Gs Paramedic Final Exam Practice

1. After starting a bag of fluids your pt has a sudden onset of respiratory distress with cyanosis that doesn't improve with 100% oxygen delivery, what should you suspect?

MI

Asthma attack

Air embolism

CO poisoning

pg. 711

Explanation

pg. 711

2. What electrolyte abnormality are you most concerned about in a crush injury?

Hyperkalemia

Hypocalcemia

Hyponatremia

Hypercalcemia

In a crush injury, there is a risk of muscle damage and breakdown, leading to the release of potassium from the damaged cells into the bloodstream. This can cause hyperkalemia, which is characterized by high levels of potassium in the blood. Hyperkalemia can be life-threatening as it can cause heart rhythm abnormalities and cardiac arrest. Therefore, it is the electrolyte abnormality that healthcare providers are most concerned about in a crush injury.

Explanation

In a crush injury, there is a risk of muscle damage and breakdown, leading to the release of potassium from the damaged cells into the bloodstream. This can cause hyperkalemia, which is characterized by high levels of potassium in the blood. Hyperkalemia can be life-threatening as it can cause heart rhythm abnormalities and cardiac arrest. Therefore, it is the electrolyte abnormality that healthcare providers are most concerned about in a crush injury.

3. Hypotension, muffled heart tones, and JVD are classic s/s of what? (Beck's triad)

Pneumothorax

Cardiac tamponade

Hemothorax

CHF

Hypotension, muffled heart tones, and JVD are classic signs and symptoms of cardiac tamponade. Cardiac tamponade occurs when fluid accumulates in the pericardial sac, putting pressure on the heart and preventing it from filling properly. This leads to decreased blood flow and hypotension. Muffled heart tones occur because the fluid surrounding the heart dampens the sound of the heartbeat. JVD, or jugular venous distention, is a result of increased pressure in the veins leading to the heart. These three findings, along with other signs such as pulsus paradoxus, are indicative of cardiac tamponade.

Explanation

Hypotension, muffled heart tones, and JVD are classic signs and symptoms of cardiac tamponade. Cardiac tamponade occurs when fluid accumulates in the pericardial sac, putting pressure on the heart and preventing it from filling properly. This leads to decreased blood flow and hypotension. Muffled heart tones occur because the fluid surrounding the heart dampens the sound of the heartbeat. JVD, or jugular venous distention, is a result of increased pressure in the veins leading to the heart. These three findings, along with other signs such as pulsus paradoxus, are indicative of cardiac tamponade.

4. PH: 7.50 PaCO2: 41 mmHg HCO3: 29

Metabolic acidosis

Metabolic alkalosis

Respiratory acidosis

Respiratory alkalosis

The given values indicate a pH level of 7.50, which is higher than the normal range of 7.35-7.45. Additionally, the HCO3 level is elevated at 29, suggesting an excess of bicarbonate in the blood. This combination of a high pH and elevated HCO3 is indicative of metabolic alkalosis, which occurs when there is an excess of bicarbonate in the body. The PaCO2 level of 41 mmHg is within the normal range and does not contribute to the diagnosis of metabolic alkalosis.

Explanation

The given values indicate a pH level of 7.50, which is higher than the normal range of 7.35-7.45. Additionally, the HCO3 level is elevated at 29, suggesting an excess of bicarbonate in the blood. This combination of a high pH and elevated HCO3 is indicative of metabolic alkalosis, which occurs when there is an excess of bicarbonate in the body. The PaCO2 level of 41 mmHg is within the normal range and does not contribute to the diagnosis of metabolic alkalosis.

5. Glucagon is naturally occurring in the pancreas but can also be administered for hypoglycemia. Why would administering it to an alcoholic pt be ineffective?

Alcoholics don't become hypoglycemic because of the sugar in alcohol

The glucagon can't be absorbed by the pts pancreas

Alcohol depletes glycogen stores in the liver

All alcoholics have pancreatitis

Ineffective in pts that are malnourished, pediatrics, alcoholics, etc.

Glycogen is a form of stored glucose in the liver. Glucagon converts the glycogen stored in the liver back into glucose. (Glycogenolysis)

So glucagon would be ineffective in pts without those stores.

pg. 329 & 1267

Explanation

Ineffective in pts that are malnourished, pediatrics, alcoholics, etc.

Glycogen is a form of stored glucose in the liver. Glucagon converts the glycogen stored in the liver back into glucose. (Glycogenolysis)

So glucagon would be ineffective in pts without those stores.

pg. 329 & 1267

6. Which of the following is responsible for hearing?

Cochlea

Vestibule

The cochlea is responsible for hearing. It is a spiral-shaped, fluid-filled structure in the inner ear that converts sound vibrations into electrical signals that can be interpreted by the brain. The cochlea contains tiny hair cells that are stimulated by the movement of fluid in response to sound waves. These hair cells then send signals to the auditory nerve, which carries the information to the brain for processing and interpretation. The vestibule, on the other hand, is responsible for balance and spatial orientation.

Explanation

The cochlea is responsible for hearing. It is a spiral-shaped, fluid-filled structure in the inner ear that converts sound vibrations into electrical signals that can be interpreted by the brain. The cochlea contains tiny hair cells that are stimulated by the movement of fluid in response to sound waves. These hair cells then send signals to the auditory nerve, which carries the information to the brain for processing and interpretation. The vestibule, on the other hand, is responsible for balance and spatial orientation.

7. Your pt has chest pain due to exertion that's typical with past episodes. What are they likely experiencing?

Stable angina

MI

Unstable angina

Prinzmetal angina

The patient is likely experiencing stable angina. Stable angina is chest pain that occurs during physical exertion or emotional stress and is relieved with rest or medication. The fact that the chest pain is typical and consistent with past episodes suggests that it is stable angina rather than a more serious condition like MI (heart attack) or unstable angina. Prinzmetal angina is a type of angina that occurs at rest due to coronary artery spasms, which is not indicated in this case.

Explanation

The patient is likely experiencing stable angina. Stable angina is chest pain that occurs during physical exertion or emotional stress and is relieved with rest or medication. The fact that the chest pain is typical and consistent with past episodes suggests that it is stable angina rather than a more serious condition like MI (heart attack) or unstable angina. Prinzmetal angina is a type of angina that occurs at rest due to coronary artery spasms, which is not indicated in this case.

8. Your main concern for a pt with food poisoning would be?

Hyperglycemia

Hypocalcemia

GI bleed

Dehydration

Dehydration is the main concern for a patient with food poisoning because vomiting and diarrhea, common symptoms of food poisoning, can lead to significant fluid loss. Dehydration can result in electrolyte imbalances, decreased blood volume, and impaired organ function. It is important to monitor the patient's fluid intake and output, provide adequate hydration, and potentially administer intravenous fluids if necessary to prevent complications associated with dehydration.

Explanation

Dehydration is the main concern for a patient with food poisoning because vomiting and diarrhea, common symptoms of food poisoning, can lead to significant fluid loss. Dehydration can result in electrolyte imbalances, decreased blood volume, and impaired organ function. It is important to monitor the patient's fluid intake and output, provide adequate hydration, and potentially administer intravenous fluids if necessary to prevent complications associated with dehydration.

9. Disease characterized by barrel chest and destruction of alveoli?

Emphysema

Chronic bronchitis

Asthma

Flail chest

Emphysema is a disease characterized by barrel chest and destruction of alveoli. In this condition, the walls of the alveoli become weak and lose their elasticity, leading to the collapse of the air sacs and trapping of air in the lungs. This causes the chest to become barrel-shaped as the lungs become hyperinflated. Chronic bronchitis is characterized by inflammation and narrowing of the airways, while asthma is a chronic condition that causes inflammation and constriction of the airways. Flail chest refers to a condition where multiple ribs are fractured, leading to a segment of the chest wall becoming detached.

Explanation

Emphysema is a disease characterized by barrel chest and destruction of alveoli. In this condition, the walls of the alveoli become weak and lose their elasticity, leading to the collapse of the air sacs and trapping of air in the lungs. This causes the chest to become barrel-shaped as the lungs become hyperinflated. Chronic bronchitis is characterized by inflammation and narrowing of the airways, while asthma is a chronic condition that causes inflammation and constriction of the airways. Flail chest refers to a condition where multiple ribs are fractured, leading to a segment of the chest wall becoming detached.

10. Cardiogenic shock occurs when heart failure is accompanied by what?

Bradycardia

Mottled skin

Crackles

Hypotension

pg. 1053

Explanation

pg. 1053

11. What rhythm is this?

Sinus tach

SVT

A-flutter

V-tach

SVT stands for supraventricular tachycardia, which is a rapid heart rhythm originating from above the ventricles. It is characterized by a fast and regular heart rate, usually above 100 beats per minute. Sinus tach, on the other hand, refers to a fast heart rhythm originating from the sinus node, which is the heart's natural pacemaker. A-flutter and V-tach are both abnormal heart rhythms originating from the atria and ventricles, respectively. Therefore, the correct answer is SVT because it describes a rapid heart rhythm originating above the ventricles.

