Paramedic FISDAP Final

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1. A 30 year old climber is experiencing sever shortness of breath after reaching an elevation of 12000feet. The PT is very anxious and has rales noted to all quadrants but is otherwise healthy. He is not accustomed to high altitudes. What should you do?
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2. A 26 year old female does not respond to verbal stimuli but moans in response to pain. A friend states the patient has ingested approx 150 amitriptyline tables. Vital Signs are BP 88/50 R16. You establish IV access and administer a fluid challenge. En route to the hospital her ECG shows a widening QRS. You should administer
11. What is the most common cause of status epilepticus in adults.Failure to take prescribed medications12. A 58 year old male with history of renal failure complains of dizziness lethargy and difficulty breathing. He says he missed his last dialysis appointment. Vital signs are BP 160/90 P 100 R 28 with rales heard in the basses. SPO2 92% you should suspect.Fluid Overload.13. A 12 year old girl is seizing. Her mom tells you that her daughter has been feeling tired for days. Her skin is dry and she has been very thirsty. Vital signs are BP 118/80 P115 R26 you should suspect.Diabetic ketoacidosis14. A 42 year old female has fallen down a flight of stairs. She appears anxious her skin is cool and clammy her radial pulses are weak at 112 beats per min and she complains of abdominal pain in the left upper quadrant with radiation to the left scapula. You should suspect.Torn or lacerated spleen.15. Emergency medical responders are ventilating an apneic medical patient with a bag valve mask. You note abdominal distention and minimal chest rise. What should you do?Reposition the head.16. A 6 month old male was found lying face down in the crib. He is cyanotic and apneic. A weak brachial pulse is present. You are unable to see a chest rise with your second attempt at rescue breathing after repositioning the head. What should you do.Start CPR17. You have just been called to a dialysis clinic for a 58 year old male in cardiac arrest. The online physician may order you to administer which of the following medications.Sodium Bicarbonate.18. A 27 year old male has been assaulted with a pen in the supraclavicular area. He is anxious and pale and his vital signs are BP 80/42 P 128 R 32 and shallow. First responders have sealed the wound with a bandage. Assessment reveals lung sounds on the right and poor chest rise what should you do.Burp dressing19. A 50 pound child is unresponsive pulseless and apneic. The cardiac monitor displays ventricular fibrillations. CPR is in progress. The initial defibrillator should be at.50 joules.20. An 11 year old male has been skateboarding in 100 degrees temperature and has been drinking caffeinated soft drinks. He complains of palpations. The cardiac monitor displays a narrow QRS tachycardia at a rate of 160 beats. Vitals signs BP 110/60 P160 R 20 What should you do?Transport the patient by ambulance monitor closely and administer fluids en route.21. An 80 year old male in server respiratory distress. He has a history of hypertension and breathing problems. He takes inderal daily. Vital signs are BP 170/70 P72 and irregular R40 and extremely labored skin warm and diaphoretic. Lung sounds are diffuse bilateral crackles and wheezing. He coughs up blood tinged sputum. Which of the following is most important.Decreasing preload22. A 50 year old patient is found lying outside on the ground. The ambient temperature is 40 degrees F. You thermometer reads 20C 86F. He is in V-fib and pulseless and apneic. You shouldDefibrillate once perform CPR intubate and transport rapidly.23. To successfully accomplish nasotracheal intubation you should advance the endotracheal tube though the glottic opening to coincide with patientInhalation25. An alert 23 year old male presents with a sudden onset of shortness of breath and chest pain after running upstairs. Breath sounds are diminished in the right side. The most likely cause is.Spontaneous pneumothorax26. First responders are treating an apneic adult female. You notice that they are applying frequent long ventilations with an oxygen resuscitator. What effects with their actions create.Increased capillary elasticity.27. You are called to a nursing home on a hot summer day for a 88 year old male. The nurse tells you he missed his dialysis appointment because he was complaining of nausea vomiting headache and running a fever. Which differential diagnosis should you consider first.Sepsis and hyperkalemia28. You have just administered adenosine to a 62 year old patient with narrow complex tach. The ECG shows an irregular rate of 50 then steadily climbs back to a rate of 169. What would should suspectrapid atrial fibrillation.29. A 63 year old male is having a diabetic emergency . He is unresponsive R12 glucometer 28. You cannot establish IV access. You shouldadminister glucagon IM30. When setting up a night time landing zone for a helicopter what is the recommended area needed.100x10031. A 67 year old with hypo-tension and bradycardia has no responded to pacing or atropine. You shouldadminister dopamine infusion32. A 19 year old male has suffered blunt trauma on his left chest. He complains of server dyspnea and pain over the affected area. Vital signs are BP 92/60 P 128 R 32. Breath sounds are very diminished over the left chest. You shouldperform needle thoracostomy33. A 44 year old patient has a persistent cough and occasional spits up bloody sputum . He has been living in a a shelter for the past three weeks and he smells like alcohol you should.Put on N95 mask and eye protection.34. While treating a patient with suspected TB. What type of personal protective equipment is essentialHEPA respirator35. A 2 year old male has been sick over the last 48 hours with a low grade fever runny nose and upper respiratory infection. He has a seal bark cough. The patient is using accessory muscles to breath and appears fatigued his upper airway has stridours sounds. His lung sounds appear clear. SPO2 92% how would you treat the patient.Oxygen nebulized racemic epinephrine transport.36. 78 year old male lying unresponsive in his bed vital signs are BP unobtainable. R 12 and normal depth radial pulse rate matches ECG below ECG bradycardiaPerform transcutaneous pacing.37. A 48 year old patient is chocking on a hot dog. He is unresponsive apneic and has a strong pulse. Chest compression are infective at relieving the obstruction. You should.use lagosopy and magill forceps to remove the object.38. 87 year male is complaining of dizziness. Physical exam revals pale cool and diaphoretic skin. Pulse matches ECG bradycardia. You shouldadminister atropine39. A 14 year old patient was pulled form a indoor pool. She is pulseless and apneic. You shouldperform CPR endotracheal intubation establish an IV and administer epinephrine40. A trauma patient has lost approx 500ml of blood the amount of crystalloid solutions needed to replace this blood loss is1500 ml of saline ( 3 to 1 rule)41. A 43 year old female has been stuck in the chest with a baseball bat. There is a large bruise over her sternum. She is obversely in pain an states her heart feels like it is beating funny Vital signs are BP 109/80 P 124 and irregular R 22 The ECG show sinus tachycardia with ST elevation and frequent PVC's. You should suspectmyocardial contusion42. A 28 year female is speaking very quickly and stating that she is going see the president of the united states after she buys all her family members a new car. She has not slept in four days because she does not need sleep. She usually takes lithium but ran out of her prescription about a week ago . vitals 144/88 P 128 R 28 you should suspect.manic phase of bipolar disorder43. A restrained 23 year old pregnant female is her third trimester was involved in a head on motor vehicle collision. She complains of abdominal pain. initial vital signs are BP 110/70 P 90 R 20. After rapid extrication and spinal immobilization via long spine board her vital signs are BP 90/40 P 110 R 28 what is the most likely explanation for her change in vitals.Supine hypotensive syndrome44. A 3 month old infant who weighs 6kg has a history of congenital heart disease. Vital signs are R60 the ECG hows a narrow complex tachycardia at a rate or 240 cyandic nail beds and spo2 at 88% what should you administer.0.6 or adenosine IV45. A 44 year old male fell from a ladder and is now complaining of pain in the middle of his back at the level of his shoulders blades. He responds to verbal stimulus and vitals signs are BP 70/50 P64 R 20. The patient is most likely suffering fromneurogenic shock46. A 63 year old female chocked on a piece of steak and is apneic. You partner has visualized a partial obstruction in the trachea. He has been trying to grab it with forceps for more than 2 minutes. What should you advise him to do?Remove the blade and attempt to ventilate.47. An unconscious 13 year old patient has minor abrasion on his torso after being struck by a vehicle. The child's parents are not on scene law enforcement and an EMS supervisor are on scene You should?transport the patent to hospital48. A 38 year old female is crowing. You note the amniotic fluid contains a substance resembling pea soup. An apneic blue limp infant with a heart rate of 80 beats is delivers. How should you treat the infant.Suction with a bulb syringe and ventilate.49. A 56 year old female has a sudden onset of substernal chest pressure. She denies any shortness of breath or nausea. She has a history of arthrosporic heart disease and is talking verapamil. Vital signs are BP 160/90 pulse matches the ECG rhythm below R 16 skin warm and dry. and lungs clear bilateral. What should you do.Nitroglycerin50. A 64 year old is sitting in his living room in moderate distress. He is able to speak to you in full sentences but claims he is not feeling right. Vitals signs are BP 1110/64 R 16. Pulse matches monitor (super vertical tachycardia) what should you do.vagal fluids adenosine.51. Which I V will be able to administer the most fluid in the least amount of time.14 gauge 1/2 inch IV catheter.52. A 30 year old man is breathing fast and deep. He works at a preschool and believes that the children plan to harm him. Which of the following statement is most helpful when treating the patient.I understand that you are concerned. Can you tell me more about why you fell this way.53. A 67 year old man has collapsed and is on the floor. He is pale clammy and moaning with vomit around his mouth. Vital signs are BP 180/30 P110 and weak R28 and shallow. Oropharynx is clear and lungs are clear bilaterally. His ECG shows ventricular tachycardia. That should you do?Synchronized cardio100J54. You arrive at the scene of a single vehicle crash. A woman walks up to a your ambulance with a cut on her forehead. You shoulddetermine if she is the only victim55. A 73 year old male has several fractured ribs on his right side with unequal chest wall movement. He has dyspnea and diminished breath sounds on the right. Vital signs are BP 124/76 P124 R 26 and shallow. His trachea is mid line and neck veins are flat. Most likely hasa flail chest segment56. You have just converted a 318 lb cardiac arrest patient into a normal sinus rhythm. She is hypotensive and you have been ordered to start the an epinephrine drip at 3mcg/min using a 60 drip set. You have mixed a 4:1 concentration of epinephrine and should set the drip rate at45 drops/min (clock)57. You are assisting with a deliver and the infants head has been deviled. You notice the umbilical cord is wrapped around the infants neck. You shouldgently slip the cord over the infants head or clamp the cord in two places and cut between the clamps to release the cord.58. A 50 year old male is complaining of a chronic cough. He has lost his appetite and has had hot flashes and periods of sweating during the night. He has noticed some red specks in his sputum when he coughs. You should suspectTuberculosis59. A patient has surfaced rapidly from a deep dive and is now complaining of difficultly breathing and extreme muscle and joint pain. You shouldTransport rapidly to the nearest hyperbaric chamber.60. It is mid-December and a 13 month old child is awakened in the middle of the night with barking cough and inspiratory stridor. The child has been ill for a few days with chills and congestion. You should suspectcroup61. An 80 year old male has just collapsed. Vital signs are BP 90/40 pulse matches ECG 3 degree block R 20 What should you do?Apply transcutaneous pacing.62. A patient involved in a motor vehicle crash has an obvious open femur fracture and an angulated right forarm. He is bleeding servery from a scalp laceration. His left arm is guarding his chest and he gasps "i cant breath". You should be MOST concerned by therespiratory difficulty63. A 37 year male is chocking and has become unconscious. Attempts to ventilate are unsuccessful. you shouldperform chest compressions64. An unconscious 78 year old male post cardiac arrest is being actively ventilated with a bag valve mask. Initial vitals are BP 98/40 P 82 and irregular. After several minutes reassessment of vital signs are etco2 22 BP 68/28 and irregular spo2 92 you shoulddecrease the rate of respirations65. An 86 year old female presents with a rhythm in the ECG she is immobile due to server arthritis and has a history or atherosclerosis and hypertension. What should you suspectLeft ventricular hypertrophy LVH66. A 37 year old suicidal male is bing violent. Police has pinned him in a prone position but he continues to struggle and fight. You shouldsedate the patient and place him supine on the stretcher in soft restraints67. The termination of pregnancy for maternal health reasons is called atherapeutic abortion68. While using the START system at a major incident you encounter a patient not breathing. After positioning the airway the patient breaths 16 a min. You should catagorize him as?Immediate69. You are transporting the victim of a major trauma which occurred yesterday to a larger facility. This patient has been experiencing progressive hypoxemia. You hear coarse crackles blatantly during auscultation of the lungs and the pulse oximetry reading is falling in spite of the patent being intubated. You should suspectthat acute respiratory distress syndrome has developed70. A 19 year old female is 25 weeks pregnant. She has server headache blurred vision and edema she has not regularly seen a doctor during her pregnancy. What other symptom should you expect.hypertension71. Which of the following is a cause of multifocal atrial tachycardiaElectrolyte imbalance72. After receiving Narcan. A patient is waking up quickly and pulling at the airway you have placed. Before removing it you shouldprepare to begin suctioning73. A 66 year old male complains of server dyspnea. His has breath sounds on the right and diminished on the left. He has a long history of cigarette smoking. Vital signs are BP 80/30 P124 R 26 and shallow SPO2 88% on 4 lpm What should you suspect?Emphysema exacerbation74. A patient is complains of left calf pain. The left leg is cool to the touch and paler than the right leg. You should suspectArterial occlusion75. After placing a combitube bilateral breath sounds are present and chest rise is equal. You notice quiet gurgling in the stomach with each ventilation. You should.add air to the distal cuff76. A seven month old is breathing at a rate of 60 per min. He has nasal flaring and intercostal retractions . You hear stridorous noises on inspiration . This is most likely caused by aforeign body obstruction the upper airway77. A 28 year old suffered a head injury. Vital signs a BP 140/120 P 55 R 30 and irregular. Which of the following signs would you expect to see in this patient.Decerebrate posturing78. During transportation you PT becomes very upset complaining about her medical expenses. How should you respond?You seem angry is there any way hat i can help79. Which of the following pharmacological agents are most likely to cause premature arterial contractions.stimulants80. You are dispatched to a house early on the morning for a family complaining of headaches and nausea. You shouldevacuate the house.81. A patient is threatening suicide because his wife left him. Which of the following statements or questions would be appropriate?What method had you intended to use to kill yourself82. A 44 year old male complains of extreme fatigue headache and fever with pain in this right upper quadrant and joints. He admits to a history of alcoholism and smoking two pack per day for the past 20 years his skin and sclera are yellow in color. You should suspecthepatitis83. A patient was just pulled from a burning building. You have started oxygen and initiated transport. While en route to the hospital you notice singed hairs around his face and a spot around his nose and mouth.. He is coughing up black sputum mixed with blood and shows signs of increasing hypoxia. Which developing condition is your biggest concern.Laryngeal edema84. A 65 year old female complain of sudden onset of server migraine headache. Vitals signs are BP 140/90 P 120 R 22. She has been non complaint with her prescribed imitrex. You should administermorphine85. Which of the following will cause a patient with a tension pneumothorax to become hypotensivean increase in intrathoracic pressure86. A 23 year old male complains of chills and headache. He was sleeping outside before waking up with these symptoms. He has a reddish ring with a small fluid filed vesicle in the center on his arm. What should you suspectSpider bite.87. Which of the following is most important when document a patient refusalThe patient's mental status88. You have orally intubated an adult pt and are evaluating the tube placement. You hear auscultation sounds over the epigastrium and an absence of breath sounds over the right and left chest. You shouldremove the ET and ventilate the patent with a bag valve mask89. Your elderly patent is supine. She complains of labored respirations. She is cyanotic and has a history of CHF vitals signs are BP 230/100 P120 R 36 What lung sounds would you expect to hear.Crackles90. You are treating an unresponsive elderly male from a nursing home. He has a surgical incision on his right hip that is is red and warm to the touch. You notice widespread deep purple bruising on his body. Vitals sings are BP 80/40 P116 R 10 spo2 89%. You should suspectdisseminated intravascular coagulation91. When arriving on a potential HAZMAT incident on the highway you should stage the emergency apparatus.Uphill and upwind92. After delivery of a newborn she cries weakly with stimulation and moves all extremities P140 R 18 and irregular her body is pink but the extremities are blue. What is her APGAR.7-893. A 21 year old male is intoxicated he was struck in the head with a bat 3 hours prior to arrival. He has suddenly began acting aggressive towards his friends. A police officer on scene states " i want to arrest him" you shouldsuspect hypoxia and head injury and transport the patient to a hospital94. A 5 year old has a sudden onset of high fever score throat and pain on swallowing. His voice is muffled and he is drooling. You should suspectepiglottis95. A 19 year old intoxicated female is distraught after being involved in a MVC she is complaining of pain in her head and multiple superficial facial lacerations. Vitals 88/40 P 128 R 28 you should suspectneurogenic shock or Hypovolemia do to bleeding from other injury's96. You are working during inclement weather in a remote location. The nearest hospital is more than two hours away. Your patient just delivers a healthy baby boy but has inverted her uterus. What orders you expect from an online physicianReplace the inverted uterus with a gloved hand97. A 67 year old female with a history of diabetes complainants of nausea and began vomiting an hour ago. She denies any pain her blood glucoses is 208 her skin is cool and pale vital signs are BP 146/88 R 24 P 126 and irregular. What should you suspectMyocardial infarction98. A 34 year old female crashed her motorcycle while wearing an open face helmet. She is unconsciousness her facial bones and soft tissue are missing from the nose to the