Block 9 (Test 2023) PTI
Block 9 (Test 2023) PTI
Block 9 (Test 2023) PTI
1) A 19-year old male was involved in a motor vehicle collision. The steering
wheel created a large contusion on his right upper quadrant of the abdomen.
What is most likely to be injured?
A. Bladder
B. Stomach
C. Spleen
D. Liver
2) You respond to the home of a 2 y/o male with difficulty breathing. On arrival,
you note an alert toddler with supraclavicular retractions, and stridor. His father
reports 2 days of fever and cough for the child, with difficulty breathing for 1
hour. HR is 140, pulse oximetry is 97%, and the patient measures 13kg by length-
based resuscitation tape. Which of the following treatments should be initiated?
5) You respond to the home of a woman who has just delivered. She states that
she was approx. 18 weeks pregnant. Your care should include:
A. Assess the fetus for gestational age and contact base if no palmar creases
B. Determine death since 18 weeks gestation is no viable
C. Assess the fetus for signs of life and begin resuscitation if present
D. Ascertain how the patient knew that she was 18 weeks pregnant
BLOCK 9
6) Examples of situations that must be reported to appropriate local/state
authorities include all the following EXCEPT:
A. Alzheimer's disease
B. Depression
C. Bipolar disorder
D. Schizophrenia
8) You have a 200# pt. The base hospital has ordered a medication at 0.1
mg/kg IP. You will administer:
A. 1 mg
B. 100 mg
C. 0.10 mg
D. 10 mg
A. The paramedic should wait 2-3 minutes before administering the next
medication
B. The paramedic should close off the IV tubing to let the medication circulate
C. The line should be flushed with 10ml of NS prior to administration of the next
medication
D. The line should be flushed with 100ml NS prior to administration of the next
medication
BLOCK 9
11) The 1st stage of the grieving process is:
A. Denial
B. Bargaining
C. Anger
D. Depression
12) The elderly trauma patient is at higher risk for fluid overload and pulmonary
edema as a result of intravenous fluids therapy due to a decrease in:
A. Chronotropic agent
B. Beta agent
C. Alpha stimulating agent
D. Inotropic agent
14) You respond to a 70 y/o female complaining of being light-headed and dizzy.
She is oriented. Skin vitals are pale and diaphoretic and lungs are clear. Vital
signs are: BP 84/56; monitor shows Sinus Brady at a rate of 46 regular, RR 14,
with poor tidal volume and 02 saturation of 88%. You should administer high flow
oxygen, an IV and:
A. Sinus Tachycardia
B. Sinus Arrhythmia
C. SVT
D. Atrial flutter with 2:1 block
BLOCK 9
16) If you are looking at lead II and the ventricle is depolarizing in an antegrade
path, on the EKG you will note:
A. A difference in morphology
B. Narrow QRS complex
C. An upright deflection
D. A retrograde deflection
17) Using a blood pressure cuff that is too large for the patient's arm will result in
a reading that is
18) You respond to a 3 y/o male whose parents state he had a seizure prior to the
arrival of the ambulance. He is awake but drowsy and is very hot to the touch.
You should:
A. Hypothermia
B. Hypocalcemia
C. Hyperkalemia
D. Cerebrovascular accident
20) Dilated veins that occur in the submucosa of the lower esophagus of cirrhotic
patients and may extend into the upper esophagus and/or stomach are called:
A. Hemorrhoids
B. Peptic ulcers
C. Esophageal varices
D. Diverticula
BLOCK 9
21)Your patient has the right to make decisions regarding their medical
care. This statement defines:
A. Altruism
B. Values
C. Autonomy
D. Ethics
A. Hypoglycemia
B. Polyuria
C. Breakdown of fatty acids
D. Weight gain
A. Diarrhea
B. Seizures
C. Ventricular tachycardia
D. Tonic motion of neck
24) You are called to the home of a 26 y/o male c/o trauma to his right forearm. He
states his forearm was trapped for 20-30 min under heavy equipment approx.. 3
hrs ago. On exam there is no deformity or crepitus, but you note tense swelling to
forearm, and pain in the forearm when you attempt to move his fingers for him.