Explanation

SVT stands for supraventricular tachycardia, which is a rapid heart rhythm originating from above the ventricles. It is characterized by a fast and regular heart rate, usually above 100 beats per minute. Sinus tach, on the other hand, refers to a fast heart rhythm originating from the sinus node, which is the heart's natural pacemaker. A-flutter and V-tach are both abnormal heart rhythms originating from the atria and ventricles, respectively. Therefore, the correct answer is SVT because it describes a rapid heart rhythm originating above the ventricles.

12. Your pt is having trouble breathing and you can hear bilateral crackles. The family informs you they've had a heart attack in the past and recently stopped taking their medications. What should you suspect?

Pneumonia

CHF

MI

Cardiac tamponade

Given the information provided, the most likely explanation for the patient's symptoms is congestive heart failure (CHF). The presence of bilateral crackles suggests fluid accumulation in the lungs, which is a common sign of CHF. The patient's history of a previous heart attack and recent discontinuation of medications further support this suspicion. Pneumonia could also cause similar symptoms, but the patient's cardiac history makes CHF a more likely diagnosis. Myocardial infarction (MI) and cardiac tamponade are less likely explanations based on the given information.

Explanation

Given the information provided, the most likely explanation for the patient's symptoms is congestive heart failure (CHF). The presence of bilateral crackles suggests fluid accumulation in the lungs, which is a common sign of CHF. The patient's history of a previous heart attack and recent discontinuation of medications further support this suspicion. Pneumonia could also cause similar symptoms, but the patient's cardiac history makes CHF a more likely diagnosis. Myocardial infarction (MI) and cardiac tamponade are less likely explanations based on the given information.

13. PH: 7.49 PaCO2: 24 mmHg HCO3: 22

Metabolic acidosis

Metabolic alkalosis

Respiratory acidosis

Respiratory alkalosis

The given values indicate a pH of 7.49, which is higher than the normal range of 7.35-7.45. This indicates alkalosis. Additionally, the PaCO2 is 24 mmHg, which is below the normal range of 35-45 mmHg. This indicates a decrease in CO2 levels, which is consistent with respiratory alkalosis. The HCO3 level of 22 is within the normal range, suggesting that it is not the primary cause of the alkalosis. Therefore, the correct answer is respiratory alkalosis.

Explanation

The given values indicate a pH of 7.49, which is higher than the normal range of 7.35-7.45. This indicates alkalosis. Additionally, the PaCO2 is 24 mmHg, which is below the normal range of 35-45 mmHg. This indicates a decrease in CO2 levels, which is consistent with respiratory alkalosis. The HCO3 level of 22 is within the normal range, suggesting that it is not the primary cause of the alkalosis. Therefore, the correct answer is respiratory alkalosis.

14. You just delivered a baby at 33 weeks and it's breathing is labored. After suctioning what is tx for the baby?

Ventilations with BVM and OPA

Begin CPR

Warm, dry, stimulate

Cut the cord

After delivering a baby at 33 weeks with labored breathing, the first step is to warm, dry, and stimulate the baby. This helps to stimulate the baby's breathing and can improve their overall condition. Ventilations with a bag-valve-mask (BVM) and an oropharyngeal airway (OPA) may be necessary if the baby's breathing does not improve after warming, drying, and stimulating. Starting CPR or cutting the cord are not the appropriate initial steps in this situation.

Explanation

After delivering a baby at 33 weeks with labored breathing, the first step is to warm, dry, and stimulate the baby. This helps to stimulate the baby's breathing and can improve their overall condition. Ventilations with a bag-valve-mask (BVM) and an oropharyngeal airway (OPA) may be necessary if the baby's breathing does not improve after warming, drying, and stimulating. Starting CPR or cutting the cord are not the appropriate initial steps in this situation.

15. Coffee ground emesis is a sign of an _____ GI bleed.

Coffee ground emesis is a sign of an upper GI bleed. This is because the coffee ground appearance is caused by the partial digestion of blood in the stomach. In upper GI bleeds, the bleeding occurs in the upper part of the gastrointestinal tract, such as the esophagus, stomach, or duodenum. The blood mixes with stomach acid, which causes it to appear dark and granular, resembling coffee grounds. This is in contrast to lower GI bleeds, where the blood is usually bright red and appears in the stool.

Explanation

Coffee ground emesis is a sign of an upper GI bleed. This is because the coffee ground appearance is caused by the partial digestion of blood in the stomach. In upper GI bleeds, the bleeding occurs in the upper part of the gastrointestinal tract, such as the esophagus, stomach, or duodenum. The blood mixes with stomach acid, which causes it to appear dark and granular, resembling coffee grounds. This is in contrast to lower GI bleeds, where the blood is usually bright red and appears in the stool.

Submit

16. PH: 7.29 PaCO2: 68.2 mmHg HCO3: 26

Metabolic acidosis

Metabolic alkalosis

Respiratory acidosis

Respiratory alkalosis

The given values of pH, PaCO2, and HCO3 indicate a respiratory acidosis. A pH of 7.29 is below the normal range (7.35-7.45), indicating acidosis. PaCO2 of 68.2 mmHg is above the normal range (35-45 mmHg), indicating an excess of carbon dioxide in the blood, which is characteristic of respiratory acidosis. HCO3 of 26 is within the normal range (22-28 mEq/L), suggesting that compensation has not occurred. Therefore, the correct answer is respiratory acidosis.

Explanation

The given values of pH, PaCO2, and HCO3 indicate a respiratory acidosis. A pH of 7.29 is below the normal range (7.35-7.45), indicating acidosis. PaCO2 of 68.2 mmHg is above the normal range (35-45 mmHg), indicating an excess of carbon dioxide in the blood, which is characteristic of respiratory acidosis. HCO3 of 26 is within the normal range (22-28 mEq/L), suggesting that compensation has not occurred. Therefore, the correct answer is respiratory acidosis.

17. S/s - persistent cough, hemoptysis, night sweats, wight loss.

PTSD

Delirium tremors

Pneumonia

TB

The symptoms described in the question, including persistent cough, hemoptysis (coughing up blood), night sweats, and weight loss, are consistent with tuberculosis (TB). TB is a bacterial infection that primarily affects the lungs and can cause these symptoms. PTSD (post-traumatic stress disorder) and delirium tremens (a severe form of alcohol withdrawal) do not typically present with these respiratory symptoms, and pneumonia may cause similar symptoms but is less likely given the context of the question. Therefore, TB is the most likely explanation for the given symptoms.

Explanation

The symptoms described in the question, including persistent cough, hemoptysis (coughing up blood), night sweats, and weight loss, are consistent with tuberculosis (TB). TB is a bacterial infection that primarily affects the lungs and can cause these symptoms. PTSD (post-traumatic stress disorder) and delirium tremens (a severe form of alcohol withdrawal) do not typically present with these respiratory symptoms, and pneumonia may cause similar symptoms but is less likely given the context of the question. Therefore, TB is the most likely explanation for the given symptoms.

18. What are ACE inhibitors commonly prescribed for?

Htn & CHF

Pulmonary htn & right sided heart failure

End stage renal & hypotension

GURD & chronic bronchitis

ACE inhibitors are commonly prescribed for hypertension (Htn) and congestive heart failure (CHF). These medications work by blocking the action of an enzyme called angiotensin-converting enzyme (ACE), which helps to relax blood vessels and reduce fluid buildup in the body. By inhibiting ACE, these drugs help to lower blood pressure and improve heart function in patients with hypertension and congestive heart failure.

Explanation

ACE inhibitors are commonly prescribed for hypertension (Htn) and congestive heart failure (CHF). These medications work by blocking the action of an enzyme called angiotensin-converting enzyme (ACE), which helps to relax blood vessels and reduce fluid buildup in the body. By inhibiting ACE, these drugs help to lower blood pressure and improve heart function in patients with hypertension and congestive heart failure.

19. Stimulation of alpha 1 receptors causes _____

Stimulation of alpha 1 receptors causes vasoconstriction, which is the narrowing of blood vessels. When these receptors are activated, it leads to the contraction of smooth muscles in the walls of blood vessels, resulting in a decrease in their diameter. This constriction increases the resistance to blood flow and raises blood pressure. Vasoconstriction is an important physiological response that helps regulate blood flow and maintain blood pressure in various situations, such as during periods of stress or hemorrhage.

Explanation

Stimulation of alpha 1 receptors causes vasoconstriction, which is the narrowing of blood vessels. When these receptors are activated, it leads to the contraction of smooth muscles in the walls of blood vessels, resulting in a decrease in their diameter. This constriction increases the resistance to blood flow and raises blood pressure. Vasoconstriction is an important physiological response that helps regulate blood flow and maintain blood pressure in various situations, such as during periods of stress or hemorrhage.

