Protocol Knowledge Exam (Intermediate/Paramedic)

53 Questions | Total Attempts: 134

SettingsSettingsSettings
Please wait...
Protocol Knowledge Exam (Intermediate/Paramedic)

Questions and Answers
  • 1. 
    A 44 year-old male bicyclist hit by a car.  Bystanders estimate the car's speed at 15 mph.  They state the patient was thrown onto the hood, starred the windshield and fell onto the concrete.  He was unresponsive for approximately one (1) minute.  The patient is belligerent and uncooperative with immobilization but is convinced to be transported. He refuses all medical care and will only allow transport. Each time you attempt c-collar placement he grows angry and threatens to jump out of the moving ambulance.
    • A. 

      Immobilize (only after medicating the patient)

    • B. 

      Do Not Immobilize

  • 2. 
    The current version of the Patient Care Guidelines (Protocols) went into effect:
    • A. 

      January 1, 2012

    • B. 

      January 1, 2014

    • C. 

      July 1, 2013

    • D. 

      They have not yet gone into effect

  • 3. 
    In a patient experiencing no obvious distress, only once oxygen saturation falls below ___ % should you deliver supplemental O2:
    • A. 

      98%

    • B. 

      96%

    • C. 

      94%

    • D. 

      99%

  • 4. 
    The EMS provider can always overrule a patient's hospital choice:
    • A. 

      True

    • B. 

      False

  • 5. 
    The following criteria must be met to consider termination of resuscitation (circle all that apply):
    • A. 

      Terminal rhythm - asystole

    • B. 

      5 minutes of ALS care

    • C. 

      Unwitnessed arrest

    • D. 

      Secured and confirmed airway

    • E. 

      Shockable initial rhythm

  • 6. 
    End tidal CO2 (capnography) reading less than ____ mmHg is indicative of cardiac death, even with adequate CPR:
    • A. 

      35

    • B. 

      50

    • C. 

      10

    • D. 

      100

  • 7. 
    How long should you delay pacing to allow pain medicine to take effect in an unstable bradycardia patient:
    • A. 

      Up to 10 minutes

    • B. 

      Up to 5 minutes

    • C. 

      Up to 2 minutes

    • D. 

      Do not delay

  • 8. 
    A STEMI patient with a blood pressure of 85/45 is most likely experiencing ________ shock:
    • A. 

      Cardiogenic

    • B. 

      Anaphylactic

    • C. 

      Septic

    • D. 

      Neurogenic

    • E. 

      Hemorrhagic

  • 9. 
    When following the “Chest Pain” protocol a 12-lead EKG should be obtained within ____ minutes of patient contact:
    • A. 

      10

    • B. 

      20

    • C. 

      Once in the ambulance

    • D. 

      30

    • E. 

      90

  • 10. 
    Once a STEMI is identified, scene time should be less than ____ minutes:
    • A. 

      60

    • B. 

      45

    • C. 

      90

    • D. 

      20

  • 11. 
    Under which of the following circumstances should Nitroglycerine be withheld (check all that apply):
    • A. 

      Patient use of Viagra shortly before EMS arrival

    • B. 

      Allergy to Nitroglycerine

    • C. 

      "It gives me a headache"

    • D. 

      ST elevation in II, III, and aVF (blood pressure 96/68)

    • E. 

      ST elevation in V1 - V3 (blood pressure 162/96)

  • 12. 
    ScenarioYou arrive on scene of a single family home and are directed by the patient's adult son to the bedroom.  You see a 72 year-old female short of breath.  The patient is sitting upright in obvious distress speaking in 2-3 word sentences.  She denies pain but vigorously nods her head in the affirmative when asked, "is it hard to breath"?  The son tells you she has had this sort of episode once before and "ended up on a ventilator".Meds: Metoprolol, Furosemide, Digoxin, Lisinopril, Synthroid, and AspirinVital Signs: P 122, BP 220/134, RR 30, O2 84% on room air, T 98.7 FPhysical Exam: tachycardic, tachypneic, lungs - coarse crackles to the bilateral mid lung fields, diaphoretic, lips pale_____________________________________________________________Which patient care guideline (protocol) is most appropriate to use:
    • A. 

      Asthma/COPD

    • B. 

      Congestive Heart Failure

    • C. 

      Supraventricular Tachycardia - Narrow QRS

    • D. 