This presentation is most consistent with a
A. Crush syndrome
B. Peripheral neuropathy
C. Compartment syndrome
D. Wrist sprain
25) Which drug is most likely to produce bradycardia and hypotension as adverse
effects:
A. Dopamine
B. Epinephrine
C. Amiodarone
D. Atropine
BLOCK 9
26) The maximum age for which patient must be transport to a pediatric
facility(EDAP, PMC or PTC) in LA County is
A. 16
B. 18
C. 12
D. 14
A. older people lose their ability to reason due to the aging process
B. medication doses must be increased to compensate for poor liver function
C. the elderly have an increased risk for fractures
D. Alzheimer's disease is a normal progressive effect of aging
A. Renal failure
B. Blindness
C. Neuropathy
D. Arthritis
30) You respond to a 53 y/o male c/o headache, blurred vision and weakness to
his left arm for the past 2 hrs. Vital signs are 180/100, P 90, R 16 and fingerstick
glucose is 345. This patient is most likely experiencing:
A. Diabetic ketoacidosis
B. Petit mal (partial) seizure
C. Cerebral vascular accident
D. New onset Multiple Sclerosis
BLOCK 9
31) According to LA County Ref No. 408; staffing on a public or private ALS unit:
A. Can be staffed with 1 paramedic in areas with run volume of less than 3 calls
a shift
B. Can be staffed with 1 paramedic and 1 EMT if one of the paramedics becomes
ill
C. Must be 2 paramedics at all times
D. Is at the discretion of the provider agency
32) You arrive to a primary care clinic for a pt with a witnessed cardiac arrest.
Clinic staff started CPR immediately and the pt was successfully defibrillated by
AED just prior to your arrival. On your evaluation, pt is lethargic, BP 110/62, HR
64 and irregular, RR 10, 02 saturation is 95%. Monitor shows NSR with frequent
PVCs. Clinic staff report the pt has a history of diabetes and hypertension. Blood
glucose is 85 and pupils are dilated. There are no other abnormalities on your
exam. The most appropriate next therapy for this pt would be:
A. Atropine 0.5mg IV
B. D10W 250mL
C. Transport with BMV
D. Narcan 2mg IV
33) You respond to a pt c/o shortness of breath. The pt is alert and oriented with
pale, warm, dry skin. He c/o moderated mid-sternal chest pain. Monitor shows a
wide complex tachycardia at 110 bpm. 12-lead ECG is as follows... In addition to
establishing an IV you would:
34) You respond to a grocery store parking lot to find a 4 y/o girl who is drowsy,
confused and poorly responsive. The mother states the child was left in the car
while she "ran in to get a few things". Outside are temp is 98 degrees. On
assessment BP 65/40, HR 120 weak and thready, R 32 with good tidal volume.
Blood glucose is 65 and her skin is warm to touch, flushed and dry. Appropriate
therapy includes:
A. Convince child to drink 1 cup apple juice. Place IV if not able to take PO fluids
B. Normal saline 10ml/kg in 250ml increments, Domaine or Push dose Epi after
IV fluids
C. Remove hot clothing and apply cool west towels. Administer IV NS
D. Contact police to arrest the mother. Administer D10W while awaiting the police
arrival.
BLOCK 9
35) After getting punched in the face, a pt. c/o loss of vision in one eye w/out
pain. The most likely injury is:
A. Intercranial hemorrhage
B. Acute glaucoma
C. Retinary artery occlusion
D. Retinal detachment
36) A 24 y/o male with history of diabetes c/o muscle weakness, dizziness and
incoordination after playing soccer. He is pale, cool and diaphoretic. You should
first evaluate for:
37) In a bed-ridden pt with fractured hip, sudden chest pain and dyspnea w/clear
lungs on auscultation would suggest which of the following:
A. Asthma
B. Pulmonary edema
C. Pulmonary embolus
D. Pneumonia
38) High potential for hypovolemia when associated with traumatic injuries would
arise from the following injuries EXCEPT:
39) An 82 y/o male fell and sustained multiple rib fractures. He is in significant
pain and doesn't want to take a deep breath. He is at increased risk to develop a
