Description

PAR 100 Volume 5 Chapter 1

1. You have been resuscitating a newborn and find that after ventilation by BVM with supplemental oxygen for 30 seconds that his HR is 78 per minute.  Which of the following should you do next?
2. Which of the following types of congenital anomalies is most common?
3. You are caring for a newly born infant delivered approximately 8 minutes ago.  The infant had a 1 minute APGAR score of 6, which improved to 7 at 5 minutes.  Despite drying, warming, suctioning, and stimulating the infant, he continues to have central cyanosis.  His HR is 132, and his respirations are 50.  Which of the following is the best action in this situation?
4. Which of the following statements is true of prehospital newborn care?
5. Which of the following sets of vital signs is normal for a newborn?
6. You have just delivered a newborn who was initially apneic and cyanotic.  After suctioning, drying, warming, and stimulating the infant and administering blow by O2, you find that the infant has a RR of 35 with signs of respiratory distress, a weak brachial pulse of 70, and continuing central cyanosis.  Which of the following should you do next?
7. Which of the following is an intrapartum risk factor for newborn distress?
8. Your assessment of a newborn reveals respiratory distress; heart sounds auscultated over the right chest; and a small, flat, abdomen.  What is your field diagnosis for this patient?
9. At 90 seconds after birth, based on the following findings, which newborn does NOT require resuscitative efforts beyond routine care?
10. You have been called to the residence of a 5 day old infant.  His parents are concerned because he sleeps about 18 hours a day.  They took a rectal temp and got a reading of 100 degrees F.  Which of the following is the best course of action?
11. Which of the following may occur secondary to suctioning the airway of an infant?
12. Based solely on a 1 minute APGAR score of 7, which of the following actions should you take?
13. Which of the following parameters is the most important indicator of neonatal distress?
14. Which of the following is NOT a consequence of respiratory insufficiency in the newborn?

Volume 5 Chapter 2

1. Which of the following is the most common cause of cardiac emergencies in pediatric pts?
2. Which of the following affects the lower airway?
3. Your pt is a 5 year old female who awoke with a harsh cough, sore throat, drooling, and high fever.  She has shallow respirations of 40 and inspiratory stridor.  She is completely focused on breathing, learning forward on her outstretched arms.  Which of the following is the best course of action?
4. Your pt is a 3 year old child who has had a mild cold for 24hrs.  This evening, the parents have called EMS because the child awoke with a hoarse, “barking’ cough and seems to be having some difficulty breathing.  You note that the child is afebrile and his breath sounds are clear but that he has significant inspiratory stridor.  His respiratory rate is 30, his pulse is 124, and he is anxious but lacks peripheral cyanosis.  Which of the following responses indicates the most likely cause and the appropriate treatment of the child’s problem?
5. Which of the following is NOT a sign of respiratory distress in the pediatric patient?
6. The most common cardiac dysrhythmias in pediatric patients are:
7. Which of the following childhood respiratory diseases has increased dramatically over he past few decades?
8. As the pediatric patient progresses from respiratory distress to respiratory failure, which of the following occurs?
9. Which of the following is true of asthma in the pediatric patient?
10. Your pt is a 4 yr old child whom you have intubated due to respiratory failure secondary to asthma.  During reassessment of the child, which of the following would indicate increased end organ perfusion?
11. Which of the following is NOT part of the pediatric assessment triangle when forming your general impression of the pts condition?
12. Your pt is a 16 yr old female cheerleader who fell while attempting a pyramid formation and struck her forehead on the back of another girls head.  She has a 2cm lac just above her right eyebrow.  Sheis tearful and asks you if you think she is going to have a scar.  Which of the following is the best response?
13. Which of the following may compromise prehospital ventilation in the pediatric pt?
14. Your pt is an 11 year old male quadriplegic who depends on a phrenic nerve stimulator to stimulate contraction of his diaphragm and allow him to breathe.  You are called to the home during a thunderstorm that has caused a power outage.  Which of the following is the best course of action?
15. Your pt is a 9 year old female who was injured when her hand slipped into a hole in the ground while she was turning a cartwheel.  She is upset and has an obvious deformity of her left humerus.  She asks you if her arm is broken.  Which of the following is the best response?
16. Which of the following is NOT a sign of respiratory distress in the pediatric pt?
17. Which of the following best explains the cause of sudden infant death syndrome?
18. Which one of the following statements regarding ventilation of the pediatric pt is true?

