Paramedics Exam Paramedic Exam EMT 3 — Questions and Answers
Question 1: Which nerve is responsible for diaphragmatic innervation, and at what spinal level does it originate?
- Vagus nerve, C10
- Phrenic nerve, C3-C5 (Correct answer)
- Intercostal nerve, T1-T6
- Accessory nerve, C1-C2
Correct answer: Phrenic nerve, C3-C5
The phrenic nerve originates from C3, C4, and C5 and is the primary motor nerve driving diaphragm contraction for breathing.
Question 2: A patient in ventricular fibrillation receives a defibrillation shock. Immediately after, you observe a flat line on the monitor. What should you do FIRST?
- Deliver a second shock immediately
- Resume CPR for 2 minutes (Correct answer)
- Administer epinephrine 1 mg IV
- Check for a pulse
Correct answer: Resume CPR for 2 minutes
Post-shock asystole or PEA should be treated by immediately resuming high-quality CPR for 2 minutes before re-analyzing the rhythm.
Question 3: Which of the following is the correct dose of atropine for symptomatic bradycardia in an adult?
- 0.1 mg IV
- 0.5 mg IV (Correct answer)
- 1.5 mg IV
- 3.0 mg IV
Correct answer: 0.5 mg IV
The initial dose of atropine for symptomatic bradycardia is 0.5 mg IV, repeated every 3–5 minutes to a maximum of 3 mg.
Question 4: A construction worker fell 30 feet. He is conscious with midline cervical spine tenderness. Despite manual stabilization, he is combative and pulling at his cervical collar. What is the most appropriate action?
- Sedate the patient and perform rapid sequence intubation (Correct answer)
- Remove the collar to reduce agitation
- Physically restrain without sedation
- Allow the patient to assume a position of comfort
Correct answer: Sedate the patient and perform rapid sequence intubation
RSI provides definitive airway control while maintaining spinal precautions in a combative trauma patient with suspected cervical injury.
Question 5: A 55-year-old male presents with crushing chest pain radiating to the left jaw, diaphoresis, and nausea. His 12-lead ECG shows 2 mm ST elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?
- Left anterior descending artery
- Left circumflex artery
- Right coronary artery (Correct answer)
- Left main coronary artery
Correct answer: Right coronary artery
ST elevation in the inferior leads (II, III, aVF) indicates inferior STEMI, most commonly caused by right coronary artery occlusion.
Question 6: You are treating a patient with signs of anaphylaxis including urticaria, bronchospasm, and hypotension. After epinephrine 1:1000 0.3 mg IM, the patient's condition worsens. What is the next step?
- Repeat epinephrine 1:1000 0.3 mg IM
- Administer diphenhydramine 50 mg IV
- Establish IV access and begin epinephrine infusion (Correct answer)
- Administer methylprednisolone 125 mg IV
Correct answer: Establish IV access and begin epinephrine infusion
Refractory anaphylaxis unresponsive to IM epinephrine requires IV epinephrine infusion (1:10,000 or infusion) along with aggressive IV fluid resuscitation.
Question 7: During a mass casualty incident, a patient is found pulseless and apneic. After repositioning the airway, the patient remains apneic. What START triage color is assigned?
- Green
- Yellow
- Red
- Black (Correct answer)
Correct answer: Black
Under START triage, patients who remain apneic after a single airway repositioning attempt are classified as black (expectant/deceased).
Paramedics Exam Paramedic Exam EMT 3
Which nerve is responsible for diaphragmatic innervation, and at what spinal level does it originate?