit mal seizures b. focal motor seizures c. marital distress d. status epilepticus   197. Which of the following is one of the earliest signs of hypoxia: a. cyanosis b. thirst c. restlessness d. weak and rapid pulse   198. Your patient is a conscious and rational adult. Failure to get consent to treat and transport could lead to what type of liability? a. assault b. battery c. false imprisonment d. all of the above   199. Aminophyline may be given in a dosage range of ____ and it's main action is_______? a. 250-500 mg rapidly; bronchial dilation b. 250-500 mg slowly; bronchial dilation c. 300 mg slowly; increased cardiac output d. 500 mg rapidly; decreased urinary output   200. What is the most common adverse side effect of IV push valium? a. hypertension b. seizures c. respiratory depression d. divorce   201. Which structure is located in the mediastinum? a. alveoli b. bronchiols c. trachea d. all of the above   202. The following are all potential hazards to endotrachial intubation EXCEPT: a. damage to the teeth b. regurgitation c. intubation of the right mainstem bronchus d. heart damage from rapidly increased oxygen   203. Which of the following is given in a weight related dose? a. verapamil b. dopamine c. epinephrine d. levophed   204. Which of the following is a calcium channel blocker? a. verapmil b. isoptin c. Calan d. all of the above   205. What drug is an antianginal, calcium blocker, antiarrythmic, and vasodilator? a. nitroglycerin b. verapamil c. nipride d. atropine   206. Chronotropic means: a. time related b. electrolytic c. force related d. nothing   207. A woman is found lying in the street. When you ask her name, she moans incoherently. You report her level of consciousness as: a. unconscious b. semi-conscious c. stuporous d. conscious and disoriented   208. Which is the best way to lower a patient? a. vertical b. horizontal c. inverted d. it doesn't matter   209. What response is seen with Cushings syndrome? a. excess production of ACTH b. decreased production of cortizone c. decreased production of ACTH d. excess production of oxytocin   210. A 90 y/o is at home, conscious, alert and well oriented. His family thinks he should be seen at the hospital for a liver problem. The man refuses to be transported. Who has the right to make the patient go to the hospital? a. the patient's family b. the patient's doctor c. a judge d. the EMS crew   211. A young Woman is complaining of sudden onset of right sided abdominal pain. She admits to being sexually active and states she missed her last period. What do you suspect is the patient likely diagnosis? a. mittleschmertz b. PID c. endometriosis d. ectopic pregnancy   212. What does the T wave represent on the ECG? a. atrial depolarization b. ventricular depolarization c. atrial repolarization d. ventricular repolarization   213. Which of the following is an ectopic rhythm? a. atrial tachycardia b. sinus tachycardia c. bradycardia d. first degree AV block   214. The correct dose of epinephrine to administer through the ET tube is: a. 5 mls of a 1:10,000 solution b. 5 mls of a 1:1000 solution c. 10 mls of a 1:10,000 solution d. 10 mls of a 1:1000 solution   215. Why does a person with diabetic ketoacidosis have Kussmall breathing? a. to blow off paCO2 b. to retain paCO2 c. to blow off excess paO2 d. to retain paO2   216. An EKG showing Torsades de Pointes is a sign of: a. narcotic overdose b. tricyclic overdose c. antidepressant overdose d. organophosphate poisoning   217. You respond to a call from a woman whose husband may be having a heart attack. Upon arrival vital signs are normal and the patient refuses transport. The wife insists that you take him to the hospital so he doesn't die at home. You should: a. transport on the advise of the patient's wife b. call the police to arrest the patient then transport him c. have wife sign an authorization for you to transport the patient d. have the patient sign a refusal of care and transportation form   E-mail for answers key