Volume 5 Chapter 3 Geriatric Emergencies

1. Which of the following is true of aging of the cardiovascular system?
2. Which of the following does NOT complicate history taking in the elderly pt?
3. The term elderly applies to a person beginning at age:
4. Which of the following factors increase the likelihood of stroke in the elderly?
5. The study of the effects of aging and age related diseases in human beings is called:
6. Which of the following does NOT contribute to poor nutrition in the elderly?
7. Your 78 year old pt gives a history of CHF, renal insufficiency, and type 2  diabetes.  Together, these conditions are called:
8. Which of the following medications does NOT cause constipation in the elderly?
9. Your pt is a 75 year old female complaining of constipation and abdominal pain for 2 days.  Your physical examination reveals a moderately distended abdomen.  Which of the following is the best course of action?
10. Which of the following actions of the paramedic may lead to decubitus ulcer development in the elderly pt?
11. Which of the following is NOT associated with diabetes in the elderly?

Volume 5 Chapter 4 Abuse and Assault

1. What is the most common physical sign of abuse in children?
2. You have responded to a residence for an injured child. The mother presents you with a 2-year-old boy crying loudly. She says he fell of the family playground equipment and won’t stop crying. You ask the boy what happened, and he points to the jungle-gym outside and cries more. You notice some 7-10-day-old bruises on his shins, but no other signs of injury. What impression could you form using your knowledge of child abuse?
3. Which characteristic makes rib fractures in children raise a high index of abuse suspicion?
4. What is your primary responsibility when you are involved in an abuse call?
5. Which of the following situations would raise your level of suspicion that a child is being abused?
6. Which type of questioning is appropriate when assessing the battered patient?
7. Which of the following is NOT a factor associated with elder abuse?

Volume 5 Chapter 5 Challenged Patient

1. You are about to transport a cancer patient who complains of dyspnea. She is hemodynamically stable, and she has a history of asthma and has some diffuse wheezes. You are going to administer an albuterol treatment, and your protocol states that you should start an IV when you give a breathing treatment. The patient says she has very bad veins, but she has an implanted port under the skin of her left chest. What is the best course of action to take regarding this patient?
2. Multiple sclerosis is classified as which of the following types of disorders?
3. Which of the following organ systems are affected by cystic fibrosis?
4. Which of the following medications are most commonly used to treat arthritis?
5. Patients undergoing chemotherapy commonly suffer from which of the following conditions?
6. Many of the complications of cystic fibrosis are due to overproduction of which of the following?
7. An injury to which cervical verterbra may prevent a person from breathing?

Volume 5 Chapter 6

1. What is the term for the skin’s ability to return to its normal appearance after being subjected to pressure?
2. Which of the following interventions would NOT be appropriate when treating a hypotensive pt due to postpartum bleeding?
3. Which of the following best describes a dialysis shunt?
4. Which of the following would NOT indicate the potential for a urinary tract infection?
5. One of the major differences between a Groshong and a PICC line is
6. Which of the following best describes a tracheostomy?

