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NREMT Paramedic Exam Solution Material
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Where do you cric someone? - Correct answer Inferior to the thyroid cartilage, and superior to the cricoid cartilage is the cricothyroid ligament (or membrane). EMS systems do not rely on mobile phones only for long distance communication why? - Correct answer It can be overwhelmed, esp in a MCI. What is the drug name most health care workers use? - Correct answer Generic. You have a neonate who is bradycardic at 48bpm, what should you do first? - Correct answer Begin compressions. What is the antidote for a tylenol OD? - Correct answer Mucomyst. A pt who is in cardiac arrest and is intubated should get how many breaths per minute? - Correct answer 10, one breath every 6 seconds. A pt has pinpoint pupils caused by a morphine OD, why does morphine cause that? - Correct answer Causes parasympathetic simulation which constricts the eyes. What shouldn't you do with transdermal patches? - Correct answer Never rub it into the skin. While trying to intubate the paramedic sees a foreign object just distal to the vocal cords, what should they do? - Correct answer Attempt to remove it with the magill forceps. What is the antidote for magnesium toxicity? - Correct answer Calcium gluconate. What change in the elderly will have the greatest impact on paramedics? - Correct answer Decrease in creatinine clearance (kidney function).
What will paramedics see on the monitor for a pt with WPW? - Correct answer Slurring of the QRS complex known as the delta wave. Which heart valve is usually the first to go? - Correct answer The bicuspid valve. Why are high-velocity bullets more dangerous than medium velocity? - Correct answer They cause cavitation which can create more damage. What is something you can do to identify crush syndrome? - Correct answer Do an EKG, and look for hyperkalemia (widening QRS and peaked T waves). What is kernig sign? - Correct answer It is suspected with meningitis, and it is when the pt is having difficulty extending the lower leg in the flexed position. Gastritis - Correct answer Sudden onset shortly after eating, abd pain, irritates the stomach, tender abd. What pulmonary issue can affect the lungs unilaterally? - Correct answer Pulmonary embolism Tilt test - Correct answer 20/10/20 rule, a decrease in systolic bp of 20, an increase in pulse of 20, and an increase in diastolic bp of 10. Used to determines pt level of hydration. Testicular Torsion - Correct answer Testicular torsion is an emergency because blood supply to the testes has been reduced due to twisting of the spermatic cord, vessels, and testicles. It commonly occurs in prepubescent boys whose scrotal sac is growing to accommodate the soon-to-enlarge testes. Chronic hypertension usually results in what kind of stroke? - Correct answer Hemorrhagic Providing no contraindications exist, what should be the first attempt of intubation? - Correct answer Visual laryngoscopy
What is the most common cause of cerebral palsy? - Correct answer The most common cause is abnormal cerebral development or cerebral dysgenisis. What is a low velocity weapon? - Correct answer Hand held items, knife, fist, sword, etc. What is a medium/high velocity weapon? - Correct answer Those that discharge projectile that pierces the body (bullet, arrow, etc). Which fracture is most likely to cause compartment syndrome? - Correct answer Femur fracture. What is the antidote for a benzo OD? - Correct answer Romazicon (flumazenil) Parenteral medication routes? - Correct answer IV, IM, subcu, intranasal. Enteral medication routes? - Correct answer All involve the GI tract. Oral, rectal, sublingual. The CAGE assessment is what? - Correct answer A well-known tool to help EMS providers identify if a pt has a substance abuse issue. C- "Have you ever been concerned about your drinking?", A- "Have you ever annoyed by criticism of your drinking?", G- "Have you ever felt guilty about your drinking?", E- "Have you ever felt the need for an eye opener?". Alpha receptors cause what? - Correct answer Vasoconstriction and pale skin. Beta receptors cause what? - Correct answer Increase in HR. A penetration injury through the thoracic disrupting what structural lining, will cause the lung to collapse? - Correct answer Parietal pleura (adheres to the chest wall), will cause air to fill that space and eventually collapse the lung. When were ambulances first used in the US? - Correct answer 1800's.
What are the two most common electrolyte imbalances associated with dehydration? - Correct answer Hypokalemia, and hypernatremia. Hypernatremia has S&S of what? - Correct answer Weak, dizzy, lethargic, dehydrated, poor skin tugor, decreased urinary output, AMS. What are common risks associated with pt's receiving bronchoscopys? - Correct answer Pneumothorax An acute stress reaction is described as what? - Correct answer When a person experiences the S&S of stress directly after the incident, (angry, anxious, crying, nervous, etc). A brown-sequard injury (incomplete cord transection) - Correct answer Usually occurs in a stabbing, or traumatic event. Pt will only experiences loss of PMS on one side of the body, (right or left), or will experiences loss of sensation in one, but loss of motor in the other, meaning that the PMS is not equal on both sides. If they were equal, it would be a complete cord injury. What doesn't cause SLUDGEM affects? - Correct answer Cyandies. Organophosphates, nerve agents, and carbamates all cause the SLUDGEM affects. An MCI is defined as? - Correct answer When the # of pt's overwhelms the system. When approaching a school bus while you are driving priority, what's the safest approach? - Correct answer Come to a complete stop. Do not endanger children. When using the START system for triage, what is the first parameter for sorting pt's out? - Correct answer Identify the pt's who can walk. What is the antidote for anthrax? - Correct answer Ciprofloxacin What is the antidote for cyanide poisoning? - Correct answer Amyl Nitrate What is the minimum space for a LZ during the day? - Correct answer 60x
What is the most life threatening risk that is associated with lower abd pain in women? - Correct answer First, ectopic pregnancy. Second, PID- can lead to sepsis. What is an anaphylactoid reaction? - Correct answer An allergic reaction that happens after the first exposure to something. It's considered abnormal, and happens when a pt starts a new med or tries a new food. What are seratonin reuptake inhibitors? - Correct answer Prozac, Zoloft, and Paxil - used to treat a multitude of psychiatric disorders. What's the first thing an EMS responder should do when dealing with a car in an MVC? - Correct answer Make sure the ignition is turned off, and make sure the car is parked with the E brake on. How far can rotor wing aircraft go? - Correct answer They are typically deployed for distances less than 100 miles. For transports greater than 100 miles, what should you do? - Correct answer Fixed wing transport should be considered first. Tension headaches present with what S&S? - Correct answer Bilateral in nature. Cluster headaches present with what S&S? - Correct answer Causes severe pain, unilateral, may be a part of a cluster of several headaches over a period of days. More likely to occur in males. What is a big factor in contributing to a wound not healing? - Correct answer A pt with type 2 diabetes. It can affect wounds more than being old. How does albuterol help in a pt with a crush injury? - Correct answer Albuterol promotes movement of potassium to the intracellular space, resolving vascular hyperkalemia. If someone has a cognitive impairment, what does it affect? - Correct answer Language skills, memory abilities, and perceptual skills. If someone has a cerebral impairment, what does that affect? - Correct answer The ability to ambulate, motor skills.
In the AVR lead, what should it look like? - Correct answer Inverted everything (P, QRS, T). How to exactly determine a NG is in the right place? - Correct answer Aspirate the liquid and verify the PH level. When using a traction splint, where should the fracture be located to indicate using one? - Correct answer At the femoral diaphysis. Midshaft fracture. Diaphysis refers to the middle of the bone. What is autonomic dysreflexia? - Correct answer Sudden onset of excessively high BP. Usually seen in pt's with a spinal cord injury that involve the throacic nerves (T6 or above). S&S of autonomic dysreflexia? - Correct answer Sweating, blurred vision, hypertension, and anxiety. Bradycardia is also common. A pt with DKA is likely to a have a hx of what? - Correct answer Type 1 diabetes. AHA says the best way to provide ventilation's to someone is how? - Correct answer Mouth to mask. Pt's age 6-12 months can do what? - Correct answer Can grasp things with their hands, sit upright on their own & identify objects. What is percussion of the lungs used for? - Correct answer To determine whether the pt has a pneumothorax or a hemothorax. If you use the percussion technique, and you hear a dull sound what does that mean? - Correct answer It is interpreted as blood or other fluid. If you use the percussion technique and you hear a hollow sound, what does that mean? - Correct answer It is interpreted as air. Adrenergic agents affect or stimulate what? - Correct answer The CNS system.
What gas law describes the bellows action of the chest? - Correct answer Boyle's law, think "Boyle's bubbles". Henry's law describes what? - Correct answer The effects of pressure on keeping gases dissolved in liquids "Henry's hyperbaric". What makes up "stroke volume"? - Correct answer Determined by ventricular preload, myocardial contractility, and afterload. Sodium bicarb is now no longer used when? - Correct answer In cardiac arrest situations. It may be used in cases of suspected hyperkalemia, metabolic acidosis, and tricyclic overdose. Use of nitroglycerin should be withheld in the event of what kind of MI? - Correct answer Inferior. How to test for a change in cardiac output? - Correct answer SV x HR. Which ever answer is furthest from the baseline is the correct one. What is one limitation to be considered when using rotor-wing transport not present in other modes of transportation? - Correct answer Pt weight. What is the major factor that sets apart a TIA from other strokes? - Correct answer It's symptoms last less than 24 hrs. The FDA categories for medication while pregnant are what? - Correct answer A, B, C, D, X, and NR. A is considered safe. B is when the risks to the fetus are remote. C indicates fetal risk, which cannot be ruled out. D means there is evidence of fetal risk. X is complete off limits for pregnancy. NR means "no rating". DNA is stored within the what of the cell? - Correct answer The nucleus. Succinylcholine is contraindicated in what kind of pts? - Correct answer Pt's with suspected hyperkalemia. Burns, crush injuries, or prolonged bed rest, and dialysis pt's because the frequently experience electrolyte imbalances. What is a cumulative effect when giving meds? - Correct answer The total effect of two medications for the clinical treatment of a single condition.
If a pt has a LVAD device, and goes into cardiac arrest, what should be done? - Correct answer A manual foot or hand pump may be used to support circulation. Do not start compression's as it could tear the LVAD from the muscle wall. Electrical therapy can be performed, but the pump needs to be disconnected first. Uncuffed ET tubes are used for what ages? - Correct answer Until ages 8-
Whats the formula for figuring out proper ET tube size? - Correct answer (age + 16) / 4 The leading cause of death in the elderly population is? - Correct answer Cardiovascular disease. Someone who is diagnosed with ataxia will experience what? - Correct answer Loss of coordination and balance. What is a cumulative effect when giving meds? - Correct answer The total effect of two medications A BGL reading less than what in a neonate is considered hypoglycemic? - Correct answer Less than 45. Tinnitus is caused by what medication? - Correct answer Baby aspirin. How do the physiological effects of aging impact the dosing of certain medications? (particularly the ones that dissolve in fat) - Correct answer The med will stay in the body longer in the elderly, because of the higher body fat %. The elderly have a lot less muscle. DKA is best treated in the prehospital setting with what? - Correct answer An isotonic fluid admin at 1.5 to 2 times typical maintenance rate. What is not a way to stabilize a vehicle? - Correct answer Lifting the vehicle off the ground, using air bags. Wernicke's encephalopathy is commonly caused by what? - Correct answer A chronic deficiency of vitamin B1.
ET intubate the pt & ventilate with a BVM or reconnect the ventilator. They can place in a new tracheostomy tube. Lastly, they can bag the stoma directly with a BVM. What is a psuedo seizure? - Correct answer It is caused by a psychiatric emergency. How many milligrams is in a gram? - Correct answer 1,000 ml's in one g. What are mongolian spots? - Correct answer They are melanotic pigmentations commonly found in african americans and native americans. They are found on the skin, and eventually go away. Crenation - Correct answer Shrinking of a cell due to osmosis. Hemolysis - Correct answer Breaking of a cell. Atrophy (of a cell) - Correct answer Also involves the shrinking of a cell, but is not due to an osmotic force, and is usually due to tissue breakdown. Hypertrophy (of a cell) - Correct answer Enlarging or thickening of a cell. Class 1 research - Correct answer Most reliable and valid, it is the highest and best for citation, research and policy development is derived from prospective, controlled, randomized, double-blind studies. Class 2 research - Correct answer Biased, non-randomized, or retrospective studies with weaker evidence. Class 3 research - Correct answer Case studies, medical opinions, or consensus documents. Clinical research - Correct answer Focuses on improving pt outcomes. Evidence-based research - Correct answer Aims to improve medical practices. Descriptive statistics - Correct answer Describes a phenomenon.
Inferential statistics - Correct answer Can use information learned in the groups to make predictions about the general public. Pandemic disease - Correct answer Meets two criteria, number 1 is it affects many people across a large region, and number 2, is the disease is infectious in nature. Trigeminal nerve - Correct answer 5th cranial nerve, it is responsible for chewing and facial sensation. Oculomotor nerve - Correct answer 3rd cranial nerve, controls eye movement. Olfactory nerve - Correct answer 1st cranial nerve, controls sense of smell.
