Paramedics Exam Paramedic Exam EMT 2 — Questions and Answers
Question 1: A patient presents with severe respiratory distress, JVD, tracheal deviation to the right, and absent breath sounds on the left. What is the priority intervention?
- Immediate needle decompression on the left (Correct answer)
- Bag-valve-mask ventilation
- Immediate needle decompression on the right
- Endotracheal intubation
Correct answer: Immediate needle decompression on the left
Tension pneumothorax on the left causes tracheal deviation away (to the right); needle decompression at the 2nd intercostal space, midclavicular line on the affected side is the priority.
Question 2: Which of the following ECG findings is most consistent with hyperkalemia?
- Prolonged QT interval
- Peaked T waves and widened QRS (Correct answer)
- ST segment depression
- Delta waves with shortened PR interval
Correct answer: Peaked T waves and widened QRS
Hyperkalemia classically produces tall, peaked T waves progressing to widened QRS complexes and eventually a sine-wave pattern.
Question 3: A 6-year-old weighing 20 kg requires an initial fluid bolus for hypovolemic shock. What is the correct volume?
- 100 mL
- 200 mL
- 400 mL (Correct answer)
- 500 mL
Correct answer: 400 mL
Pediatric fluid resuscitation for shock is 20 mL/kg; 20 kg × 20 mL/kg = 400 mL of isotonic crystalloid.
Question 4: During a difficult airway attempt, your first intubation is unsuccessful. What is the maximum recommended number of intubation attempts before moving to a rescue airway?
- 1
- 2
- 3 (Correct answer)
- 4
Correct answer: 3
Most airway management guidelines recommend no more than 3 attempts at laryngoscopy before moving to a definitive rescue airway device.
Question 5: A patient with known CHF presents with severe pulmonary edema and a BP of 180/110 mmHg. Which medication is MOST appropriate as a first-line agent?
- Furosemide 40 mg IV
- Nitroglycerin 0.4 mg SL (Correct answer)
- Dopamine infusion
- Adenosine 6 mg rapid IV push
Correct answer: Nitroglycerin 0.4 mg SL
Nitroglycerin causes venodilation, rapidly reducing preload and afterload, making it first-line for hypertensive acute pulmonary edema.
Question 6: When using the Parkland formula for burn resuscitation, how much fluid does a 70 kg patient with 40% TBSA burns receive in the first 8 hours?
- 2,800 mL
- 5,600 mL (Correct answer)
- 11,200 mL
- 4,000 mL
Correct answer: 5,600 mL
Parkland formula: 4 mL × kg × %TBSA = 4 × 70 × 40 = 11,200 mL total; half (5,600 mL) is given in the first 8 hours.
Question 7: A patient is unresponsive with a suspected opioid overdose and has agonal respirations. What is the FIRST action?
- Administer naloxone 2 mg IN
- Open the airway and provide assisted ventilations (Correct answer)
- Establish IV access
- Apply a cardiac monitor
Correct answer: Open the airway and provide assisted ventilations
Airway management and oxygenation take priority over naloxone administration; ventilate the patient first to correct hypoxia.
Paramedics Exam Paramedic Exam EMT 2
A patient presents with severe respiratory distress, JVD, tracheal deviation to the right, and absent breath sounds on the left.
What is the priority intervention?