upper part of her neck. You are having difficulty ventilating her and you can see bubbles coming from the center of a large mass of tissues when she exhales. You shouldinsert an ET at the site of the bubbles99. A 14 year old female is crying and complain of knee pain after a soccer injury. The knee is deformed and obviously angulated. Distal pulses are intact. You shouldapply ice split in position found and transport100. A 53 year old man fell from a ladder. he has multiple abrasions and localized swelling on his head. You have oratorically intubated him. His ETOC2 is 30 his pupils are midpoint and reactive how many times per minute should you ventilate10102. A patient involved in a fist fight. He complains of point tenderness in the right upper abdominal quadrant. You should suspect injury to theliver103. Successful intubation of a newborn is more successful by placing padding under theshoulders104. For the past 5 min you have been providing ventilations to an intubated patient and performing CPR it is becoming progressively more difficult to ventilate and the chest is moving less during inspiration. What should you suspecttension pneumothorax105. An elderly pt is complaining of dyspnea that woke her from sleep about an hour ago. She denies chest pain. Auscultation reveals wheezing and crackles in both lower lobes of her lungs. Vitals signs are 158/108 P 128 and irregular R 32 and slightly labored what should you administeralbuterol106. A 59 year old pt is lethargic with shallow respiration he has a valid DNR order during transport his respiratory rate diminishes to 8 breaths a min you shouldbegin assisting with a bvm107. a 89 year old nursing home pt is in respiratory distress. She is on 3 lpm of oxygen by nasal cannula. She has a history of COPD asthma and diabetic and you note wheezing in all lung fields. Vitals BP 146/84 P 114 R 24 you shouldplace her on 15 lpm or oxygen via nonrebreather mask108. you are performing Orotracheal intubation with a mac blade. You can see the cords when you notice the top of the blade is in the vellicula you shouldpass an ET through the cords109. A confused 34 year old male is ambulatory ofter crashing his car. Airbags were deployed he complains of extreme wrist pain and double vision . You note deformity and superficial burns on his writs what should you docspine110 A patient with server closed head injury vitals 180/112 P 48 R 8 and irregular immediate treatment should includeintubate and ventilate at 20 breaths per min110 A 22 year old pregnant patient is experiencing a significant amount of painless bleeding shorty after sexual intercourse. The most likely cause isplacenta previa111. An elderly patient has been ill for last few days and has been vomiting. He reports chest discomfort and is now pale and diaphoretic. Vitals BP 130/70 R24. ECG shows (afib RVR) You administer oxygen and now have an IV you should.Fluid bolus112. Signs and symptoms of hypoglycemia may mimic which of the following conditionsCVA113. A patient complains of server right upper quadrant pain. Right scapula pain and nausea after eating a cheeseburger you should suspectcholecystitis114. Your patent is suffering from exacerbated emphysema which of the following medications is least likely to be a part of his standard therapynitrates115. A 7 year old has a suspected broken arm and numerous bruises what finding would lead you to suspect that a mothers account of the injures may not be true.You note purple yellow and green bruises ( indicates different stages of healing)116. A 19 year old female collapsed in the top bleaches during a concert. She is unresponsive and does not appear to be breathing. how should you asses her respiratory status?place a hand on the chest117. Followng a cardioversion of a 72 year old female she coverts to the rhythm bellow ( 3 degree) you identity this asthird degree heart block118. A 13 year old has been found unresponsive. Her mother proves you with a prescription bottle of Oxycontin. What should you give?narcan119 A man was involved in a lateral impact auto accident that deformed the vehicle. The patient could have sustained a?traumatic aortic dissection120 You are assisting with vaginal delivery. The infant head has been delivered and the mouth and nose suction. To deliver the anterior shoulder you shouldgently guide the infants head downward121. A 22 year old female 22 weeks pregnant is experiencing abdominal discomfort during evaluation you notice the umbilical cord is pressing the vaginal canal. How should the patient be positionedsupine with legs open122. Which of the following situations constitutes abandonment?A patient is unattended in the ambulance while loading a second patient123. A patient is arching his back and rolling his eyes upward. He was recently prescribed compazine. How should you teat this patient?25 mg benadryl IVP124. A 38 year old male has been sick for a few days he is now complaining of sharp mid chest pain vitals 118/69 pulse 124 and regular and R 24 and slight laberod temp 102. You should suspect?pericarditis125 46 year old male is alert oriented and complains of a headache. He has tremors in his hands he has been in the detox unit for 32 hours . Vitals signs are BP 210/100 P100 R 25. He has a history of alcoholism and seizures. He takes tegretol you should administer20mg diazepam126. You are reliving a crew form a 24 hour shift before you compete the ambulance check you are dispatched to a cardiac arrest with CPR in progress. what should you do before leaving for the call?ensure essential equipment is present and the ECG monitor is functional127. A pregnant patient is experiencing contractions upon examination you notice that the infantst head is bulging from the premium and the patent has the urge to push what stage of labor is this?two128. you are dispatched to a playground for a patent with difficulty breathing. Upon arrival you find a five year old male who appears anxious with noted cyanosis and intercostal retraction BP 85/pb P112 R24 with swelling of the upper airway. You should suspectanaphylaxis129. A 28 year old female is 34 weeks pregnant and experiences sudden sharp tearing pain in her abdomen and developers a rigid abdomen what should you suspectabruptio placenta130. After a prehospital delivery the mother should be allowed to breastfeed her newborn becausebreast feeding helps constrict the uterus and reduce bleeding131. A two year old male has been ill for several days with a respirator tract infection. Yesterday he developed server headache high fever and extreme lethargy. You should suspect.meningitis132. When starting an external jugular IV the needle should pointtoward the feet133. while using the backwards upward right pressure BURP maneuver during an orotracheal intubation you patient begins to vomit. What should you do?Stop the intubation attempt and suction134. You have just assisted with the delivery of a 32 week old infant. She is apneic and has a pulse of 64. What should you do?open the airway ventilate with a bag valve mask for 30 seconds and reassess135. During a yearly heath screening a clinic discovered your patient has the heart rhythm shown below (bradycardia). She alert and oriented but scared because the clinic call for an ambulance Vital signs bp 114/50 R12 spo2 99%. You should administeratropine136. A 18 year old male was 40 miles into a long distance bike race when he had a syncopal episode and fell off his bike. He responds to painful stimulation BP 60/40 P160 skin cool and diaphoretic. You should administer?lactated ringers137 An 18 year old male suffered second degree burns to his entire head and neck anterior chest and both arms while removing a radiator cap from his overheated engine. Using the rule of nines what percentage of his body is burned?36%138 You are unable to ventilate a trauma patient with extreme facial trauma using advanced airway maneuvers. You shouldinsert a 14 g needle in cricothyroid membrane 45 degree angle.139. Which of the following is a prehospital medication given for compartment syndromesodium bicarbonate140. which of the following would be an indication for the use of needle cricothyrotomy?Inability to ventilate141. A pale diaphoretic patient complains of chest pain at a level of 6 on 1-20 BP 132/88 you see the following ECG (ST elevation) You have established oxygen and an IV you should give?ASA and admin nitroglycerin142. Identify this rhythmpaced rhythm143 A 25 year old female was bitten by something while hiking 12 hours ago. She has slurred speech double vision and excessive salivation her boyfriend states she had a seizure about 20 min ago. You should:thoroughly wash and immobilize the wound and start an IV144. An obese 77 year old woman called EMS complaining of dyspnea cough with hemoptysis and diaphoresis. You note tachypnea tachycardia crackles and wheezing. She also has varicose veins. Find significance differences in BP between the right and left arms. You should suspect.aortic aneurysm145. A 76 year old patient is lying in soiled sheets with diarrhea and vomit . Both the stools and emesis look thick black and tarry similar to coffee grounds What should you suspect?upper gastrointestinal bleeding146. Your 3 lead ECG is shown below. You correctly identity the rhythm as?1st degree147. A six year old female has suffered blunt trauma to her right upper quadrant . She responds to painful stimulation vitals signs 50/30 P132 R 32 she is in?hypovolemic shock148. You are first on scene of a crash. Where should you park your the ambulance to block traffic149. A 50 year old male at a mountain resort has begun to experiencing shortness of breath headache and dizziness. Lung sounds reveal inspiratory crackles. You should suspecthigh altitude pulmonary edema150. A seven year old is having difficulty breathing. He is lethargic with central cyanosis and poor muscle tone. Vitals Signs are P 70 and R 10. You should suspect?Respiratory failure151. An 84 year old male has extreme difficulty breathing apprehension cyanosis and diaphoresis. Assessment findings include elevated pulse and blood pressure and rales and rhonchi you should treat this patient for?left ventricular failure152. Online medical direction has ordered you to administer 13 mcgkf/min of dop to a patient who weighs 190lbs. Your concentration of dopamine is 1600 mc/mi you are going to administer this through a Micro-drip tubing. At how many drops per minute should you set the IV infusion42 gtts/min153. You have just given a bolus of dextrose to an unconscious female patient with a blood glucose level of 30 . The repeat blood glucose level is now 120. She is now alert and oriented and she refuses further treatment of transport. What should you do?ask a neighbor to monitor the patient after you leave.154. Ten workers were exposed to fluorine gas fumes but only two exhibit symptoms. One additional worker was exposed to hydro-fluoric acid on his skin. He is being decontaminated with water by the company's response team. Two ambulances are on scene . You should plan and prepare to?order a full scale mass casualty response including eleven ambulances and additional fire and law enforcement agencies155. A 54 year old male has fallen and is holding pressure on his abdomen with bloody kitchen rag. He has had abdominal surgery last week and his incision has ruptured and the abdominal contents are protruding. Vitals are BP 100/68 P 124 R 20 what should you do?remove the rag apply a moist sterile dressing156. You have just been stuck with a blood contaminated needle. You should you immediately deal with the exposure?wash the affected area with soap and water157. A container of hydro-flouric acid has spilled at a local metal plant. The hazmat team is responding and you are asked to stage at the front gate of the business where the company safety manger is waiting for you. What info would ou expect his manger to havematerial safety data sheet MSDA158. A 33lbs child is experiencing fever poor appetite purpura and vomiting. His cap refill is 3 seconds he is tachycardic you should administer300ml of crystalloid solution159. Your crew is the first unit to arrive for a suspected radiation emergence after a box labeled recitative material was found unattended in a park. What three principals should you follow?time distance and shielding160. A 19 year old male has suffered a significant blunt trauma to his left anterior chest. He is in obvious respiratory distress vital signs are BP 80/p P 140 R 32 lung sounds are diminished and there is dullness to percussion over the left side of the chest. You should suspecthemothorax161. Side effects of oral contraceptives includepulmonary embolism and stroke.162. You are first on scene of a car crash. You partner stops the ambulance a safe distance from a single vehicle that crashed into a concrete barrier. Black smoke is coming from underneath the hood. The vehicles only occupant screams for assistance you should?rapidly extricate the occupant without a cervical collar163. A 50 year old female is experiencing chest pressure her ECG is ( sinus tack) she becomes unresponsive while you are obtaining iv access her ECG changes to the rhythm below. What should you do?asses for a pulse164. A 50 year old female is experiencing chest pain then goes into ventricular fibrillation. What should you do?Defibrillate165 The medications prepreanolol atenolol and metoproloe are examples of?beta adrengic blockers165 A 17 year old male alert was struck in abdomen with large wrench vitals 90/78 P128 weak R 22 skin is pale and cool and diaphoretic. The abdomen is bruised and rigid you should?rapidly transport to a level one166. A 14 year old male is found in an intoxicated condition. His friends report he admitted to drinking alcohol taken from his fathers workshop. The container is marked methanol not for human consumption. Definitive treatment for his condition is administration ofethanol167. A 74 year old patent is short of breath he has had a slight fever since yesterday and he suffers from frequent urinary track infections. Lung sounds are present with rhonchi and slight crackles in all fields. Vitals 110/80 P100 R30 temp 102 you should suspect?pneumonia168. The ECG of a post cardiac arrest adult shows sinus tachycardia at a rate of 120 with bp 60/40 you should give?dopamine 5-20169 One year old has been ill with multiple episodes of emesis and diarrhea. Asses shows a lethargic 35 pond child who has mottled skin dry mucous membranes cap >2 sounds P 220. After securing airway you providing high consultation oxygen and establishing an IV you should?give 320 cc fluid bolus170. A 79 year old female complains of labored respirations she is cyanotic and has a history of CHF identify the following rhythm (sinus tach) and appropriate treatmentsinus tachycardia administer nitroglycerin171. A patient who complains of pain in left upper quadrant is most likely suffering frompancreatitis172. A 28 year old woman complains of sudden onset severe abdominal pain that radiates to her shoulder 88/60 P 100 R 20 skin cool pale and clammy states her last menstrual period was 8-10 weeks ago you should suspectectopic pregnancy173. You have just fished a stressful shift. you are frustrated and angry with how some of your calls resolved you shouldtalk to an internal critical incident stress counselor174. A 78 year old female is lying supine in an nursing home bed with labored respiration she is semi-conscious cyanotic and the nurse tells you she has a history of CHF 80/40 spo2 90 pulse is ventricular tachycardia you should?perform sync cardiovert175 An adult has a foot laceration from a farming accident he is alert and refusing treatment his religious beliefs do not permit medical you shoulddocument the patient wishes176. A 50 year old female tripped down four steps. Her airway is patent radial P 100 R 16 what other initial information do you need to decide if she is unstable?mental status177. Management of all newborns includesprevent heat loss opening the airway and evaluating of the infant178 A 6 year old female has suffered blunt trauma to her upper right quadrant she responds to painful stimulation BP 50/30 P110 you should most likely suspect damage to her?liver179 A 12 lead show 4mm of ST elevation in leads II III and avf you should suspect?an inferior wall MI180. A 58 year old male is complaining of swollen legs and feet and increased heart rate. you note distended neck veins and abdominal distention you should suspectright sided heart failure181. In what hazardous material zones does triage and treatment occurcold182. An 87 year old patient with recent history of hematuria and lower abdominal pain now presents with altered mental status her physical exam is otherwise unremarkable. She is resident of adult foster home. A likely cause is?urinary tract infection183. A 26 year old male is experiencing dyspnea after being struck in the chest during a bar fight. He has a history of asthma and has taken his inhaler without relief he has busing to the right side of the rib cage with crepitus P128 R24 with clear bilateral lung sounds spo2 86% what should you do?assist ventilations with a bag valve mask184 You have just intubated and adult and you have been successful you hear no sounds in epigastric and equal lung sounds you should?attach etco2 monitor185. A 50 year old female has just been struck by a car she is alert and complains of shortness of breath. You note crepitation and paradoxical movement in her right chest R 26 spo2 89 you shouldaugment ventilation with positive pressure186. While treating a patient for a cardiac event, you forget to administer aspirin. The patient suffers a MI and subsequently dies. The family is suing you for negligence, which element of negligence still needs to be proven?proximate cause187. A patent has sustained a soft tissue injury to the face you main concern is?managing the airway188 Your partner started an IV and dropped the needed. The exposed needle is wedged between the stretcher bracket and crack on the tile you should?use a needle nose clap to properly dispose of the needle189. Which of the following medication is most likely to be prescribed for a server resp conditionsipratropium190. You should use lactated ringers and normal saline if you goal is to deliver aisotonic what will remain in the intravascular space longer than other crystalloids191. You have been assigned to triage at an MCI a patent complains of small laceration on his forearm R24 and absent radial pulses using start triage you should assign this person as?immediate192. A 26 year old female has been involved in an explosion at a chem lab. She has first and second degree burns to her face. Witnesses state that her shirt had been on fire and stopped burning you should suspect?extensive airway burns193. A 3 year old female has surfed burns to both her hands after grabbing a hot exhaust pipe the injured area shows dark chard skin. These burns should be considered?critical194. A 200 pound woman is having difficulty breathing which of the following devices is most appropriate for carrying her down stars.?stair chair195 A patient has polymorphic ventricular fibrillation you would give?mag196 A 65 year old female is short of breathe clear lungs and no jvd she has a significant cardiac history what should you admin?oxygen and 12 lead197 An 18 month has a seizure for first time and according to the parents she has become increasing ill over the last few hours and her current temp is 104 they describe the patent arms curling toward her chest and her legs straightening and pointing together. The parents do not want to go to the hospital tonight. You should?have the parents speak with an online physician198. A 44 year old female has sustained server blunt trauma to the chest she responds to painful stimulation and her vitals are 88/76 P 130 R 24 muffled heart sounds and flat neck veins. The definitive treatment for this patient ispericardiocentesis199. A 12 year old becomes ill yesterday and has become progressively sicker. His temp is 103F and he has small specks on his chest the patient appears to be unable to turn his head you should suspect?meningitis200 A 65 year old male with emphysema is sitting in a chair he is lethargic and struggling to keep his head up his skin is ashen vital sings a {P 134 R 30 and shallow what should you do?assist ventilation with a bag valve mask