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1. What is the effect of oral glucose?
A. Lowers blood sugar
B. Raises blood sugar
C. Stimulates gluconeogenesis
D. Increases the rate of digestion
Answer: B
Oral glucose is used to treat hypoglycemia by increasing blood sugar levels quickly.
2. A 14 year old male is hot, dry and complaining of nausea and vomiting after mowing the lawn.
What should you suspect?
A. Hypothermia
B. Heat exhaustion
C. Heat stroke
D. Hyperemesis
Answer: C
Heat stroke is characterized by hot, dry skin and symptoms like nausea and vomiting due to the
body's inability to regulate temperature.
3. What occurs during compression of the inferior vena cava?
A. Preeclampsia
B. Supine hypotensive syndrome
C. Pregnancy induced hypertension
D. Eclampsia
Answer: B

Supine hypotensive syndrome occurs when the inferior vena cava is compressed, reducing blood
return to the heart and causing hypotension.
4. An unresponsive 32 year old female was pulled from a frozen lake after 3 minutes of
submersion. Vital signs are BP 90/70, P 24, R 8. Why is it important to handle her gently while
A. Any lung damage due to submersion is greatly reduced.
B. She could go into shock.
C. It prevents her from losing any limbs.
D. She could convert into V-Fib or V-Tach rhythm.
Answer: D
Handling a hypothermic patient roughly can precipitate cardiac arrhythmias such as ventricular
fibrillation (V-Fib) or ventricular tachycardia (V-Tach).
5. A 56 year old male complains of chest pain after shoveling the driveway. He states that his
pain was a 9/10, but it is now a 5/10 after rest and taking 2 of his nitroglycerin. Vital signs are BP
100/66, P 87, R 16. What should you do?
A. Apply high-flow oxygen.
B. Apply pulse oximetry.
C. Obtain a second set of vital signs.
D. Administer aspirin.
Answer: D
Administering aspirin is recommended for suspected myocardial infarction (heart attack) to
reduce platelet aggregation and minimize further clot formation.
6. A 71 year old female is short of breath and has lower leg pain. She took 2 doses of her
prescribed nitroglycerine and 324 mg aspirin 10 minutes ago. Vital signs are BP 160/90, P 88, R
24, SpO2 88%. What should you do?
A. Administer a third dose of nitroglycerin.

B. Apply oxygen by non-rebreather mask.
C. Administer an additional dose of aspirin.
D. Obtain a second set of vital signs.
Answer: B
Applying oxygen by non-rebreather mask is appropriate to improve her oxygen saturation, which
is low (SpO2 88%).
7. A 66 year old female has shortness of breath and diffuse back pain. Auscultation of lungs
reveal crackles in the bases. Vital signs are BP 170/110 and P 112. What should you do
A. Adenosine
B. Furosemide
C. Albuterol
D. Nitroglycerin
Answer: D
Nitroglycerin can help relieve symptoms of pulmonary edema by reducing preload and afterload,
thus decreasing the workload on the heart.
8. An unresponsive 2 day old female is in respiratory distress. Her skin is cyanotic and vital signs
are P 184, R 72. What should you do?
A. Assist her ventilations.
B. Administer albuterol.
C. Apply blow-by oxygen.
D. Asses for a blood pressure.
Answer: A
Assisting ventilations is critical in managing respiratory distress in a neonate to ensure adequate
oxygenation and ventilation.

9. A 22 year old male complains of shortness of breath with diminished lung sounds on the right
side. Vital signs are BP 130/90, P 86, R 24. What should you suspect?
A. Asthma attack
B. Pneumothorax
C. Tension pneumothorax
D. Exacerbation of COPD
Answer: B
Pneumothorax is suspected due to the diminished lung sounds on one side, indicating a possible
collapsed lung.
10. An 66 year old female had a syncopal episode while attempting to stand up. She describes a
history of COPD, CHF, and gout. Vital signs are BP 96/40, P 56, R 18. What should you suspect?
A. Rapid increase of insulin.
B. Increase in oxygen levels.
C. Decrease in cerebral blood flow.
D. Hypoglycemic event.
Answer: C
The syncopal episode and hypotension (BP 96/40) suggest decreased cerebral blood flow, likely
due to orthostatic hypotension.
11. What is the best protection from contracting a communicable disease from a patient?
A. Frequent hand washing.
B. Changing clothes after run.
C. Wearing goggles during run.
D. Putting on a mask.
Answer: A
Frequent hand washing is the most effective way to prevent the spread of communicable diseases
by removing pathogens from the hands.

12. An anxious 55 year old male is severely short of breath and is coughing up pink frothy
sputum. He is sitting upright and tells you that his "feet are more swollen than normal." Vital
signs are BP 202/112, P 110, R 36 with crackles. What should you do?
A. Obtain a detailed medical history.
B. Position him supine and apply high-flow oxygen.
C. Administer aspirin.
D. Assist his ventilations with a BVM.
Answer: D
The patient is in severe respiratory distress with pulmonary edema. Assisting ventilations with a
BVM will help improve oxygenation and ventilation.
13. A 34 year old male complains that people are "out to hurt me." He thinks you are attempting
to kill him with poison gas while applying a nonrebreather mask. What should you do?
A. Position the mask for blow-by oxygen.
B. Forcefully restrain him then apply the mask.
C. Switch to a nasal cannula.
D. Explain the benefits of oxygen.
Answer: D
Explaining the benefits of oxygen calmly may help alleviate the patient's paranoia and improve
cooperation with treatment.
14. What condition is caused by twisting of the spermatic cord, resulting in a sudden onset of
severe scrotal pain?
A. Epididymitis
B. Urinary calculi
C. Priapism
D. Testicular torsion
Answer: D

Testicular torsion is a medical emergency caused by the twisting of the spermatic cord, leading to
severe scrotal pain and potential loss of the testicle if not treated promptly.
15. How should you treat asystole in a patient?
A. Shock with an AED.
B. Provide positive pressure ventilation.
C. Provide chest compressions.
D. Administer high-flow oxygen.
Answer: C
Asystole (flatline) is treated with chest compressions as part of CPR, as it is a non-shockable
16. A 45 year old female had a return of spontaneous circulation (ROSC) after 10 minutes in
cardiac arrest. She is unresponsive. Vital signs are BP 96/40, P 88, R 18, SpO2 74%. What should
you do?
A. Assist her ventilations with a BVM.
B. Continue to use the AED to analyze her pulse.
C. Position her in a recovery position and apply high-flow oxygen.
D. Provide low-flow oxygen by non-rebreather mask.
Answer: C
After ROSC, positioning the patient in the recovery position and providing high-flow oxygen
helps maintain airway patency and improve oxygenation.
17. A 16 year old boy tells you that he "caught" his 40 year old mother "holding a handful of
sleeping pills." The son explains that she is depressed, and he is convinced that she meant to kill
herself. She is extremely agitated and is refusing treatment. What should you do?
A. Carefully document the woman's refusal and have her sign the form.
B. Request law enforcement assistance to transport the patient.

C. Contact social services to recommend they follow up on this family.
D. Encourage the patient to see a mental health professional that day.
Answer: B
Patients who are a danger to themselves can be transported against their will with the assistance
of law enforcement, ensuring they receive the necessary care.
18. A 76 year old female complains of chest pain on the right side directly above her 4th
intercostal space. She states that she had a "hip replaced" a couple of weeks ago and that she is
recovering well. What should you suspect?
A. Pulmonary embolism
B. Acute coronary syndrome
C. Pneumothorax
D. Myocardial infarction
Answer: A
A recent surgery and chest pain are indicative of a potential pulmonary embolism, a common
complication after surgery due to blood clots.
19. A 22 year old intoxicated male responds to voice by moaning. You note vomit in his airway,
what should you do?
A. Insert a nasal airway.
B. Suction the mouth.
C. Manually stabilize c-spine.
D. Turn the patient on his side.
Answer: B
Clearing the airway by suctioning the mouth is critical to ensure the patient can breathe and to
prevent aspiration of vomit.

