Term
| For symptomatic patients with organophosphate poisoning, IV medications should include: |
|
Definition
A) Glucagon mg.
B) Dopamine 5-15 mcg/kg/min until systolic blood pressure > 100 and MAP > 65
C) Atropine 2 mg IV per dose until secretions dry
D) Metoprolol (Lopressor) 5 mg IV per dose until heart rate < 100 |
|
|
Term
| The best initial medication intervention for a 24 year old patient experiencing an acute asthma attack where the patient is in severe distress and very tired. HR 120 BP 140/82 RR 38 SaO2 88%: |
|
Definition
A) Magnesium 2 gm IV
B) Epinephrine 1:1,000 0.3 - 0.5 mg IM
C) Albuterol 2.5 mg in 3 mL (unit dose) and Ipratropium Bromide (Atrovent) 0.5 mg in 2.5 mL (unit dose)
D) Methylprednisolone (SoluMedrol) 125 mg IV |
|
|
Term
| A 26 year old police officer has suffered a 10 cm laceration to his right upper arm. Direct pressure does not stop the bleeding. What should be done next? |
|
Definition
A) Elevation
B) Additional dressings
C) Pressure point
D) Tourniquet |
|
|
Term
| Immediately after placing an endotracheal tube in an adult patient, the paramedic should; |
|
Definition
A) Suction the endotracheal tube
B) Auscultate over the lungs
C) Attach a BVM and ventilate
D) Attach a waveform capnography device |
|
|
Term
| What is the appropriate standing order for the initial dose of analgesia for an 39 year old, 150 pound (70 kilograms) patient complaining of a shoulder injury? He has no allergies and no medical problems. VS HR 110, BP 130/70, RR 24, O2Sat 100%. |
|
Definition
A) Fentanyl 100 mcg IV
B) Morphine 10 mg IV
C) Ketorolac 30 mg IV
D) Morphine 5 mg IV |
|
|
Term
| What dose of midazolam (Versed) can be administered on standing orders to an adult who is seizing? |
|
Definition
A) 2.5 mg IV or 5 mg IM or IN with a repeat x1 in 10 minutes
B) 5 mg IV or 2.5 mg IM or IN with a repeat x1 in 5 minutes
C) 2.5 mg IV or 5 mg IM or IN with a repeatx1 in 5 minutes
D) 2.5 mg IV, IM, or IN with a repeat x1 in 10 minutes |
|
|
Term
| You have just arrived at the home of a woman who called 911 for active labor. She is rubbing the back and patting the buttocks of a neonate who is grayish-blue in color, taking a few irregular weak breaths, and making no movements. The umbilical cord is still intact. The exam of the neonate shows the following: mild clear to bloody fluid is easily suctioned from the mouth and nose with no change in respiratory effort or skin color. HR = 120bpm. There is no crying or movements.After clamping and cutting the umbilical cord you should: |
|
Definition
A) Place pediatric nonrebreather mask at 15 LPM and monitor heart rate
B) Perform oral intubation and mechanical ventilation at 30 breaths per minute
C) Perform BVM ventilations and chest compressions
D) Perform BVM ventilations at 40-60 breaths per minute |
|
|
Term
| A lethargic 68 year old male has a chief complaint of sub-sternal chest pain. The patient has a blood pressure of 78 mmHg and wide complex tachycardia on the ECG monitor at a rate of 160 beats per minute. The appropriate action for the to take is: |
|
Definition
A) Perform synchronized cardioversion at 100 Joules or the bi-phasic equivalent
B) Sedate the pt. with 1 mg. Etomidate IV bolus
C) Administer 150 mg. of Amiodarone IV over 10 mins
D) Administer 6 mg. of Adenosine IV bolus |
|
|
Term
| The patient has a gunshot wound to the face. The patient’s airway is partially occluded by copious bleeding. The community hospital is 8 minutes away and the Level One Trauma Center is 18 minutes away. A helicopter is enroute. Vital signs: GCS 14, BP 160/120, HR 52, RR 36, O2Sat unobtainable. The patient should be transported to: |
|
Definition
A) The closest community hospital
B) Treated and transported by the helicopter crew
C) By ground to the Trauma Center |
|
|
Term
| A 55 year old female presents with severe respiratory distress secondary to heart failure. Physical exam reveals crackles (rales) and wheezes bilaterally, tachypnea, and a room air SaO2 of 90%. Standing orders include: |
|
Definition
A) Albuterol/Ipratropium Bromide (Atrovent), Furosemide (Lasix), ASA, and CPAP
B) No standing orders exist for this protocol
C) Albuterol/Ipratropium Bromide (Atrovent), Magnesium Sulfate, ASA
D) Albuterol/Ipratropium Bromide (Atrovent), Nitroglycerin SL, CPAP |
|
|
Term
| What medication is used to treat a symptomatic organophosphate exposure in a pediatric patient? |
|
Definition
A) Lopressor
B) Epinephrine
C) Atropine
D) Glucagon
|
|
|
Term
| What is the correct intervention for a patient who is becoming increasingly angry and agitated despite efforts to de-escalate the situation? |
|
Definition
A) Diphenhydramine (Benadryl) 25 mg IM
B) Haloperidol (Haldol) 5 mg IN or IM
C) Midazolam (Versed) 5 mg IN or IM
D) Diazepam (Valium) 5 mg IM |
|
|
Term
| The treatment for a patient with symptomatic bradycardia includes all of the following EXCEPT: |
|
Definition
A) Transcutaneous pacing
B) 1 mg. of epinephrine 1:10,000 IV
C) Dopamine infusion at 5 mcg/min
D) 0.5 mg. Atropine IV |
|
|
Term
| What is the correct dosage when giving midazolam (Versed) IM or IN to a pediatric patient weighing 25 KGs and who is in an active seizure? |
|
Definition
A) 0. 25 mg.
B) 2.5 mg.
C) 25 mg.
D) 0.025 mg. |
|
|
Term
| Common post-resuscitative interventions performed by Paramedics on standing orders include all of the following, EXCEPT: |
|
Definition
A) Antriarrythmic Infusion
B) Use of paralytics
C) Stabilizing the blood pressure
D) Initiating therapeutic hypothermia |
|
|
Term
| A resuscitation may be terminated as a physician option provided that the patient meets all of the following criteria EXCEPT: |
|
Definition
A) Normothermic
B) Asystole
C) Unresponsive to standard medical treatment
D) The scene is appropiate for termination order |
|
|
Term
| Which of the following situations would contraindicate the administration of nitroglycerin? |
|
Definition
A) Use of clopidogrel bisulfate (Plavix) within the last 12 hours
B) Sildenifil (Viagra) use 4 days before
C) Systolic BP less than 90 mm/Hg
D) Hypersensitivity to sulfur
|
|
|
Term
| First line medications for a male patient presenting with grand mal seizure include: |
|
Definition
A) Midazolam (Versed) 2.5 mg. IV or 5 mg. IM or IN
B) Diazepam 5 mg. IV
C) Magnesium 4 g. IV over 2 mins.
D) Dextrose 10% up to 25 g. |
|
|
Term
| A 67 year old male presents with severe difficulty breathing, marked jugular venous distention, coarse crackles in all lung fields and extremely anxious. Which of the following interventions will have the MOST immediate and positive effect? |
|
Definition
A) CPAP
B) Lasix 40 mg. slow IVP
C) Nitroglycerin paste 1 1/2 inches
D) Albuterol/Ipratropium Bromide (Atrovent) nebulized |
|
|
Term
| Trauma criteria identifying an unstable patient include a GCS of less than: |
|
Definition
|
|
Term
| Major (adult) trauma is present if, on examination, the patient is unstable (as defined by the protocol) or one of the following physical findings is noted: |
|
Definition
A) Amputation proximal to wrist or ankle
B) Point tenderness to neck or spine
C) Blunt trauma to chest or abdomen
D) Penetrating trauma in foot
|
|
|
Term
| An 83 year old male patient has been found to have a fever of 101 degrees F, HR 120, BP 84/50, R 22, and PAO2 88% on room air. His family advises that he has had a productive cough for about a week. You should |
|
Definition
A) Admin O2, infuse 2 L of Normal Saline
B) Administer O2, infuse 500 mL of NS, obtain a 12-Lead EKG and notify the hospital of potential sepsis
C) Begin ventilations with a BVM
D) Begin CPAP, give a fluid bolus of 500 mL and notify the hospital of impending respiratory failure |
|
|
Term
| The patient with a ventricular assist device goes unresponsive and does not have a carotid pulse. The ALS provider should not: |
|
Definition
A) Listen to the motor of pump over heart
B) Perform CPR
C) Infuse 500 mL of NS bolus |
|
|
Term
| How many does of Albuterol 2.5 mg and Ipratropium (Atrovent) 0.5 mg may be administered on standing orders to a patient having an acute asthma attack? |
|
Definition
|
|
Term
| If IO access is started in a conscious patient, the IO should be flushed with; |
|
Definition
A) Benadryl 40 mg. (2 mL) of adults, or 1 mg/kg for pediatric pt.'s
B) Lasix 40 mg (2 mL) for adults, or 1 mg/kg for pediatric pt.'s
C) Amiodarone 40 mg (2 mL) for adults, or 1 mg/kg for pediatric pt.'s
D) Lidocaine (2%) 40 mg (2mL) for adults, or 1 mg/kg for pediatric pt.'s |
|
|
Term
| Best chance for success is when reimplantation of a tooth occurs; |
|
Definition
A) Less than 5 minutes from injury
B) Within 2-4 hrs.
C) Within 1 hour
D) Within 4-6 hrs.
|
|
|
Term
| An 80 kg 18 year old female is complaining of significant lower left arm pain after a cycling crash. There is obvious deformity to the left lower extremity with point tenderness at the midpoint. Vital signs BP 132/84, HR 124, Resp 20. Which of the following is most appropriate for controlling the patient’s pain? |
|
Definition
A) Adminster morphine 5 mg IV, repeating in 5 mins
B) Administer Ketorolac (Toradol) 30 mg IV
C) Administer Midazolam (Versed) 0.05 mg/kg IV if the pt. is agitated
D) Administer Fentanyl 25 mcg |
|
|
Term
| Resuscitation can be withheld if a _________ is presented |
|
Definition
A) In-hospital DNR order
B) Living Will
C) Healthcare Proxy
D) MOLST indicating DNR |
|
|
Term
| A 26 y/o female has begun having regular contractions at 26 weeks gestation. standing orders include: |
|
Definition
A) Metoprolol (Lopressor) 5 mg every 5 min x3
B) Midazolam (Versed) 2.5 mg IV or 5 mg IN
C) Magnesium 2 gm over 20 minutes
D) NS 500 mL IV bolus |
|
|
Term
| Which of the following is a contraindication to the administration of Ondansetron (Zofran)? |
|
Definition
A) Lack of IV/IO access
B) The pt. is allergic to peanuts
C) The pt. is less than 2 yrs old
D) Previous admin of Fentanyl
|
|
|
Term
| Which of these patients from a bus crash should go to the trauma center? |
|
Definition
A) 36 y/o with neck pain
B) 22 y/o with HR of 120
C) 80 y/o with abrasion on head on warfarin
D) 16 y/o with broken forearm |
|
|
Term
| You are called to a 36 y/o male whose legs are crushed under a car for 2 hrs. On standing orders what medication should this patient should receive 1 minute prior to extrication: |
|
Definition
A) Glucagon 1 mg IV
B) Calcium Chloride 1 gm
C) Magnesium 2 gms IV
D) Sodium Bicarbonate 50 meq IV
|
|
|
Term
| A 45 year old male patient is agitated and hypertensive following an overdose of cocaine. Which medication is best used to treat this emergency? |
|
Definition
A)Metoprolol (Lopressor)
B) Midazolam (Versed)
C) Sodium Bicarbonate
D) Naloxone (Narcan)
|
|
|
Term
| A 96 year old woman has fallen down a flight of stairs. She has severe pain to her mid-back and right arm. Vital signs HR 100, BP 106/70 RR 22 SaO2 98%. What should she receive for pain? |
|
Definition
A) Morphine 2.5 mg IV
B) Midazolam (Versed) 5 mg IV
C) Fentanyl 25 mcg IV
D) Ketorolac (Toradol) 30 mg IV |
|
|
Term
| For symptomatic patients with organophosphate poisoning, IV medications should include: |
|
Definition
A) Metoprolol (Lopressor) 5 mg IV per dose until HR <100
B) Dopamine 5-15 mcg/kg/min until systolic blood pressure >100 and MAP>65
C) Atropine 2 mg IV per dose until secretions dry
D) Glucagon 2 mg |
|
|
Term
| Paramedic standing orders for the pregnant patient who is having a seizure include: |
|
Definition
A) Midazolam (Versed) 2.5 mg IM
B) Diazepam (Valium) 5 mg IV
C) Metoprolol (Lopressor) 5 mg IV
D) Magnesium Sulfate 4 g over 2 mins IV |
|
|
Term
| A 76 year old oxygen dependant COPD patient has a worsening cough, sputum, fever, and wheezing. She is awake but her oxygen saturation has worsened despite Albuterol + Atrovent nebulizer treatments. mental status is declining rapidly and she has failed a trial of CPAP. Endotracheal intubation is necessary. What is the next action? |
|
Definition
A) Contact Medical control and request Etomidate 0.3 mg/kg IV
B) Administer Midazolam (Versed) 2.5 mg IV on standing orders
C) Contact Medical Control and request Etomidate 0.1 mg/kg IV
D) Administer Etomidate 0.1 mg/kg IV on standing orders |
|
|
Term
| A patient is stabbed once in the right chest. There are no breath sounds on the right. Vital signs: GCS 15 HR 140, BP 70/50, RR 32, SaO2 88%. Which of the following should the Paramedic do first? |
|
Definition
A) Cervical collar placement
B) Rapid transport
C) Needle decompression
D) Venous access |
|
|
Term
| Providers should suspect nerve agent poisoning in patients presenting with: |
|
Definition
A) Salivation, lacrimation, GI distress and muscle twitching
B) Brittle hair, tachycardia, hyperthermia, and weight loss
C) Tachycardia, hypertension, and flushing
D) Bitter almond smell on their breath |
|
|
Term
| What is the medication and maximum dose used to relieve a dystonic reaction in a child? |
|
Definition
A) Calcium chloride 1 gm
B) Diphenhydramine (Benadryl) 50 mg/kg
C) Sodium Bicarbonate 1 mEq/kg
D) Diphenhydramine (Benadryl) 50 mg |
|
|
Term
| A 54 year old male with cardiac history presents with severe shortness of breath, rales on lung exam, and peripheral edema. He is very anxious. VS BP 180/120, HR 120, RR 24, O2Sat 88%. Which of the following medications should be administered? |
|
Definition
A) Midazolam (Versed) 5 mg IV if the pt. is agitated
B) Nitroglycerin 0.4 mg SL