Volume 5 Chapters 7 and 8

1. Which of the following statements best describes the criticality of the paramedic’s ability to proficiently perform patient assessment and formulate field diagnoses?
2. You have responded to the scene of a patient who has been vomiting dark blood and blood clots. She is weak and anxious and has cool, diaphoretic skin. Her pulse is 130, her blood pressure is 94/60, and her respirations are 24. Which patient assessment approach should you take?
3. Your patient is a 70-year-old female who was getting her hair done at the beauty salon when she became ill. She is awake but does not respond to your presence. Her lips and nail beds are cyanotic, and she is making weak, rapid respiratory effort. Which of the following should you do first?
4. Which of the following best describes the relative importance of the history and physical examination?
5. You have been dispatched to assist a BLS unit on the scene of a crash approximately 15 miles outside town. The BLS crew reports that they have a 45-year-old male involved in a single vehicle crash. They say he is normotensive and complaining of abdominal pain. You are puzzled as to why they do not transport, or at least intercept. Upon arrival, you find the BLS unit stuck in the mud. The patient is a pit worse off than they conveyed. His blood pressure is 80/50, his heart rate 110, and his respiratory rate 16. He complains of abdominal pain, and you believe he has an unstable pelvis. You are 20 minutes by ground from a Level 1 trauma center. That center does have a helicopter. What is your best action?
6. Your patient is a high-school basketball player who suddenly became short of breath during practice. As he ran down the court, he felt a sharp pain in the left side of his chest, which he describes as being “behind his nipple.” He appears to be in moderate respiratory distress. He is breathing 28 times per minute, has a room air pulse oximetry reading of 95%, a heart rate of 96, blood pressure 116/78, and warm, moist skin. The monitor show that he is in a sinus rhythm, and auscultation of the chest reveals diminished lung sounds on the left. Which of the following interventions is indicated for this patient?
7. Most state rules regarding ambulance supplies tend to regulate which of the following types of standards?
8. Your patient is a 45-year-old male who has received several stab wounds to the chest and abdomen. Although bleeding was significant at first, the rate of bleeding has slowed considerably on your arrival. The patient is agitated and confused, pale, diaphoretic, and cool to the touch. He lacks a radial pulse, and his carotid pulse is weak and rapid. Respirations are 28 and shallow. Which of the following can be said about this patient with certainty?
9. Which of the following items would NOT typically be seen on a vehicle/equipment checklist?
10. Which of the following factors should you allow to determine your driving speed when responding on a call?
11. In general, the best assessment approach for a patient with a behavioral emergency is:
12. Which of the following phenomena affects devices such as ETT cuffs and MAST pants during helicopter flight?
13. You have just arrived at work when the house captain informs you that you have a new employee riding along today to observe ambulance operations. He tells you to have the “rookie” do everything he can. What should your reaction be?
14. Which of the following best describes the danger in using an escort to or from?
15. Which of the following guidelines should you following when arriving for you’re your duty shift?
16. Your patient is a 34-year-old female found unresponsive in a bathtub of cold water in a house in a part of town known for drug trafficking. She is unresponsive to all stimuli, is breathing shallowly at 4 times per minute, has a barely palpable radial pulse of 60, and her skin is very cool and mottled. Upon checking her pupils, you note that they are very constricted and nonreactive to light. Of course you will remove her from the bathtub. After that, what should you do?
17. Which of the following patients does NOT require a detailed physical examination?
18. Your patient was just released from the emergency department after being treated for nausea and vomiting. Her roommate called because the patient is having a spasm in her neck, causing her head to be fixed in an awkward position. This patient is most likely suffering from________________ and should be treated with _______________.
19. Which definition best describes System Status Management?