Submit

20. During glycogenolysis, what is converted into glucose?

Glucagon

Insulin

Glycogen

Somatostatin

pg. 329

Explanation

pg. 329

21. Your pt is 38 weeks pregnant with her 5th child. She called 911 because she had very painful contractions which have since turned into a constant pain. The pt is altered, tachy, and clammy. What should you suspect?

Uterine rupture

Ectopic pregnancy

Shoulder dystocia

Pre-eclampsia

Based on the given information, the patient is experiencing very painful contractions that have turned into constant pain. Additionally, the patient is altered, tachycardic (tachy), and clammy. These symptoms are indicative of a serious condition called uterine rupture. Uterine rupture occurs when the uterine wall tears during pregnancy, typically during labor. This can lead to severe pain, altered mental status, rapid heart rate, and clamminess due to internal bleeding. Therefore, based on the symptoms described, uterine rupture is the most likely explanation for the patient's condition.

Explanation

Based on the given information, the patient is experiencing very painful contractions that have turned into constant pain. Additionally, the patient is altered, tachycardic (tachy), and clammy. These symptoms are indicative of a serious condition called uterine rupture. Uterine rupture occurs when the uterine wall tears during pregnancy, typically during labor. This can lead to severe pain, altered mental status, rapid heart rate, and clamminess due to internal bleeding. Therefore, based on the symptoms described, uterine rupture is the most likely explanation for the patient's condition.

22. Match the following

Osmosis

Albumins

Diffusion

Fibrinogen

Submit

23. What should you suspect when a ped pt has bruising to the buttocks only and it's reported that they fell out of a tree?

Child abuse

Axial load

Head injury

Spinal injury

Hx inconsistent with presenting injury
Pg. 2184

Explanation

Hx inconsistent with presenting injury
Pg. 2184

24. PH: 7.30 PaCO2: 64 mmHg HCO3: 26

Metabolic acidosis

Metabolic alkalosis

Respiratory acidosis

Respiratory alkalosis

The given values of pH, PaCO2, and HCO3 indicate a respiratory acidosis. A pH of 7.30 is lower than the normal range (7.35-7.45), which suggests acidosis. The PaCO2 value of 64 mmHg is higher than the normal range (35-45 mmHg), indicating an excess of carbon dioxide in the blood, which is associated with respiratory acidosis. The HCO3 value of 26 is within the normal range (22-28 mEq/L), suggesting that the kidneys are compensating for the acidosis by retaining bicarbonate. Therefore, the correct answer is respiratory acidosis.

Explanation

The given values of pH, PaCO2, and HCO3 indicate a respiratory acidosis. A pH of 7.30 is lower than the normal range (7.35-7.45), which suggests acidosis. The PaCO2 value of 64 mmHg is higher than the normal range (35-45 mmHg), indicating an excess of carbon dioxide in the blood, which is associated with respiratory acidosis. The HCO3 value of 26 is within the normal range (22-28 mEq/L), suggesting that the kidneys are compensating for the acidosis by retaining bicarbonate. Therefore, the correct answer is respiratory acidosis.

25. You're called for the 3yo pt that had a sudden onset of fever, stridor, drooling, and is working to breathe. What do you suspect?

Anaphylaxis

Epiglottitis

Croup

Meningitis

Epiglottitis is a condition characterized by inflammation and swelling of the epiglottis, a flap of tissue that covers the entrance to the trachea. The sudden onset of fever, stridor (high-pitched breathing sound), drooling, and difficulty breathing are classic symptoms of epiglottitis. This condition is a medical emergency and can rapidly progress to airway obstruction, leading to respiratory distress. Prompt recognition and intervention are crucial to prevent life-threatening complications. Anaphylaxis, croup, and meningitis may also present with some similar symptoms, but the combination of fever, stridor, drooling, and respiratory distress is highly suggestive of epiglottitis.

Explanation

Epiglottitis is a condition characterized by inflammation and swelling of the epiglottis, a flap of tissue that covers the entrance to the trachea. The sudden onset of fever, stridor (high-pitched breathing sound), drooling, and difficulty breathing are classic symptoms of epiglottitis. This condition is a medical emergency and can rapidly progress to airway obstruction, leading to respiratory distress. Prompt recognition and intervention are crucial to prevent life-threatening complications. Anaphylaxis, croup, and meningitis may also present with some similar symptoms, but the combination of fever, stridor, drooling, and respiratory distress is highly suggestive of epiglottitis.

26. Your pt having an asthma attack is still showing shark-fin waveform with an ETCO2 of 48 mmHg - after Albuterol has been administered. What are they most likely experiencing?

Respiratory alkalosis

Organophosphate poisoning

Status asthmaticus

Croup

pg. 940

Explanation

pg. 940

27. S/s - labored breathing, increased RR, low BP, thready/absent pulse, AMS, cool, pale.

Compensated shock

Hyperkalemia

Decompensated shock

Hypoglycemia

The given symptoms indicate a state of shock. Labored breathing, increased respiratory rate, low blood pressure, thready/absent pulse, altered mental status, cool, and pale skin are all signs of decompensated shock. Decompensated shock occurs when the body's compensatory mechanisms are no longer able to maintain adequate tissue perfusion. In this stage, the body is unable to effectively deliver oxygen and nutrients to the organs and tissues, leading to a life-threatening condition. Prompt medical intervention is necessary to stabilize the patient's condition and prevent further deterioration.

Explanation

The given symptoms indicate a state of shock. Labored breathing, increased respiratory rate, low blood pressure, thready/absent pulse, altered mental status, cool, and pale skin are all signs of decompensated shock. Decompensated shock occurs when the body's compensatory mechanisms are no longer able to maintain adequate tissue perfusion. In this stage, the body is unable to effectively deliver oxygen and nutrients to the organs and tissues, leading to a life-threatening condition. Prompt medical intervention is necessary to stabilize the patient's condition and prevent further deterioration.

28. Scope of practice is defined as?

Protocols agreed upon by a consensus of emergency physicians.

The level of care that a paramedic's employer allows the paramedic to provide.

National patient care guidelines established by the federal government.

Care that a paramedic is permitted to perform under the certifying state.

pg. 12

Explanation

pg. 12

29. Match the following

Dilated pupils

Pinpoint pupils

Submit

30. Main concerns with hyperemesis gravidarum?

Dehydration and malnutrition

Dehydration and hyperglycemia

Hyperglycemia and sepsis

Renal failure and cardiac dysrhythmia

pg. 2038

Explanation

pg. 2038

31. Where is the macula located?

Fovea

Retina

Medial canthus

Lens

The macula is located in the retina. The retina is the innermost layer of the eye that contains light-sensitive cells called photoreceptors. The macula is a small, specialized area in the center of the retina that is responsible for central vision and allows us to see fine details clearly. It contains a high concentration of cone cells, which are responsible for color vision and visual acuity.

Explanation

The macula is located in the retina. The retina is the innermost layer of the eye that contains light-sensitive cells called photoreceptors. The macula is a small, specialized area in the center of the retina that is responsible for central vision and allows us to see fine details clearly. It contains a high concentration of cone cells, which are responsible for color vision and visual acuity.

32. Your 70yo pt presents with slurred speech and facial drooping. They inform you that they stopped taking their Warfarin prescribed for a-fib. What should you suspect?

Bells Palsy

Hemorrhagic stroke

Ischemic stroke

PE

pg. 999 - clots formed during a-fib may become emboli that block circulation elsewhere in the body

Explanation

pg. 999 - clots formed during a-fib may become emboli that block circulation elsewhere in the body

33. What class is Metoprolol?

Sodium channel blocker

Antiemetic

ACE Inhibitor

Beta blocker

Metoprolol is classified as a beta blocker. Beta blockers work by blocking the effects of adrenaline on the beta receptors in the body, which helps to lower blood pressure and reduce the workload on the heart. Metoprolol is commonly prescribed to treat conditions such as hypertension, angina, and heart failure. It is also used to prevent heart attacks in patients who have already had one.

Explanation

Metoprolol is classified as a beta blocker. Beta blockers work by blocking the effects of adrenaline on the beta receptors in the body, which helps to lower blood pressure and reduce the workload on the heart. Metoprolol is commonly prescribed to treat conditions such as hypertension, angina, and heart failure. It is also used to prevent heart attacks in patients who have already had one.

34. _____ is a false verbal statement that injures someones good name.

Slander refers to a false verbal statement that harms someone's reputation. It involves making false statements about someone that can damage their good name or character. Slander is a form of defamation and can result in legal consequences for the person making the false statement.