C) Albuterol 2.5 mg and Ipratropium Bromide (Atrovent) 0.5 mg
D) Furosemide (Lasix) 40 mg IV over 2 mins |
|
|
Term
| You have a patient with a past medical history of diabetes that was found unconscious and unresponsive. Your exam reveals no signs of traumatic injury, vital signs BP 126/78, HR 82, R 16, PaO2 98% on room air, BG 42 . You begin infusing Dextrose 10% 250 ml. The patient regains normal responsiveness after only 100 ml has infused. You should: |
|
Definition
A) Change the Dextrose 10% to D5W and continue a KVO infusion
B) Continue the infusion and contact medical control immediately
C) Continue the infusion until it is finished and transport
D) Stop the infusion and record the amount infused
|
|
|
Term
| A 45 year old female has been involved in a car crash. She has a femur fracture and is in severe pain. IV access has been established , vital signs: HR 120 BP 140/82 RR 24 SaO2 100%. How should her pain be treated? |
|
Definition
A) Morphine 5 mg IV
B) Ketorolac (Toradol) 30 mg IV
C) Midazolam (Versed) 5 mg IV
D) Fentanyl 1 mcg/kg IV |
|
|
Term
| The appropriate dosing for magnesium sulfate for an asthma patient in severe respiratory distress is |
|
Definition
A) 2 gm IV push
B) 5 gm in 100 mL of NS over 10 mins
C) 2 gm in 100 mL of NS over 10 mins
D) 1 gm IV push |
|
|
Term
A pregnant patient with a blood pressure greater than 140/90, who is also complaining of severe headache, confusion and/or hyper-reflexia should be considered to be
experiencing: |
|
Definition
A) Pre-eclampsia
B) Eclampsia
C) Pulmonary Hypertension
D) Placenta Praevia |
|
|
Term
| What is the correct dose of Nitroglycerin for a patient with pulmonary edema? |
|
Definition
A) 0.4 mg SL or equivalent, every 5-10 mins with a systolic BP>120mmHg or MAP>80mmHg
B) 0.4 mg SL once provided the systolic BP>120mmHg or MAP>80mmHg
C) 0.4 mg SL continuous regardless of systolic BP or MAP
D) 0.4 mg SL or equivalent, every 2-5 mins with a systolic BP>120 mmHg or MAP>80 mmHg |
|
|
Term
| A patient with anterior wall ST elevation MI may receive all of the following on standing orders EXCEPT: |
|
Definition
A) Metoprolol (Lopressor)
B) Nitroglycerin
C) NS bolus
D) ASA
|
|
|
Term
| What medication should be considered in preparation for transcutaneous pacing of an adult patient with symptomatic 3rd degree AV Block. VS HR 26, BP 112/56, RR 22? |
|
Definition
A) Midazolam (Versed) 2.5 mg IV or 5 mg IM or IN
B) Etomidate 0.3 mg/kg IV
C) Diazepam (Valium) 5 mg IV
D) Etomidate 0.2 mg/kg IV |
|
|
Term
| A 53 year old male has been injured in a motorcycle accident. Physical exam reveals minimal left chest wall movement on inspiration, diminished breath sounds on the left, and noticeable bruising on the lateral left chest wall The vital signs are a respiratory rate of 36 and labored, radial pulse is 130 and weak, and blood pressure is 88/46. The patient is very anxious. The Paramedic should: |
|
Definition
A) Administer Morphine 5 mg IV for pain
B) Adminster Midazolam (Versed) 5 mg IV for anxiety
C) Intubate the pt.
D)Perform needle chest decompression |
|
|
Term
| A 68 year old woman with chest pain has a blood pressure of 72/50 and wide complex bradycardia with a rate of 28. You would: |
|
Definition
A) Give a fluid bolus of 2 L to assure MAP of 100 mmHg
B) Attempt TCP
C) Intubate
D) Admin 0.5 mg atropine IV |
|
|
Term
| Pediatric patients may be intubated by _______________. |
|
Definition
A) Paramedics and CCT's
B) Paramedics only
C) Paramedics, CCT's and Intermediates
D) All ALS providers, depending on the pt.'s condition |
|
|