20. Your patient is a 32-year-old female, 28 weeks pregnant. She was shopping in a department store when she became lightheaded and short of breath. On your arrival, she is sitting in a chair, complaining of palpitations, faintness, and the inability to catch her breath. She is pale and anxious, but alert. Her skin is dry, her blood pressure 108/78, her radial pulse weak and rapid, and her respirations are 28. The monitor shows an SVT at a rate of 180 per minute. Which of the following interventions should be attempted first?
21. Your patient is a 40-year-old female 10 days postoperative for an abdominal hysterectomy. She has a history of asthma and type I diabetes. Her husband called EMS this morning because she became very short of breath and complained of chest pain while getting dressed. On your arrival, you note 20-word dyspnea and that the patient is diaphoretic with cyanosis of her lips, ears, and nail beds. Her blood pressure is 92/60, and her heart rate is 120 with the monitor showing sinus tachycardia; her respiratory rate is 32. Auscultation of the chest reveals clear and equal bilateral lung sounds. The abdomen is soft and nondistended with minor incisional tenderness. There is no peripheral edema. Which of the following is the best treatment option?
22. Which of the following best describes the concept of due regard?
23. Which of the following best describes the appropriate timing of the rapid trauma assessment?
24. Your patient is a 32-year-old female with a history of epilepsy. Her fiancé called EMS when she had a grand mal seizure. On your arrival, the patient responds to painful stimuli and has copious oral secretions, deep respirations at 28 per minute, and a radial pulse of 88. The fiancé reports that the seizure lasted about 1 ½ minutes. Which of the following represents the best course of action for this patient?
25. A siren is typically heard how many feet ahead of it my motorists?
26. How often should a thorough check of equipment on the ambulance be made?
27. Intuition in field diagnosis develops as a result of:
28. You have just arrived on the scene of “a pedestrian struck” to find one of your “frequent fliers,” a homeless individual with a history of chronic alcoholism, lying in the street next to a vehicle. You have transported “Albert” several times for allegedly being struck by a vehicle, but you suspect that he deliberately walks into the side of  slow-moving vehicles in an attempt to receive compensation for “damages.” On this night, Albert is belligerent and uncooperative and smells of ethanol, which is not unusual. Albert has vomited on his clothing and has been incontinent of urine. His speech is slurred and rambling, and he does not answer your inquiries with appropriate responses. Which of the following may explain Albert’s behavior?
29. Which of the following refers to the type of ambulance with a standard van chassis?
30. Which of the following may result in an inaccurate or incomplete history and patient assessment?
31. Which of the following is the general rule for setting up the dimensions of a helicopter landing zone?
32. Which of the following refers to the type of ambulance that is fairly new to the market and is designed to carry loads of over 24,000 pounds?
33. When is a “spotter” used?
34. Which patient would NOT be a candidate for helicopter transport?
35. Your patient is a 19-year-old female who had a syncopal episode but is alert and oriented on your arrival. She is in no apparent distress. Which patient assessment approach is appropriate for this situation?
36. Which of the following is a good rule of thumb for determining the distance to use when positioning the ambulance at a crash scene?
37. Which of the following was identified by data from New York State as the most common type of crash involving an ambulance?
38. Your patient is a 60-year-old female whom you are transporting due to a chief complaint of chest pain with associated shortness of breath. You have administered oxygen, nitroglycerin, aspirin, and morphine. En route, you note an asystolic rhythm on the monitor. Which of the following should be your first action?
39. Which of the following plays a role in accurate field diagnosis?
40. Which of the following refers to the process by which an agency maneuvers equipment and personnel to reduce response times?
41. Which of the following describes a system that uses a number of agencies, responder levels, and delivery vehicles?
42. Which of the following agencies became involved with setting ambulance standards due to an increased awareness of infectious disease and hazardous materials?
43. Which of the following types of ambulance supplies do NOT have expiration dates?
44. Fixed wing aircraft are typically used for transports exceeding which distance in miles?
45. Which of the following best describes “peak load”?
46. Which of the following is the general rule for setting up the dimensions of a helicopter landing zone?
47. Which of the following refers to the equipment and supplies required on every ambulance?