Explanation

Slander refers to a false verbal statement that harms someone's reputation. It involves making false statements about someone that can damage their good name or character. Slander is a form of defamation and can result in legal consequences for the person making the false statement.

Submit

35. "Master gland" - its secretions control the secretions of other endocrine glands

Hypothalamus

Adrenal gland

Pancreas

Pituitary gland

326

Explanation

326

36. What class is Verapamil?

Sodium channel blocker

Calcium channel blocker

Beta blocker

ACE inhibitor

Verapamil is classified as a calcium channel blocker. Calcium channel blockers work by blocking the flow of calcium ions into the smooth muscle cells of the heart and blood vessels. This helps to relax and widen the blood vessels, reducing blood pressure and improving blood flow. Verapamil is commonly used to treat high blood pressure, angina (chest pain), and certain heart rhythm disorders.

Explanation

Verapamil is classified as a calcium channel blocker. Calcium channel blockers work by blocking the flow of calcium ions into the smooth muscle cells of the heart and blood vessels. This helps to relax and widen the blood vessels, reducing blood pressure and improving blood flow. Verapamil is commonly used to treat high blood pressure, angina (chest pain), and certain heart rhythm disorders.

37. You're called to the scene of a church where multiple pts are light headed and SOB. You have on your proper PPE and have called for additional resources. What should you do next?

Find out number of pts

Secure the scene

Spine precautions

Hose down the pts

SPANS

Explanation

SPANS

38. Kernig and Brudzinski sign suggest what?

Cholecystitis

Mumps

Meningitis

Measles

pg. 1128

Explanation

pg. 1128

39. S/S - sudden onset of dyspnea, anxious, cyanotic, chest pain?

Pulmonary embolism

MI

Cardiac tamponade

Stroke

The sudden onset of dyspnea, anxiety, cyanosis, and chest pain are classic symptoms of a pulmonary embolism. A pulmonary embolism occurs when a blood clot travels to the lungs and blocks blood flow. This can lead to a decrease in oxygenation, causing cyanosis and shortness of breath. Chest pain can occur due to the strain on the heart caused by the clot. MI (heart attack), cardiac tamponade, and stroke may also present with some similar symptoms, but the sudden onset of dyspnea and chest pain is more indicative of a pulmonary embolism.

Explanation

The sudden onset of dyspnea, anxiety, cyanosis, and chest pain are classic symptoms of a pulmonary embolism. A pulmonary embolism occurs when a blood clot travels to the lungs and blocks blood flow. This can lead to a decrease in oxygenation, causing cyanosis and shortness of breath. Chest pain can occur due to the strain on the heart caused by the clot. MI (heart attack), cardiac tamponade, and stroke may also present with some similar symptoms, but the sudden onset of dyspnea and chest pain is more indicative of a pulmonary embolism.

40. Your pt is experiencing the worst headache of his life after working out. What should you suspect?

Subarachnoid hemorrhage

Epidural hematoma

Subdural hematoma

Migraine

pg. 1745
*ruptured aneurysm

Explanation

pg. 1745
*ruptured aneurysm

41. What is the reason for Aspirin use in an MI?

Reduce mortality

Decrease pain

Lower blood pressure

Vasodilate

Aspirin is used in an MI (myocardial infarction) to reduce mortality. This is because aspirin works as a blood thinner, preventing blood clots from forming in the arteries. In an MI, a blood clot can block the blood flow to the heart, leading to tissue damage and potentially death. By reducing the risk of blood clot formation, aspirin helps to prevent further damage to the heart and improve survival rates.

Explanation

Aspirin is used in an MI (myocardial infarction) to reduce mortality. This is because aspirin works as a blood thinner, preventing blood clots from forming in the arteries. In an MI, a blood clot can block the blood flow to the heart, leading to tissue damage and potentially death. By reducing the risk of blood clot formation, aspirin helps to prevent further damage to the heart and improve survival rates.

42. After eating a fatty meal, abdominal pain begins hours later due to a flare up of what condition?

Appendicitis

Pancreatitis

Hepatitis

Cholecystitis

Cholecystitis is the inflammation of the gallbladder, which can be triggered by consuming a fatty meal. The gallbladder stores bile, which helps in the digestion of fats. When a fatty meal is consumed, the gallbladder contracts to release bile into the small intestine. In the case of cholecystitis, the gallbladder becomes inflamed, usually due to the presence of gallstones that block the bile ducts. This inflammation can cause abdominal pain that typically starts a few hours after eating a fatty meal. Therefore, cholecystitis is the most likely condition to cause abdominal pain after consuming a fatty meal.

Explanation

Cholecystitis is the inflammation of the gallbladder, which can be triggered by consuming a fatty meal. The gallbladder stores bile, which helps in the digestion of fats. When a fatty meal is consumed, the gallbladder contracts to release bile into the small intestine. In the case of cholecystitis, the gallbladder becomes inflamed, usually due to the presence of gallstones that block the bile ducts. This inflammation can cause abdominal pain that typically starts a few hours after eating a fatty meal. Therefore, cholecystitis is the most likely condition to cause abdominal pain after consuming a fatty meal.

43. Pts with a board-hard abdomen usually have what?

Alcoholism

Kidney stone

Peritonitis

Hepatomegaly

pg. 1190

Explanation

pg. 1190

44. What is the most common cause of painless bleeding during the second or third trimester of pregnancy? (Usually closer to delivery).

Spontaneous abortion

Abruptio placenta

Placenta previa

Ectopic pregnancy

pg 2042-2043

Explanation

pg 2042-2043

45. You're called for a dialysis pt that has no pulse but shows normal sinus on the monitor. After starting CPR you'd administer Epi and what?

Lidocaine

Sodium Bicarb

Amiodarone

D50

In this scenario, the patient has no pulse but shows normal sinus on the monitor. This suggests a potential metabolic cause for the cardiac arrest, such as severe acidosis. Sodium bicarbonate is commonly used in cardiac arrest situations where metabolic acidosis is suspected or confirmed. It helps to correct the acid-base imbalance and improve the effectiveness of CPR. Therefore, after administering epinephrine, the next appropriate medication to administer would be sodium bicarbonate.

Explanation

In this scenario, the patient has no pulse but shows normal sinus on the monitor. This suggests a potential metabolic cause for the cardiac arrest, such as severe acidosis. Sodium bicarbonate is commonly used in cardiac arrest situations where metabolic acidosis is suspected or confirmed. It helps to correct the acid-base imbalance and improve the effectiveness of CPR. Therefore, after administering epinephrine, the next appropriate medication to administer would be sodium bicarbonate.

46. Which plasma protein is responsible for clotting?

Fibrin

Globulin

Fibrinogen

Albumin

Pg. 334

Explanation

Pg. 334

47. Your pt took 15mg of Alprazolam and washed it down with Vodka. What's your initial tx?

Fluoxetine IN

Airway management

Pt position and fluid bolus

Narcan IN

The initial treatment in this scenario would be airway management. The combination of Alprazolam (a sedative) and Vodka (alcohol) can cause central nervous system depression, leading to respiratory depression and potential airway obstruction. Therefore, ensuring a patent airway and providing necessary support for breathing would be the priority in this situation.

Explanation

The initial treatment in this scenario would be airway management. The combination of Alprazolam (a sedative) and Vodka (alcohol) can cause central nervous system depression, leading to respiratory depression and potential airway obstruction. Therefore, ensuring a patent airway and providing necessary support for breathing would be the priority in this situation.

48. A pt with Leukemia is most likely prone to what?

Seizures

Kidney failure

Uncontrolled bleeding

Frequent infections

Leukemia is a type of cancer that affects the bone marrow and blood. It leads to the production of abnormal white blood cells, which weakens the immune system. As a result, individuals with leukemia have a compromised immune system and are more susceptible to infections. Therefore, frequent infections are a common occurrence in patients with leukemia.

Explanation

Leukemia is a type of cancer that affects the bone marrow and blood. It leads to the production of abnormal white blood cells, which weakens the immune system. As a result, individuals with leukemia have a compromised immune system and are more susceptible to infections. Therefore, frequent infections are a common occurrence in patients with leukemia.

49. Peds initial defib setting?

1 j/kg

2 j/kg

3 j/kg

4 j/kg

The initial defibrillation setting for pediatric patients is 2 j/kg. This means that for every kilogram of the child's body weight, a 2-joule shock is delivered. This setting is based on the current guidelines for pediatric resuscitation and is considered safe and effective in delivering the necessary energy to restore normal heart rhythm in children.

Explanation

The initial defibrillation setting for pediatric patients is 2 j/kg. This means that for every kilogram of the child's body weight, a 2-joule shock is delivered. This setting is based on the current guidelines for pediatric resuscitation and is considered safe and effective in delivering the necessary energy to restore normal heart rhythm in children.

50. Your pt had painful and cloudy urination accompanied by flank tenderness. After 5 days the pain now radiates to the neck and you were called bc the pt is now altered and has a fever. What should you suspect?

Kidney stone

Pyelonephritis

Chlamydia

UTI

pg. 1221

UTI pts are usually stable but if left untreated can lead to pyelonephritis which presents unstable.

Explanation

pg. 1221

UTI pts are usually stable but if left untreated can lead to pyelonephritis which presents unstable.

51. Your 3yo pt has been seizing for 10 minutes and is hot to the touch. What should you do?

Start an IV for cold fluids

Remove clothing to begin cooling

Administer Versed IM

Apply a wet cloth to pts forehead

In this scenario, the 3-year-old patient is experiencing a seizure and is hot to the touch. Removing clothing to begin cooling is the most appropriate action. Seizures can cause an increase in body temperature, and cooling the patient can help prevent further complications. Removing clothing allows for better heat dissipation and can help lower the body temperature. It is important to address the elevated body temperature promptly to prevent potential brain damage or other complications associated with prolonged seizures.

Explanation

In this scenario, the 3-year-old patient is experiencing a seizure and is hot to the touch. Removing clothing to begin cooling is the most appropriate action. Seizures can cause an increase in body temperature, and cooling the patient can help prevent further complications. Removing clothing allows for better heat dissipation and can help lower the body temperature. It is important to address the elevated body temperature promptly to prevent potential brain damage or other complications associated with prolonged seizures.

52. Sarin, Soman, Tabun, and VX are all what?

Organophosphates

Nerve agents

Pesticides

Antidotes

pg. 2444

Explanation

pg. 2444

53. 98.6 degrees F is _____ degrees C

The given question is asking for the conversion of 98.6 degrees Fahrenheit to degrees Celsius. To convert Fahrenheit to Celsius, you subtract 32 from the Fahrenheit temperature and then multiply the result by 5/9. In this case, when you subtract 32 from 98.6, you get 66.6. Then, when you multiply 66.6 by 5/9, you get 37. Therefore, 98.6 degrees Fahrenheit is equal to 37 degrees Celsius.

Explanation

The given question is asking for the conversion of 98.6 degrees Fahrenheit to degrees Celsius. To convert Fahrenheit to Celsius, you subtract 32 from the Fahrenheit temperature and then multiply the result by 5/9. In this case, when you subtract 32 from 98.6, you get 66.6. Then, when you multiply 66.6 by 5/9, you get 37. Therefore, 98.6 degrees Fahrenheit is equal to 37 degrees Celsius.

Submit

54. What rhythm is this?

3rd degree

2nd degree type I

2nd degree type II

Sinus dysrhythmia

not-available-via-ai

Explanation

not-available-via-ai

55. A pregnant pt was hit by a car and sustained a tibia fx. Her BP is 84/56. How should she be positioned?

LLR

Trendelenburg

Left side by padding 4 - 6 inches under right side of backboard

Supine with manually displaced uterus

The correct answer is to position the pregnant patient on her left side by padding 4-6 inches under the right side of the backboard. This position, known as the left lateral tilt or left lateral recumbent position, is recommended for pregnant patients who are experiencing hypotension. By tilting the patient to the left side, it helps to relieve pressure on the inferior vena cava, which can be compressed by the weight of the uterus in a supine position. This allows for better blood flow and helps to improve blood pressure.

Explanation

The correct answer is to position the pregnant patient on her left side by padding 4-6 inches under the right side of the backboard. This position, known as the left lateral tilt or left lateral recumbent position, is recommended for pregnant patients who are experiencing hypotension. By tilting the patient to the left side, it helps to relieve pressure on the inferior vena cava, which can be compressed by the weight of the uterus in a supine position. This allows for better blood flow and helps to improve blood pressure.

56. What is the most common cause of right sided heart failure?

COPD

MI

Left sided heart failure

Polycythemia

Left sided heart failure is the most common cause of right sided heart failure. In left sided heart failure, the left ventricle of the heart is unable to pump blood effectively, leading to a backup of blood in the lungs. This increased pressure in the lungs can eventually lead to right sided heart failure, where the right ventricle is unable to pump blood efficiently to the rest of the body. Therefore, left sided heart failure is the underlying cause of right sided heart failure.

Explanation

Left sided heart failure is the most common cause of right sided heart failure. In left sided heart failure, the left ventricle of the heart is unable to pump blood effectively, leading to a backup of blood in the lungs. This increased pressure in the lungs can eventually lead to right sided heart failure, where the right ventricle is unable to pump blood efficiently to the rest of the body. Therefore, left sided heart failure is the underlying cause of right sided heart failure.

57. Match the following

Perform an act you were never allowed to do

Perform an act you're allowed to do, but did it in an improper manner

Failure to perform a required act or duty

Submit

58. A woman in her 3rd trimester of pregnancy will have a larger volume of blood and compensatory mechanisms already functioning due to being pregnant. What does this put her at risk for?

Quick decompensation

Pre-eclampsia

Loss of large amount of blood before s/s hypovolemia appear

Eclampsia

pg. 2041-2042

Explanation

pg. 2041-2042

59. In order for CPAP to be used the pts SBP needs to be greater than _____ mmHg.

CPAP (Continuous Positive Airway Pressure) is a treatment method used for patients with sleep apnea or other breathing difficulties. It involves the use of a machine that delivers a constant flow of air pressure to keep the airways open during sleep. In order for CPAP to be effective and safe, the patient's systolic blood pressure (SBP) needs to be greater than 90 mmHg. This is because CPAP can slightly increase blood pressure, and if the SBP is too low, there may be a risk of decreased blood flow to vital organs.

Explanation

CPAP (Continuous Positive Airway Pressure) is a treatment method used for patients with sleep apnea or other breathing difficulties. It involves the use of a machine that delivers a constant flow of air pressure to keep the airways open during sleep. In order for CPAP to be effective and safe, the patient's systolic blood pressure (SBP) needs to be greater than 90 mmHg. This is because CPAP can slightly increase blood pressure, and if the SBP is too low, there may be a risk of decreased blood flow to vital organs.

Submit

60. Pulses paradoxus is a drop in SBP by _____ mmHg during inspiration.

Pulses paradoxus is a phenomenon where there is a drop in systolic blood pressure (SBP) by a certain amount during inspiration. In this case, the drop in SBP is specifically 10 mmHg. This means that when a person breathes in, their SBP decreases by 10 mmHg. This paradoxical drop in blood pressure during inspiration can be seen in certain medical conditions, such as cardiac tamponade or severe asthma, and is characterized by an exaggerated decrease in SBP during inspiration.

Explanation

Pulses paradoxus is a phenomenon where there is a drop in systolic blood pressure (SBP) by a certain amount during inspiration. In this case, the drop in SBP is specifically 10 mmHg. This means that when a person breathes in, their SBP decreases by 10 mmHg. This paradoxical drop in blood pressure during inspiration can be seen in certain medical conditions, such as cardiac tamponade or severe asthma, and is characterized by an exaggerated decrease in SBP during inspiration.

Submit

61. 67yo female had vague abdominal discomfort 45 minutes ago that is now 10/10 pain radiating from her back to her groin. What should you suspect?

Ectopic pregnancy

Cholecystitis

Kidney stone

UTI

pg. 1222

Explanation

pg. 1222

62. Meningitis is very contagious and primarily spread via which route?

Contact

Airborne

Droplet

Vector

Meningitis is primarily spread through droplets. When an infected person coughs or sneezes, tiny droplets containing the bacteria or virus can be released into the air. These droplets can then be inhaled by others, leading to the transmission of meningitis. This is why close contact with an infected person, especially in crowded places, increases the risk of contracting the disease. Other routes of transmission, such as contact or airborne, may also play a role in the spread of meningitis, but droplet transmission is the most common and significant.

Explanation

Meningitis is primarily spread through droplets. When an infected person coughs or sneezes, tiny droplets containing the bacteria or virus can be released into the air. These droplets can then be inhaled by others, leading to the transmission of meningitis. This is why close contact with an infected person, especially in crowded places, increases the risk of contracting the disease. Other routes of transmission, such as contact or airborne, may also play a role in the spread of meningitis, but droplet transmission is the most common and significant.

63. Your pt is choking and can no longer move air. They are also 35 weeks pregnant. How should you treat?

Back slaps

Abdominal thrusts

Supine and begin chest compressions

Chest thrusts

In this scenario, the correct answer is chest thrusts. When a person is choking and unable to move air, chest thrusts are the recommended treatment. This technique involves standing behind the person, placing your hands on their chest, and applying firm pressure to compress the chest in an attempt to dislodge the obstruction. However, due to the fact that the patient is 35 weeks pregnant, it is important to modify the technique slightly to avoid putting excessive pressure on the abdomen.

Explanation

In this scenario, the correct answer is chest thrusts. When a person is choking and unable to move air, chest thrusts are the recommended treatment. This technique involves standing behind the person, placing your hands on their chest, and applying firm pressure to compress the chest in an attempt to dislodge the obstruction. However, due to the fact that the patient is 35 weeks pregnant, it is important to modify the technique slightly to avoid putting excessive pressure on the abdomen.

64. Your pt has JVD and hepatomegaly. What is this a sign of?

Left sided heart failure

Right sided heart failure

Cardiac tamponade

Hemothorax

Jugular venous distention (JVD) and hepatomegaly are both clinical signs associated with right sided heart failure. Right sided heart failure occurs when the right ventricle is unable to effectively pump blood to the lungs for oxygenation. This leads to a backup of blood in the systemic venous system, causing increased pressure in the jugular veins and resulting in JVD. Hepatomegaly, or enlargement of the liver, occurs because of congestion and increased blood flow in the liver due to the right heart's inability to efficiently pump blood. Therefore, the presence of JVD and hepatomegaly is indicative of right sided heart failure.

Explanation

Jugular venous distention (JVD) and hepatomegaly are both clinical signs associated with right sided heart failure. Right sided heart failure occurs when the right ventricle is unable to effectively pump blood to the lungs for oxygenation. This leads to a backup of blood in the systemic venous system, causing increased pressure in the jugular veins and resulting in JVD. Hepatomegaly, or enlargement of the liver, occurs because of congestion and increased blood flow in the liver due to the right heart's inability to efficiently pump blood. Therefore, the presence of JVD and hepatomegaly is indicative of right sided heart failure.

65. When would you see exophthalmos?

Addison's disease

Cushing syndrome

Grave's disease

Myasthenia Gravis

pg. 1282

Explanation

pg. 1282

66. Rebound tenderness would be a result of?

Damage to solid organs

Torn/sprained ligaments

Damage to hollow organs

Pneumothorax

Rebound tenderness occurs when there is damage to hollow organs. This is because hollow organs, such as the intestines or bladder, are filled with fluid or air. When these organs are damaged, the fluid or air leaks out and irritates the surrounding tissues. When pressure is applied to the area and then released, the irritated tissues "rebound" and cause pain or tenderness. Damage to solid organs or ligaments would not cause rebound tenderness. Pneumothorax, which is a collapsed lung due to air in the chest cavity, could also cause rebound tenderness.

Explanation

Rebound tenderness occurs when there is damage to hollow organs. This is because hollow organs, such as the intestines or bladder, are filled with fluid or air. When these organs are damaged, the fluid or air leaks out and irritates the surrounding tissues. When pressure is applied to the area and then released, the irritated tissues "rebound" and cause pain or tenderness. Damage to solid organs or ligaments would not cause rebound tenderness. Pneumothorax, which is a collapsed lung due to air in the chest cavity, could also cause rebound tenderness.

67. Adult initial cardioversion settings?

100j

120j

150j

200j

The correct answer for the initial cardioversion settings in adults is 100j. This refers to the amount of energy delivered during the procedure to restore a normal heart rhythm. It is important to start with a lower energy setting and gradually increase if needed to minimize the risk of complications. 100j is a commonly used starting point for adult patients.

Explanation

The correct answer for the initial cardioversion settings in adults is 100j. This refers to the amount of energy delivered during the procedure to restore a normal heart rhythm. It is important to start with a lower energy setting and gradually increase if needed to minimize the risk of complications. 100j is a commonly used starting point for adult patients.

68. Marfan's syndrome is associated with which of the following?

Mitral valve prolapse

Endocarditis

Restrictive cardiomyopathy

Aortic dissection

pg. 456

Explanation

pg. 456

69. What are (2) main organs damaged by alcoholism?

Liver & kidneys

Heart & liver

Liver & pancreas

Kidneys & stomach

Alcoholism can cause damage to several organs in the body, but the liver and pancreas are two of the main organs that are commonly affected. Excessive alcohol consumption can lead to liver disease, such as alcoholic hepatitis or cirrhosis, which can impair the liver's ability to function properly. The pancreas can also be damaged by alcohol, leading to inflammation known as pancreatitis. Both liver and pancreatic damage can have serious health consequences and may require medical intervention.

Explanation

Alcoholism can cause damage to several organs in the body, but the liver and pancreas are two of the main organs that are commonly affected. Excessive alcohol consumption can lead to liver disease, such as alcoholic hepatitis or cirrhosis, which can impair the liver's ability to function properly. The pancreas can also be damaged by alcohol, leading to inflammation known as pancreatitis. Both liver and pancreatic damage can have serious health consequences and may require medical intervention.

70. Peds SVT synchronized cardioversion initial shock?

1 j/kg

2 j/kg

3 j/kg

4 j/kg

In pediatric patients with supraventricular tachycardia (SVT), synchronized cardioversion is the initial treatment of choice. The recommended initial shock energy for pediatric synchronized cardioversion is 1 joule per kilogram (j/kg). This means that for each kilogram of the child's body weight, a shock of 1 joule should be delivered. The use of synchronized cardioversion helps to minimize the risk of causing further arrhythmias or hemodynamic instability. Therefore, the correct answer is 1 j/kg.

Explanation

In pediatric patients with supraventricular tachycardia (SVT), synchronized cardioversion is the initial treatment of choice. The recommended initial shock energy for pediatric synchronized cardioversion is 1 joule per kilogram (j/kg). This means that for each kilogram of the child's body weight, a shock of 1 joule should be delivered. The use of synchronized cardioversion helps to minimize the risk of causing further arrhythmias or hemodynamic instability. Therefore, the correct answer is 1 j/kg.

71. What causes febrile seizures?

Rapid increase in temperature

Infection that has spread to the spine

High body temperature for prolonged amount of time

Electrolyte imbalance from prolonged sweating

Febrile seizures are caused by a rapid increase in temperature. When a child's body temperature rises quickly, it can trigger a seizure. Febrile seizures are most common in children between the ages of 6 months and 5 years. It is important to note that febrile seizures are not caused by an infection that has spread to the spine, high body temperature for a prolonged amount of time, or electrolyte imbalance from prolonged sweating.

Explanation

Febrile seizures are caused by a rapid increase in temperature. When a child's body temperature rises quickly, it can trigger a seizure. Febrile seizures are most common in children between the ages of 6 months and 5 years. It is important to note that febrile seizures are not caused by an infection that has spread to the spine, high body temperature for a prolonged amount of time, or electrolyte imbalance from prolonged sweating.

72. If your pt is over 35yo and you can hear S3 heart tones - what should you suspect?

Amphetamine use

Heart failure

COPD

Narrowing artery

If a patient is over 35 years old and the healthcare provider can hear S3 heart tones, it is likely that the patient is experiencing heart failure. S3 heart tones, also known as ventricular gallops, are abnormal heart sounds that can indicate fluid overload and impaired ventricular function, both of which are common in heart failure. Therefore, the presence of S3 heart tones in an older patient suggests the possibility of heart failure as the cause of their symptoms.

Explanation

If a patient is over 35 years old and the healthcare provider can hear S3 heart tones, it is likely that the patient is experiencing heart failure. S3 heart tones, also known as ventricular gallops, are abnormal heart sounds that can indicate fluid overload and impaired ventricular function, both of which are common in heart failure. Therefore, the presence of S3 heart tones in an older patient suggests the possibility of heart failure as the cause of their symptoms.

73. During rhabdomyolysis, destruction of muscles results in the release of potassium and _____

During rhabdomyolysis, the destruction of muscles leads to the release of potassium and myoglobin. Rhabdomyolysis is a condition where muscle tissue breaks down rapidly, causing the release of various substances into the bloodstream. One of these substances is myoglobin, a protein found in muscle cells that carries oxygen. When muscle cells are damaged, myoglobin is released, and high levels of myoglobin in the blood can be toxic to the kidneys. Potassium is also released during muscle breakdown and can cause electrolyte imbalances and other complications if levels become too high.

Explanation

During rhabdomyolysis, the destruction of muscles leads to the release of potassium and myoglobin. Rhabdomyolysis is a condition where muscle tissue breaks down rapidly, causing the release of various substances into the bloodstream. One of these substances is myoglobin, a protein found in muscle cells that carries oxygen. When muscle cells are damaged, myoglobin is released, and high levels of myoglobin in the blood can be toxic to the kidneys. Potassium is also released during muscle breakdown and can cause electrolyte imbalances and other complications if levels become too high.

Submit

74. S/S - headache, photophobia, severe eye pain, N/V, halo vision

Hyphema

Narrow angle glaucoma

Concussion

Papilladema

*EMERGENCY* - if intraocular pressure is not reduced then permanent vision loss can occur

Explanation

*EMERGENCY* - if intraocular pressure is not reduced then permanent vision loss can occur

75. What is the most commonly involved coronary artery in an MI?

Left circumflex artery (LCA)

Right coronary artery (RCA)

Left anterior descending artery (LAD)

Posterior descending artery (PDA)

The left anterior descending artery (LAD) is the most commonly involved coronary artery in a myocardial infarction (MI). This is because the LAD supplies blood to a large portion of the left ventricle, which is the main pumping chamber of the heart. When there is a blockage or narrowing in the LAD, it can lead to a decrease in blood flow to the heart muscle, causing a heart attack. Therefore, the LAD is often implicated in MIs.

Explanation

The left anterior descending artery (LAD) is the most commonly involved coronary artery in a myocardial infarction (MI). This is because the LAD supplies blood to a large portion of the left ventricle, which is the main pumping chamber of the heart. When there is a blockage or narrowing in the LAD, it can lead to a decrease in blood flow to the heart muscle, causing a heart attack. Therefore, the LAD is often implicated in MIs.

76. What occurs during all shock?

Ischemia

Hemorrhage

Hypoxia

Tachycardia

During all shock, the body experiences a decrease in the supply of oxygen to the tissues, which is known as hypoxia. Shock is a condition where there is inadequate blood flow to the organs and tissues, leading to a lack of oxygen and nutrients. This can occur due to various reasons such as severe bleeding, heart failure, or severe infection. Hypoxia is a common feature of shock and can have serious consequences if not promptly treated. It can lead to organ dysfunction and damage, and if left untreated, it can be life-threatening.

Explanation

During all shock, the body experiences a decrease in the supply of oxygen to the tissues, which is known as hypoxia. Shock is a condition where there is inadequate blood flow to the organs and tissues, leading to a lack of oxygen and nutrients. This can occur due to various reasons such as severe bleeding, heart failure, or severe infection. Hypoxia is a common feature of shock and can have serious consequences if not promptly treated. It can lead to organ dysfunction and damage, and if left untreated, it can be life-threatening.

77. The "M" in SLUDGEBAM stands for what?

Mydriasis

Miosis

The "M" in SLUDGEBAM stands for Miosis. Miosis refers to the constriction of the pupil, which is the opposite of mydriasis, where the pupil dilates. In the context of SLUDGEBAM, which is an acronym used to remember the signs and symptoms of cholinergic toxicity, Miosis signifies the presence of pinpoint pupils, which is a characteristic feature of cholinergic poisoning.

Explanation

The "M" in SLUDGEBAM stands for Miosis. Miosis refers to the constriction of the pupil, which is the opposite of mydriasis, where the pupil dilates. In the context of SLUDGEBAM, which is an acronym used to remember the signs and symptoms of cholinergic toxicity, Miosis signifies the presence of pinpoint pupils, which is a characteristic feature of cholinergic poisoning.

78. During an adult cardiac arrest what are the defib settings for a Zoll?

200j, 250j, 300j

100j, 150j, 200j

120j, 150j, 200j

100j, 200j, 250j

The correct answer is 120j, 150j, 200j. These are the defibrillation settings for a Zoll defibrillator during an adult cardiac arrest.

Explanation

The correct answer is 120j, 150j, 200j. These are the defibrillation settings for a Zoll defibrillator during an adult cardiac arrest.

79. Which of the following is appropriate for a 35kg child with croup and mild difficulty breathing?

Epi 1:1000 3mg IM

Establish IV access in preparation for intubation

Blow by O2

High FiO2 via NRB and transport

Blow by O2 is appropriate for a 35kg child with croup and mild difficulty breathing because it is a non-invasive method of delivering oxygen. This method involves placing an oxygen mask near the child's face, allowing them to breathe in the oxygen-rich air. It can help improve oxygenation and alleviate respiratory distress without the need for invasive procedures or medications.

Explanation

Blow by O2 is appropriate for a 35kg child with croup and mild difficulty breathing because it is a non-invasive method of delivering oxygen. This method involves placing an oxygen mask near the child's face, allowing them to breathe in the oxygen-rich air. It can help improve oxygenation and alleviate respiratory distress without the need for invasive procedures or medications.

80. You're called for the 25yo pt that started having a seizure while gardening. On scene the pt is still seizing. Family informs you pt has no medical Hx or allergies. What should you suspect?

Febrile seizure

Snake bite

Organophosphate poisoning

Heat stroke

Given the information provided, the most likely explanation for the patient's seizure is organophosphate poisoning. This is suggested by the fact that the patient has no previous medical history or allergies, and the family did not mention any other potential causes such as a snake bite or heat stroke. Organophosphates are commonly used in pesticides, and accidental or intentional ingestion can lead to seizures.

Explanation

Given the information provided, the most likely explanation for the patient's seizure is organophosphate poisoning. This is suggested by the fact that the patient has no previous medical history or allergies, and the family did not mention any other potential causes such as a snake bite or heat stroke. Organophosphates are commonly used in pesticides, and accidental or intentional ingestion can lead to seizures.

81. Organophosphates affect the parasympathetic nervous system which causes the pupils to _____ (dilate/constrict)?

Organophosphates affect the parasympathetic nervous system, which is responsible for controlling involuntary functions such as pupil size. When the parasympathetic nervous system is activated, the pupils constrict or become smaller. Therefore, the correct answer is "constrict."

Explanation

Organophosphates affect the parasympathetic nervous system, which is responsible for controlling involuntary functions such as pupil size. When the parasympathetic nervous system is activated, the pupils constrict or become smaller. Therefore, the correct answer is "constrict."

Submit

82. 100.4 degrees F is _____ degrees C

The given question is asking for the conversion of 100.4 degrees Fahrenheit to degrees Celsius. To convert Fahrenheit to Celsius, we subtract 32 and then multiply by 5/9. Applying this formula, we subtract 32 from 100.4, which gives us 68.4. Then, multiplying 68.4 by 5/9, we get approximately 38 degrees Celsius.

Explanation

The given question is asking for the conversion of 100.4 degrees Fahrenheit to degrees Celsius. To convert Fahrenheit to Celsius, we subtract 32 and then multiply by 5/9. Applying this formula, we subtract 32 from 100.4, which gives us 68.4. Then, multiplying 68.4 by 5/9, we get approximately 38 degrees Celsius.

Submit

83. Which one do you like?

Option 1

Option 2

Option 3

Option 4

not-available-via-ai

Explanation

not-available-via-ai

84. Vasodilation and loss of temperature control below the injury occurs in _____ shock.

Neurogenic shock is characterized by vasodilation, which is the widening of blood vessels, and loss of temperature control below the injury. This occurs due to a disruption in the autonomic nervous system, specifically the sympathetic nervous system, which controls these functions.

Explanation

Neurogenic shock is characterized by vasodilation, which is the widening of blood vessels, and loss of temperature control below the injury. This occurs due to a disruption in the autonomic nervous system, specifically the sympathetic nervous system, which controls these functions.

Submit

85. Endocrine disorder in which the adrenal glands don't produce enough steroid hormones?

Grave's disease

Addison disease

Cushing syndrome

Hypothyroidism

pg. 1279

Explanation

pg. 1279

86. Your pt with PUD has a sudden increase in strength and quality of the gnawing pain. You should now assume the ulcer has _____ - which means it has eaten through the stomach or duodenum.

When a patient with peptic ulcer disease (PUD) experiences a sudden increase in the strength and quality of the gnawing pain, it is indicative of a serious complication called perforation. Perforation refers to the ulcer eating through the stomach or duodenum, leading to a hole in the wall of these organs. This can result in the leakage of stomach acid and digestive juices into the abdominal cavity, causing severe pain and potentially life-threatening complications. Therefore, assuming the ulcer has perforated is crucial in order to promptly diagnose and manage this critical condition.

Explanation

When a patient with peptic ulcer disease (PUD) experiences a sudden increase in the strength and quality of the gnawing pain, it is indicative of a serious complication called perforation. Perforation refers to the ulcer eating through the stomach or duodenum, leading to a hole in the wall of these organs. This can result in the leakage of stomach acid and digestive juices into the abdominal cavity, causing severe pain and potentially life-threatening complications. Therefore, assuming the ulcer has perforated is crucial in order to promptly diagnose and manage this critical condition.

Submit

87. Match the following regarding a blast injury:

When a person is hurled by the explosion into a stationary object (wall, ground, etc.)

Damage to the body caused by pressure waves

Being struck by flying debris

Submit

88. Negligence order

Harm resulted

Breach of duty

Failure to act

Duty

Submit

89. If your pt in stable v-tach has no response to Amiodarone drip, what should you do next?

Call med control to consider Lidocaine drip

Synchronized cardioversion

Call med control to consider Adenosine

Administer second Amiodarone drip

If a patient in stable ventricular tachycardia does not respond to an Amiodarone drip, the next step would be to call medical control to consider Adenosine. Adenosine is a medication commonly used to treat supraventricular tachycardia, but it can also be considered in certain cases of stable ventricular tachycardia. Medical control should be consulted to determine the appropriate course of action in this situation.

Explanation

If a patient in stable ventricular tachycardia does not respond to an Amiodarone drip, the next step would be to call medical control to consider Adenosine. Adenosine is a medication commonly used to treat supraventricular tachycardia, but it can also be considered in certain cases of stable ventricular tachycardia. Medical control should be consulted to determine the appropriate course of action in this situation.

90. An air embolism is a serious risk for pts with long term vascular devices because it usually goes directly into where?

Left atrium

Pulmonary artery

Left ventricle

Vena cava

pg. 759

Explanation

pg. 759

91. All meds administered during a cardiac arrest should be flushed with _____ mL of normal saline.

During a cardiac arrest, it is important to flush all medications with a sufficient amount of normal saline to ensure proper administration and circulation. Flushing the medications with 20 mL of normal saline helps to ensure that the medication is fully delivered and reaches the bloodstream effectively. This volume is considered adequate for flushing the medications and ensuring their proper distribution throughout the body.

Explanation

During a cardiac arrest, it is important to flush all medications with a sufficient amount of normal saline to ensure proper administration and circulation. Flushing the medications with 20 mL of normal saline helps to ensure that the medication is fully delivered and reaches the bloodstream effectively. This volume is considered adequate for flushing the medications and ensuring their proper distribution throughout the body.

Submit

92. You were called for the 5yo (25kg) having an asthma attack. After administering Albuterol via neb his breathing begins to slow down and you can no longer hear wheezing. His ETCO2 is was 48 mmHg when you started the ned and is now 63 mmHg. What should you do next?

Sodium bicarb 1mEq/kg

O2 via NRB at 15lpm and transport in position of comfort

Epi 1:1000 0.15mg IM

Repeat Albuterol neb

After administering Albuterol via nebulizer, the patient's breathing has slowed down and wheezing is no longer audible. However, the patient's ETCO2 has increased from 48 mmHg to 63 mmHg, indicating worsening respiratory distress. The correct next step would be to administer Epi 1:1000 0.15mg IM. This is because the patient's condition suggests that they are experiencing a severe asthma attack that is not responding adequately to the initial treatment. Epi 1:1000 is a bronchodilator that can help relieve the airway constriction and improve the patient's breathing.

Explanation

After administering Albuterol via nebulizer, the patient's breathing has slowed down and wheezing is no longer audible. However, the patient's ETCO2 has increased from 48 mmHg to 63 mmHg, indicating worsening respiratory distress. The correct next step would be to administer Epi 1:1000 0.15mg IM. This is because the patient's condition suggests that they are experiencing a severe asthma attack that is not responding adequately to the initial treatment. Epi 1:1000 is a bronchodilator that can help relieve the airway constriction and improve the patient's breathing.

93. Your 34yo pt sustained a head injury and has a GCS of 8, BP 100/80, HR 98, gasping respirations, and intact gag reflex. What should you do next?

DAI

NRB @ 15lpm

BVM with adjunct

Narcan

The correct answer is DAI. DAI stands for Diffuse Axonal Injury, which is a type of brain injury that occurs due to shearing forces in the brain. The patient in this scenario has a low Glasgow Coma Scale (GCS) score of 8, which indicates a severe brain injury. The other options, NRB @ 15lpm, BVM with adjunct, and Narcan, are not appropriate in this situation as they do not address the underlying brain injury.

Explanation

The correct answer is DAI. DAI stands for Diffuse Axonal Injury, which is a type of brain injury that occurs due to shearing forces in the brain. The patient in this scenario has a low Glasgow Coma Scale (GCS) score of 8, which indicates a severe brain injury. The other options, NRB @ 15lpm, BVM with adjunct, and Narcan, are not appropriate in this situation as they do not address the underlying brain injury.

94. How can you treat hyperemesis gravidarum in the field? (After fluid boluses)

Zofran

Glucagon

Diphenhydramine

Sodium Bicarb

Per pg. 2038 you can give Zofran after Diphenhydramine if protocols allow; BUT Lauren's answer during scenarios and review of this was always Diphenhydramine.

Explanation

Per pg. 2038 you can give Zofran after Diphenhydramine if protocols allow; BUT Lauren's answer during scenarios and review of this was always Diphenhydramine.

95. Pain in the epigastrium that subsides after eating but returns 2 hours later. Presents as a burning or gnawing pain. Often accompanied by N/V, belching, fatigue. What does this describe?

PUD

Ectopic pregnancy

Esophageal stenosis

GERD

1185

Explanation

1185

96. After applying CPAP, it's important to monitor the pts BP because CPAP causes an increase in intrathoracic pressure which decreases _____.

After applying CPAP, it's important to monitor the patient's blood pressure because CPAP causes an increase in intrathoracic pressure. This increase in pressure can lead to a decrease in preload, which refers to the amount of blood returning to the heart. Monitoring the patient's blood pressure allows healthcare providers to assess the effectiveness of CPAP and ensure that the patient's preload is maintained within a normal range.

Explanation

After applying CPAP, it's important to monitor the patient's blood pressure because CPAP causes an increase in intrathoracic pressure. This increase in pressure can lead to a decrease in preload, which refers to the amount of blood returning to the heart. Monitoring the patient's blood pressure allows healthcare providers to assess the effectiveness of CPAP and ensure that the patient's preload is maintained within a normal range.

Submit

97. Contraindications for use of Lidocaine

AV blocks

V-tach

IVR

Inferior wall MI

V-fib

Lateral wall MI

Lidocaine is a medication used for local anesthesia and to treat certain types of abnormal heart rhythms. However, there are contraindications, or situations where it should not be used. AV blocks, which are abnormalities in the electrical conduction system of the heart, can be worsened by lidocaine and therefore it should not be used in patients with this condition. IVR, or idioventricular rhythm, is a slow heart rhythm that can also be worsened by lidocaine. Inferior wall MI, which refers to a heart attack affecting the lower part of the heart, is another contraindication for lidocaine use.

Explanation

Lidocaine is a medication used for local anesthesia and to treat certain types of abnormal heart rhythms. However, there are contraindications, or situations where it should not be used. AV blocks, which are abnormalities in the electrical conduction system of the heart, can be worsened by lidocaine and therefore it should not be used in patients with this condition. IVR, or idioventricular rhythm, is a slow heart rhythm that can also be worsened by lidocaine. Inferior wall MI, which refers to a heart attack affecting the lower part of the heart, is another contraindication for lidocaine use.

Submit

98. A pt with shoulder dystocia should be positioned how?

Supine with knees to chest

Trendelenburg with knees to shoulders

Supine with knees to shoulders

Trendelenburg with knees to chest

The correct answer is Supine with knees to shoulders. When a patient is experiencing shoulder dystocia, it is important to position them in a way that can help alleviate the obstruction. Placing the patient in a supine position with their knees pulled up towards their shoulders can create more space in the pelvic area and increase the chances of successfully delivering the baby. This position allows for easier access to the baby's shoulder and can facilitate maneuvers such as the McRoberts maneuver or the Woods' screw maneuver.

Explanation

The correct answer is Supine with knees to shoulders. When a patient is experiencing shoulder dystocia, it is important to position them in a way that can help alleviate the obstruction. Placing the patient in a supine position with their knees pulled up towards their shoulders can create more space in the pelvic area and increase the chances of successfully delivering the baby. This position allows for easier access to the baby's shoulder and can facilitate maneuvers such as the McRoberts maneuver or the Woods' screw maneuver.

99. Your pt was in an MVC and presents with labored breathing at 34 breaths per min, SpO2 at 84%, and paradoxical chest movement. You suspect a flail chest. How should you treat?

DAI

High flow O2 via NRB

Low flow O2 via NC

CPAP and Fentanyl

The correct answer is DAI, which stands for Definitive Airway Intervention. In a patient with a suspected flail chest, the primary concern is compromised breathing and oxygenation. Therefore, the priority is to secure the airway and provide adequate ventilation. CPAP (Continuous Positive Airway Pressure) can help improve oxygenation by keeping the airways open and increasing lung volume. Fentanyl, a potent analgesic, can be administered to manage pain associated with the flail chest. Therefore, the combination of CPAP and Fentanyl would be an appropriate treatment approach in this scenario.

Explanation

The correct answer is DAI, which stands for Definitive Airway Intervention. In a patient with a suspected flail chest, the primary concern is compromised breathing and oxygenation. Therefore, the priority is to secure the airway and provide adequate ventilation. CPAP (Continuous Positive Airway Pressure) can help improve oxygenation by keeping the airways open and increasing lung volume. Fentanyl, a potent analgesic, can be administered to manage pain associated with the flail chest. Therefore, the combination of CPAP and Fentanyl would be an appropriate treatment approach in this scenario.