You are called to assist an adult with chest pain. The patient has a cardiac history of twoposterior myocardial infarctions. He is conscious and alert, stating he is having a hard time breathing, and the chest pain worsens when he attempts to lay flat on his back. His skin is pale and hot, while auscultation of his lung sounds reveals mild crackles. He reports the pain worsens on deep inspiration and movement. Based on the patient's history, and signs and symptoms, which of the following should you suspect? A. Unstable angina pectoris B. Pericarditis C. Myocardial infarction D. Cardiomyopathy ANS - B. You are the first ambulance to arrive on the scene of a single-car accident. As you approach the scene, you see four patients, two have been ejected from their vehicle, and two are still in the vehicle. What should be your next course of action? A. Call medical control, and advise them of the situation B. Request additional resources, such as fire rescue, and additional ambulances to respond to the scene C. Begin immediate triage and treatment of the two patients ejected first while awaiting fire department response D. Notify the local trauma center so they can prepare for the patients ANS - B. A patient is experiencing a possible neurological emergency from a blunt force closed head injury. He is found to have abnormal pupillary reactions to light and has lost the ability to move his eyes from side to side to follow your finger movements. He is also unable to identify the number of fingers you are holding up. He reports he is able to see the fingers but is not able to focus enough to identify how many fingers are present. Which of the following cranial nerves should you suspect may be involved in his injury? A. Cranial nerves I, V, and VI B. Cranial nerves V and VII C. Cranial nerves IX and X D. Cranial nerves II, III, and IV ANS - D. Simply put, shock is a state of hypoperfusion due to several different causes. Which one of the following types of shock would be considered distributive shock? A. Hypovolemic shock B.Cardiogenic shock C.Anaphylactic shock D.Toxic shock syndrome ANS - C. Which of the following is responsible for initiating the sympathetic response to shock during a traumatic event? A.Increased oxygen level and increased PCO2 B.Increased peripheral vascular resistance and alkalosis C.Decreased perfusion and increased acidosis D.Peripheral vasodilation and increased capillary permeability ANS - C. During which wave, complex, interval, or segment of an electrocardiogram tracing does the absolute refractory period take place in a normally functioning heart? A. S-T segment B.P-R interval C.P wave D. Q-T interval ANS - D. You are preparing to perform synchronized electrical cardioversion with a biphasic defibrillator on your unstable adult patient who is experiencing supraventricular tachycardia at 160 beats per minute on the monitor. Which of the following initial energy settings would be recommended if he was exhibiting a narrow complex, regular supraventricular tachycardia, in which his palpable carotid pulse matches the rhythm on the monitor? A. Synchronized cardioversion at 50-100 joules B. Defibrillation at 100 joules C. Synchronized cardioversion at 360 joules D. Defibrillation at 360 joules ANS - A. Other than a stroke, what is a common cause of one-sided facial droop and paralysis in an adult patient who exhibits no other neurological findings? A.Amyotrophic lateral sclerosis (ALS) B.Multiple sclerosis C.Huntington's disease D.Bell's palsy ANS - D. You are on-scene with a patient who was struck by a car on her bicycle. She is conscious and alert but has a possible closed right mid-shaft femur fracture. The patient advises you that she is sixteen but does not need parental consent to be treated. Which of the following situations would make this statement true? A.She can be treated under implied consent because her injury may become life-threatening B.She is not an American citizen, visiting on a student visa C.She is an emancipated minor granted by the court D.She is an orphaned minor who lives alone ANS - C. Your adult patient is showing signs and symptoms of being severely hyperkalemic. Medical control recommends the administration of a high-dose nebulized albuterol treatment as well as calcium chloride. Why is high-dose albuterol being recommended for this patient? A.To improve the patient's ventilatory status B.To assist with metabolic acidosis C.To increase the amount of available calcium at the cellular level D.To help lower dangerous potassium levels ANS - D. When monitoring the electrical activity of a patient's heart, which standard limb lead records the difference in electrical potential between the left leg and the right arm when the left leg is positive and the right arm is negative? A.Augmented limb lead aVL B.Bipolar limb lead II (LII) C.Bipolar limb lead III (LIII) D.Bipolar limb lead I (LI) ANS - B.