Volume 5 Chapter 9

1. Which of the following may result if incident command is not established early in an incident?
2. Which piece of equipment can aid in the management of an MCI by making identification of key officers quicker and easier?
3. What level of the incident management system is rarely implemented at small- and medium-scale incidents?
4. You are a paramedic assigned to a nontransporting ALS unit for a rural fire department. You are the only paramedic on duty in the country. You are dispatched and first on the scene of a crash along a two-lane road. A van carrying a family was turning in the family’s driveway when it was struck from behind by a tractor-trailer. There were 9 people in the van and 2 in the tractor. A neighbor, who is also a nurse in the local ER, lives next door and is on scene doing CPR on one of the children. What would be a prudent action for you to take and why?
5. What is the preferred method of assessing perfusion in the adult victim during triage?
6. Which of the following patients would be tagged “red” using the START system?
7. How many people should be in the “span of control” of one individual at an incident?
8. When transferring command, which of the following must be done?
9. By which of the following means should sector and branch officers be identified at single or multijurisdictional incidents?
10. Which of the following types of command would be best to implement in a multijurisdictional incident?
11. Which of the following agencies established a standardized national approach to incident management for mass casualty incidents?
12. Which of the following best describes the role of the safety officer in the incident management system?
13. Which of the following serves as a guideline determining the threshold for classifying a situation as a multiple-casualty incident?
14. Which of the following best describes “size-up”?
15. You have responded to an explosion on a subway train. Because you are a paramedic, the officer on your engine tells you to begin to triage the victims. What should your first action be with regards to triage?
16. You have arrived on the scene of a motor-vehicle collision with multiple patients. You are the fourth-due unit. You are given an assignment to establish a triage sector for the 10-plus patients who have been identified. You find one person you believe must be transported immediately. What is the most prudent action you should take?
17. Which of the following may evolve into a Mass Casualty Incident?
18. Which of the following is the only acceptable technique for airway management during triage?
19. Which of the following is true of MCI drills?
20. What is your top priority at a multiple-casualty incident?
21. What basic medical supplies should triage officers always carry with?
22. Which of the following serves as a mnemonic for remembering the main functional areas of the Incident Management System?
23. Which of the following is the purpose of early identification of a “staging area”
24. How long should it take you to triage one patient during an MCI?

Volume 5 Chapter 10

1. The windshield of automobiles is made of:
2. Which of the following is a toxic gas which results from incomplete exhaustion and may be found in a confined space
3. Which of the following water factors directly impacts a pts survival in the water?
4. In which of the following ways can hypothermia interfere with water rescue efforts?
5. The key to smooth, safe, rescue operations is:
6. You have been caught in a flash flood and have underestimated the depth of the water and the strength of the current.  As you float downstream, you notice a partially submerged tree in the water.  Which of the following approaches should you take?
7. Which of the following is the most common type of rescue
8. Which of the following posts supports the roof of an automobile at the windshield?

Volume 5 Chapter 11 Hazmat

1. Which of the following is NOT a responsibility of EMS personnel responding to a hazardous materials incident?
2. You are dealing with a substance that has a specific gravity of 0.46%.  This means that the substance will:
3. The main objective of terrorist acts is to:
4. Which of the following spreads radioactive contamination through converntional explosives?
5. “Any substance which pose an unreasonable risk to the health and safety of operating or emergency personnel, the public, and/or the environment if not properly controlled during handling, storage, manufacture, processing, packaging, use, disposal, or transportation” best defines which of the following?
6. As you approach the scene of a MVC, you realize that there is a tanker truck involved and that it has tipped over.  Which of the following actions is appropriate?
7. When you reach the scene, look for any placards on the tanker and reference the Emergency Guide Book Which of the following is the most important goal to achieve in the initial minutes of an MCI?
8. The most accurate information about a transported substance can be found in which of the following?
9. When staging resources for a hazardous materials incident, the best location is:
10. Which of the following is the most common route of exposure to hazardous materials?
11. The temperature at which a liquid becomes a gas is known as the:
12. Which of the following is the universal decontamination agent for hazardous materials exposure?
13. Which of the following is used to identify hazardous materials in fixed facilities?
14. You and your partner are first on the scene of an explosion at a university lab where stem cell research is being done.  Of which of the following should you be aware?
15. It has been determined that the concentration of a substance is at the IDLH.  This means that pts exposed to the area:
16. Which of the following is the weapon of choice for terrorists worldwide?
17. Which of the following is used to identify hazardous materials in transit?