20. What is the movement of drugs in the body as they are absorbed, distributed, metabolized,
and excreted called?
A. Pharmacodynamics
B. Pharmacokinetics
C. Biotransformation
D. The mechanism of action
Answer: B
Pharmacokinetics is the study of how drugs move through the body during absorption,
distribution, metabolism, and excretion.
21. Scenario: A 32 year old female attempted to commit suicide by taking sleeping pills and
cutting her wrists. She has dark red blood oozing from the wrist lacerations. Vital signs are BP
90/52, P 130 and weak, R 18. What type of bleeding and shock is she experiencing?
A. Venous bleeding with hypovolemic shock.
B. Arterial bleeding with hypovolemic shock.
C. Capillary bleeding with cardiogenic shock.
D. Venous bleeding with neurogenic shock.
Answer: A
The dark red, oozing blood indicates venous bleeding. The low blood pressure and weak, rapid
pulse suggest hypovolemic shock due to blood loss.
22. What is a sign of an upper GI bleed?
A. Dark black emesis
B. Dry warm skin
C. High blood pressure and dizziness
D. Pain in the right shoulder
Answer: A

Dark black emesis, also known as coffee-ground vomit, indicates the presence of digested blood,
a common sign of an upper gastrointestinal bleed.
23. A 40 year old male was stung by a bee. His skin is pink and dry, his lung sounds are clear and
he has equal chest rise. Vitals are BP 122/82, P 78, R 18, SpO2 98%. What should you do?
A. Administer high-flow oxygen by non-rebreather mask.
B. Assist with the administration of his EpiPen.
C. Contact poison control.
D. Perform a secondary assessment.
Answer: D
The patient shows no signs of anaphylaxis or respiratory distress. A secondary assessment is
necessary to monitor for any delayed reactions and to gather more information.
24. A 2 year old male is conscious after ingesting a small quantity of bleach. What should you
A. Hot, dry skin and diarrhea
B. Chemical burns around the mouth
C. Dilated pupils and labored breathing
D. Bright, red skin on child's extremities
Answer: B
Ingesting bleach can cause chemical burns around the mouth and throat, which is a common
presentation in such poisonings.
25. A 25 year old female is stung by a bee. She complains of shortness of breath, hives and has
audible wheezes. What should you do?
A. Assist in the use of her metered dose inhaler.
B. Obtain an oxygen saturation reading.
C. Have family members confirm her bee allergy.
D. Remove the stinger using a credit card.

Answer: D
Removing the stinger promptly helps to stop further venom injection. Using a credit card to
scrape it out reduces the risk of squeezing more venom into the wound.
26. What signs and symptoms should make you suspect a heroin overdose?
A. Pinpoint pupils, coma, and respiratory depression
B. Hypertension, tachycardia, and urinary retention
C. Lacrimation, bradycardia, and hyperactivity
D. Dilated pupils, coma, and hyperpnea
Answer: A
Heroin overdose typically presents with pinpoint pupils, respiratory depression, and decreased
level of consciousness, which can lead to coma.
27. What can rough handling of a patient with severe hypothermia cause?
A. Increased shivering
B. Decreased respirations
C. Ventricular fibrillation
D. Ventricular tachycardia
Answer: C
Rough handling of a severely hypothermic patient can cause the heart to go into ventricular
fibrillation, a life-threatening arrhythmia.
28. A 23 year old male complains of neck stiffness and flu symptoms for the past few days. He
also describes a high fever with a severe headache, dizziness and blurred vision. What should
you suspect?
A. Influenza
B. Meningitis
C. Migraine

D. Hemorrhagic stroke
Answer: B
Neck stiffness, high fever, severe headache, dizziness, and blurred vision are classic signs of
meningitis, an infection of the membranes surrounding the brain and spinal cord.
29. A 27 year old pregnant female is complaining of extreme bouts of thirst, nausea and
urination. What should you suspect?
A. Urinary tract infection
B. Pre-eclampsia
C. Early stage kidney failure
D. Gestational diabetes
Answer: D
Extreme thirst, nausea, and frequent urination are symptoms of gestational diabetes, a condition
where pregnancy causes high blood sugar levels.
30. A 34 year old female complains of an open sore on her leg that will not go away. She says
that she cut her leg while shaving in the shower at her local gym 2 weeks ago. Her doctor
prescribed antibiotics, but nothing has changed. What should you suspect?
A. Boils
C. Varicose vein
D. Necrotizing fasciitis
Answer: B
MRSA (Methicillin-resistant Staphylococcus aureus) is a type of bacterial infection resistant to
many antibiotics. The persistence of the sore despite antibiotic treatment suggests a MRSA
31. What risk factor may cause the development of an esophageal varice?

A. Cirrhosis
B. Gastritis
C. Forceful vomiting
D. Anticoagulation therapy
Answer: A
Cirrhosis, a chronic liver disease, causes portal hypertension which can lead to the development
of esophageal varices as blood flow through the liver is obstructed, increasing pressure in the
veins of the esophagus.
32. What abdominal complaint is MOST concerning?
A. A sudden, tearing pain.
B. A dull, gradual-onset pain.
C. Pain that is relieved by rocking or movement.
D. Pain that increases with eating.
Answer: A
A sudden, tearing pain is a symptom of an abdominal aortic aneurysm, which is a life-threatening
emergency that requires immediate medical attention.
33. What medical term describes wheals on the skin during an allergic reaction?
A. Angioedema
B. Myxedema
C. Urticaria
D. Pruritus
Answer: C
Urticaria, commonly known as hives, refers to wheals or welts on the skin that are often seen
during allergic reactions.
34. What gland joins the nervous system with the endocrine system?

A. Hypothalamus
B. Thymus
C. Pituitary
D. Pineal
Answer: A
The hypothalamus links the nervous system to the endocrine system via the pituitary gland and
plays a crucial role in hormone regulation.
35. You assisted a 46 year old female with her prescribed nitroglycerin. She is now light-headed
and feels dizzy. What should you do?
A. Contact medical control.
B. Check her blood sugar.
C. Perform a stroke assessment scale.
D. Position her supine.
Answer: D
Light-headedness and dizziness are signs of hypotension, a common side effect of nitroglycerin.
Positioning her supine helps to improve cerebral perfusion by enhancing blood flow to the brain.
36. A 20 year old male complains of nausea and headache after working on his car in the garage.
Vital signs are BP 130/90, P 76, R 16. What should you suspect?
A. CO poisoning
B. Cholinergic poisoning
C. Migraine
D. Brain aneurysm
Answer: A
Symptoms like nausea, headache, and prolonged exposure in an enclosed space with a car
suggest carbon monoxide (CO) poisoning, a common and dangerous condition caused by
inhaling CO gas.

37. Lifeguards have rescued an unconscious 42 year old near-drowning victim from the water.
What should be your most important treatment for this patient?
A. Establish and maintain C-spine immobilization.
B. Immediately transport to the local hospital.
C. Perform a rapid primary survey.
D. Acquire information about what happened.
Answer: A
Near-drowning victims may have sustained cervical spine injuries due to the mechanism of
injury. Establishing and maintaining C-spine immobilization is crucial to prevent further spinal
38. A 26 year old male has Kussmaul's respirations. He has a diabetic alert bracelet. What should
you suspect?
A. Diabetic ketoacidosis (DKA)
B. Hyperglycemic hyperosmolar nonketotic coma (HHNC)
C. Hypoglycemia
D. Insulin shock
Answer: A
Kussmaul’s respirations are deep, labored breathing patterns typically seen in diabetic
ketoacidosis (DKA), a serious complication of diabetes characterized by high blood glucose and
ketone levels.
39. A 46 year old male complains of difficulty breathing and a productive cough. He states that
his cough began about 2 weeks ago. Lung sounds reveal coarse rhonchi in all fields. His skin
color is ashen and he is diaphoretic. What should you do?
A. Don an N95 mask.
B. Obtain baseline vitals.
C. Apply oxygen by non-rebreather mask.

D. Assist with administration of his albuterol inhaler.
Answer: A
The patient's symptoms, especially the productive cough and rhonchi, suggest a possible
respiratory infection like tuberculosis, which is highly contagious. Wearing an N95 mask is
essential for protecting against airborne pathogens.
40. Possible splenic injury or ectopic pregnancy can have referred left shoulder pain called?
A. Kehr's
B. Turner's
C. Kernig's
D. Hammain's
Answer: A
Kehr's sign is the occurrence of left shoulder pain as a result of diaphragmatic irritation, which
can occur due to splenic injury or an ectopic pregnancy causing internal bleeding.
41. Which of the following is NOT part of the Cincinnati Stroke Test?
A. Facial droop
B. Ability to walk
C. Slurred speech
D. Arm drift
Answer: B
The Cincinnati Stroke Test includes facial droop, slurred speech, and arm drift. The ability to
walk is not part of this test.
42. Scenario: A 32 year old male presents with difficulty breathing. He has bilateral inspiratory
and expiratory wheezing. Vital signs are BP 120/80, P 89, R 32, SpO2 93%. What should you
A. Emphysema

B. Asthma
C. Chronic bronchitis
D. Congestive heart failure
Answer: B
Bilateral wheezing on both inspiration and expiration is characteristic of asthma, which involves
airway constriction.
43. A 22 year old male working at a factory has recently inhaled a poison. After ensuring scene
safety, what should you do?
A. Obtain a set of vital signs.
B. Move the patient to an area outside.
C. Administer high-flow oxygen.
D. Insert an oral airway.
Answer: B
Moving the patient to fresh air is the priority to stop further inhalation of the poison and to
ensure a safer environment for treatment.
44. A 19 year old male hides in his closet and thinks that aliens are about to abduct him. What
should you do?
A. Tell him that aliens don't exist.
B. Acknowledge his fears as real.
C. Say you saw the aliens leave.
D. Tell him he should not be afraid.
Answer: B
Acknowledging his fears as real helps build trust and rapport, which is essential when dealing
with a psychiatric emergency.

45. A 47 year old male has a ROSC after 10 min of CPR but remains unconscious. How should
you transport him?
A. Prone with feet elevated 15 degrees
B. Left-lateral recumbent
C. Trendelenburg position
D. Semi-Fowler's at 30 degrees
Answer: B
Transporting the patient in the left-lateral recumbent (recovery) position helps maintain an open
airway and reduces the risk of aspiration.
46. What can unequal pupils indicate?
A. Head injury
B. Heat emergency
C. Poisoning
D. Severe hypoxia
Answer: A
Unequal pupils (anisocoria) can be a sign of a head injury, indicating possible brain trauma.
47. A 20 year old male has been exposed to cold temperatures for an unknown period of time.
Where should you assess his skin temperature?
A. Abdomen
B. Armpit
C. Chest
D. Leg
Answer: A
The abdomen is a good site to assess core temperature because it is less affected by external cold
conditions than the extremities.

48. How is nitroglycerin spray administered?
A. Topically.
B. Ingestion.
C. Injection.
D. Sublingually.
Answer: D
Nitroglycerin spray is administered sublingually (under the tongue) for rapid absorption to
relieve chest pain.
49. A 58 year old unconscious male has a return of spontaneous circulation (ROSC) after 10
minutes of CPR and 3 shocks from an AED. Vital signs are BP 90/60, P 54, R 4. What should
you do?
A. Assist his ventilations with a BVM.
B. Remove the oral airway.
C. Continue CPR.
D. Discontinue interventions.
Answer: A
With a respiratory rate of 4, the patient requires assisted ventilation to ensure adequate
oxygenation and ventilation post-ROSC.
50. A 51 year old male with a history of COPD is having difficulty breathing. Vital signs are BP
136/74, R 22, P 100, SpO2 95%. What should you do?
A. Withhold oxygen to avoid decreasing the hypoxic drive.
B. Administer oxygen by nonrebreather mask.
C. Apply high-flow oxygen by bag-valve mask.
D. Apply low-flow oxygen by nasal cannula.
Answer: B

Administering oxygen by nonrebreather mask ensures adequate oxygen delivery while
monitoring for any signs of respiratory depression in a COPD patient.
51. A 21 year old female was lost in the woods for several hours. The ambient temperature is 25
degrees Fahrenheit. She is lethargic and confused. The skin on her hands is waxy and white.
What should you do?
A. Apply heat packs on her neck, armpits, and groin.
B. Place several heat packs on her legs and arms.
C. Gently wrap the patient in several dry blankets.
D. Vigorously rub the patient's extremities.
Answer: C
The patient’s altered mental status suggests severe hypothermia. Active rewarming could induce
ventricular fibrillation. Local cold injuries should be handled gently to prevent further tissue
52. What is the most common communicable disease contracted by bloodborne pathogen
B. Hepatitis A
D. Hepatitis B
Answer: D
Hepatitis B is the most common communicable disease contracted through bloodborne pathogen
exposure, being highly infectious and more easily transmitted than HIV.
53. A 22 year old female was recently involved in a sexual assault. She wants to take a shower,
what should you do?
A. Ask her to wait until she gets admitted to the hospital.
B. Allow her to do so after she places her clothing in an evidence bag.

C. Perform a thorough pelvic exam before letting her shower.
D. Advise her to speak to a police officer before showering.
Answer: A
To preserve evidence for forensic examination, the patient should avoid showering until she is
seen at the hospital.
54. An 80 year old male is confused and in his apartment on a hot summer day. Vital signs are BP
80/P, P 132 and regular, R 40 and shallow, skin is hot and dry. What should you suspect?
A. Hypoglycemia
B. Dementia
C. Heat exhaustion
D. Heatstroke
Answer: D
Hot and dry skin along with confusion and abnormal vital signs indicates heatstroke, a medical
55. What is a contraindication for the administration of nitroglycerin?
A. Pain that radiates down the left arm
B. Recent use of erectile dysfunction medication
C. Blood pressure greater than 100 systolic
D. Diastolic blood pressure less than 90
Answer: B
The recent use of erectile dysfunction medications (e.g., sildenafil) can cause severe hypotension
if nitroglycerin is administered.
56. A 12 year old is complaining of an "itchy throat" and stomach cramping after sharing a
sandwich at school. What should you suspect?
A. Anaphylaxis

B. Food poisoning
C. Allergic reaction
D. Foreign body airway obstruction
Answer: C
An itchy throat and stomach cramping after eating suggests an allergic reaction. Anaphylaxis
would present with more severe symptoms such as difficulty breathing.
57. What cardiac dysrhythmia will an AED defibrillate?
A. Pulseless electrical activity
B. Ventricular tachycardia
C. Bradycardia
D. Asystole
Answer: B
AEDs are designed to defibrillate ventricular tachycardia and ventricular fibrillation. They do not
defibrillate pulseless electrical activity, bradycardia, or asystole.
58. What are the names of the four valves in the heart?
A. Left Atrial, Right Atrial, Septal, Ventricular
B. Ventral, Caudal, Transverse, Lateral
C. Mitral, Tricuspid, Pulmonic, Aortic
D. Mitre, Trigeminal, Pulmonary, Aorta
Answer: C
The four valves in the heart are the mitral, tricuspid, pulmonic, and aortic valves.
59. A 67 year old female is undergoing dialysis treatment for renal failure. Which of her organs is
A. Liver
B. Lungs

C. Kidneys
D. Pancreas
Answer: C
Dialysis is a treatment for renal failure, indicating compromised kidney function.
60. An unresponsive 64 year old male has a stoma. He is supine and apneic. What should you
A. Assist his ventilations with an adult bag-valve mask and cover the stoma.
B. Apply a cervical collar and perform a jaw thrust maneuver.
C. Place a pediatric-sized BVM over the stoma and ventilate.
D. Obtain a set of vital signs and apply an AED.
Answer: C
To ventilate a patient with a stoma, use a pediatric-sized BVM over the stoma. Prepare to suction
if needed.
61. What chemical substance, released by a gland, controls processes in other glands or body
A. Hormone
B. Glucocorticoid
C. Catecholamine
D. Steroid
Answer: A
Hormones are chemical substances released by glands that regulate various bodily functions,
including processes in other glands or body systems.
62. Excessive urination is known by what medical term?
A. Polyphagia
B. Polyuria

C. Polydipsia
D. Glycosuria
Answer: B
Polyuria is the medical term for excessive urination, often seen in conditions such as diabetes.
63. Which of the following is NOT a communicable disease?
B. Cancer
C. Tuberculosis
D. Hepatitis B
Answer: B
Cancer is not a communicable disease; it does not spread from person to person. HIV/AIDS,
tuberculosis, and hepatitis B are all communicable diseases.
64. A 23 year old female has ingested an unknown poison. She is crying uncontrollably and
begging you to save her life. What should you do?
A. Contact medical direction and transport rapidly.
B. Administer activated charcoal.
C. Position patient to anticipate vomiting.
D. Obtain a second set of vital signs while preparing to transport.
Answer: A
Contacting medical direction and transporting rapidly ensures the patient receives appropriate
and timely care. Administering treatments without specific medical advice could be dangerous
with an unknown poison.
65. What is the most common complaint of patients with cardiac compromise?
A. Hypertension
B. Leg pain

C. Hypotension
D. Dyspnea
Answer: D
Dyspnea, or difficulty breathing, is a common complaint among patients with cardiac
compromise. This can occur with or without chest pain.
66. An elderly patient has left-sided heart failure. What lung sounds should you suspect to hear?
A. Wheezing
B. Ronchi
C. Stridor
D. Crackles
Answer: D
Crackles (rales) are often heard in patients with left-sided heart failure due to fluid accumulation
in the lungs.
67. A 84 year old female becomes unconscious while eating her breakfast. Her home-care nurse
states that she was "fine one minute and then complained of a bad headache" before losing
consciousness. Vital signs are 178/120, P 62, R 10 and irregular. What should you suspect?
A. Hemorrhagic stroke
B. Hypoglycemia
C. Transient ischemic attack
D. Myocardial infarction
Answer: A
The sudden onset of a severe headache and unconsciousness, along with high blood pressure,
suggests a hemorrhagic stroke.
68. What is the primary action of insulin?
A. Facilitate glucose transport into cells.

B. Add a functional group during gluconeogenesis.
C. Reduce the glucose consumption of the cells.
D. Increase blood glucose levels.
Answer: A
Insulin facilitates the transport of glucose into cells, lowering blood glucose levels and providing
cells with energy.
69. A 45 year old male has chest pain. What should you determine before administering a dose of
A. His blood pressure
B. A pulse oximetry reading
C. Recent use of blood thinners
D. Recent use of an inhaler
Answer: A
It is essential to check the patient's blood pressure before administering nitroglycerin because it
can cause hypotension.
70. You have assisted with the administration of an Albuterol inhaler. The patient's heart rate
begins to increase. What should you do?
A. Obtain an additional set of vitals and transport to the hospital.
B. Administer a single dose of nitroglycerin.
C. Discontinue administration and apply low-flow oxygen.
D. Listen to lung sounds and obtain a SAMPLE history.
Answer: A
An increase in heart rate can be a side effect of Albuterol. Monitoring vitals and transporting the
patient ensures they receive further evaluation and care if necessary.

71. A 32 year old male has ingested an unknown quantity of gasoline in an attempt to kill
himself. What should you do?
A. Administer 75 grams of activated charcoal by mouth.
B. Administer 30 mL of syrup of ipecac followed by a glass of water.
C. Apply high-flow oxygen and transport immediately.
D. Ask him if he plans on hurting others.
Answer: C
In cases of ingestion of a toxic substance like gasoline, the priority is to maintain airway,
breathing, and circulation. Applying high-flow oxygen and prompt transport to a medical facility
are essential.
72. You are called to a bar for a 52 year old male who has slurred speech and difficulty sitting
upright. He is unable to follow your commands and refuses to leave the bar. Which of the
following should you consider LAST?
A. Stroke
B. Diabetic reaction
C. Seizure
D. Alcohol intoxication
Answer: D
Given the setting and the patient's presentation, alcohol intoxication should be considered last, as
it is the most likely cause of his symptoms in this context.
73. A 64 year old male is unresponsive. Bystanders tell you he has been down for 10-15 minutes
and resuscitation efforts have not been attempted. What should you do?
A. Assess a carotid pulse.
B. Apply an AED.
C. Ventilate him with a BVM.
D. Request ALS intercept.
Answer: A

Before initiating any resuscitation efforts, it is important to confirm the absence of a pulse to
determine if CPR is warranted.
74. A systolic blood pressure is less than 90. What should this indicate?
A. Hypertension
B. Hypotension
C. Tachycardia
D. Bradycardia
Answer: B
A systolic blood pressure less than 90 mmHg indicates hypotension, which can be indicative of
shock or other serious medical conditions.
75. Which type of shock presents itself with respiratory distress, crackles, and chest pain?
A. Hypovolemic
B. Anaphylactic
C. Cardiogenic
D. Neurogenic
Answer: C
Cardiogenic shock, often due to heart failure, can present with respiratory distress, crackles
(rales), and chest pain due to fluid buildup in the lungs.
76. A 87 year old female has bilateral rales. What should you suspect?
A. Pulmonary edema
B. Abdominal edema
C. Sacral edema
D. Pedal edema
Answer: A

Bilateral rales (crackles) are often indicative of pulmonary edema, which is the accumulation of
fluid in the lungs.
77. A 24 year old female complains of a sudden onset of lower quadrant abdominal pain. She is
pale and has a rapid, weak pulse. What should you ask her?
A. "How many sexual partners do you have?"
B. "Are you on birth control?"
C. "Are you sexually active?"
D. "Is there any possibility you are pregnant?"
Answer: C
Lower quadrant abdominal pain, pallor, and a rapid, weak pulse can be indicative of various
conditions, including ectopic pregnancy or pelvic inflammatory disease. Asking if she is sexually
active can help gather more information about possible causes.
78. What is a hazardous, odorless gas resulting from incomplete combustion?
A. Carbon dioxide
B. Nitrogen
C. Sarin
D. Carbon monoxide
Answer: D
Carbon monoxide is an odorless, colorless gas produced by incomplete combustion of carboncontaining fuels. It is toxic and can be lethal in high concentrations.
79. Which statement about suicide is correct?
A. There is a high correlation between suicide and alcohol use.
B. People who talk about suicide rarely act on it.
C. All suicidal people are mentally ill.
D. The suicide rate is lowest during holiday seasons.
Answer: A

There is a high correlation between suicide and alcohol use, as alcohol can lower inhibitions and
impair judgment, leading to impulsive behavior.
80. What condition presents with a fruity, acetone-like odor on the breath?
A. Diabetic ketoacidosis (DKA)
B. Hyperosmolar hyperglycemic nonketotic coma (HHNC)
C. Hypoglycemia
D. Hyperglycemia
Answer: A
Diabetic ketoacidosis (DKA) is a serious complication of diabetes that occurs when your body
produces high levels of blood acids called ketones. This can result in a fruity, acetone-like odor
on the breath.
81. A 21 year old male complains of dark colored urine. His eyes and nail beds have a yellow
discoloration. He has general weakness and has upper right quadrant discomfort. What should
you suspect?
A. Hepatitis
B. Pancreatitis
C. Splenic injury
D. Kidney failure
Answer: A
The symptoms described are indicative of hepatitis, specifically jaundice (yellow discoloration of
eyes and skin), dark colored urine, weakness, and upper right quadrant discomfort.
82. Which of the following is a contraindication for Nitroglycerin?
A. Renal failure.
B. Hypotension.
C. MAO Inhibitors.

D. Pulmonary hypertension.
Answer: B
Nitroglycerin is contraindicated in patients with hypotension (low blood pressure) as it can
further decrease blood pressure.
83. A 43 year old male complains of a stiff neck, persistent cough, and fever for the past week.
He states he has been in and out of homeless shelters for the past 5 months. What should you do?
A. Put on eye protection and a surgical mask.
B. Have the patient wear a HEPA mask.
C. Apply oxygen by non-rebreather mask.
D. Use gloves, gown, and HEPA mask.
Answer: D
Given the patient's symptoms and history of homelessness, there is a concern for tuberculosis
(TB) or other infectious respiratory diseases. Using personal protective equipment (PPE)
including gloves, gown, and HEPA mask is appropriate to prevent transmission.
84. What condition is NOT commonly associated with sickle cell anemia?
A. Musculoskeletal pain
B. Excessive bleeding
C. Abdominal pain
D. Renal disease
Answer: B
Excessive bleeding is not commonly associated with sickle cell anemia. Common complications
include musculoskeletal pain, abdominal pain (from vaso-occlusive crises), and renal disease.
85. What is status epilepticus?
A. When the patient sees an aura prior to a seizure
B. A seizure affecting one area of the body

C. Two or more continuous seizures
D. A seizure that occurs during a fever
Answer: C
Status epilepticus is defined as two or more continuous seizures without full recovery of
consciousness between them, or a single seizure lasting more than 5 minutes.
86. A 70 year old male complains of shortness of breath and has wheezing. Vitals signs are BP
126/90, P 74, R 22, SpO2 92%. What should you do?
A. Assist his ventilations with a bag-valve mask.
B. Apply oxygen by nasal cannula at 2 lpm.
C. Apply oxygen by non-rebreather mask at 15 lpm.
D. Administer albuterol
Answer: C
The patient's wheezing and shortness of breath indicate a need for high-flow oxygen therapy,
which can be provided by a non-rebreather mask at 15 liters per minute (lpm).
87. A 26 year old female is supine and only responding to voice with unintelligible gurgling
noises. Her husband tells you she is an epileptic. She had a seizure during which he was able to
gently assist her to the ground. What should you do?
A. Apply a c-collar and place her on a long backboard.
B. Load the patient on a stretcher and apply soft restraints.
C. Roll the patient onto her side and suction the airway.
D. Perform a thorough trauma assessment and patient history.
Answer: C
The patient is likely experiencing postictal state after a seizure. Rolling her onto her side
(recovery position) and suctioning the airway to clear any secretions or vomit is appropriate.

88. What type of drug abuse is characterized by the patient "seeing" or "hearing" things that are
not present?
A. Volatile chemicals
B. Downers
C. Hallucinogens
D. Uppers
Answer: C
Hallucinogens are drugs that can cause hallucinations, which are perceptions of things that are
not present.
89. You are transporting a 44 year old male complaining of chest pain when he becomes
unconscious, pulseless, and stops breathing. What should you do?
A. Contact another unit for help.
B. Contact medical control for direction.
C. Ask your partner to go with lights and siren to the hospital.
D. Begin CPR and attach the AED.
Answer: D
The patient is now in cardiac arrest, and CPR should be initiated immediately along with the use
of an AED.
90. What does the body use for fuel in diabetic ketoacidosis?
A. Ketones
B. Fats
C. Acids
D. Glucose
Answer: B
In diabetic ketoacidosis (DKA), the body is unable to use glucose for energy due to a lack of
insulin, so it begins to break down fats for fuel, leading to the production of ketones.

91. What statement is used to gain information about the "P" in OPQRST?
A. What were you doing when the pain began?
B. Do you have any past history of this complaint?
C. Did the pain begin suddenly or gradually?
D. Is there anything that worsens or relieves the pain?
Answer: D
The "P" in OPQRST stands for provocation/palliation, which refers to factors that worsen or
relieve the pain. This question helps gather information about what makes the pain better or
92. A 56 year old male has intercostal retractions and is in the tripod position. Vital signs are BP
116/78, P 90, R 32. What should you do?
A. Assist his ventilations.
B. Administer oxygen by nasal cannula.
C. Administer albuterol.
D. Apply a non-rebreather mask at 15 lpm.
Answer: A
Intercostal retractions and tripod positioning indicate significant respiratory distress. Assisting
ventilations is appropriate to support the patient's breathing.
93. What is the phase after a generalized seizure called?
A. Psychosis
B. Translucent
C. Aura
D. Postictal
Answer: D

The postictal phase occurs after a seizure and is characterized by confusion, drowsiness, and
other neurological symptoms as the brain recovers from the seizure activity.
94. An 18 month infant is pulseless and apneic. What should you do?
A. Two minutes of CPR
B. Administer 2 rescue breaths
C. Call medical control
D. Defibrillate
Answer: A
For a pulseless and apneic infant, CPR should be initiated immediately with a ratio of 30
compressions to 2 ventilations.
95. When should you obtain a blood glucose level?
A. Every patient
B. For all adults over 65
C. Patients with an altered mental status
D. When your local protocols dictate
Answer: C
Checking blood glucose levels is particularly important for patients with altered mental status, as
hypoglycemia or hyperglycemia can be a cause.
96. A 30 year old female is having an asthma attack. She has taken several inhaler treatments
without relief. Vital signs are P 160, R 40. What should you do?
A. Administer 15 lpm oxygen via non-rebreather mask.
B. Administer 6 lpm oxygen by nasal cannula.
C. Assist her ventilations with a bag valve mask.
D. Administer another dose of albuterol.
Answer: C

In severe asthma attacks with inadequate response to initial treatments, assisting ventilations
with a bag valve mask may be necessary to improve oxygenation.
97. The ability of the heart to generate its own muscle contractions is known as?
A. Cardiac contractility
B. Myocardial automaticity
C. Involuntary muscle movement
D. Spontaneous muscle contraction
Answer: B
Myocardial automaticity refers to the heart's ability to initiate its own electrical impulses and
generate muscle contractions without external stimulation.
98. An 18 year old male presents with symptoms of hypoglycemia. What criteria must be met for
him to receive oral glucose?
A. His blood glucose analysis must be between 70 and 95 mg/dL.
B. He must have a prescription for oral glucose.
C. He must be conscious, with a patent airway.
D. He must have a history of type 1 diabetes.
Answer: C
Oral glucose is indicated for conscious patients with hypoglycemia who are able to swallow and
protect their airway.
99. A 55 year old female is unconscious, apneic and pulseless. What should you do?
A. Determine the absence of a pulse and call ALS.
B. Apply AED and deliver three consecutive shocks.
C. Begin CPR, and apply the AED.
D. Apply AED, and follow directions.
Answer: C

In a patient who is unconscious, apneic, and pulseless, CPR should be initiated immediately
along with the use of an AED.
100. Scenario: A 42 year old female is unconscious and apneic. What should you do?
A. Assess the carotid pulse.
B. Perform a jaw thrust maneuver.
C. Insert oralpharyngeal airway.
D. Open the airway with a head-tilt.
Answer: A
In an unconscious and apneic patient, the first step is to assess for the presence of a pulse.
Checking the carotid pulse is a quick way to determine if the patient has a perfusing rhythm.
101. How does the blood flow through the heart?
A. Left atrium to left ventricle to lungs to right atrium to right ventricle
B. Right atrium to right ventricle to lungs to left atrium to left ventricle
C. Right ventricle to right atrium to lungs to left ventricle to left atrium
D. Left ventricle to left atrium to lungs to right ventricle to right atrium
Answer: B
Blood flows from the right atrium to the right ventricle, then to the lungs to pick up oxygen. It
then returns to the left atrium and passes into the left ventricle, which pumps it out to the rest of
the body.
102. What should you do when the automated external defibrillator (AED) performs its rhythm
A. Perform chest compressions.
B. Administer 2 rescue breaths.
C. Remain clear of the patient.
D. Check for carotid pulse.
Answer: C

During the AED's rhythm analysis, it's crucial to stay clear of the patient to avoid interfering with
the device's assessment and potential shock delivery.
103. When administering nitroglycerin to a patient with angina, to which structures are you
hoping to alleviate ischemia?
A. Jugular veins
B. Pulmonary veins
C. Carotid arteries
D. Coronary arteries
Answer: D
Nitroglycerin dilates coronary arteries, increasing blood flow to the heart muscle and relieving
104. Scenario: A 62 year old female complains of chest pain and shortness of breath. She is
extremely anxious. Vital signs are BP 80/56, P 118, R 24 with crackles, SpO2 87%. What is the
most likely cause?
A. Cardiogenic shock
B. Hypovolemic shock
C. Pulmonary embolus
D. Right-sided heart failure
Answer: A
The combination of chest pain, shortness of breath, crackles, and hypotension indicates
cardiogenic shock, which occurs when the heart cannot pump enough blood to meet the body's
105. A 3 year old male has inspiratory wheezes. After assisting with his inhaler you now hear
both inspiratory and expiratory wheezing. What should you do?
A. Document the respiratory improvement.

B. Assist ventilations with a bag-valve mask.
C. Call medical control to indicate deterioration.
D. Position him on his back and administer oxygen.
Answer: A
Hearing both inspiratory and expiratory wheezing may indicate an improvement in airway
obstruction. Documenting this improvement is appropriate.
106. Which of the following is NOT a sign of heatstroke?
A. Flushed skin
B. Unconsciousness
C. Diaphoresis
D. Dilated pupils
Answer: C
Heatstroke is characterized by hot, dry skin, not diaphoresis (sweating).
107. Which of the following is NOT a definitive sign of death?
A. Rigor mortis
B. Absence of breath sounds
C. Dependent lividity
D. Putrefaction
Answer: B
The absence of breath sounds is a clinical sign but not a definitive sign of death. Definitive signs
include rigor mortis, dependent lividity, and putrefaction.
108. What symptom would a person who overdosed on barbiturates have?
A. Rapid eye movement
B. Sluggish movements
C. Pupillary constriction

D. Anxiousness
Answer: B
Barbiturate overdose can cause central nervous system depression, leading to sluggish
movements and drowsiness.
109. A 57 year old female complains of difficulty breathing. She has jugular vein distension
(JVD), pedal edema and fatigue. What chamber of the heart should you suspect is weakened?
A. Right ventricle
B. Left atrium
C. Left ventricle
D. Right atrium
Answer: A
Symptoms such as JVD, pedal edema, and fatigue suggest right-sided heart failure, which
indicates weakness or dysfunction of the right ventricle.
110. A euphoric patient states that she can save the world while sitting on the roof of her house.
What should you suspect?
A. Psychosis
B. Neurosis
C. Delusion
D. Hysteria
Answer: C
The patient's belief that she can save the world is a delusion, which is a fixed, false belief that is
not based in reality. Delusions are often associated with psychotic disorders.
111. Scenario: A 33 year old male has respirations of 22 per minute. How should you administer
oxygen to him?
A. Simple rebreather mask at 4 lpm.

B. Non-rebreather mask at 15 lpm.
C. Bag-valve mask at 8 lpm.
D. Venturi mask at 8 lpm.
Answer: B
A non-rebreather mask at 15 lpm is appropriate for a patient with a respiratory rate of 22 per
minute, providing a high concentration of oxygen.
112. Which of the following is a common side effect of nitroglycerin?
A. Bleeding
B. Hypotension
C. Bronchospasm
D. Heartburn
Answer: B
Hypotension is a common side effect of nitroglycerin due to its vasodilatory effects.
113. Where are the first electrical impulses stimulating the heart located?
A. Left atrium
B. Myocardium
C. Right atrium
D. Aorta Valve
Answer: C
The first electrical impulses stimulating the heart originate in the SA node, located in the right
114. An apneic 79 year old female is found lying unconscious on the floor. Vital signs are P 45, R
0. What should you do?
A. Manually immobilize her c-spine.
B. Provide ventilations with a BVM.

C. Check for a medical alert bracelet or card.
D. Open the airway with a head-tilt chin-lift.
Answer: B
An apneic patient requires immediate ventilatory support. Use a bag-valve mask (BVM) to
provide ventilations.
115. A 56 year old male complains of "squeezing" chest pain after doing yard work. He states the
pain has subsided slightly with rest. What should you do?
A. Assess his vital signs
B. Administer oxygen
C. Assist with his prescribed nitroglycerin
D. Administer aspirin
Answer: D
Chest pain suggestive of cardiac origin should prompt the administration of aspirin, which can
help reduce the risk of clot formation.
116. Where does the electrical impulse in the heart begin?
A. AV node
B. SA node
C. Bundle of His
D. Purkinje fibers
Answer: B
The electrical impulse in the heart begins in the sinoatrial (SA) node, the heart's natural
117. After assisting your patient with the self-administration of their prescribed metered-dose
inhaler medication, what should you do?
A. Wait for the patient's condition to alleviate.

B. Discontinue high-flow oxygenation of the patient.
C. Ensure the medication belongs to the patient.
D. Gather an additional set of vital signs.
Answer: D
After assisting with medication administration, it is important to reassess the patient's condition
and gather additional vital signs to monitor their response to treatment.
118. A 60 year old female has a history of type 2 diabetes and complains of nausea and
weakness. You notice a sharp, fruity odor on her breath. What should you suspect?
A. Hypoglycemia
B. Diabetic ketoacidosis
C. Hyperglycemia
D. Hyperglycemic hyperosmolar nonketotic syndrome
Answer: B
A fruity odor on the breath, along with symptoms of nausea and weakness, are indicative of
diabetic ketoacidosis (DKA), a serious complication of diabetes.
119. A 59 year old female missed her weekly renal dialysis appointment. She is feeling weak and
unable to care for herself. What should you suspect?
A. Fluid overload
B. Polyuria
C. Hypokalemia
D. Anemia
Answer: A
Missing a renal dialysis appointment can lead to fluid overload, as the kidneys are unable to
adequately remove excess fluid from the body.

120. A 57 year old male complains of chest pain. He is slightly pale, but warm and dry. He has a
20 year cardiac history and is taking metoprolol. Vital signs are BP 86/64, P 84, R 22. What
should you do?
A. Administer 324 mg aspirin.
B. Assist him in taking nitroglycerin.
C. Place him in the Trendelenburg position.
D. Apply oxygen by non-rebreather mask.
Answer: A
Administering aspirin is indicated for a patient with suspected cardiac chest pain to help prevent
clot formation. Nitroglycerin is contraindicated in patients with hypotension.
121. A 14 year old male is recovered from a 30F pond after falling through the ice 10 minutes
ago. How should he be moved to the ambulance?
A. Gently on a backboard
B. Dragging slowly by his torso
C. Sliding him across the ice in a stokes basket
D. Fireman's carry
Answer: A
The patient should be moved gently on a backboard to prevent further injury, especially
considering the potential for hypothermia after being in cold water.
122. An unrestrained 47 year old female is in cardiac arrest after a car crash on the freeway. She
has been pulseless for 20 minutes, and CPR was withheld. What should you do?
A. Look for signs of occult bleeding.
B. Provide chest compressions for 2 minutes then apply the AED.
C. Apply the AED and start CPR simultaneously.
D. Start CPR and contact medical control to terminate efforts.
Answer: D

After 20 minutes of pulselessness and no CPR, the chances of successful resuscitation are
extremely low, and it may be appropriate to consider terminating resuscitative efforts.
123. What is the normal rate of breathing for an adult?
A. 12 to 20 breaths per minute.
B. 22 to 26 breaths per minute.
C. 28 to 36 breaths per minute.
D. 6 to 10 breaths per minute.
Answer: A
The normal respiratory rate for an adult is 12 to 20 breaths per minute.
124. A 19 year old male complains of sudden difficulty breathing on his right side after sneezing
vigorously. He has diminished breath sounds on his right side. What should you suspect?
A. Spontaneous pneumothorax
B. Pericardial tamponade
C. Pulmonary edema
D. Traumatic asphyxia
Answer: A
Diminished breath sounds on one side after a precipitating event like sneezing can be indicative
of a spontaneous pneumothorax.
125. Which structure contains the vocal cords?
A. Sternum
B. Pharynx
C. Trachea
D. Larynx
Answer: D
The vocal cords are located in the larynx, which is commonly known as the voice box.

126. What is the normal range for blood sugar?
A. 80 - 120
B. 60 - 70
C. 130 - 140
D. 200 – 300
Answer: A
The normal range for blood sugar is typically considered to be between 80 and 120 mg/dL.
127. A 42 year old male complains of hives and itching on his lower right leg immediately after
mowing the lawn. Vital signs are BP 146/84, P 92, R 16. What should you suspect?
A. Eczema
B. Anaphylaxis
C. Allergic reaction
D. Insecticide poisoning
Answer: C
The symptoms of hives and itching after exposure to a potential allergen suggest an allergic
128. A 75 year old male describes sharp, tearing pain in his abdomen and blood pressures are
114/ in his left arm 60/0 in his right arm. He is pale and diaphoretic. What should you suspect?
A. Simple pneumothorax
B. Aortic dissection
C. Pulmonary embolism
D. Acute myocardial infarction
Answer: B
The sharp, tearing pain in the abdomen along with the significant difference in blood pressure
between the arms is highly suggestive of an aortic dissection.

129. What treatment is NOT correct when caring for a patient with hypothermia?
A. Remove wet clothing.
B. Wrap in warm blankets.
C. Provide high flow oxygen.
D. Active rewarming.
Answer: D
Active rewarming is not typically recommended in the prehospital setting for hypothermia.
Passive rewarming methods, such as using blankets and providing warm fluids, are usually
130. What does a pulsating mass in the abdomen suggest?
A. Ruptured ectopic pregnancy
B. Abdominal aortic aneurysm
C. Perforated ulcer
D. Hernia
Answer: B
A pulsating mass in the abdomen is a classic sign of an abdominal aortic aneurysm, which is a
potentially life-threatening condition.
131. What are agonal respirations?
A. Shallow, rapid, and regular panting breaths.
B. Shallow, slow, and irregular gasping breaths.
C. Deep, very slow and irregular breaths.
D. Deep, rapid, and regular breaths.
Answer: B
Agonal respirations are often described as shallow, slow, and irregular gasping breaths. They are
a sign of severe respiratory distress or impending respiratory failure.

132. A 45 year old male is supine and unconscious. His wife states he came in from mowing the
lawn and had slurred speech, followed complaints of the "worst headache of his life." What
should you suspect?
A. Ischemic stroke
B. Pericardial tamponade
C. Hemorrhagic stroke
D. Acute myocardial infarction
Answer: C
The sudden onset of severe headache, especially in the context of slurred speech and
unconsciousness, is suggestive of a hemorrhagic stroke, which involves bleeding in the brain.
133. Why is diabetic ketoacidosis (DKA) associated with a fruity smelling breath?
A. Excessive amounts of glucose molecules in their blood.
B. Salivary amylase creates an increase in glucose digestion.
C. Elevated insulin levels.
D. An increase in ketone levels.
Answer: D
Diabetic ketoacidosis (DKA) is associated with a fruity smelling breath due to the presence of
ketones, which are produced when the body breaks down fat for energy in the absence of
sufficient insulin.
134. An alert 45 year old female is pale and cyanotic. Her vitals are BP 180/104, P 102 and
irregular, R 28 with bilateral crackles. What is the most likely cause of her shortness of breath?
A. Simple pneumothorax
B. Asthma
C. Anaphylaxis
D. Pulmonary edema
Answer: D

The combination of hypertension, irregular pulse, cyanosis, and crackles is indicative of
pulmonary edema, which is often caused by heart failure.
135. Scenario: A 26 year old male is leaning over the toilet vomiting a steady stream of bright,
red blood. He is a chronic alcoholic. What should you do?
A. Immobilize the patient and transport.
B. Transport in a position of comfort.
C. Position him supine and suction his airway.
D. Apply a non-rebreather mask.
Answer: B
In this scenario, the patient should be transported in a position of comfort to the hospital due to
the potential seriousness of vomiting bright, red blood.
136. What division of the autonomic nervous system is responsible for the "fight-or-flight"
A. Sympathetic
B. Central
C. Peripheral
D. Parasympathetic
Answer: A
The sympathetic division of the autonomic nervous system is responsible for the "fight-or-flight"
response, which prepares the body for action in response to stress or danger.
137. What is homeostasis?
A. The body's ability to maintain a temperature equal to the external temperature.
B. The relative stability and constancy of the body's internal environment.
C. The liver's ability to convert glycogen to glucose.
D. The control mechanism known as a negative feedback loop.

Answer: B
Homeostasis refers to the body's ability to maintain a relatively stable and constant internal
environment, including factors such as temperature, pH, and glucose levels.
138. How many vertebrae make up the cervical spine?
A. Twelve
B. Ten
C. Seven
D. Five
Answer: C
The cervical spine is made up of seven vertebrae, labeled C1 to C7, which form the upper part of
the spinal column.
139. What gland secretes chemical substances directly into the blood and is also called a ductless
A. Adrenocorticotropic
B. Sebaceous
C. Endocrine
D. Exocrine
Answer: C
The endocrine gland secretes hormones directly into the bloodstream, and it is called a ductless
gland because its secretions are released directly into the blood rather than through ducts.
140. What are the structures that branch off from the trachea called?
A. Arterioles
B. Bronchi
C. Carina
D. Alveoli

Answer: B
The bronchi are the structures that branch off from the trachea and carry air into the lungs.
141. A 35 year old man is pulseless and apneic. He was found in a lake after falling through the
ice. His wife says he left the house 3 hours ago. What should you do?
A. Provide chest compressions.
B. Contact the medical examiner.
C. Tell the wife that her husband has died.
D. Begin active rewarming techniques.
Answer: A
In cases of hypothermia-induced cardiac arrest, resuscitative efforts should be initiated, as
hypothermia may protect the brain and body from hypoxic injury. Active rewarming techniques
should also be considered.
142. A 36 year old male and his 34 year old wife complain of severe headaches, confusion, and
dizziness. He also complains of chest pain. Both are short of breath. What type of poisoning
should you suspect?
A. Carbon dioxide
B. Ammonia
C. Carbon monoxide
D. Organophosphate
Answer: C
The symptoms described are characteristic of carbon monoxide poisoning, which can result from
exposure to carbon monoxide gas.
143. At a mass gathering several hundred people suddenly began to experience severe salivation,
lacrimation, urination, and vomiting. What should you do?
A. Evacuate all of the patients from the premises.

B. Contact the Department of Homeland Security.
C. Alert the Center for Disease Control.
D. Set up a command post and ensure scene safety.
Answer: D
The symptoms described suggest exposure to a possible chemical agent. Ensuring scene safety
and setting up a command post to manage the situation are crucial initial steps.
144. A 26 year old male underwent a recent surgery. He has fever, altered mental status, and
decreased urine output. What should you suspect?
A. Neurogenic shock
B. Anaphylactic shock
C. Septic shock
D. Hypovolemic shock
Answer: C
The symptoms described are indicative of septic shock, which can occur as a result of an
infection following surgery.
145. How many times faster does heat loss occur during water immersion as compared to air
A. 50
B. 25
C. 2
D. 100
Answer: B
Heat loss occurs approximately 25 times faster in water than in air of the same temperature.
146. Which of the following capillary refill times is considered normal?
A. 2 seconds

B. 6 seconds
C. 3 seconds
D. 4 seconds
Answer: A
A capillary refill time of 2 seconds or less is considered normal in adults.
147. You have completed your initial assessment of a ten year old unresponsive medical patient.
How should you start your focused assessment?
A. A SAMPLE history from family members.
B. A history of childhood illnesses from family members.
C. A physical exam of head and chest.
D. A rapid physical exam.
Answer: D
A rapid physical exam should be conducted following the initial assessment to gather more
specific information about the patient's condition.
148. What condition can present with paranoia, delusions, and auditory hallucinations?
A. Schizophrenia
B. Organic brain syndrome
C. Obsessive-compulsive disorder
D. Bi-polar disorder
Answer: A
Schizophrenia is a mental disorder characterized by symptoms such as paranoia, delusions, and
auditory hallucinations.
149. What does the "O" in the OPQRST mnemonic stand for?
A. Observe
B. Oral intake

C. Occult injury
D. Onset
Answer: D
In the OPQRST mnemonic used for assessing pain, "O" stands for onset, referring to when the
pain began or how it started.
150. What type of procedure does a patient with chronic renal failure undergo?
A. Peritoneal hemolysis
B. Renal dialysis
C. Renal calculi
D. Renal hemolysis
Answer: B
Patients with chronic renal failure often undergo renal dialysis, a procedure that helps to filter
waste and excess fluids from the blood when the kidneys are no longer able to perform this
function effectively.
151. What environmental emergency is life-threatening?
A. Chilblains
B. Heat stroke
C. Frostbite
D. Heat exhaustion
Answer: B
Heat stroke is a life-threatening condition characterized by a high body temperature (often above
104°F) and other symptoms such as altered mental state, nausea, and rapid breathing. Immediate
medical attention is required.

152. Scenario: A 45 year old male has fallen down a flight of stairs. He is unresponsive and has
diminished breath sounds bilaterally with subcutaneous emphysema around the base of his neck.
What should you suspect?
A. Fractured trachea
B. Pneumothorax
C. Flail chest
D. Hemothorax
Answer: A
The symptoms described are indicative of a fractured trachea, which can occur as a result of
severe trauma to the neck.
153. A 65 year old male complains of circumferential burns around his hands and wrists. His
homecare nurse says that he burned himself while helping cook dinner that evening. What should
you suspect?
A. Psychosis
B. Dementia
C. Neglect
D. Abuse
Answer: D
The circumstances described suggest the possibility of abuse, as the patient has circumferential
burns that may be indicative of restraint or immersion injuries.
154. An 84 year old man is in cardiac arrest in the passenger seat of a vehicle following a single
car crash. The driver tells you that his passenger had complained of chest pain prior to the car
crash. What should you do?
A. Contact the patient's personal physician.
B. Treat the other patients while attempting to contact medical control.
C. Establish an incident command post.
D. Start CPR and call for additional ambulances.

Answer: D
In the case of a patient in cardiac arrest, immediate CPR should be initiated while additional
resources are summoned.
155. A 6 year old male with sudden onset stridor and drooling is seated upright. His skin is hot
and he is lethargic to respond. Vital signs are BP 80/54, P 140, RR 32. What should you do?
A. Insert an oral thermometer.
B. Transport supine and suction.
C. Transport in fowler's position.
D. Insert an oropharyngeal airway.
Answer: C
The patient's presentation is consistent with epiglottitis, and positioning him in a comfortable
position for breathing is important to maintain his airway.
156. What is the name of the leaf-shaped valve that prevents food from entering the trachea?
A. Bronchi
B. Pharynx
C. Epiglottis
D. Larynx
Answer: C
The epiglottis is a flap of tissue that covers the trachea during swallowing, preventing food from
entering the airway.
157. A 21 year old male was involved in a motor vehicle collision. He has a puncture wound to
the neck that is actively bleeding. What should you apply?
A. An occlusive dressing.
B. A sterile bulky dressing.
C. A gloved hand for direct pressure.

D. A c-collar with sterile dressing underneath.
Answer: C
Applying direct pressure with a gloved hand to the puncture wound can help control the bleeding
and protect against air embolism.
158. Why do patients with cardiac compromise have chest pain?
A. The heart rate increases too rapidly.
B. Blood supply is diminished to the lung tissue.
C. There is not enough oxygen to the heart.
D. The patient is working too hard to breathe.
Answer: C
Chest pain in patients with cardiac compromise is often due to insufficient oxygen supply to the
heart muscle, known as myocardial ischemia.
159. A 22 year old female complains of body aches, severe headache, and blurred vision. She
admits to having large amounts of alcohol the night before. What diagnosis should you consider
A. Meningitis
B. Cerebral vascular accident
C. Hangover
D. Migraine headache
Answer: C
The symptoms described are consistent with a hangover, which is a common consequence of
excessive alcohol consumption and typically resolves on its own.
160. Which of the following MOST accurately defines an allergic reaction?
A. An exaggerated immune system response to any substance.
B. A release of erythrocytes in response to a foreign substance.

C. Destruction of the immune system by an external substance.
D. A direct negative effect on the body by an external substance.
Answer: A
An allergic reaction is an exaggerated immune system response to a substance that is normally
harmless, leading to symptoms such as itching, swelling, and difficulty breathing.
161. A patient with AIDS vomited blood during transport. How should you disinfect your
A. Using universal precautions, spray a bleach-based cleaning solution and carefully wipe down
the stretcher.
B. Place the ambulance out of service until a full OSHA cleaning can be completed.
C. Soak the mattress pad for 20 minutes in disinfectant, then let the mattress stand for 6 hours
before use.
D. Replace the mattress and throw out the sheets.
Answer: A
The correct answer is A because using a bleach-based cleaning solution is effective in killing the
HIV virus. Universal precautions should always be followed when cleaning up potentially
infectious materials.
162. A 17-year-old female has a tick embedded in her scalp. How should you remove the tick?
A. Burn the tick with the head of a burnt match.
B. Gently pull the tick straight out.
C. Pop the tick with your fingernails, then pull it out.
D. Pull the tick out with a twisting motion.
Answer: B
The correct answer is B because gently pulling the tick straight out with tweezers is the
recommended method to remove a tick. This helps ensure the tick is removed intact, reducing the
risk of leaving parts of the tick embedded in the skin.

163. After your combative patient has been placed in restraints, what should you do?
A. Perform a primary survey.
B. Contact law enforcement.
C. Check distal functions.
D. Contact medical control.
Answer: C
The correct answer is C because checking distal functions, such as circulation, sensation, and
movement, is important after placing a patient in restraints to ensure there is no compromise to
the extremities.
164. How often should you reassess vital signs in an unstable patient?
A. 15 minutes
B. 3 minutes
C. 10 minutes
D. 5 minutes
Answer: D
The correct answer is D because reassessing vital signs every 5 minutes allows for early
detection of any changes in the patient's condition, which is crucial in managing unstable
165. What mechanism does the body lose the majority of heat?
A. Convection
B. Evaporation
C. Radiation
D. Conduction
Answer: C

The correct answer is C because radiation is the primary mechanism through which the body
loses heat. This process involves the transfer of heat energy in the form of electromagnetic
166. Which of the following effects of anaphylaxis will be fatal if not treated immediately?
A. Bronchoconstriction
B. Diffuse uticaria
C. Systemic vasodilation
D. Severe hypotension
Answer: A
The correct answer is A because bronchoconstriction can lead to severe respiratory distress and
ultimately respiratory failure if not treated immediately. This is one of the most critical effects of
anaphylaxis that requires prompt intervention.
167. What chamber of the heart pumps oxygenated blood to the peripheral body systems?
A. Right ventricle
B. Left atrium
C. Left ventricle
D. Right atrium
Answer: C
The correct answer is C because the left ventricle is responsible for pumping oxygenated blood
to the peripheral body systems through the systemic circulation. This blood carries oxygen and
nutrients to the body tissues.
168. What term describes away from or being the farthest from a point of origin.
A. Proximal
B. Superficial
C. Distal
D. Deep

Answer: C
The correct answer is C because distal refers to a position farther away from the point of origin
or attachment. It is the opposite of proximal, which refers to a position closer to the point of

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