      Cardiogenic Shock

  • 13. 
    Scenario (same as above)You arrive on scene of a single family home and are directed by the patient's adult son to the bedroom.  You see a 72 year-old female short of breath.  The patient is sitting upright in obvious distress speaking in 2-3 word sentences.  She denies pain but vigorously nods her head in the affirmative when asked, "is it hard to breath"?  The son tells you she has had this sort of episode once before and "ended up on a ventilator".Meds: Metoprolol, Furosemide, Digoxin, Lisinopril, Synthroid, and AspirinVital Signs: P 122, BP 220/134, RR 30, O2 84% on room air, T 98.7 FPhysical Exam: tachycardic, tachypneic, lungs - coarse crackles to the bilateral mid lung fields, diaphoretic, lips paleCardiac Monitor:The cardiac monitor represents:
    • A. 

      Supraventricular Tachycardia (SVT)

    • B. 

      Atrial Fibrillation (A-fib)

    • C. 

      Sinus Tachycardia

    • D. 

      Third Degree Heart Block

  • 14. 
    Scenario (same as above)You arrive on scene of a single family home and are directed by the patient's adult son to the bedroom.  You see a 72 year-old female short of breath.  The patient is sitting upright in obvious distress speaking in 2-3 word sentences.  She denies pain but vigorously nods her head in the affirmative when asked, "is it hard to breath"?  The son tells you she has had this sort of episode once before and "ended up on a ventilator".Meds: Metoprolol, Furosemide, Digoxin, Lisinopril, Synthroid, and AspirinVital Signs: P 122, BP 220/134, RR 30, O2 84% on room air, T 98.7 FPhysical Exam: tachycardic, tachypneic, lungs - coarse crackles to the bilateral mid lung fields, diaphoretic, lips paleThe intervention likely to help this patient most rapidly and thoroughly is:
    • A. 

      Defibrillation

    • B. 

      Duoneb

    • C. 

      CPAP

    • D. 

      Oxygen by nasal cannula

  • 15. 
    Scenario (same as above)You arrive on scene of a single family home and are directed by the patient's adult son to the bedroom.  You see a 72 year-old female short of breath.  The patient is sitting upright in obvious distress speaking in 2-3 word sentences.  She denies pain but vigorously nods her head in the affirmative when asked, "is it hard to breath"?  The son tells you she has had this sort of episode once before and "ended up on a ventilator".Meds: Metoprolol, Furosemide, Digoxin, Lisinopril, Synthroid, and AspirinVital Signs: P 122, BP 220/134, RR 30, O2 84% on room air, T 98.7 FPhysical Exam: tachycardic, tachypneic, lungs - coarse crackles to the bilateral mid lung fields, diaphoretic, lips paleCapnography will alert you to patient decompensation before pulseOx:
    • A. 

      True

    • B. 

      False

  • 16. 
    Appropriate medication for a patient in pulseless electrical activity (PEA) or asystole:
    • A. 

      Epinephrine (1:10,000) 1 mg IVP/IO every 3-5 minutes

    • B. 

      Atropine 1 mg IVP/IO every 5 minutes

    • C. 

      Adenosine 12 mg IVP, repeat x 1

    • D. 

      Epinephrine (1:1,000) 1 mg IVP/IO every 5 minutes

  • 17. 
    ScenarioYou arrive on scene at the local church for a 57 year-old male not conscious, not breathing.  As you make contact 40 bystanders have formed a circle around your patient with a family member performing CPR.  While setting up your equipment the man's wife frantically tells you, "He hasn't been feeling well all morning, he just turned to me and said I think I'm going to be sick and collapsed!"  She is unable to provide any further details.Meds: "something for blood pressure" but non-compliantVital signs: pulse not palpable, BP 0/0, RR agonal, PulseOx 40% on room airPhysical Exam: obese male unresponsive, skin still warm__________________________________________________________________Your first action in caring for this patient is: 
    • A. 

      Start an IV

    • B. 

      Place a supraglottic device for airway control

    • C. 

      Instruct the bystander to continue CPR until EMS can take over

    • D. 

      Tell the bystander to stop compressions while you prepare your equipment

  • 18. 
    Scenario (same as above)You arrive on scene at the local church for a 57 year-old male not conscious, not breathing.  As you make contact 40 bystanders have formed a circle around your patient with a family member performing CPR.  While setting up your equipment the man's wife frantically tells you, "He hasn't been feeling well all morning, he just turned to me and said I think I'm going to be sick and collapsed!"  She is unable to provide any further details.Meds: "something for blood pressure" but non-compliantVital signs: pulse not palpable, BP 0/0, RR agonal, PulseOx 40% on room airPhysical Exam: obese male unresponsive, skin still warmCardiac Monitor (same patient):What rhythm is shown on this monitor:
    • A. 

      Ventricular Tachycardia

    • B. 

      Atrial Fibrillation

    • C. 

      Asystole

    • D. 

      Second degree heart block

    • E. 

      Ventricular Fibrillation

  • 19. 
    Scenario (same as above)You arrive on scene at the local church for a 57 year-old male not conscious, not breathing.  As you make contact 40 bystanders have formed a circle around your patient with a family member performing CPR.  While setting up your equipment the man's wife frantically tells you, "He hasn't been feeling well all morning, he just turned to me and said I think I'm going to be sick and collapsed!"  She is unable to provide any further details.Meds: "something for blood pressure" but non-compliantVital signs: pulse not palpable, BP 0/0, RR agonal, PulseOx 40% on room airPhysical Exam: obese male unresponsive, skin still warmYou are unable to establish an IV, your options include all of the following for delivering Epinephrine (circle all that apply):
    • A. 

      Intraosseus (IO), double the IV dose

    • B. 

      Intraosseus (IO), same as IV dose

    • C. 

      ET tube, same as IV dose

    • D. 

      ET tube, double the IV dose

    • E. 

      Wait until reaching the hospital before administering any medication

  • 20. 
    Scenario (same as above)You arrive on scene at the local church for a 57 year-old male not conscious, not breathing.  As you make contact 40 bystanders have formed a circle around your patient with a family member performing CPR.  While setting up your equipment the man's wife frantically tells you, "He hasn't been feeling well all morning, he just turned to me and said I think I'm going to be sick and collapsed!"  She is unable to provide any further details.Meds: "something for blood pressure" but non-compliantVital signs: pulse not palpable, BP 0/0, RR agonal, PulseOx 40% on room airPhysical Exam: obese male unresponsive, skin still warmDespite repeated electrical shocks and appropriate use of epinephrine your patient remains in the same rhythm, your next step includes:
    • A. 

      Atropine

    • B. 

      Calcium Chloride

    • C. 

      Amiodarone

    • D. 

      Epinephrine at double the original dose

  • 21. 
    Scenario (same as above)You arrive on scene at the local church for a 57 year-old male not conscious, not breathing.  As you make contact 40 bystanders have formed a circle around your patient with a family member performing CPR.  While setting up your equipment the man's wife frantically tells you, "He hasn't been feeling well all morning, he just turned to me and said I think I'm going to be sick and collapsed!"  She is unable to provide any further details.Meds: "something for blood pressure" but non-compliantVital signs: pulse not palpable, BP 0/0, RR agonal, PulseOx 40% on room airPhysical Exam: obese male unresponsive, skin still warmYour patient finally changes rhythm after your eighth shock and displays the following on the cardiac monitor:  Your next medication includes:
    • A. 

      Magnesium

    • B. 

      Synchronized Cardioversion

    • C. 

      Lidocaine

    • D. 

      Repeat Epinephrine

  • 22. 
    Your treatment of a crushed patient requiring two hours of extrication include (circle all that apply):
    • A. 

      Sodium Bicarbonate after release

    • B. 

      Sodium Bicarbonate just prior to release

    • C. 

      Duoneb

    • D. 

      Epinephrine

    • E. 

      Ice packs to injured extremity

  • 23. 
    In the following scenarios you must decide if it is appropriate to immobilize the patient._______________________________________________________________An 18 year-old unhelmeted male involved in an ATV accident.  He was traveling at 30 mph, ejected, and according to his friend, was unconscious for about two (2) minutes. The patient has the smell of alcohol on his breath and admits to drinking but will not quantify.  He has definite short-term memory deficit and is repeating questions.  There is no obvious neurologic deficit but he has a six (6) cm deep laceration across his forehead.
    • A. 

      Immobilize

    • B. 

      Do Not Immobilize

  • 24. 
    A 34 year-old restrained driver involved in a two car MVC where his car was struck by a semi-trailer at approximately 40 mph.  The patient denies loss of consciousness and although his vehicle is badly damaged he was ambulatory following the incident. He complains of bilateral wrist pain but there is no deformity and the patient rates his discomfort at 2/10.  Vital signs and physical exam are unremarkable (except for mild tenderness to his wrists).
    • A. 

      Immobilize

    • B. 

      Do Not Immobilize

  • 25. 
    An 18 year-old female at a house party reportedly jumped from the second story balcony on a "dare". She landed on her back but nobody is certain if she hit her head.  The patient had not been drinking (yet) and has no focal neurologic complaint. Her friend says to your partner though "she's not acting right, she seems confused, and is definitely slower than normal."
    • A. 

      Immobilize

    • B. 

      Do Not Immobilize

Back to Top Back to top