Volume 5 Chapter 12 Crime Scene

1. You are on the scene of a call for an injured woman.  Your scene sizeup did not reveal any indications of danger.  Upon assessing the pt, she tells you that she was beaten with a telephone receiver by her estranged husband.  Before you can request law enforcement assistance, the husband returns with a baseball bat and threatens to kill you if you don’t leave the house and states that, “She’s staying here,” in reference to the pt.  The assailant is standing with the bat held above his shoulder, ready to swing.  Which of the following is the best course of action?
2. You have responded to a report of an unresponsive person in a vehicle on a dark city street.  On arrival, you note the vehicle dexcribed by dispatch, but there is not one around it.  Which of the following apply in this situation?
3. You have responded to a call of difficulty breathing at a rural location.  As memory serves you, the farm house you are responding to has been abandoned for years.  As you approach on the main road, you see several vehicles parked around the house, although it is apparent that the house is not in livable condition.  For which of the following should you maintain a high index of suspicion?
4. Which of the following is the most important considerations when dealing with a pt who has a behavioral emergency?
5. You are on the scene of an assault.  While you quickly assess the pt, your partner is observing the scene for danger.  This is called the ____ approach
6. You have arrived at the scene of a vacant building for a report of a “man down”.  The odors and activity at the scene lead you to suspect that this is a clandestine drug lab.  Which of the following is the best course of action?
7. Which of the following guidelines should paramedics follow to protect themselves from physical violence?
8. Which of the following best describes the necessity of paramedics wearing gloves when providing pt care at a crime scene?
9. You have started an IV at the scene of a crime and left some blood on the floor.  Which of the following best describes the reason why you should notify police?
10. You are transporting a pt with a gunshot wound to the hospital and are being accompanied in the pt compartment by a police officer.  Just before going into cardiac arrest, the pt says, “it was Joey.  Joey did this to me.” The pt cannot be resuscitated and is pronounced dead in the emergency department.  Which of the following is true regarding the pt’s dying declaration?
11. People in which of the following age groups are more likely to commit a violent crime?
12. Which of the following is a benefit of computer aided dispatch in preventing violence against EMS personnel?
13.  You have just approached a residence for a “injured person”. Which of the following safety measures should you take?

PAR 100 Volume 5 Chapter 13 Rural EMS

1. Which of the following may adversely impact the delivery of EMS in rural areas? 
2. Which of the following poses a threat to agricultural workers in the rural setting?
3. Which of the following factors can account for a delay in the time it takes a pt in a rural setting to reach definitive care?
4. Although hospitals are widely scattered in rural areas, you might expect to find _____, which are capable of providing limited, nonemergent medical care to meet some of the urgent health care needs of the community.
5. Which of the following types of trauma would you expect in a rural area?
6. Which of the following best describes the EMS staffing situation in rural areas?
7. Which of the following is a characteristic of the rural setting?

Volume 5 Chapter 14 Terrorism

1. The main objective of terrorist acts is to:
2. Terrorist attacks are most likely to be targeted toward which of the following?
3. Which of the following is the cardinal sign of a toxic chemical release?
4. Which of the following is NOT a typical indication of exposure to a chemical nerve agent?
5. Which of the following is an example of an incendiary agent or device?
6. Which of the following questions should guide the paramedic in ethical decision Making?
7. When students are working with patients under a preceptor in an EMS system, at which point should the preceptor inform the patients that their care or part of it is being performed by a student?
8. When analyzing an ethical problem, the method in which you ask yourself whether you would be willing to undergo a procedure or action if you were in the pts place is know as
9. When analyzing an ethical problem, the method in which you ask whether you would want an action performed in all relevantly similar circumstances is known as the :
10. The most common situations involving allocation of scarce resources that paramedics will usually face are these involving:
11. The right of competent people to determine what happens to their bodies is one example of the principle of:
12. The four fundamental priniciples or values used to resolve problems in bioethics today include all of the following except?
13. When analyzing an ethical problem, the method in which you ask yourself whether you can vindicate your actions to others is know as the
14. Rules and standards that govern the conduct of a particular group or profession are called
15. Socail, religious, or personal standards of the right and wrong are called:
16. The obligation of a paramedic to treat all pts fairly is an example of the priniciple of: