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1. A 45-year-old patient is found supine on the floor. Healthcare providers note pinpoint pupils, shallow respirations, and vomitus in and around the mouth. What course of action should be taken next? a. Initiate an IV and administer naloxone c. Obtain a blood glucose level d. Begin BVM ventilations - b. Supplemental oxygen and suction 2. Patients with a history of COPD that present with an acute onset of shortness of breath are likely to have what condition? b. Angina pectoris c. Angioedema d. Hypertensive crisis - a. Pulmonary embolism 3. During compensatory shock, the renin-angiotensin-aldosterone system is activated to cause a/an: b. Decrease in preload, afterload, and re-absorption of sodium c. Hypotension and bradycardia d. Vasodilation and sodium retention - a. Increase in preload, afterload, and re- absorption of sodium 4. What clinical findings are most commonly associated with a pulmonary embolus? b. Rhonchi auscultated bilaterally with hypercarbia c. Crackles heard in the bases with bradycardia d. Fever, tachycardia, and tachypnea with increased work of breathing - a. Clear breath sounds with tachypnea 5. What condition is most likely to cause respiratory acidosis? a. Anxiety/panic attack c. Methanol ingestion d. Diabetic ketoacidosis - b. Narcotic overdose 6. A 55-year-old complains of an 'aching' chest discomfort that persists over several days. The patient has a temperature of 101F (38.3C). Which finding will help narrow the diagnosis to pericarditis? a. Pain is relicved when supine b. Pulsus alternans is present c. $3 gallop is auscultated d. ST-segment elevation in all leads - d. ST-segment elevation in all leads 7. Anaphylaxis is most associated with which physiological cvent? a. Hemorrhage c. Bradycardia d. Hypertension - b. Vasodilation 8. Acute Respiratory Distress Syndrome (ARDS) is characterized by what pathological change? a. Excessive mucous production b. Inflammation of the visceral pleura d. Accumulation of fluid between the pleural layers - c. Breakdown of the alveolar- capillary membrane d. Decrease in dead space ventilation - c. Decrease in lung compliance 14. Paroxysmal nocturnal dyspnea is most common in patients with a history of: b. Pneumonia c. Asthma d. Multiple sclerosis - a. Left-sided heart failure (?) 15. The patient presents with a history of fever and an upper respiratory infection. Historical information reveals increasing water intake, orthostatic hypotension, and an increase in urination. You suspect these symptoms are caused by: b. Hypoglycemia c. Hypokalemia d. Respiratory acidosis - a. Hyperglycemia 16. You are dispatched to the home of a 32yo patient with a history of Graves' disease. The patient was in the ER earlier today for some "tests for my ulcers." He received contrast and was discharged. He is now complaining of not feeling well, chest pain, and palpitations. You note an anxious patient with fine tremors. He is diaphoretic and has a temperature of 101.5F, BP 100/62, P 156 (sinus tach), R 30, glucose level 133. Which of the following arc management considerations for this patient? a. Aspirin (ASA) b. Fluids restriction c. Amiodarone d. Beta blockers - d. Beta Blockers 17. Metabolic acidosis is best described by which arterial blood gas interpretation? a. pH clevated, pCO2 clevated, H2CO3 normal range c. pH decreased, pCO2 elevated, H2CO3 normal range d. pH elevated, pCO2 elevated, H2CO3 normal low - b. pH decreased, pCO2 decreased, H2CO3 low (?) 18. The AMLS Assessment Pathway first advises safety and initial observations of the scene. The second process described in this pathway asks the healthcare provider to: a. Perform a focused physical exam b. Obtain diagnostic information d. Reassess and refine the diagnosis - c. Identify and manage life threats 19. Observing a patient's body positioning can be an early indicator that the patient is: b. Does not speak the same language as the provider c. Has family who can provide historical information d. Diagnosed with multiple underlying medical conditions - a. Sick or not sick 20. Which asscssment finding is crucial to obtain from a paticnt suspected of a stroke? a. Last oral intake b. Medication allergics d. Risk factors - c. Onset of symptoms ” 21. A 62yo patient presents with a severe headache. It is described as a "thunderclap accompanied with nausea, blurred vision, and an elevated blood pressure. What neurologic condition is most likely the cause of this paticnt's presentation? a. Brain abscess b. Ischemic stroke c. Epidural hematoma @Sibarachnoidihemorhage - d. Subarachnoid hemorrhage d. Clostridum difficile - c. Methicillin-resistant Staphylococcus aureus 26. A foreign exchange university student is found by his roommate and EMS is dispatched. The patient presents with an unusual flat red rash on his chest and arms. He has been ill with fever, nausea, and vomiting. Physical exam reveals stiffness of the neck. The healthcare provider will anticipate which diagnosis? a. Chicken pox (varicella) c. Encephalitis d. H5, N1 (avian) influenza - b. Meningitis 27. Healthcare providers are treating a 49yo male complaining of diffuse abdominal cramping. He has been ill with vomiting for 3 days. What working diagnosis is most probable? a. Appendicitis b. Cholecystitis c. Diverticulitis G@NGasiroentenus - d. Gastroenteritis 28. While assessing your patient, you note he involuntary flexes the legs in response to flexing his neck. The patient is presenting with: a. A positive Murphy's sign indicating possible cholecystitis c. A positive Psoas sign indicating possible meningitis d. The presence of a Babinski reflex indicating possible spinal cord lesion - b. A positive Brudzinski's sign indicating possible meningitis 29. Healthcare providers are assessing an obese 49yo who is lethargic and has not been feeling well for several days. His family reports a history of extreme thirst. Vital sings are P 143, R 14, and BP 88/58. He takes medication for type 2 diabetes daily. What is the most probably working diagnosis? a. Thyroid storm b. Cushing's syndrome c. Diabetic ketoacidosis SA YPEOSHNGI AT PeMAIVeeMIeMONREME|eoMA - d. Hyperosmolar hyperglycemic nonketotic coma 30. A firefighter has been working a fire for 4 hours on a humid, hot day. He suddenly becomes nauseated and restless. The provider observes pupil dilation and an almond odor to his breath. The vital signs are P 56, R 22, BP 140/86. The ECG reveals sinus bradycardia with occasional PACs. Which toxin exposure has occurred? a. Carbon monoxide poisoning b. Cocaine overdose c. Ethanol poisoning SUGARS PSINOAIAS - d. Cyanide poisoning 31. Healthcare providers are treating a patient that has taken an unknown amount of a prescribed pain medicine along with an OTC analgesic numerous times over the last 36 hours for chronic lumbar pain. The patient is experiencing abdominal pain, nausea, and vomiting. The providers note pallor and diaphoresis. Blood glucose is 42. What toxin overdose is suspected? a. Amphetamine c. Barbiturate d. Benzodiazepine - b. Acetaminophen 32. A patient complains of nausea and is passing black, tarry stools rectally. This patient is most likely suffering from: a. Cholecystitis b. Lower GI bleed d. Bowel obstruction - c. Upper GI bleed 37. If untreated, a cardiac tamponade will present with signs and symptoms of which type of shock? a. Hypovolemia b. Neurogenic d. Cardiogenic - c. Obstructive 38. A paticnt presents anxious with difficulty in breathing and chest pain. An assessment reveals hypotension, muffled heart tones, and distended neck veins. There is a past medical history of pericarditis. The provider notes that there is a decrease in systolic blood pressure when the patient inhales. Which diagnosis would be considered with this presentation? a. Acute coronary syndrome c. Tension pneumothorax d. Pneumonia - b. Cardiac tamponade (?) 39. The healthcare provider is assessing a 60yo female patient with complaints of indigestion and mild upper abdominal discomfort. This presentation should prompt the provider to: b. Place a gastric tube and assess for GI bleeding c. Listen for heart sounds and determine if pericardial fluid is present d. Don a mask, gown, and observe standard precautions in case of influenza - a. Perform a 12-lead ECG 40. The most common underlying medical conditions found in patients with acute pancrealilis is: b. Esophageal varices and stomach ulcers c. Mallory-Weiss syndrome and nephritis d. Peptic ulcer discase and diverticulitis - a. Gall stones and heavy alcohol use 41. A patient complaining of a 3-day history of left lower abdominal pain describes it as sharp and, during the focused physical exam, the pain intensifies during palpation over the site. Differentials should include: b. Pancreatitis or gall bladder infection c. Peritonitis or intestinal obstruction d. Appendicitis or hepatitis - a. Ectopic pregnancy or diverticulitis 42. A 22yo male has recently undergone a surgical procedure to repair an injury to thoracic vertebrae T4-T6. Assessment indicates the patient is alert and oriented, bradycardic, hypotensive, and has warm, dry skin. Which type of shock is most likely occurring? a. Hypovolemic b. Obstructive c. Cardiogenic GUNGHISEEREE - d. Neurogenic 43. A caregiver for a quadriplegic patient notes an onset of difficulty in breathing and anxiousness in her patient. Further assessment shows a temperature of 1011.2F, P 128, BP 86/68, and R 24. Physical cxam reveals the skin is warm and urine in the catheter is dark yellow and cloudy. This patient is most likely experiencing which type of shock? a. Hypovolemia c. Obstructive d. Cardiogenic - b. Septic 44. When assessing geriatric patients, infectious diseases are more difficult to identify for all of the following reasons EXCEPT: a. History may be difficult to obtain 48. A 20yo female presents with a 2-day history of dyspnea, nonproductive cough, chest tightness, and audible wheezing. Further exam reveals no fever or stridor. The patient has rapid respirations with difficulty exhaling. Which diagnosis is most likely? a. Epiglottitis b. Respiratory syncytial virus d. Bronchiolitis - c. Asthma 49. An elderly patient with a 1-week history of productive cough and wheezing notices an increase in difficulty breathing when grocery shopping. Further assessment reveals pursed lip breathing, rhonchi, and minimal jugular vein distension. Which diagnosis should the provider suspect? b. Pulmonary embolism ce, CHF d. Epiglottitis - a. COPD 50. A 50yo female has called 9-1-1. She complains of shortness of breath and chest discomfort. Assessment reveals her skin is pale, moist, and cool. BP is 102/68, R 24 and labored with crackles, P of 130 and regular. Which type of shock is most likely occurring? a. Septic b. Obstructive c. Hypovolemic d. Cardiogenic - d. Cardiogenic 