pH of
A. 7.30
B. 7.60
C. 7.50
D. 7.40
BLOCK 9
40) When dealing with a hostile or aggressive pt, you should
A. lace hand on shoulder and state "you appear upset, can I help you?"
B. restrain the pt with gauze bandages
C. place the pt between you and the nearest exit
D. attempt to talk with pt in a non-threatening manner
A. cardiac tamponade
B. ascites
C. ectopic pregnancy
D. pelvic inflammatory disease
42) The most reliable sign of early hypovolemia in the pediatric pt is:
A. Electric shock
B. Drowning
C. Heart attach
D. Respiratory failure
45) You are treating a 12 y/o female involved in a minor traffic collision. The
patient's mother requests that the pt be transported to their HMO hospital that is
12 min away, the paramedic captain wants the pt to go to the nearest EDAP that is
7 min away, the base hospital wants the pt transported to the Pediatric Medical
Center that is 14 min away. According to LA County Ref. 502 (patient destination):
A. Expiration
B. Flail chest
C. Inhalation
D. Collapsed lung
A. EKG rhythm
B. Pupillary response
C. Level of consciousness
D. Muscle activity
49) All of the following are possible adverse effects of a medication EXCEPT:
50) Which of the following statements best describes micro-drip tubing and
identifies its use:
51) You have established an IV and 02 on a 58 y/o male c/o chest pain. He
suddenly has a full body seizure lasting 30 seconds, which stops spontaneously.
Your first action following the seizure should be to:
A. Increase in PVT
B. Heart rate of 64
C. Decrease in preload
D. Fluid overload
A. Pneumonia
B. Epiglottis
C. Foreign body aspiration
D. Croup
A. Oral-fecal contamination
B. Skin puncture with a contaminated needle
C. Inhalation of infected airborne droplets
D. Dermal exposure to contaminated blood
55) You are caring for a 52 y/o pulseless and apneic male. The monitor initially
shows V-fib. After defibrillation and CPR you note the rhythm shown below.
ETCO2 increases to 40 and the pt has a palpable pulse on the next check. The pt
gags when you attempt to insert an OP airway. Vital signs include BP 84/60, P 68,
R 18 with good tidal volume, 02 saturation is 95% on NRB. The next appropriate
treatment is:
56) Your 26 y/o female pt is c/o 1 day progressive severe left flank pain, pain with
urination, nausea and vomiting. Vitals: BP 106/70, P 100, R 16. Her skin is hot to
the touch. You suspect her pain is caused by:
A. Splenic rupture
B. Pyelonephritis
C. Cholecystitis
D. Pancreatitis
BLOCK 9
57) The most complete scale identifying level of consciousness is:
A. AVPU
B. Orientation
C. GCS
D. Stimulus and response
58) To best auscultate for aortic stenosis, a paramedic should place his
stethoscope on the:
60) Paramedics respond to the home of a 12 y/o female. Family members state
that she was choking on a candy jaw breaker. The obstruction has been cleared
using abdominal thrusts. The pt remains unconscious; pulse is 120, respirations
are 0. What physiologic state would the pt most likely be in
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
66) According to LA County Ref. No 519, the authority at the scene of an MCI is
the:
67) Your pt presents with chest pain and mild shortness of breath. You do a 12-
lead ECG on him and it reads ***ACUTE MI*** on the top of the print out. You
notice ST elevation in leads II, IlI and aVF. This indicates an infarction to which
area of the heart:
A. Septal
B. Anterior
C. Lateral
D. Inferior
A. Nausea/vomiting
B. Cyanosis
C. Headache
D. Confusion
69) A pt has sustained an injury to his right thigh. Physical findings are
suggestive of a fractured femur and you consider applying a traction splint. When
considering application of a traction splint, you must first:
A. Junctional Tachycardia
B. Sinus Tachycardia
C. Supraventricular tachycardia
D. Atrial fibrillation with rapid ventricular rate
72) You respond to a restless, 64 y/o male c/o dizziness following a syncopal
episode. Vitals - BP 82/46, skin is cool and clammy. The cardiac monitor shows
the rhythm below. The primary contributor to the decreased blood pressure is:
A. Decrease in chronotropy
B. Decrease in cardiac contractility
C. Loss of atrial kick
D. Decrease in diastolic filling time
73) You respond to a pt who has fallen from the roof of a house and impacted his
head on a concrete garden planter. The pt has significant facial trauma and scalp
swelling. GCS 1-1-1. The vitals you might expect to see would include:
75) What is present in chronic volume loss that may not present in acute volume
loss:
A. Intra-abdominal hemorrhage
B. Intoxication
C. Tension pneumothorax
D. Increased intracranial pressure
77) 28 y/o male was stabbed at the level of T4, right posterior thorax. He is c/o
dyspnea. You note diminished breath sounds on the right chest wall. BP 140/80, P
120, R 24 labored. Suspicion is highest for:
A. tracheobronchial injury
B. tension pneumothorax
C. pericardial tamponade
D. open pneumothorax
78) After confirming the placement of the endotracheal tube you note frothy
sputum coming up from the ET tube with ventilations. In order to ensure diffusion
of 02 and CO2 the next appropriate step to take is:
79) A complication of late pregnancy which results in reduced venous return due
to the gravid uterus compressing on the inferior vena cava is called:
A. Premature labor
B. Placenta previa
C. Eclampsia
D. Supine hypotension
A. Iron
B. Thiamine
C. Ascorbic acid
D. Folic acid
BLOCK 9
81) A pt sustains a thermal burn to his head and face. The most likely immediate
cause of death would be related to:
A. infection
B. loss of fluid from the burn site
C. cerebral edema
D. respiratory failure
A. smooth muscle
B. cartilaginous rings
C. the thyroid cartilage
D. pharynx
83) You respond to a 26 y/o female who is 9 weeks pregnant, c/o sudden onset of
severe abdominal pain. Vital signs are BP 86/50, P 120, R 24, normal tidal volume.
Skin vitals are pale, cool and moist. Physical exam reveals a tender abdomen.
She denies vaginal bleeding. Of the following the most likely cause of her
symptoms is:
A. Spontaneous abortion
B. Uterine rupture
C. Ruptured ectopic pregnancy
D. Abruption placenta
84) The first sound heard while auscultating a blood pressure is directly
influenced by
A. Ventricular systole
B. Closing of the aortic valve
C. Atrial systole
D. Ventricular diastole
85) The greatest danger to the infant caused by a prolapsed umbilical cord is that
the cord will
87) The amount of blood flow needed by the cardiac muscle is directly related to
the:
A. chemo receptors
B. heart's metabolic rate
C. pressure in the aorta
D. patient's blood pressure
88) Paramedics are dispatched to the home of an altered 64 y/o male. Family
states the pt is taking multiple medications but unaware of their names. On initial
inspection the paramedics are concerned the pt may be having a stroke. What
neurologic exam should they perform first and what does that exam include?
91) Write the dose of Midazolam for a 3 y/o, 24 kg pt actively seizing. Include all
route(s), repeat dose, repeat times and maximum total dose:
92)Write the route, dose and location of the initial Epinephrine administration
when given to treat an adult pt with anaphylaxis:
93)Write the administration for Midazolam in an agitated delirium pt. include dose,
route, repeat time intervals, and number of times it can be repeated:
94) Narcan 1.0 mg has been ordered. It is packaged in 0.4 mg/1 mL preloads.
How many mL should be administered:
98) Write the administration of Calcium Choride in a Cardiac Arrest. Include dose,
route, repeat dose and time:
99) Write the dose of Morphine for an 8 y/o pt, weight 34kg, with pain from burns.
Include routes, repeat dose, repeat times before and after base: