Fp-C Study Guide Back To Basics

Front 1

Kehr's Sign

Back 1

referred left shoulder pain--possible splenic injury or ectopic pregnancy

Front 2

Kernig's Sign

Back 2

back, leg pain on knee extension--possible bacterial meningitis

Front 3

Brudzinski's Sign

Back 3

back, leg pain on neck flexion--possible bacterial meningitis or subarachnoid bleed

Front 4

Hamman's Sign

Back 4

crunching sound heard with auscultation over the anterior chest synchronized with heartbeat--trancheobronchial injury

Front 5

Steeple SIgn

Back 5

Possible croup

(laryngotracheobronchitis)

A/P neck View X-ray

Front 6

Thumbprint Sign

Back 6

Possible epiglottitis

lateral neck view x-ray

Front 7

ABG Values

Back 7

pCO2=35-45

pH=7.35-7.45

HCO3=22-26

Front 8

Drugs for AAA

Back 8

Nipride and beta blockers

Front 9

First adjustment on ventilator

Back 9

Tidal Volume first than rate

Front 10

Most common Disslocation

Back 10

Hip

Front 11

Most common spontaneous recurrence

Back 11

Anterior Shoulder

Front 12

Brain natriuretic peptide (BNP)

Back 12

Heart failure marker that measures BNP released by an over distention of the heart

below 100=normal

above 500-700=heart failure

Front 13

Rotor-wing pilot required hours

Back 13

2000 hours

1000PIC

100 hours at night

Front 14

"bottle to throttle" time

Back 14

at least 8 hours

Front 15

CVP

Measures?

Normal Parameter?

Which port to use?

Back 15

Measures: preload(RA Pressure)

Norm: 2-6

Port: proximal port

Front 16

Spinal Cord Syndromes (ABC)

Back 16

Anterior Cord

Brown-Sequard

Central Cord Syndrome

Autonomic dysreflexia

Front 17

Anterior Cord Syndrome

Back 17

complete motor, pain and temperature loss below the lesion

Front 18

Brown-Sequard Syndrome

Back 18

ipsilateral loss of motor, position and vibration sense; contralateral loss of pain and temperature perception

Front 19

Central Cord Syndrome

Back 19

greater motor weakness in UE than LE with varying degrees of sensory loss

Front 20

Autonomic Dysreflexia

Back 20

urinary retention, massive increase in sympathetic tone which can cause HTN, treated by insertion of foley

Front 21

Normal Urinary Output

Back 21

UO: 30-50ml/hr(Adult)

UO: 1-2ml/hr(peds)

Front 22

Normal Blood Volume

Back 22

70ml/kg (Adults)

80ml/kg(Peds)

Front 23

Normal Temperature

Back 23

37.6/98.6

Front 24

Mild Hypothermia

Back 24

32-36degrees

decreased HR

Front 25

Moderate Hypothermia

Back 25

29-32 degrees

loss of shivering and ALOC

Front 26

Severe Hypothermia

Back 26

20-28 degrees

Coma, VF common

Front 27

2 major causes of heat loss?

Back 27

Radiation & evaporation

Front 28

Thermoregulation ceases at?

Back 28

28 degrees

Front 29

Rules of flight following

Back 29

-Sterile cockpit during critical phase of flight

-15 minutes maximum between communication center during flight

-45 minutes maximum while on the ground

Front 30

Rotor-wing shut off sequence

Back 30

REMEMBER "TFB"

Throttle

Fuel

Battery

Take survival bag and meet at twelve o' clock position

Front 31

Survival Sequence

Back 31

Shelter

Fire

Water

Food

Front 32

order how to assess the abdomen

Back 32

Inspect

Auscultation

Palpation

Percussion

Front 33

Contraindications for thrombolytics

Back 33

History of hemmorrhagic stroke

CVA last 12 months

Pregnancy or 1 month post pardem

Front 34

FAR's

Back 34

PART 91: no passengers

PART 135: passengers(PTs) (14 hours for pilots)

Front 35

Local Flying area determined by?

Back 35

Certificate Holder

Front 36

Cell phones prohibited when?

Back 36

While airborne

Front 37

PaO2

Back 37

plasma-measured as pressure

Front 38

SaO2

Back 38

hemoglobin-measured as percentage

Front 39

Bariobariatrauma

Back 39

nitrogen release in obese patients, administer high flow oxygen 15 minutes to lift off to wash out nitrogen

Front 40

Normal Pediatric SBP?

When does it drop?

Back 40

BP LAST TO GO...

SBP: 90+(2xage)

after loss of 25%

DBP: 2/3 SBP

Front 41

Three killers of ventilator patients during flight

Back 41

Pericardial tamponade

Tension pneumothorax

Hypovelemia

Front 42

Death from a crush injury is do to?

Complication of crush injury?

Back 42

renal failure

complications: DIC, compartment syndrome, renal failure and hypercalemia

Front 43

CAMTS

1. Medical director is not required to?

2. Intubation requirement?

3. Live intubation required during training?

4. Specialty team response time?

Back 43

1. live in same state

2.quarterly

3. 5

4. 45 minutes

Front 44

Pilots area orientation day/night

Back 44

5 hours day

2 hours night

Front 45

helipad required to have

Back 45

2 paths, security

Front 46

Fixed wing twin engine time

Back 46

500 hours

Front 47

ambulance fuel requirement

Back 47

175 miles

Front 48

ELT set off at

Back 48

4Gs

Front 49

Uniform fit

Back 49

1/4 inch space between body and uniform

Front 50

The bends, decompression, soda can, CO2 in blood

Back 50

Henry's Law

Front 51

Tissue swelling, hypoxic hypoxia, O2 available at altitude

Back 51

Dalton's Law

Front 52

Cellular gas exchange, diffusion

Back 52

Graham's Law

Front 53

Oxygen tank pressure in heat or cold

Back 53

Gay-Lussac's Law

Front 54

BP cuff, ETT cuff, MAST

Back 54

Boyle's Law

(IABP purges with ascent and decent)

Front 55

High velocity

Back 55

above 2000 FPS

Front 56

Medium Velocity

Back 56

1000-2000 FPS

Front 57

Low Velocity

Back 57

Under 1000 FPS

Front 58

Tumbling

Back 58

rotation on 360 degrees axis

Front 59

Yaw

Back 59

deviation up to 90 degrees from straight path

Front 60

CVP/RAP

Back 60

2-6

Front 61

Cardiac Output

Back 61

SVxHR

4-8L/MIN

Front 62

Cardiac Index

Back 62

2.5-4.2

Front 63

PA Systolic/Diastolic

Back 63

15-25/8-12

Front 64

PAWP

Back 64

8-12

Front 65

SVR

Back 65

800-1200

Front 66

Chest tube location

Back 66

Fourth ICS, anterior axillary

Front 67

Needle Thoracostomy location

Back 67

Second ICS midclavicular or the fifth ICS anterior mid axillary line

Front 68

What do you suspect with a fracture of the first 3 ribs?

Back 68

Aortic disruption

Front 69

Scaphoid abdomen indicates?

Back 69

Diaphragmatic Rupture

Front 70

Abruptio placenta

Back 70

dark red, painful

Front 71

Placenta previa

Back 71

red, painless

Front 72

Terbutaline dose

Back 72

0.25 SQ

Front 73

Define postpartum Hemmorrhage

Back 73

Over 500 ml

Front 74

Uterine Rupture

Back 74

Fetal parts can be palpated over abdomen

Front 75

Effects of altitude worsen with:

Back 75

Cold upper latitudes

Front 76

Gay-Lussac's Law

Back 76

Temperature increases and pressure increases

temperature decreases and pressure decreases

EXAMPLE: O2 tank pressure at 2200 in the afternoon, pressure drops to 1800 in the evening(temp decreased in the evening so pressure dropped)

Front 77

Universal Law

Back 77

Combines Boyle's and Charles Law

Front 78

Graham's Law

Back 78

Gas moves from low to high concentration

EXAMPLE: gas through liquid, cellular gas exchange

Front 79

Henry's Law

Back 79

Gas in liquid proportional to gas above liquid

EXAMPLE: the bends, co2 in blood, decompression

Front 80

Volume of gas in GI expands thrice at what altitude?

Back 80

25,000 feet

Front 81

What law effects GI the most?

Back 81

Boyle's Law

Front 82

Cardiogenic Shock

CVP

Cardiac Output

Cardiac Index

PAS/PAD

PAWP

SVR

Heart Rate

Back 82

CVP: high

CO: low

CI: low

PAS/PAD: high

PCWP: high

SVR: high

Heart rate initially fast, then slows down

Front 83

Passive rewarming?

Back 83

mild hypothermia only. Up 1degrees Celcius/hr with blankets, heater

Front 84

Active Rewarming?

Back 84

apply heat to body

Front 85

Warm and dead?

Back 85

32 degrees celcius

Front 86

Heat stroke

Back 86

over 42 degrees celcius

Front 87

Grey Turner's sign

Back 87

Flank bruising (retroperitoneal bleeding)

Front 88

Coopernail's Sign

Back 88

Scrotum/labia (abdominal/pelvic bleeding)

Front 89

Halstead's Sign

Back 89

Marbled Abdomen (bleeding)

Front 90

Cullen's Sign

Back 90

Umbilical Discoloration(pancreatitis)

Front 91

Murphy's Sign

Back 91

RUQ pain with inspiration (gallbladder)

Front 92

Levine's Sign

Back 92

Fist to chest "clutching" (cardiac)

Front 93

Hypoxic Hypoxia

Back 93

altitude hypoxia, decreased alveolar oxygen,, tension pnemo (altitude)

Front 94

Hypemic hypoxia

Back 94

decreased O2 carrying capacity in blood

Front 95

Histotoxic hypoxia

Back 95

poisoning (ie. nitrates)

Front 96

Stagnant hypoxia

Back 96

decreased cardiac output, poor circulation(g forces, CHF)

Front 97

Normal Fetal Heart Rate

Back 97

120-160

Front 98

Factors fetal well-being

Back 98

FHR, fetal movement, variability

Front 99

most important factor in high risk ob

Back 99

variability

Front 100

TX for fetal distress

Back 100

LOCK: left lateral recumbent, O2, correct contributing factors, keep reassessing

Front 101

CHF Preload

Back 101

Many CHF patients are relatively hypovolemic. Careful with diuretics and medications that can decrease preload

Front 102

CHF Lab test

Back 102

BNP=lab test nonspecific >500

Front 103

CHF Medications

Back 103

No beta-blockers, except for carvidolol(coreg)

Natracor(neseritide)=synthetic version of BNP

Front 104

Primary douse of death with ventilator dependent patients

Back 104

Ventilator acquired pnemonia

Front 105

Digoxin

Class

Causes with electrolyte imbalance

ECG Changes

Back 105

Cardiac glycoside

Hypokalemia

ECG-"dip dip" ST depression

Front 106

ARDS

Treatment

CXR

Back 106

PEEP

CXR reveals widespread pulmonary infiltrates; glass like appearance

Front 107

PEEP

Effects of PEEP

Normal physiologic PEEP

Back 107

PEEP

Increased pulmonary vascular resistance

Can cause hypotension over 15 CM H2O

Normal Range: 3-5 cm H2O

Front 108

Treat HTN when BP?

Back 108

Over 220 systolic

MAP over 130

Front 109

Dehydration raises serum?

Back 109

Sodium

Normal sodium: 135-145

Front 110

Objective data?

Back 110

ABCs, neurological assessment

Differential diagnosis for altered mental status:AEIOUTIPS

Front 111

Bowel sounds in chest cavity?

Back 111

Diaphragmatic rupture

most common in the left chest

Front 112

Crunching sound heard over chest with auscultation, may be synchronized with heartbeat?

Back 112

Associated with tracheobronchial injury and is called Hamman's sign

Front 113

Preffered method for moving spinal injured patients

Back 113

Scoop stretcher is preferred rather than performing a log roll

Front 114

Differential diagnosis

1. pulmonary contusion

2. ruptured diaphragm

3. Tracheobronchial injury

4. Esophageal perforation

5. fat embolus

Back 114

1. low sats despite O2, rales

2. chest/abd pain radiated to left shoulder

3. hemoptysis, sub-q air, air leak with chest tube, advance ETT below level of injury into right mainstem

4. fever, hematemesis

5. fever, rash after fracture

Front 115

Bloss loss of humerous

Back 115

750ml

Front 116

Blood loss of femur

Back 116

1500 ml

Front 117

PAWP/PCWP

Function

Normal

Back 117

Pulmonary artery wedge pressure/Pulmonary capillary Wedge pressure

looks at the left side of the heart, if high can indicate pulmonary congestion, CHF, and cardiogenic shock

PAWP/PCWP: 8-12 mmHg

Front 118

EET Depth

Back 118

Adult: 3 x ETT size of average is 19-23CM

PEDS: 10 + age in years

Neonatal: 6 + age weight in KG

Front 119

Ventilator miscellaneous

1. to change CO2

2. To change Oxygenation

Back 119

1. adjust rate, TV

2. adjust PEEP, PAP

Front 120

Rule of nines for adult and pediatrics

Back 120

Know your rule of nines for both adult and pediatric patients

Front 121

Parkland Formula

Back 121

4ml xKG x TBSA.

1/2 over 1st 8hours, rest over 16 hours

Front 122

Brooke's formula

Back 122

2 ml x KG x TBSA.

12 over 1st 8 hours, rest over 16 hours

Front 123

Consensus formula

Back 123

2-4 ml x KG x TBSA.

1/2 over 1st 8 hours, rest over next 16 hours.

Front 124

ELT Frequency

Back 124

121.5

Front 125

Confirm ELT working

Back 125

Tune it in and listen

Front 126

Twin engine required offshore

Back 126

Raft, vest

Front 127

Induction agent of choice with bronchospastic patients

Back 127

Ketamine(ketalar)

Front 128

Ativan: indication dose, Max

Back 128

Lorazepam, seizures, 1-2mg, Max 4mg

Front 129

Mannitol dose

Back 129

1-2g/kg

Front 130

Drug choice for cyclic antidepressant OD

Back 130

Sodium Bicarbonate

Front 131

Drug Choice for beta-blocker OD

Back 131

Glucagon

Front 132

Fentanyl dose

Back 132

Sublimaze (3ug/kg)

Front 133

Treatment for malignant hyperthermia

Back 133

Dantrium (dantrolene)

Front 134

Drug for GI Bleed

Back 134

Sandostatin (octreotide)

Front 135

Neurogenic Shock

CVP

Cardiac Output

Cardiac Index

PAWP/PCWP

SVR

Heart Rate

Back 135

CVP: down

CO: down

CI: down

PCWP: down

SVR: down (distributive shock)

HR Can be normal or slow

Front 136

Arterial Lines

Sites

Purpose

Back 136

Radial, Femoral

Monitor pressure, blood draw, ABGs

Maintain pressure bag at 300mmHg

Underdampening: caused by having air in the system, loose connection, a low pressure bag and altitude changes

Overdampening: caused by kinking, increased bag pressure, and tip against the wall

Front 137

Most common reperfusion dysrhythmia

Back 137

AIVR

Front 138

most common hypothermia dysrhythmia

Back 138

VF(osborn wave)

Front 139

Hypokalemia on ECG

Back 139

Peaked P's / Flat Ts

Front 140

Hyperkalemia on ECG

Back 140

Flat P's, peaked T's(treat with calcium)

Front 141

MAP goal with CHI

CPP goal with increased ICP

Back 141

MAP: 80-10

CPP: 70-90

Front 142

Normal ICP

Normal CPP (head)

Normal MAP

Normal CPP (heart)

(Coronary perfusion Pressure)

Back 142

ICP: 0-10

CPP:70-90

MAP: 80-100

Heart CPP: 50-60

Remember your head is higher than your heart

Front 143

GCS

Mild

Moderate

Severe

Back 143

Mild: 14-15

Moderate:9-13

Severe: 3-8

Front 144

CPP(head) Formula

Back 144

MAP-ICP

Front 145

MAP Formula

Back 145

2 x diastolic + systolic/3

Front 146

CPP Heart Formula

Back 146

DBP-wedge

Front 147

Rotor-wing minimums ceiling/visibility

Day/local

Day/cross-country

Night/local

Night/cross-country

Back 147

Day/local: 500 foot ceiling and 1 mile visibility

Day/Cross-country: 1000 foot ceiling and 1 mile visibility

Night/local: 500 foot ceiling and 2 mile visibility

Night/cross country: 1000 foot ceiling and 3 mile visibility

Front 148

Number one cause of air medical crashes

Back 148

controlled flight into terrain, pushing the weather

Front 149

Normal Potassium

Back 149

3.5-5.5

Front 150

Normal sodium

Back 150

135-145

Front 151

Normal chloride

Back 151

95-105

Front 152

normal calcium

Back 152

8.5-10.5

Front 153

Metabolic acidosis elevates?

Back 153

potassium

Front 154

Time of useful consciousness with sudden decompression at:

30,000 feet

41,000 feet

Back 154

30,000: 90 seconds

41,000: under 15 seconds

Least amount of time is your answer on exam

Front 155

Inferior

Back 155

II, III, AVF

Front 156

Septal

Back 156

V1, V2

Front 157

Anterior

Back 157

V3, V4

Front 158

Lateral

Back 158

I, aVL, V5, V6

Front 159

Posterior

Back 159

ST segment depression or reciprocal changes noted in V1-V4, ST elevation V6

Front 160

Ischemia

Back 160

St depression >1mm in 2 leads

Front 161

Injury

Back 161

ST elevation >1mm in 2 leads

Front 162

Infarct

Back 162

Q wave>25% the height of the R wave

Front 163

Pediatric age guidelines

ETT cuffed versus uncuffed

Needle cricothyrotomy

Nasal intubations

Back 163

"10, 11, 12" Rules

uncuffed tube under 10

Needle Cricothyrotomy only under 11

No nasal intubation under 12

Front 164

Primary Cause of PTL(Preterm Labor)

Back 164

Infection

Front 165

Terbutaline contraindications

Back 165

IDDM, Maternal HR over 120, vaginal bleeding

Front 166

PIH(Pregnancy induced HTN) triad signs

Back 166

HTN, edema, proteinuria

Front 167

O2 adjustment calculation to maintain saturation at altitude

Back 167

% oxygen patient is already on X pressure at departure (mmHg)

pressure at altitude

this equals pressure needed in flight

EXAMPLE: Pt on FIO2 of 0.40

Depart: 681mmHg Altitude: 565mmHg

patient needs 48% Oxygen

Front 168

Ventilator Mode

CMV(continuous Mandatory Ventilation)

Back 168

preset volume of PIP at set rate. Patient can't initiate breath

Front 169

Ventilator Mode

AC(Assist-Control)

Back 169

preset volume or PIP with every breath. Can trigger breath, can't control TV

Front 170

Ventilator Mode

IMV(Intermittent Mandatory Ventilation)

Back 170

preset breaths, TV, PIP. Patient breaths allowed

Front 171

Ventilator Mode

SIMV(Synchronized Intermittent Mandatory Ventilation)

Back 171

allows variation of support

Front 172

IABP

1. action

2. Deflates

3. Dicrotic Notch

Back 172

1. Increase cardiac output, coronary perfusion

2. during ventricular systole

3. aortic valve closing, synchronized with aline or ECG(most common trigger)

Front 173

IABP

Signs/symptoms of ballon leak

Back 173

blood specs in tubing, alarm

Front 174

IABP

Clot prevention

Back 174

cycle manually every 30 minutes

Front 175

IABP increases CO by?

Back 175

10-20%

Front 176

IABP Balloon Rupture

Back 176

rusty flakes in line turn the machine off

Front 177

IABP migration/dislodged

Back 177

access Radial pulses and urinary output

Front 178

Lethal IABP timing cycles

Back 178

late deflation and early inflation

Front 179

Oxyhemoglobin disassociation curve

(left shift)

Back 179

"L" stands for Alkalosis

Left shift = low

Hemoglobin holding O2 alkalosis

Low CO2/Low temp/LOW DPG/Mxydema coma

Front 180

Oxyhemoglobin disassociation curve

(right shift)

Back 180

"R" stands for raised

Right=raise/released O2

Acidosis

Raised CO2

Raised Temp/Raised DPG/Thyroid storm

Front 181

Phlebostatic Axis

Where?

When?

Back 181

Where pressure measurements are made with invasive line

4th intercostal space

level of atria

Front 182

Boyle's Law Ascent

Back 182

Barondontalgia (toothache)

Barosinutis can occur on ascent

Bariobariatrauma(obese)=Nitgrogen in the fat cells can expand causing the "bends" administer high flow O2 for 15 minutes prior to lift off to remove nitrogen

Front 183

Boyle's Law Decent

Back 183

Barotitis media(middle ear) can affect the patient during decent

Front 184

Mild Hypertension

Back 184

140-159/90-99

Front 185

Moderate Hypertension

Back 185

160-179/100-109

Front 186

Severe Hypertension

Back 186

over 180/0ver 110

Front 187

Volume for RBC

Back 187

10ml/kg

Front 188

Volume for WBC

Back 188

20ml/kg

Front 189

ABG Rules

1. CO2 and pH

2. Bicarb and pH

3. Bicarb replacement

4. PaO2 at altitude

Back 189

1. CO2 up 10=pH down 0.08(inverse)

2. HCO3 up 10=pH up 15 (proportional)

3. KG/4 X base deficit=meq of bicarb needed

4. PaCo2 drops 5 for every 1000 feet elevation

Front 190

Stages of hypoxia

Back 190

Indifferent

Compensatory

Disturbance

Critical

Front 191

Indifferent Stage

Back 191

10,000 feet MSL

increased HR, increased RR, decreased night vision

Front 192

Compensatory stage

Back 192

10,000-15,000 feet MSL

Hypertension, task impairment

Front 193

Disturbance Stage

Back 193

15,000-20,000 feet MSL

dizzy, sleepy, cyanosis

Front 194

Critical Stage

Back 194

20,000-30,000 feet MSL

ALOC, incapacitated

Front 195

Night Vision lost at:

Back 195

5000 MSL

Front 196

PA Catheter

1. Named?

2. Proximal port is for?

3. S/S of bad placement

4. Procedure for bad placement?

5. Measures?

6. Which port used?

7. Pressure bag set to?

Back 196

1. Swan-Ganz

2. CVP, medication

3. VT, ventricular ectopy

4. Float forward to PA or Pull back to RA

5. Right Heart directly, left heart indirectly

6. Distal Port

7. 300 mmHg

Front 197

Normal Cardiac index

Back 197

2.5-4.3

Front 198

Stressors of Flight

Back 198

1. third spacing

2. fatigue

3. g-forces

4. noise

5. vibration

6. hypoxia

7. dehydration

8. temp changes

9. barometric pressure changes

Front 199

Personal factors affecting stressors of flight?

Back 199

DEATH

Drugs

Exhaustion

Alcohol

Tobacco

Hypoglycemia

Front 200

Dalton's Law

Back 200

Sum total of partial pressures equal to total atmospheric pressures(Dalton's Gang)

EXAMPLE: tissue swelling, altitude hypoxia, hypoxic hypoxia

This is why O2 is needed at altitude

Front 201

Thrombolytics must be administered within?

Back 201

three hours of onset of chest pain

Front 202

Diving Injuries

ATM(atmosphere)

Back 202

1 ATM for every 33 feet decent

and

add 1 if asking for total ATM versus water pressure

Front 203

Hypovolemic Shock

CVP

CO

Cardiac Index

Wedge

SVR

Heart Rate

Back 203

CVP: down

CO: down

CI: down

PAWP: down

SVR: high

Heart Rate: fast

Front 204

Acute Respiratory Failure

Back 204

pO2 below 60

pCO2 above 50

Front 205

Newton's Law

Back 205

First Law: an object in motion tends to stay in motion

Second law: force=mass X acceleration

third Law: every action has=and opposite reaction

Front 206

Tetralogy of Fallet(TOF)

Back 206

Remember PROV

P=pulmonary stenosis

R=right ventricular hypertrophy

O=overriding aorta

V=ventricular septal defect

Front 207

What is a tet spell?

Back 207

blood flow across the right ventricular outflow tract is significantly decreased, resulting in shunting right to left through the VSD out of the aorta, thus bypassing the lungs. Causes include: spasms, sudden decrease in systemic vascular resistance secondary to hypovolemia, dehydration, hot weather, or defecation. Tet spells are usually seen in neonatal period, and peak in incidence between two and four months of life

Front 208

Atrial Waveforms

Back 208

"filling pressures"

Right atrial pressure(CVP)

Left atrial pressure (PAWP/PCWP)

Front 209

Ventricular Waveforms

Back 209

Right ventricular pressure obtained upon insertion of PA catheter or if the catheter has been dislodged backward into the right ventricle resulting in a right ventricular waveform

looks like VT, no dicrotic notch seen on the downslpoe of the right side of the waveform

Left ventricular pressure measured during cardiac catheterization

Front 210

Arterial Waveforms

Back 210

Arterial Lines

Pulmonary artery pressure (PAP)

Dicrotic notch seen on the downslope of the right side of the waveform

Front 211

Waves

Back 211

A wave= rise in atrial pressure as a result of atrial contraction

C wave=not always visible on the tracing, rise in the atrial pressure which closure of the AV valves (tricuspid and mitral) bulge upward into the atrium following valve closure

V wave=rise in atrial pressure as it refills during ventricular contraction

Front 212

A wave

Correlation to ECG

Back 212

A wave generally coincides with the PR interval on the ECG in a right atrial pressure waveform

It will be slightly delayed in a left atrial pressure waveform

Front 213

C wave

Correlation to ECG

Back 213

C wave generally coincides with mid to late QRS on the ECG in a right atrial pressure waveform

It will be slightly delayed in a left atrial pressure waveform

Front 214

V wave

Correlation to ECG

Back 214

V wave is generally seen immediately after the peak of the T wave on the ECG in a right atrial pressure waveform

It will be slightly delayed in a left atrial pressure waveform

Front 215

Wave decents

Back 215

Decline in right atrial pressure during atrial relaxation

(remember "X" in relaXation)

Decline in right atrial pressure resulting from atrial emptying

(remember "Y" in emptYing)

Front 216

Breathing and Waveforms

Back 216

RECORD PRESSURE MEASUREMENTS AT THE END OF EXHALATION

In a spontaneously breathing patient, inspiration is the fall in pressure, expiration is the rise in pressure. End-expiration occurs just prior to the respiratory drop in pressure.

Positive pressure mechanical ventilated patients will cause cardiac pressure to rise upon inspiration

Front 217

Measuring Waveforms

Back 217

The end-diastolic pressure can be estimated by identifying the "Z" point

A line is drawn from the end of the QRS to the hemodynamic tracing. The point where the line intersects with the waveform is the "Z" point. The "Z" point on the PAWP tracing will be delayed by 0.08-0.12 seconds from the QRS

Front 218

Cardiac Output

Back 218

Heart Rate X stroke Volume=CO

Front 219

Dicrotic Notch

Back 219

Closure of the Aortic valve

Front 220

CPK>20,000

Back 220

CPK (muscle enzyme) levels greater than 20,000 is ominous and is an indication of later DIC, acute renal failure and is potentially dangerous hyperkalemia in the heatstroke patient

Front 221

ANION GAP

Back 221

NA-(Cl+bicarb/CO2)=AG

Normal 12+/-4

>16 indicates an underlying metabolic acidosis

Remember MUDPILES

Methanal

Uremia

DKA

Paraldehyde

Isoniazide/Iron

Lactate

Ethhylene glycol

Salicylate

Front 222

2. Which of the following coronary arteries supplies the majority of the circulation to the

inferior portion of the heart?

Back 222

C. Right coronary

Front 223

3. V1-V6 chest leads are categorized as

Back 223

C. Unipolar leads

Front 224

4. Which of the following references can be used to determine ST elevation, ST

depression, or QRS duration on the ECG tracing?

Back 224

B. J point

Front 225

6. ST elevation seen on the ECG tracing can indicate

Back 225

B. Injury

Front 226

7. Hyperkalemia >7.0 can exhibit which of the following changes on the ECG tracing?

Back 226

C. Tented or peaked T waves

Front 227

11. ST depression can indicate all of the following, except

Back 227

C. Acute injury

Front 228

12. Q waves present with ST elevation can indicate

Back 228

B. Acute injury

Front 229

16. Your patient is exhibiting ST elevation in leads II, III, and AVF. ST depression is

noted in V1-V3. Which of the following may prove hazardous?

Back 229

D. Nitroglycerin

Front 230

18. In which sequence does blood flow through the heart valves?

Back 230

A. Tricuspid, pulmonic, mitral, aortic

Front 231

21. The ECG may show peaked P waves, flattened/slurred Ts, and appearance of U

waves, which may indicate

Back 231

B. Hypokalemia

Front 232

23. Inferior wall MI is caused by an occlusion of which coronary artery?

Back 232

B. RCA

Front 233

26. On 12-lead ECG, posterior wall MIs manifest as

Back 233

C. ST depression in V1-V4 with abnormally tall R waves

Front 234

30. ST elevation in leads I, aVL, V5, and V6 are indicative of injury to which area of the

heart?

Back 234

B. Lateral

Front 235

31. A patient with a history of tricyclic antidepressant overdose can exhibit which of the

following on the ECG tracing?

Back 235

C. Prolonged QT interval

Front 236

34. What changes in the ECG would a patient presenting with an inferior wall MI most

likely have?

Back 236

C. ST elevation in leads II, III, and aVF

Front 237

35. Normal K+ lab value is

Back 237

B. 3.5-4.5

Front 238

38. Diagnosis of a right ventricular MI includes

Back 238

A. Right-sided 12-lead ECG with ST elevation in V4

Front 239

41. Your IABP begins to purge during ascent. The triggering mechanism for this function

was initiated as a result of which gas law?

Back 239

A. Boyle’s law

Front 240

42. The balloon has dislodged when treating your IABP patient. Which is the most

common site that will be affected?

Back 240

B. Left radial

Front 241

43. During transport you note rust-colored “flakes” in the IABP tubing. This indicates

Back 241

D. Balloon rupture

Front 242

45. The primary trigger used for most IABP operations is the

Back 242

C. EKG

Front 243

46. Inadvertent migration of the IAB may cause which of the following, except

Back 243

C. Loss of flow to the carotid vein

Front 244

47. When timing the IABP, inflation should initiate in synchronization with

Back 244

D. Dicrotic notch indicated on the A-line pressure wave

Front 245

49. Which of the following is the most potentially harmful timing error?

Back 245

C. Late deflation

Front 246

50. During transport you experience a complete IABP failure. You should

Back 246

D. Cycle the balloon manually every thirty minutes regardless of timing

Front 247

1. Normal value for monitoring PA pressures are

Back 247

B. 15-25/8-15 mmHg

Front 248

6. The patient’s PA catheter is exhibiting a large, well defined hemodynamic waveform

with an obvious “notch” on the left side of the waveform. The distal tip is most likely

located in the

Back 248

D. right ventricle

Front 249

9. A common cause of elevated PA pressures is

Back 249

A. mitral valve stenosis

B. mitral valve regurgitation

C. left ventricular failure

D. all of the above

Front 250

11. The patient’s peripheral A-line is showing a very sharp waveform with readings that

appear exaggerated. This may be due to

Back 250

B. catheter whip

Front 251

12. Your fast flush test indicates under-dampening of the system present. Which of the

following may be the cause?

Back 251

A. Air in the system

B. Low-pressure bag pressure

C. Altitude change

D. All of the above

Front 252

13. When attempting to “wedge” a PA catheter, you should always

Back 252

A. fill the balloon with exactly 1.5 mL, no more

B. fill the balloon with exactly 2.5 mL, no more

C. fill the balloon with exactly 0.5 mL, no more

D. none of the above

Front 253

14. Your patient’s PA waveform has suddenly changed to resemble a low-amplitude

rolling waveform. This is most likely

Back 253

D. inadvertent advance to wedge

Front 254

15. Your patient’s PA waveform is in wedge position. You would

Back 254

B. have the patient cough forcefully

Front 255

16. Your patient presents with the following: CVP 2, CI 6.4, PA S/D 34/16, wedge 7, and

SVR 400. What is your diagnosis?

Back 255

B. septic shock

Front 256

17. Your patient presents with following parameters: CVP 20, CI 1.1, PA S/D 8/4, wedge

3, and SVR 1,800. What, is your diagnosis?

Back 256

B. right ventricular MI

Front 257

19. Central venous pressure is a reflection of

Back 257

A. right atrial pressure

Front 258

20. Pulmonary artery pressure reflects

Back 258

D. right- and left-sided heart pressures

Front 259

21. The pulmonary artery wedge pressure evaluates

Back 259

C. the left side of the heart

Front 260

23. Normal range for cardiac output is

Back 260

B. 4-8 L/minute

Front 261

24. Normal range for PAWP is

Back 261

B. 8-12 mmHg

Front 262

25. Normal range for right atrial pressure is

Back 262

A. 2-6 mmHg

Front 263

26. Cardiac output is determined by

Back 263

B. heart rate and stroke volume

Front 264

27. Systemic vascular resistance measures the

Back 264

D. afterload for the left side of the heart

Front 265

28. Pulmonary vascular resistance measures the

Back 265

C. afterload for the right side of the heart

Front 266

29. Stroke volume is

Back 266

C. the amount of blood ejected with each heartbeat from the ventricles during systole

Front 267

30. The dicrotic notch signifies

Back 267

C. closure of the aortic valve

Front 268

31. A decrease in the patient’s CVP can indicate all of the following, except

Back 268

D. right-sided heart failure

Front 269

32. A decrease in the patient’s SVR can indicate all of the following, except

Back 269

B. hypovolemic shock

Front 270

33. An increase in SVR can indicate all of the following, except

Back 270

C. septic shock

Front 271

34. Medications that can decrease preload include all of the following, except

Back 271

C. vasopressin

Front 272

35. Atrial waveforms are described as “filling pressures” and include which of the

following?

Back 272

B. right atrial and left atrial pressures

Front 273

36. The PAWP tracing is an indirect measurement of

Back 273

C. left atrial pressure

Front 274

37. Arterial pressure waveforms include all of the following, except

Back 274

D. ventricular pressures

Front 275

38. The “a” wave seen on an atrial waveform indicates

Back 275

A. rise in atrial pressure as a result of atrial contraction

Front 276

39. The “c” wave, when seen (not always visible) on an atrial waveform, indicates

Back 276

B. rise in atrial pressure when the AV valves are closed

Front 277

40. The “v” wave seen on an atrial waveform indicates

Back 277

C. rise in atrial pressure as it refills during ventricular contraction

Front 278

41. The “a” wave, when assessing a right atrial pressure waveform, coincides with which

area of the ECG cycle?

Back 278

C. in the PR interval

Front 279

42. In a right atrial waveform, if the “c” wave is present, it generally coincides with

which area of the ECG cycle?

Back 279

A. mid- to late QRS

Front 280

43. The “v” waves, when assessing a right atrial pressure waveform, coincides with

which area of the ECG cycle?

Back 280

B. immediately after the peak of the T wave

Front 281

44. The downslope on the “v” wave represents atrial emptying, which is called

Back 281

D. Y descent

Front 282

45. The downslope of the “a” wave represents atrial relaxation, which is called

Back 282

C. X descent

Front 283

46. The period following diastole when all the four heart valves are closed is called

Back 283

A. isovolumetric contraction

Front 284

47. Arterial lines have which of the following pressure characteristics as compared to

pulmonary artery pressures?

Back 284

A. much higher pressures

Front 285

48. Positive pressure ventilation will cause cardiac pressure to

Back 285

A. rise upon inspiration

Front 286

49. Hemodynamic pressures should be assessed and recorded at the

Back 286

A. end of exhalation

Front 287

50. Which of the following is used as standard for measuring atrial pressures?

Back 287

C. identification of the “Z” point from the end of the QRS to the waveform

Front 288

1 . You are en-flight with a seventy-year-old male cardiac patient on 6 L of oxygen by

NC. You are at 5,000 feet and the patient is becoming hypoxic. What is your initial

intervention for this patient?

Back 288

B. Increase oxygen delivery to the patient

Front 289

2. Which patient is not affected with altitude temperature changes?

Back 289

A. Cardiac patient

Front 290

4 . Your patient is experiencing left ventricular diastolic failure. Therapy should be

focused on

Back 290

D. Diuretics and relief of anxiety

Front 291

5. Your patient is exhibiting ST elevation in leads II, III, and AVF. ST depression is noted

in V1-V3. Which of the following may prove hazardous?

Back 291

D. Nitroglycerin

Front 292

7. Electrical alternans may be caused by

Back 292

B. Pericardial tamponade/effusion

Front 293

8. Antidote for Coumadin overdose is

Back 293

C. Vitamin K, FFP

Front 294

9. Your patient has a chief complaint of dyspnea and weakness with the following vitals:

BP 72/64, HR 112, RR 28, SpO2 88%, temp. 99.1°F. He is on 6 L/minute of oxygen via

NC. The ECG shows ST with frequent PVCs. Physical exam reveals profound vesicular

rales and bronchial wheezing. Your most likely diagnosis is

Back 294

D. Cardiogenic shock

Front 295

10. Treatment of cardiac tamponade includes all of the following, except

Back 295

D. Needle thoracostomy

Front 296

11. A patient presenting with Beck’s triad is most likely experiencing

Back 296

C. Cardiac tamponade

Front 297

1 2 . You are transporting a forty-five-year-old man with acute respiratory distress

syndrome (ARDS) and MODS secondary to probable organ rejection after a heart

transplant. During transport the patient becomes bradycardic with heart rate in the 30s

with hypotension. Which of the following therapies will likely prove fruitless?

Back 297

D. Atropine 0.5-1 mg IV push

Front 298

13. Your patient presents with following parameters: CVP 20, CI 1.1, PA S/D 8/4, wedge

3, and SVR 1,800. What is your diagnosis?

Back 298

B. RVMI

Front 299

1 4 . You are transporting a fifty-year-old man from ICU to another facility for further

evaluation. The patient has been diagnosed with AMI. He has been complaining of

increasing CP, SOB, and dramatic weight loss. He appears very nervous, and you note

tremors. His ECG shows AF at 148. The patient may be experiencing

Back 299

B. Thyrotoxicosis (grave’s dieases)

Front 300

15. The formula to calculate MAP is

Back 300

B. 2 × DBP + SBP divided by 3

Front 301

16. Normal coronary perfusion pressure (CPP) is

Back 301

A. 50-60 mmHg

Front 302

17. When performing a pericardiocentesis, the insertion site is

Back 302

C. Just left of the subxyphoid process

Front 303

1 9 . sixty-year-old man complains of chest pain for three days with a low-grade fever.

Patient complains of increased pain when lying in supine position and states that the

chest pain decreases when sitting forward. What is the most likely diagnosis?

Back 303

C. Pericarditis

Front 304

21. How is the coronary perfusion pressurecalculated?

Back 304

A. DBP − PCWP

Front 305

22. Inferior wall MI is caused by an occlusion of which coronary artery?

Back 305

B. RCA

Front 306

2 3 . What medications would you expect to administer to a patient presenting with

severe chest/abdominal pain, diaphoresis, and is restless? SBP is 170/palp and heart

rate in 116. You note a difference in blood pressures when taken on each arm.

Back 306

B. Nipride and b-blockers

Front 307

24. A sign of hyperventilation and hypocalcemia is

Back 307

C. Trousseau’s

Front 308

25. All of the following are signs of cardiac tamponade, except

Back 308

B. Pulsus alternans

Front 309

2 6 . You are transporting a sixty-year-old man complaining of severe chest pain and

midscapular pain. He is short of breath and is hypertensive in the upper extremities.

You auscultate a harsh systolic murmur. Your diagnosis of this patient is

Back 309

B. Aortic rupture

Front 310

2 7. The MD has ordered a brain natriuretic peptide (BNP), which would evaluate the

patient for

Back 310

D. CHF

Front 311

28. Levine’s sign relates to

Back 311

C. Cardiac; clenched fist over chest

Front 312

29. Kussmaul’s sign is a

Back 312

A. Rise in venous pressure with inspiration

Front 313

30. Drug of choice for treating a GI bleed is

Back 313

D. Sandostatin

Front 314

31. You are transporting a fifty-year-old man from a rural facility. Your patient’s ECG is

demonstrating ST at 112 with peaked P waves. The ABG indicates pH 7.2, pCO2 18,

HCO3 12 and pO2 108. CMP reveals Na 130, K 2.3, Cl 95, HCO3 10, BUN 48, creat 2.2,

and glucose of 685. The most appropriate diagnosis would be

Back 314

B. DKA

Front 315

32. Recommended urinary output when caring for an adult patient should be

Back 315

B. 30-50 mL/hr

Front 316

3 3 . Your patient’s EKG is demonstrating ST at 130. ABG indicates pH 7.34, pCO2 35,

HCO3 23, pO2 104. The patient’s CMP reveals: Na 132, K 2.5, Cl 97, HCO 3 22, BUN 44,

creat 2.0, and glucose 1,185. The most appropriate diagnosis would be

Back 316

D. HHNK

Front 317

34. A patient presenting with meningitis may exhibit which sign on assessment?

Back 317

C. Kernig’s

Front 318

35. Murphy’s sign would indicate which of the following conditions?

Back 318

D. Gallbladder

Front 319

36. A common problem seen with hepatic encephalopathy is

Back 319

B. Increased ammonia levels

Front 320

37. Treatment of pancreatitis would include all of the following, except

Back 320

C. Morphine for pain

Front 321

38. The patient presenting with HHNK has a problem with

Back 321

A. Sugar

Front 322

39. The treatment of diabetes insipidus is

Back 322

A. Aggressive fluid replacement and vasopressin

Front 323

40. Adrenal insufficiency, weight loss, hypotension—the patient may be experiencing

Back 323

A. Addison’s disease

Front 324

41. Myxedema coma is also known as

Back 324

C. Hypothyroidism

Front 325

42. Most common presentation of a patient with hypothyroidism are all of the following,

except

Back 325

D. Primarily in men

Front 326

43. Drug of choice for profound hypotension in septic shock is

Back 326

B. Levophed

Front 327

44. You are managing a patient who has been diagnosed with hepatic encephalopathy.

His ammonia levels are elevated. Your management in preparing this patient for

transport is to inhibit elevated protein level by

Back 327

B. Stop GI bleeding and evacuate bowel of blood

Front 328

45. Grey Turner’s sign may indicate

Back 328

C. Pancreatitis

Front 329

46. Repeated doses of etomidate can cause

Back 329

B. Acute adrenal insufficiency

Front 330

47. A type of angina that can occur at rest, while sleeping, or after exercise is called

Back 330

B. Prinzmetal’s

Front 331

48. A clinical sign that indicates hypocalcemia may be present is

Back 331

C. Chvostek’s

Front 332

49. Your patient presents upper body obesity with thin arms and legs. He has a rounded

face “buffalo hump” and is complaining fatigue. He is hypertensive and hyperglycemic.

What condition is he most likely presenting?

Back 332

D. Cushing’s syndrome

Front 333

50. Cullen’s sign may indicate

Back 333

B. Pancreatitis

Front 334

1. You are transporting a thirty-year-old man involved in a MCA from a rural area

facility. The 70-kg patient is on a ventilator with the following settings: FIO2 1.0, Vt

500, rate 16, PIP 22, and PEEP 5. The ABG results are pH 7.01, pCO2 68, HCO2 12, pO2

280. Interpretation of the blood gas reveals

Back 334

A. Metabolic and respiratory acidosis

Front 335

2. You are transporting a ten-year-old boy weighing 60 kg with diagnosis of status

asthmaticus on a ventilator. EtCO 2 is 56 and pulse oximetry reading is 95%. Ventilator

settings are at Vt 450, FIO2 1.0, Rate 16, I:E 1:2, PEEP 5, PIP 48. How will you manage

this patient?

Back 335

B. Reduce I:E ratio

Front 336

3. When inserting a chest tube, correct insertion site recommended is

Back 336

B. 4th-5th ICS anterior axillary line

Front 337

4. ABG’s reveal pH 7.31, pCO2 58, Bicarb 26, pO2 106. What is your interpretation?

Back 337

B. Respiratory acidosis

Front 338

5. A patient in early shock most probably has which acid-base imbalance?

Back 338

D. Respiratory alkalosis

Front 339

6. Your patient’s ABG’s are: pH 7.43, pCO2 56, HCO3 34. You should correct the pCO2 by

Back 339

D. Analyze electrolytes and replace deficiency

Front 340

8. Electrical alternans may be caused by

Back 340

A. Pericardial effusion

Front 341

9. You are on the scene of a thirty-year-old man involved in a single vehicle rollover

accident who was reported to be ejected from the vehicle. The left chest has been

decompressed with a needle. The patient is orally intubated and continues to

desaturate, and you note an increase in SQ air on the left side of the chest and neck.

The next intervention will be to

Back 341

C. Advance ET tube below the level of the injury; right main stem intubation

Front 342

10. Your patient presents with a history of asthma, coronary artery disease,

hypertension, and has a chief complaint of dyspnea and weakness with the following

vitals: BP 72/64, HR 112, RR 40, SpO2 82%, temp. 99.1°F. He is on 6 L/minute of

oxygen via nasal cannula. The ECG shows sinus tachycardia with frequent PVCs. ABG

reveals: pH 7.28, pCO2 68, HCO3 24. pO2 58. Physical exam reveals profound vesicular

rales and bronchial wheezing. Your most likely diagnosis is

Back 342

D. Cardiogenic shock; uncompensated respiratory acidosis, hypoxemia

Front 343

11. You are transporting a twenty-four-year-old trauma patient from a rural facility who

has just been given Anectine in preparation for endotracheal intubation. The patient’s

heart rate increases, muscle rigidity is present, and you observe that his end-tidal CO2

has increased to 60 mmHg. Your next intervention would be to administer

Back 343

C. Dantrolene

Front 344

12. When performing a needle thoracostomy, which of the following is generally the

preferred site?

Back 344

D. 2nd intercostal space, midclavicular line

Front 345

13. Your patient presents with ABG’s of pH 7.39, pCO 2 68 HCO3 32, pO2 82. He has

history of COPD and weighs 65 kg. He presents with a history of SOB for 3 days with a

RR 20 and is on 4 L/minute of oxygen by NC. He speaks in four- to five-word sentences.

What acid-base disorder is present?

Back 345

B. Respiratory acidosis with complete compensation

Front 346

14. Hamman’s sign may indicate which of the following?

Back 346

B. Tracheobronchial injury

Front 347

15. ABG reveals pH 7.41, pCO2 38, HCO3 22, pO2 56 of a 70-kg patient on a ventilator

with the following settings: Vt 700, F 14, FIO2 0.5, I:E 1:2, PIP 46, Pplat 40, and PEEP 5.

How will you manage this patient?

Back 347

A. Increase FIO2

Front 348

16. When managing pO2 of <60, you would

Back 348

A. Increase FIO2 and apply/or increase PEEP

Front 349

17. The patient you are transporting reveals the following ABG: pH 7.51, pCO 2 28, HCO3

24, pO2 110. He is a 60-kg male patient with Vt 650, F14, FIO2 0.21, I:E 1:2, PIP 46,

Pplat 42, and PEEP 0. What is your ABG interpretation, and how will you correct it?

Back 349

B. Respiratory alkalosis; decrease Vt

Front 350

18. Minute ventilation is

Back 350

D. Vt × RR

Front 351

19. High-pressure alarms can be caused by all of the following, except

Back 351

A. Hypovolemia

Front 352

20. Low-pressure alarms can be caused by all of the following, except

Back 352

C. Pneumothorax

Front 353

21. Vt is calculated at

Back 353

B. 5-8 mL/kg

Front 354

22. The test most often used to diagnose a pulmonary embolism is

Back 354

B. V/Q lung scan

Front 355

23. Acute respiratory failure is defined as

Back 355

A. pO2 <60 mmHg and pCO2 >50

Front 356

24. Situations that involve a left shift in the oxygen-hemoglobin dissociation curve are

all of the following, except

Back 356

D. Increased levels of 2,3-DPG

Front 357

25. Situations that involve a right shift in the oxygen-hemoglobin dissociation curve are

all of the following, except

Back 357

A. Alkalosis

Front 358

26. Repeated doses of etomidate can cause

Back 358

B. Acute adrenal insufficiency

Front 359

27. Interpret the following blood gas: pH 7.39, HCO3 18, pCO2 31.

Back 359

D. Metabolic acidosis; completely compensated

Front 360

28. You are transporting a forty-year-old man from a rural ICU. The CXR reveals a

ground glass appearance. The patient is on a ventilator with settings at: Vt 900 mL,

rate of 16, FIO2 0.8 with a PEEP of 5. ABG’s reveal: pH 7.34, pO 2 76, pCO2 38 and HCO3

of 24. What pulmonary condition do you suspect?

Back 360

C. ARDS

Front 361

29. You would manage the above patient by

Back 361

B. Increasing PEEP

Front 362

30. The MD has ordered a BNP, which would evaluate the patient for

Back 362

D. CHF

Front 363

31. Which of the following paralytics stimulates motor end plate acetylcholine receptors

causing persistent depolarization?

Back 363

A. Succinylcholine

Front 364

32. When administering a defasciculating neuromuscular blockade, the dose

recommended is

Back 364

B. 10% normal RSI dosage of NMBA

Front 365

33. You are transporting a twenty-five-year-old woman with a history of suspected

overdose. The following ABGs were obtained prior to your arrival at the sending facility:

pH 7.52, pCO2 27, HCO3 24, pO2 110. You would most likely suspect

Back 365

C. Early salicylate poisoning

Front 366

34. If the PIP does not change on a ventilator patient with respiratory acidosis, always

Back 366

B. Decrease Vt before rate

Front 367

35. Trouble-shooting high-pressure alarms on the ventilator can be caused by all of the

following, except

Back 367

D. Leak in ventilator tubing

Front 368

36. An elevated anion gap can indicate the presence of which of the following?

Back 368

C. Metabolic acidosis

Front 369

37. The average endotracheal tube size that should be utilized in an adult male patient

is

Back 369

C. 8.0

Front 370

38. The administration of Succinylcholine is contraindicated in which of the following?

Back 370

B. Hyperkalemia

Front 371

39. Midazolam is classified as a

Back 371

C. Benzodiazepine

Front 372

40. Ketamine administration is considered the drug of choice for a patient presenting

with which of the following?

Back 372

C. Asthma

Front 373

41. Management of an intubated patient presenting with a diagnosis of ARDS would

include

Back 373

A. Application of positive end-expiratory pressure

Front 374

42. Excess of mucous secretions and chronic inflammation of the bronchi, leading to

obstruction of airflow, hypoxemia, and hypercapnea best describes which of the

following conditions?

Back 374

B. Chronic bronchitis

Front 375

43. A chronic obstructive pulmonary disease (COPD) patient would most likely present

with which of the following x-ray findings?

Back 375

A . Hyperinflation of the lungs, narrow and elongated heart shadow, increased

anterior-posterior diameter of the chest

Front 376

44. The diagnosis of ARDS would most likely present with which of the following x-ray

findings?

Back 376

B. Widespread pulmonary infiltrates, ground-glassy appearance

Front 377

45. An ominous sign of impending acute respiratory failure in the asthma patient would

most likely be which of the following?

Back 377

C. Decreased or absence of bronchoconstriction

Front 378

46. Signs and symptoms for a patient presenting with a tension pneumothorax would

include all of the following, except

Back 378

D. Widening pulse pressure

Front 379

47. The normal range for pCO2 when evaluating an arterial blood gas is

Back 379

B. 35-45 mmHg

Front 380

48. The normal range for pH when evaluating an arterial blood gas is

Back 380

C. 7.35-7.45

Front 381

49. The normal range for HCO3 when evaluating an arterial blood gas is

Back 381

C. 22-26 mEq/L

Front 382

50. The most likely causes of metabolic alkalosis can include all of the following, except

Back 382

C. Diarrhea

Front 383

1. You are preparing to transport a twenty-year-old man weighing 200 pounds with a

history of a self-inflicted gunshot wound to the head. He is intubated with A/C

ventilator settings of FIO2 0.5, Vt 600, I/E 1:2, flow 5 L, RR 10, PIP 30. Vital signs are

BP 100/60, HR 66, and SaO2 94%. ICP reading of 28. His cerebral perfusion pressure is

approximately

Back 383

D. <50 mmHg

Front 384

2. What is the initial clinical presentation that may indicate that ICP may be increasing?

Back 384

B. Deteriorating level of consciousness

Front 385

3. You are transporting an eighteen-year-old female patient with a history of being

ejected from a motor vehicle accident. She is currently awake and oriented to person,

place, and time; however, she is slow to respond. Vital signs are a BP of 70/42, HR 68,

RR 26, SaO2 95%, temp. 98.8°F. Hemodynamic readings are CVP 3, CI 2.0, and SVR

600. ICP reading at 6 with a urine output of 100 mL over the last two hours. Your

patient is exhibiting signs and symptoms of

Back 385

C. Spinal cord injury

Front 386

4. You are transporting a forty-year-old male diagnosed with a subarachnoid

hemorrhage. Which of the following assessment findings can be associated with his

diagnosis?

Back 386

C. Positive Brudzinski’s sign

Front 387

5. You arrive on the scene to manage a fall victim. She presents with a BP 70/palp, HR

62, RR 24, Sats 96%. EMS reports brief LOC but now has a GCS of 14. You note a

deformity of the right femur, and she is complaining of neck pain. The clinical

presentation is most likely a diagnosis of

Back 387

A. Neurogenic shock

Front 388

6. Pupillary dilation in response to the oculomotor nerve insult that occurs in uncal

herniation is a result of

Back 388

A. Loss of parasympathetic stimulation

Front 389

7. Which formula can be used when calculating a cerebral perfusion pressure (CPP)?

Back 389

B. MAP − ICP

Front 390

8. An early sign of tentorial herniation would be

Back 390

D. Ipsilateral pupillary dilation

Front 391

9. You have been requested to transport a thirty-two-year-old male involved in a twocar

motor vehicle collision in which the right side of his head struck the “A-post.” Right

middle meningeal artery damage has been noted by CT with right-sided “mass effect”

resulting. You would expect which of the following?

Back 391

A. Epidural hematoma

B. Ventricular collapse

C. Cranial midline shift to the left

D. All of the above

Front 392

10. The patient presents with a skull fracture that appears to have a central focal point

with multiple fractures outward on radiography. This skull fracture would be described

as

Back 392

B. Linear stellate

Front 393

11. A head-injured patient would most likely experience an increased ICP as a result of

which action?

Back 393

A. Hip flexion

B. Gagging on the ETT

C. Adduction of the arms

D. Rotation of the head

E. All of the above

Front 394

12. You are transporting an awake multisystem trauma patient from a small rural facility

with the following vital signs: BP 200/66, HR 56, RR 20-36, SaO2 97%, and temp.

99.9°F. Further assessment reveals a large laceration to the occipital area of the head,

with bleeding controlled, and is moving all extremities. Pupils are reactive to light and

equal at 4 mm with extraocular movements intact. The patient’s clinical presentation is

suggestive of which of the following?

Back 394

A. Demonstrating signs/symptoms of cushing’s triad

Front 395

13. You are transporting a thirty-year-old female who was involved in a single vehicle

rollover two hours prior to your arrival. She has a swan catheter in place with the

following values: CVP 2, CI 2.0, PA S/D 12/6, wedge 7, SVR 400. Vital signs: BP 80/48,

HR 46, RR 24, SaO2 90%. The patient’s clinical presentation is suggestive of which

diagnosis?

Back 395

D. Neurogenic shock

Front 396

14. The expected average normal cerebral perfusion pressure range (CPP) is

Back 396

C. 70-90 mmHg

Front 397

15. The average normal ICP range is

Back 397

A. 0-10 mmHg

Front 398

16. The formula to calculate a mean arterial pressure (MAP) is

Back 398

B. [(DBP × 2) + SBP] divided by 3

Front 399

17. The patient presents with the following hemodynamic parameters: CVP 1, CI 1.7, PA

S/D 12/6, wedge 6, and SVR 300. Vital signs are 78/40, HR 60, RR 16, SaO2 98%. The

most likely cause is

Back 399

B. Neurogenic shock

Front 400

18. Classic picture of neurogenic shock presents with

Back 400

B. Absence of tachycardia

Front 401

19. You are transporting a patient with a spinal cord injury above T6 level. His baseline

vital signs prior to lift off: BP 160/80, HR 62, RR 20. During transport, the patient

begins to complain of a throbbing headache with nasal stuffiness. Your assessment

reveals that the patient is becoming increasingly agitated. His skin color is flushed and

profusely diaphoretic. Repeat vital signs are a BP 206/100, HR 52, RR 26. Your initial

management of the patient would be

Back 401

A. Insert a foley catheter

Front 402

20. You have been requested to transport a forty-year-old male fall victim of

approximately 25-30 feet, three hours prior to your arrival. Your assessment reveals a

greater motor weakness in upper extremities than in lower extremities, with varying

degrees of sensory loss. The clinical presentation may suggest which of the following

spinal cord syndrome?

Back 402

B. Central cord

Front 403

21. Hypothermia, low levels of 2,3-DPG, and hypocarbia can cause the oxyhemoglobin

dissociation curve shift to go

Back 403

D. Left

Front 404

22. In addition to glucose, which electrolyte must be maintained within normal limits

when managing a head-injured patient?

Back 404

D. Sodium

Front 405

23. You are transporting a twenty-year-old male, with penetrating head and facial

trauma. During transport, the patient complains of a severe headache, nausea, and

vertigo. Your assessment reveals nuchal rigidity, aphasia, dysphasia, along with the

patient having episodes of vomiting. What is your diagnosis?

Back 405

B. Pneumocephalus

Front 406

24. Calculate the following patient’s cerebral perfusion pressure (CPP): BP 150/75, HR

140, RR 28, SpO2 100%, CVP 2, ICP 25.

Back 406

D. 75

Front 407

25. You are transporting a normotensive patient, who is presenting with a history of

head injury and complaining of extreme thirst. Your assessment reveals he is excreting

large amounts of diluted urine, sunken appearance to the eyes, dry mouth, and

tachycardia is noted. The initial treatment of the patient would be?

Back 407

C. Aggressive fluid replacement and vasopressin

Front 408

26. Cushing’s triad includes all of the following, except

Back 408

B. Narrowing pulse pressure

Front 409

27. A patient presenting with an initial loss of consciousness with a period of a lucid

interval, with return of a normal neurologic status, suddenly complains of a headache,

with a deteriorating level of consciousness. The patient is most likely experiencing a

Back 409

D. Epidural bleed

Front 410

28. Brudzinski’s clinical sign may indicate

Back 410

A. Subarachnoid bleed or meningitis

Front 411

29. The presence of a Babinski’s sign in an adult patient would exhibited by

Back 411

B. Plantar flexor reflex

Front 412

30. You have been requested to transport a thirty-two-year-old male intravenous drug

user who was brought to the ED without vascular access with a history of having had a

witnessed generalized tonic-clonic seizure ten minutes prior to your arrival. The patient

arrived post-ictal, but responsive. No other medical history was available. On

examining, the blood pressure is 130/80 mmHg, HR 88, respirations 14, and oxygen

saturation of 98% on room air. The head is atraumatic, the pupils are 4 mm and

reactive, cardiopulmonary exam was normal. Neurologically the patient is oriented to

person only; he has no facial asymmetry, moves all four extremities, deep tendon

reflexes were + 4 symmetrically, and no Babinski reflexes were present. The blood

sugar is 110 mEq/dL. While looking for venous access over the patient’s scarred

extremities, the patient began a second generalized tonic-clonic seizure. What is the

“best” first line therapy for acute seizure management?

Back 412

D. Benzodiazepines

Front 413

31. Which cranial nerve is affected with a patient presenting with Bell’s Palsy?

Back 413

C. VII

Front 414

32. Cranial nerve III is also known as the

Back 414

B. Oculomotor nerve

Front 415

33. You are transporting a twenty-six-year-old male patient involved in a fall injury.

Upon your arrival on the scene, your assessment reveals an awake patient who is not

able to shrug his shoulders. Which cranial nerve is most likely affected?

Back 415

D. XI

Front 416

34. A patient diagnosed with Guillan-Barre would most likely present with all of the

following, except

Back 416

A. Descending paralysis

Front 417

35. You are transporting a twenty-five-year-old male with a history of acute alcohol

intoxication who was involved in a single vehicle roll-over two hours prior to your

arrival. The patient is presenting with variable loss of motor function and sensory

function from the nipple line down. Which dermatome would most likely be affected

and what clinical condition you do suspect?

Back 417

C. T4; anterior cord syndrome

Front 418

36. You have been requested to transport a twenty-year-old male involved in a motor

vehicle accident. Your assessment reveals an ethanol-like odor on his breath, GCS 15,

with slurred speech, and the patient is able to grossly flex the arms at the elbow but

unable to extend his arms at the elbows or wrists or flex or extend the fingers, with no

sensation to the medial side of the arm and small finger. The patient was noted to

have the capability of extending both lower legs at the knee, but definite weakness

was present. He was able to extend and flex his ankles and toes. The clinical findings

affect which dermatome and what clinical condition is suspected?

Back 418

C. C8, T1; central cord syndrome

Front 419

37. The presence of a plantar extensor reflex in an adult patient can indicate

Back 419

A. Damage to nerve pathways connecting the spinal cord and brain

Front 420

38. Oculocephalic reflex is also known as

Back 420

C. Doll’s eyes

Front 421

39. The oculovestibular reflex exam is used to assess

Back 421

B. Brainstem function

Front 422

40. Mydriasis is defined as

Back 422

C. Dilated pupils

Front 423

41. The patient presenting with Battle’s and Racoon’s clinical signs is most likely

experiencing which of the following?

Back 423

B. Basilar skull fracture

Front 424

42. Which of the following is most likely affected with a patient presenting with an

epidural bleed?

Back 424

A. Middle meningeal artery

Front 425

43. Another term used to describe pinpoint pupils is

Back 425

B. Miosis

Front 426

44. You would expect the normal range when measuring a mean arterial pressure (MAP)

to be

Back 426

C. 80-100 mmHg

Front 427

45. Which clinical sign/symptom initially would indicate that a ventricular-peritoneal

shunt is malfunctioning?

Back 427

B. Vomiting

Front 428

46. You have been requested to transport a thirty-year-old male with a history of being

stabbed multiple times in the back. The patient presents with ipsilateral loss of motor

function and contralateral loss of pain and temperature. The most likely diagnosis is

Back 428

B. Brown-Séquard syndrome

Front 429

47. You are transporting a patient with a history of diving into shallow water and is

presenting with complete loss of motor, pain and temperature below the injured spinal

cord lesion. The patient is most likely diagnosed with

Back 429

A. Anterior cord syndrome

Front 430

48. What personal protective equipment (PPE) should be worn when transporting a

patient with bacterial meningitis?

Back 430

A. Mask, gloves, gown, and eye protection

Front 431

49. The patient you are transporting is exhibiting decerebrate posturing. What does this

term mean?

Back 431

A . Increased tone in the extensor muscles with active tonic reflexes, resulting in all

four limbs being rigidly extended and rotated internally, opisthotonos, and clenched

teeth.

Front 432

50. On examining, the sixty-year-old female patient that you are preparing for transport

appears awake but is unable to speak or follow commands. Vitals are: T 99, BP

168/104, HR 82, RR 18, SaO2 98% on 4 liter of oxygen by nasal cannula. She moves her

left side spontaneously but has no movement of the right arm and very little movement

of the right leg. The staff reports that she is right handed; radiography revealed no

cranial/hip/pelvic fractures and CSF was clear, with no erythrocytes. What blood vessel

do you suspect is involved?

Back 432

B. Middle cerebral artery in the left hemisphere

Front 433

1. You are on the scene where a thirty-five-year-old man having gunshot wound to the

left chest. The left chest has been decompressed with a needle prior to your arrival.

The patient is intubated and continues to desaturate. Your assessment reveals an

increase in SQ air to the chest and neck. The next intervention would be to

Back 433

B. Advance ET tube below the level of the injury; right main stem intubation

Front 434

2. You are managing a burn patient who weighs 90 kg with a 65% burn surface area

(BSA). How much fluid should this patient receive in the first eight hours when using

the Parkland formula?

Back 434

B. 11,700 mL

Front 435

3. What does the clinical presentation of abnormal posturing generally indicate?

Back 435

C. Severe injury/damage to the brain and brainstem

Front 436

4. Using the Consensus formula, calculate how much fluid this 70-kg patient with a 50%

BSA would receive in the first 8 hours of care?

Back 436

C. 3,500-7,000 mL

Front 437

5. The most commonly abused organ orsystem is?

Back 437

C. Integumentary

Front 438

6. You are transporting a twenty-year-old man involved in a high-speed motor vehicle

accident with a history of being ejected from the vehicle two hours prior to your arrival.

The patient has been intubated and remains unconscious, with abnormal posturing

noted. Mechanisms of injury associated with acceleration and deceleration that occurs

with high-speed motor vehicle accidents or ejection from a vehicle can cause which

type of brain injury?

Back 438

C. Diffuse axonal injury

Front 439

7. When inserting a chest tube, correct insertion site recommended is

Back 439

B. 5th ICS anterior midaxillary

Front 440

8. You are transporting a twenty-three-year-old man, with a diagnosis of left-sided

hemothorax. Guidelines for tube clamping suggest that the chest tube be clamped after

how many milliliters of blood have been removed in the adult patient?

Back 440

B. 1,000 mL

Front 441

9. You arrive on the scene to manage a fall victim. She presents with a BP 80/50, HR

128, RR 36, SaO2 90%. Ground EMS reports that upon their physical examination, the

patient revealed decreased bowel-like breath sounds on the left side of the chest. The

patient is complaining of difficulty in breathing and severe left shoulder pain. The most

likely diagnosis of this patient is

Back 441

A. Diaphragmatic rupture and spleen injury

Front 442

10. You are preparing to transport a seventy-two-kg patient presenting with second and

third degree burns to his entire face, anterior torso, and complete left arm. How much

fluid should the patient receive in the first eight hours using the Parkland formula?

Back 442

A. 4,600 mL

Front 443

11. A sixty-year-old male patient has been trapped under a tractor for almost six hours.

Once extricated, he is most likely to experience

Back 443

C. Rhabdomyolysis

Front 444

12. Your patient was struck from behind while driving. The most common area of injury

from a rear-end collision is

Back 444

D. T12-L1 injuries

Front 445

13. The clotting cascade can be triggered through an extrinsic pathway. The triggering

mechanism is the release of

Back 445

D. Tissue thromboplastin

Front 446

14. A patient in early shock most probably would present with which of the following

acid-base imbalance?

Back 446

D. Respiratory alkalosis

Front 447

15. Which blood component does not require typing and crossmatching before

administration?

Back 447

D. Albumin

Front 448

17. Platelets are considered low at

Back 448

D. <150

Front 449

18. Electrical alternans may be caused by a

Back 449

B. Pericardial effusion

Front 450

19. Normal K+ value is

Back 450

B. 3.5-4.5

Front 451

20. You are managing a twenty-five-year-old man with burns to the entire face, left

forearm, right hand, and anterior portion of the entire left leg. His BSA would be

Back 451

B. 19%

Front 452

21. A twenty-one-year-old patient with history of stab wounds to the chest, presenting

with a drop in the systolic blood pressure of 20 mmHg during inspiration, a narrowing

pulse pressure, and clear equal breath sounds bilaterally would most likely be managed

with all of the following, except

Back 452

D. Needle thoracostomy

Front 453

22. A patient presenting with Beck’s triad is most likely experiencing

Back 453

C. Cardiac tamponade

Front 454

23. Immediate release of intrapleural pressure should be performed where

Back 454

D. Second intercostal space, midclavicular line

Front 455

24. An object in motion will remain in motion and an object at rest will remain at rest

unless acted upon by a force; this law is known as

Back 455

A. Newton’s first law

Front 456

25. Your patient was involved in a single car roll-over and is complaining of neck and left

shoulder pain. You note bruising to the left chest wall. Vital signs are BP 80/48, HR

130, RR 28, SpO2 96%. The most likely cause is

Back 456

C. Splenic injury

Front 457

26. What is a common problem associated with electrical injuries?

Back 457

A. Myoglobinuria

Front 458

27. When managing a patient with an electrical injury that presents with

hematochromagen urine, you should maintain a urine output of

Back 458

D. A minimum 100 mL/hr

Front 459

28. Normal cerebral perfusion pressure is at least?

Back 459

C. 70-90 mmHg

Front 460

29. Your patient presents with following parameters: CVP 0, CI 1, PA S/D 8/4, wedge 3,

and SVR 1,800. What is your diagnosis?

Back 460

A. Hypovolemic shock

Front 461

30. Normal ICPis

Back 461

A. 0-10 mmHg

Front 462

31. The formula used to calculate mean arterial pressure is:

Back 462

B. [(DBP × 2) + SBP] divided by 3

Front 463

32. What is the formula used when calculating cerebral perfusion pressure?

Back 463

B. MAP − ICP

Front 464

33. Grey Turner’s sign may indicate

Back 464

C. Retroperitoneal bleed

Front 465

34. Most commonly seen injuries with side impact or “lay it down” motorcycle crashes

include all of the following, except

Back 465

B. Pelvic fractures

Front 466

35. Predictable injuries that can occur with falls can include all of the following, except

Back 466

B. C2 fracture

Front 467

36. Dry chemicals such as lime should be

Back 467

A. Brushed off before irrigation

Front 468

37. Hamman’s sign may indicate the presence of

Back 468

B. Tracheobronchial injury

Front 469

38. Recommended urinary output when managing a burn patient without an electrical

injury is

Back 469

C. 30-50 mL/hr

Front 470

39. Hydrofluoric burns can be managed with copious amounts of water and

Back 470

A. Calcium gluconate

Front 471

40. The management approach for a patient experiencing brain herniation can include

all of the following, except

Back 471

D. Hyperventilation to maintain EtCO2 at 20-30 mmHg

Front 472

41. Classic picture of neurogenic shock presents with

Back 472

B. Absence of tachycardia

Front 473

42. Your patient presents with motor loss, numbness to touch, vibration on the same

side of the spinal injury, loss of pain, and temperature sensation on the opposite side.

You suspect that the most likely spinal cord syndrome present is

Back 473

A. Brown-Séquard

Front 474

43. When should escharotomies ideally be performed?

Back 474

C. Circumferential burns to the chest decrease chest wall compliance

Front 475

44. A patient presents with a further drop in MAP of 20% with an increase in fluid loss of

over 1,800 mL. Vasoconstriction continues and leads to oxygen deficiency.

Physiologically, the body switches to anaerobic metabolism, forming lactic acid as a

waste product. The patient would most likely be in which stage of shock?

Back 475

C. Intermediate or progressive and decompensated shock

Front 476

45. Calculate the following patient’s cerebral perfusion pressure (CPP): BP 180/90, HR

120, RR 24, SpO2 98%, CVP 2, ICP 25.

Back 476

D. 95

Front 477

46. All of the following conditions are considered a form of obstructive shock, except

Back 477

B. ICP

Front 478

47. You are managing a 100-kg burned patient with 70% BSA. How much fluid will the

patient receive in the first eight hours using the Consensus formula?

Back 478

B. 7,000-14,000 mL

Front 479

48. Late signs and symptoms of a tension pneumothorax can include all of the following,

except

Back 479

A. Narrowing pulse pressure

Front 480

49. The most common cause of pulseless electrical activity in a trauma patient is

Back 480

B. Hypovolemia

Front 481

50. You have responded to a fire in a building with five victims. You notice that a large

portion of the synthetic carpet has been burned in the room where you are treating the

patients. The patients are exhibiting increasing signs of respiratory distress and

coughing after high oxygen has been applied. What may be causing the patients’ signs

and symptoms?

Back 481

A. Cyanide

Front 482

1. You are transporting a thirty-eight-year-old man who is presented to the ER with a

history of cocaine-induced tachycardia and is complaining of midsternal chest pain.

Vital signs are as follows: temperature 101.2°F, BP 200/100, HR 140, RR 28, SaO 2 97%

on 2 liters/min of oxygen via nasal cannula. Which of the following medication is

contraindicated for management of this patient?

Back 482

C. Metoprolol

Front 483

3. You have been requested to transport a twenty-year-old female with a history of

acetylsalicylic acid poisoning two hours prior to your arrival at the sending facility. The

patient is complaining of nausea, headache, and tinnitus. When evaluating her ABGs,

you would expect which of the following acid-base disturbances to manifest in the early

stage of poisoning?

Back 483

A. Respiratory alkalosis

Front 484

4. All of the following muscle enzymes, if elevated, are a diagnostic hallmark in a

heatstroke patient, except

Back 484

B. Troponin 1 and 2

Front 485

5. Defibrillation is usually not effective until the body core temperature is greater than

Back 485

C. 30°C

Front 486

6. Which of the following rewarming techniques can best avoid the dangers of the

afterdrop phenomenon when managing a hypothermic patient?

Back 486

B. Active internal

Front 487

7. You are transporting a patient with history of seizures while on a camping trip in July.

Her husband drove her to the closest ER for treatment. She has a history of cardiac

heart failure and only takes furosemide daily. Labs reveal CK 27,000, LDH 800, BUN 34,

CR 1.1, K 3.1, Hgb 15.3, Hct 44, CO2 16, and glucose of 62. The foley bag contains urine

that appears dark greenish-brown in color with an output of less than 20 mL in the last

hour. She is unresponsive with BP 100/40, HR 144, RR 32, and SaO2 94%. The decrease

in urine output and abnormal urine character is most likely the result of which of the

following?

Back 487

C. Rhabdomyolysis secondary to heatstroke

Front 488

8. Which of the following blood transfusion reaction can occur within minutes of

administration?

Back 488

A. Hemolytic

Front 489

9. You are transporting a forty-year-old mane with history of esophageal varices. The

sending physician has ordered a unit of PRBC’s transfusion to be infused during

transport. Transport time to the receiving facility is approximately 20-30 minutes. The

patient should be monitored for which of the following during transport?

Back 489

D. Hemolytic reaction

Front 490

11. The treatment for acetaminophen poisoning is

Back 490

B. N-acetylcysteine (NAC)

Front 491

12. Antidote for Coumadin overdose is

Back 491

C. Vitamin K, FFP

Front 492

13. Treatment of Digitalis toxicity would include all of the following, except

Back 492

D. Beta-blockers

Front 493

14. When managing a patient with an electrical injury, with the presence of

hemochromogen, you should maintain a minimum urine output of

Back 493

D. 100 mL/hr

Front 494

15. The drug of choice for a patient exhibiting signs and symptoms of malignant

hyperthermia is

Back 494

C. Dantrolene

Front 495

18. The most critical goal and life-saving measure in heat illness is

Back 495

A. Cooling the patient to rapidly decrease body temperature

Front 496

19. A scuba diver descended to a depth of ninety-nine feet. The scuba diver is under an

ambient pressure of how many ATA?

Back 496

D. 4

Front 497

20. The most common type of decompression sickness typically seen diving emergencies

is

Back 497

B. Pulmonary

Front 498

21. Situations that involve a right shift in the oxygen-hemoglobin dissociation curve are

all of the following, except

Back 498

A. Alkalosis

Front 499

22. Gases in the lungs of a scuba diver expand as ambient pressure decreases during

ascent best describes which gas law?

Back 499

D. Boyle’s

Front 500

23. You are transporting a patient who you note has tea-colored urine in small amount

in the foley catheter bag. The nurse reports that his output is only 50 mL in the last

twenty-four hours. What treatment would you expect to initiate during the two-hour

flight?

Back 500

A. Rapid fluid resuscitation, sodium bicarbonate drip, and consider Lasix and mannitol

Front 501

24. Your head-injured patient is hypothermic. In what direction does the oxyhemoglobin

dissociation curve shift to?

Back 501

D. Left

Front 502

25. Poisoning of the cytochrome oxidase enzyme system may cause

Back 502

A. Histotoxic hypoxia

Front 503

26. Two types of drug poisoning that cause hallucinations are

Back 503

B. PCP and lysergic acid diethylamide

Front 504

27. You have been requested to a farming area to transport a forty-year-old man

involved in a plane crash. On arrival, the patient is complaining of shortness of breath

with increased salivation and blurred vision. Vital signs are BP 100/58, HR 50, RR 36,

SaO2 92%. Management of this patient would include all of the following, except

Back 504

C. Sodium thiosulfate

Front 505

28. One of the major organs that must be functional if heat is to be dissipated is the

Back 505

A. Skin

Front 506

29. ARDS and DIC are a result of what in the hyperthermic patient?

Back 506

B. Lysosomal enzymes

Front 507

30. The antidote for ethanol toxicity is

Back 507

C. Fomepizole

Front 508

31. Digitalis toxicity can easily be exacerbated by

Back 508

D. Beta-blockers

Front 509

32. All of the following medications are classified as calcium channel blockers, except

Back 509

D. Metoprolol

Front 510

33. A patient presenting with a complaint of tinnitus and flulike symptoms will most

likely have which of the following diagnosis?

Back 510

C. Salicylate overdose

Front 511

34. Which of the following lab test is typically ordered four hours postingestion of

acetaminophen overdose?

Back 511

B. Liver function

Front 512

35. Antidote that can be administered for benzodiazepine overdose is

Back 512

B. Romazicon

Front 513

36. Iron poisoning can be managed with

Back 513

C. Deferoxamine

Front 514

37. A patient presenting with ethylene glycol ingestion would present with the following

signs and symptoms, except

Back 514

D. Metabolic alkalosis

Front 515

38. What assessment when managing a patient with iron ingestion would indicate that

the treatment is effective?

Back 515

A. Urine output appears pink in color

Front 516

39. The administration of Romazicon can cause which of the following adverse

reactions?

Back 516

B. Seizures

Front 517

40. Which of the following conditions is commonly associated with ethanol intoxication?

Back 517

B. Hypoglycemia

Front 518

41. Pralidoxime chloride is administered in the management of

Back 518

B. Organophosphate exposure

Front 519

42. Antidote for heparin overdose is

Back 519

C. Protamine sulfate

Front 520

43. Normal BUN is

Back 520

D. 35-45

Front 521

44. Elevated BUN can indicate all of the following, except

Back 521

D. Cerebral vascular accident

Front 522

45. A patient exposed to organophosphates can present with the following clinical

signs/symptoms, except

Back 522

C. Mydriasis

Front 523

46. A patient presenting with tachycardia, pale skin, a change in behavior, and

diaphoresis is most likely experiencing which of the following?

Back 523

A. Insulin shock

Front 524

47. Organophosphate exposure causes the overproduction of the neurotransmitter

acetylcholine by

Back 524

A . Deactivation of the acetylcholinesterase enzyme, which is responsible for the

breakdown of acetylcholine

Front 525

48. Management of cyanide toxicity includes all of the following, except

Back 525

C. Protopam chloride

Front 526

49. Which medication will require the addition of sodium thiosulfate in the infusion bag

to prevent thiocyanate toxicity?

Back 526

D. Nitroprusside

Front 527

1. You arrive on the scene of twenty-one-year-old woman involved a single roll-over

accident, who is approximately twenty-eight weeks pregnant. Your assessment reveals

palpation of fetal parts over the abdomen. What is your diagnosis of the patient?

Back 527

B. Uterine rupture

Front 528

2. The patient is in a breech presentation and delivery appears to be halted upon

delivery of the head. The appropriate action would be to

Back 528

D. Perform Mauriceau’s maneuver

Front 529

3. Your patient is experiencing hypertonic uterine contractions. Appropriate therapy

would be to

Back 529

C. Discontinue any oxytocin administration

Front 530

4. The patient fetus is exhibiting variable decelerations. This is most likely due to

Back 530

B. Cord problems (prolapse, nuchal, short, compression)

Front 531

5. Late decelerations may indicate

Back 531

D. Uterine placental insufficiency

Front 532

6. The second stage of labor ends with

Back 532

D. Delivery of the infant

Front 533

7. The fetus of a pre-eclamptic mother during labor will commonly experience

Back 533

B. Late decelerations

Front 534

8. Normal magnesium level value is

Back 534

C. 1.5-2.5

Front 535

9. Preeclampsia is characterized by of the following, except

Back 535

D. Seizures

Front 536

10. The fetus’s variability is

Back 536

A. The best indicator of fetal viability

B. Normally 10-15 beats per minute

C. Expected to increase during active labor

D. All of the above

Front 537

11. Sinusoidal patterns are commonly associated with all of the following, except

Back 537

C. Pregnancy-induced hypertension

Front 538

12. You are transporting a twenty-five year-old G1, PO female who is twenty-eight

weeks gestation with a history of presenting to the ER department with headache,

hyperreflexia, nausea, vomiting, epigastric pain, and dyspnea. Assessment revealed

moist rales on auscultation, wheezing with tachycardia seen on the cardiac monitor.

When evaluating her lab results, consumptive thrombocytopenia unaccompanied by

any other coagulation factor abnormalities is characteristic of HELLP syndrome, which is

defined as a platelet count of less than

Back 538

C. 100,000/mm3

Front 539

13. After administering fluid resuscitation, performing vigorous fundal massage and

giving oxytocin, your patient continues with postpartum hemorrhage. Which drug would

be indicated to decrease blood loss?

Back 539

B. Methergine

Front 540

14. When administering magnesium sulfate, the following adverse reactions can occur,

except

Back 540

C. Increase in FHR variability

Front 541

15. Hemolytic disease of the newborn can be prevented by the administration of which

of the following to a Rhesus negative mother who had a pregnancy with a Rhesus

positive infant?

Back 541

B. Rho(D) immune globulin

Front 542

16. Frequency of a contraction is defined as

Back 542

D. Beginning of the contraction to the beginning of the next contraction

Front 543

17. Duration of a contraction is defined as

Back 543

C. Beginning of contraction to the end of the contraction

Front 544

18. Gravida means

Back 544

B. Total number of pregnancies

Front 545

19. You are transporting a twenty-three-year-old female from a small rural hospital with

a diagnosis of preterm labor. Her fundal height is measured just slightly above the

umbilicus. Your patient is approximately in how many weeks’ gestation?

Back 545

B. 20-24 weeks

Front 546

20. The most common site for an ectopic pregnancy to occur is the

Back 546

C. Fallopian tube

Front 547

21. When managing preterm labor, all of the following medications can decrease or stop

uterine activity, except

Back 547

A. Apresoline

Front 548

22. The administration of which of the following medications can help decrease the

chance that the fetus will have respiratory distress syndrome when born?

Back 548

C. Betamethasone

Front 549

24. Which of the following terms best describes an intermittent, painless contraction

that may occur every ten to twenty minutes after the first trimester of pregnancy?

Back 549

D. Braxton Hicks

Front 550

25. Regular and rhythmic contractions that produce progressive cervical changes after

the twentieth week of gestation and before the thirty-seventh week is known as

Back 550

C. Preterm labor

Front 551

26. A small amount of fluid is spread on a slide and allowed to dry completely. A frond

crystallization pattern of dried amnionitc fluid (with high concentration of sodium

chloride) will be seen under microscopic examination. The test finding is called

Back 551

A. Positive ferning

Front 552

27. Nitrazine paper will turn what color in the presence of amniotic fluid?

Back 552

D. Blue

Front 553

28. Labetalol—

Back 553

B . Is a selective mixed alpha-beta adrenergic antagonist agent that decreases

systemic vascular resistance without changing cardiac output.

Front 554

29. A patient exhibiting signs and symptoms of magnesium sulfate toxicity can present

with all of the following, except

Back 554

C. Depressed deep tendon reflexes

Front 555

30. You are transporting a twenty-four-year-old female, twentyeight-

week gestation, G2, P1, who presents to the ER department complaining of lower

abdominal contractions every 5-10 minutes. She has a history of myasthenia gravis and

gestational diabetes. Which of the following medications would not be administered to

control uterine activity?

Back 555

A. Magnesium sulfate

Front 556

31. A patient presenting with shoulder pain and lower abdominal pain with a history of

having her last menses approximately 6-8 weeks, is most likely exhibiting which of the

following?

Back 556

B. Ectopic pregnancy

Front 557

32. Which of the following can be a serious complication if, Terbutaline is administered

to an insulin-dependent pregnant diabetic patient?

Back 557

D. Transient hyperglycemic response

Front 558

33. Macrosomia refers to

Back 558

B . A fetus that is large for gestational age, with increased fat deposition, and an

enlarged spleen and liver

Front 559

34. Inversion of the uterus may occur with any of the following, except

Back 559

A. Hypertonic uterus

Front 560

35. Which of the following has been recognized as a primary cause of preterm labor?

Back 560

C. Infection

Front 561

36. Signs and symptoms of preeclampsia include all of the following, except

Back 561

D. Seizures

Front 562

39. Preeclampsia most commonly occurs during

Back 562

B. End of second trimester, beginning of third trimester

Front 563

40. Placental abruption can be defined as

Back 563

D. The premature detachment of a normally implanted placenta from the uterine wall.

Front 564

41. You are preparing to transport a twenty-year-old female, twenty-four weeks

gestation, G3, P1, AB 1. The mother is being placed in lateral recumbent position to

prevent which of the following?

Back 564

B. Supine hypotensive syndrome

Front 565

42. The diastolic blood pressure goal when managing pregnancyinduced

hypertension is

Back 565

C. 90-100 mmHg

Front 566

43. You are transporting a nineteen-year-old female, thirty weeks gestation, G2, P1,

who is presented in a small rural ER department with abdominal pain after receiving a

blow to the abdomen two hours prior. The sending staff is concerned that the patient

may be exhibiting signs and symptoms of a placental abruption. Which of the following

would assist the transport team in recognizing that the presence of concealed bleeding

may be increasing?

Back 566

C. Marking and determining the fundal height frequently

Front 567

46. The most common cause of postpartum hemorrhage (PPH) is

Back 567

D. Uterine atony

Front 568

47. Acute fetal tachycardia is defined as

Back 568

C. >160 beats per minute

Front 569

50. Leopold’s maneuver can be used to

Back 569

B. Assess fetal position

Front 570

1. Pediatric dose for Epinephrine is

Back 570

D. 0.01 mg/kg IV

Front 571

2. The pediatric patient may be pretreated with which medication prior to administering

Anectine for the purpose of preventing bradycardia?

Back 571

B. Atropine

Front 572

3. You are transporting a thirty-two-week premature neonate with respiratory distress.

Which drug may be administered in preparation for transport?

Back 572

B. Surfactant

Front 573

4. A neonate who is experiencing repetitive motions of a bicycling type action with lip

smacking is presenting with what type of seizure?

Back 573

A. Subtle

Front 574

5. Your patient is PDA dependent. This would indicate likely require the administration

of which of the following drugs?

Back 574

D. Synthetic surfactant

Front 575

6. Which of the following would calculate an appropriate ETT size for a pediatric patient?

Back 575

C. (Age + 16)/4

Front 576

7. Some pediatric endotracheal tubes are cuffless, which prevents

Back 576

D. Subglottic stenosis and ulcerations

Front 577

8. Persistent Pulmonary Hypertension (PPHN) is a syndrome characterized by persistent

elevated pulmonary vascular resistance resulting in

Back 577

A. Right-to-left shunt

Front 578

9. The most common side effect, complicating transport of a newborn with the use of

Prostaglandin E1 is

Back 578

B. Apnea, hypoventilation

Front 579

10. A medication utilized in the neonate that accelerates closure of the PDA is

Back 579

C. PGE1

Front 580

11. A pediatric patient presents to the ED in acute respiratory distress, with increased

work of breathing and reduced oxygen saturation. The patient is treated with multiple

rounds of nebulized albuterol, ipratropium, oxygen supplementation, and parental

steroids, with none to minimal improvement in clinical and objective evidence of

respiratory distress. Which of the following medications is recommended for sedation

prior to intubation because of the bronchodilatory effect it possesses?

Back 580

B. Ketamine

Front 581

12. You are transporting a nine-year-old man weighing 40 kg with diagnosis of status

asthmaticus on a ventilator. EtCO2 is 60. Ventilator settings are at Vt 250, FIO2 1.0, Rate

16, I:E 1:3, PEEP 5, PIP 48. How will you manage this patient?

Back 581

B. Increase I:E ratio

Front 582

13. Recommended urinary output when caring for a pediatric patient should be

Back 582

C. 1-2 cc/kg/hr

Front 583

14. You are transporting a three-year-old boy who was struck by a vehicle two hours

prior to your arrival in the ER department. Your assessment reveals BP 60/38, HR 54,

RR 36, SaO2 92%, skin condition is cool, with a delayed capillary refill. He is awake but

is restless and irritable. Which of the following should always be recognized as ominous

signs and should be treated aggressively in the pediatric patient?

Back 583

D. Hypotension and bradycardia

Front 584

15. You are transporting a 20-kg patient presenting with second- and third-degree burns

to his entire face, anterior torso, and complete left arm. How much fluid should the

patient receive in the first eight hours using the Parkland formula?

Back 584

C. 1,440 mL

Front 585

16. You are transporting a newborn who was delivered vaginally in a small ER about six

hours prior to your arrival with a history of bilious vomiting, abdominal distention,

feeding intolerance, and lack of stools for the last twenty-four hours. Initial

management would include

Back 585

C. Decompression of the bowel with intermittent large-bore gastric suction

Front 586

17. You are managing a four-year-old boy presenting lethargic with nystagmus. You

note he has depressed DTRs and has a profound anion-gap. The patient should be

managed with which of the following?

Back 586

A. IV ethanol drip

Front 587

18. The fetus was delivered with obvious meconium staining. His one-minute APGAR is

8. Endotracheal suctioning

Back 587

D. Should not be performed

Front 588

19. Which of the following lab test is used to diagnose Reye’s syndrome?

Back 588

A. Liver function tests

Front 589

20. During transport, management of a thirty-seven week newborn diagnosed with

persistent pulmonary hypertension (PPHN) may include which of the following to

prevent right-to-left shunting?

Back 589

B . Continuous monitoring of the blood pressure; support blood pressure with fluid

volume replacement, and a vasopressor as needed

Front 590

21. Pediatric airway anatomy differs from adult anatomy in the following ways, except

Back 590

D . In children, younger than six years of age, the narrowest portion of the trachea is

at the cricoid process.

Front 591

22. Primary cause of bradycardia in the neonate and pediatric patient is

Back 591

B. Hypoxia

Front 592

23. Drug of choice for profound hypotension in septic shock is

Back 592

B. Levophed

Front 593

24. You are managing a four-year-old boy who is requiring intubation. The appropriate

size ET tube for this patient would be

Back 593

D. 5.0

Front 594

25. What finding would you expect to see on a chest x-ray for a patient presenting with

laryngotracheobronchitis?

Back 594

C. Steeple sign

Front 595

26. Vt is calculated at

Back 595

B. 5-8 mL/kg

Front 596

27. A scaphoid abdomen, unequeal breath sounds, dyspnea, and a shift in the PMI are a

classic presentation of which of the following in the neonate patient?

Back 596

B. Diaphragmatic hernia

Front 597

28. Hypoglycemia in the neonate can be treated with

Back 597

B. D 10% 2-4 mL/kg

Front 598

29. You are transporting a ten-year-old boy with a history of being struck by a vehicle

while riding his bicycle. Your assessment reveals a deteriorating neurologic status,

hypotension, and bradycardia. Your management of the this patient would include all of

the following, except

Back 598

D. Nasal intubation

Front 599

30. A full-term newborn weighing 2,800 grams should be intubated with what size

endotracheal tube?

Back 599

C. 3.5

Front 600

31. An eight-year-old child was hit by a car. Your assessment reveals radiation of pain to

the left shoulder, ecchymosis, and abrasions to the retroperitoneal area bilaterally and

abdominal distention. What injury do you suspect?

Back 600

B. Spleen

Front 601

32. What finding would you expect to see on the lateral neck x-ray to confirm suspicion

of epiglottitis?

Back 601

D. Thumb print sign

Front 602

33. Fluid resuscitation in a neonate patient should be administered at

Back 602

B. 10 mL/kg

Front 603

34. You are transporting a four-year-old boy trauma patient. You are preparing to

administer a weight per kg based medication. How many kilograms does patient weigh

approximately?

Back 603

C. 15 kg

Front 604

35. Expected endotracheal tube centimeter depth for a neonate can best be determined

by using which of the following formulas?

Back 604

A. 6 + weight in kg

Front 605

36. When identifying vessels on the umbilical stump, the umbilical vein, as compared to

the umbilical arteries, is usually located at what position?

Back 605

C. 12 o’clock

Front 606

37. The circulating blood volume in a child is

Back 606

D. 70-80 mL/kg

Front 607

38. A surgical airway can be placed through the cricothyroid membrane on children over

the age of

Back 607

C. 11 years

Front 608

39. In an emergency situation, an umbilical vein catheter when placed correctly should

only be inserted as far as necessary to obtain blood and should not go beyond which of

the following?

Back 608

B. Liver

Front 609

40. Noninitiation or discontinuation of newborn resuscitation as recommended by the

International Guidelines for Neonatal Resuscitation include all of the following, except?

Back 609

C. Gestational age < 28 weeks

Front 610

41. One of the most common causes of new-onset wheezing in children is

Back 610

B. Bronchiolitis

Front 611

42. Which of the following is not indicated for the treatment of bronchiolitis?

Back 611

C. Corticosteroids

Front 612

43. You are transporting a five-year-old boy with a diagnosis of sepsis secondary, a

localized necrotic skin area of unknown etiology. The “bull’s-eye” appearing necrotic

area is noted to the left upper thigh area. Which of the following may be the most

likely cause?

Back 612

B. Brown recluse spider bite

Front 613

44. A ten-year-old boy presents to the emergency department with a history of feeling a

“sharp” pinprick, dull numbing pain to the right foot, muscle cramping, with intense

abdominal pain that started about thirty minutes prior. Which of the following may be

the most likely cause

Back 613

A. Black widow spider bite

Front 614

45. You have been called to the scene for a six-year-old girl with a history of snake bite

to the left lower extremity while on a camping trip. Management of this patient would

include all of the following, except

Back 614

D. Application of ice to the affected area

Front 615

46. A newborn who is hypoxic in room air but demonstrates a partial pressure of oxygen

greater than 150 in 100% oxygen is more likely to have which of the following?

Back 615

B. Pulmonary disease

Front 616

47. Gastroschisis in a newborn is best described as

Back 616

D . A defect in the abdominal wall that has otherwise completed its development and

allows protrusion of abdominal contents which is not covered by a membrane

Front 617

48. When transporting a neonate suspected of having esophageal atresia, you should

immediately

Back 617

B. Elevate the head of the bed to prevent gastric reflux

Front 618

49. Which of the following scenarios would be most suspicious for possible child abuse?

Back 618

C . Four month old who presents with a nondisplaced femur fracture after reportedly

rolling off of the changing table

Front 619

50. You have been requested to transport a five-year-old who was involved in a single

rollover accident two hours prior to your arrival at the referring facility. Your exam

reveals the following vital signs: Temp. 37.0, P160, RR ventilated via the tracheal tube

at 20, BP 100/80, oxygen saturation 97%. He is still unresponsive and being ventilated

via the tracheal tube. His pupils are briskly reactive to light. There is excellent chest

wall rise and fall via ventilation through the tracheal tube. There are numerous

abrasions over his face, chest, abdomen, and lower extremities. The abdomen is

distended with decreased bowel sounds. His pelvis is stable, but his right thigh is

obviously swollen and tense. Distal perfusion to all four extremities seems adequate.

The remainder of his physical examination is unremarkable. The child is clinically

presenting with which of the following?

Back 619

D. Compensated progressive shock

Front 620

1. Initial intervention for managing a patient presenting with bariobariatrauma is?

Back 620

C. Administer high flow oxygen by NRM 15 minutes prior to lift off

Front 621

2. An expanding ETT cuff in flight is an indication of what gas law?

Back 621

C. Boyle’s law

Front 622

3. Your oxygen tank pressure reading at 1,200 hours was 1,800 psi. The pilot rechecked

the unused oxygen tank in the evening and reported that the gauge reading was 1,500

psi. Which gas law best describes the decrease in pressure?

Back 622

A. Gay-Lussac’s law

Front 623

4. How should your flight suit fit to provide space of insulation per CAMTS

recommendations?

Back 623

D. ¼ in.

Front 624

5. You are beginning to prepare for landing and you have news reporter riding along for

the day. You see a high-rise tower at 1,100 high. Sterile cockpit applies how?

Back 624

B. Flight crew members are the only one allowed to speak

Front 625

6. You have just crash landed your aircraft and your pilot has asked you to exit the

aircraft. What should you take with you?

Back 625

C. Survival kit

Front 626

7. You are transporting a non-intubated seventy-year-old man with a history of bilateral

pneumonia on 2 L of oxygen by nasal cannula. You are at 10,000 feet and the patient’s

vital signs are BP 190/100, HR 102, RR 24, and SaO2 86%. What is the immediate

intervention for this patient?

Back 626

B. Increase oxygen delivery to the patient

Front 627

8. You are transporting a thirty-year-old man who was involved in a motor vehicle crash.

He has a closed femur fracture with a history of alcohol consumption of unknown

amount. On the basis of the physiologic effects elicited on the body, which type of

hypoxia problems may occur in flight?

Back 627

A. Histotoxic and hypemic

Front 628

9. Which one of the following has been determined to be an unreliable sign of hypoxia?

Back 628

A. Cyanosis

Front 629

10. An increase in altitude produces?

Back 629

B. Low humidity and low temperature

Front 630

11. After a forced aircraft landing, the pilot is incapacitated; your main priority is to?

Back 630

C. Turn off throttle, fuel, and then battery

Front 631

12. Your immediate concerns of survival after an aircraft accident include all of the

following, except?

Back 631

A. Obtain water and go for help

Front 632

13. No pilot may takeoff or land an aircraft under visual flight rules (VFR) when the

reported ceiling or visibility is less than which of the following for local day weather

minimums?

Back 632

B. 500 feet and 1 mile

Front 633

14. The emergency transmit frequency is?

Back 633

A. 121.5

Front 634

15. Average time of useful consciousness (TUC) for a non-pressurized aircraft at 45,000

feet is?

Back 634

D. 15 seconds or less

Front 635

16. You are asked to respond to a local scene call with night vision goggles (NVG)

capability involving an MVA with multiple injured patients at 2,300. You have been

having bad weather off and on. The pilot-in-command (PIC) advises you that weather

minimums are currently at 800 and 1. What will you do?

Back 635

C. Abort the flight due to weather

Front 636

17. The percentage of oxygen at 25,000 MSL is

Back 636

B. 21%

Front 637

18. The altitude at which one begins to lose their night vision is

Back 637

D. 5,000 feet

Front 638

19. The pilot made contact upon the aircraft lifting at 1455. The second contact was at

1510 after landing. The communication center has not heard from the transport team

since the last flight following transmission. The postaccident incident plan (PAIP)

should be initiated at what time?

Back 638

C. 1555

Front 639

20. Gas that diffuses from an area of higher concentration to an area of lower

concentration, best describes which gas law?

Back 639

D. Henry’s law

Front 640

21. Your patient would most likely experience barodontalgia during which phase of

flight?

Back 640

A. Ascent

Front 641

22. You will be transporting a stable twenty-seven-year-old man with nontraumatic

pneumocephalous secondary to gas producing necrotizing bacteria from rural hospital

at 8,500 feet elevation to a local hospital at 1,200 feet sea level. What might be the

best transport option? What gas law will most affect this patient negatively?

Back 641

A. Ground; Boyle’s law

Front 642

23. You are transporting a sixty-year-old man with a history of nonembolic stroke by

rotor-wing aircraft in the middle of a sunny afternoon. When the pilot begins to turn the

rotors, the flight team notices that the patient’s eyes are blinking rapidly and he begins

to experience a generalized tonic-clonic seizure. The monitor shows what appears to be

ventricular fibrillation, but a pulse can be palpated. The seizure activity ceased when

the rotor blades stopped and started again with start-up. The seizure activity is most

likely due to?

Back 642

A. Flicker vertigo

Front 643

24. You are doing a night flight when you encounter bad weather. The helicopter

suddenly impacts the ground and the cockpit is filled with smoke. The best action of

the flight team immediately after experiencing the hard landing should be which of the

following?

Back 643

C . Exit the helicopter after the aircraft has come to a complete stop and meet at a

predesignated position a safe distance from the aircraft

Front 644

25. Your IABP begins to purge during ascent. The triggering mechanism for this function

was initiated as a result of which gas law?

Back 644

A. Boyle’s law

Front 645

26. Henry’s law best describes which of the following patient conditions?

Back 645

A. Bends

Front 646

27. On a long fixed wing flight, an option may be to place water on the ET tube cuff to

counteract. Which gas law is it?

Back 646

D. Boyle’s law

Front 647

28. Overdue aircraft procedures during flight start after

Back 647

C. 45 minutes without contact

Front 648

29. The absolute minimum hours required by the Federal Aviation Regulation (FAR) Part

135 with regard to a pilot’s “bottle to throttle” rule is

Back 648

A. 8

Front 649

30. Who has the ultimate authority to initiate or complete a mission?

Back 649

C. The PIC

Front 650

31. The flight team should be prepared that an aircraft will capsize when it hits water

because helicopters are top heavy as a result of the weight of the engines and

transmission. Once in the water, the flight team can minimize heat loss by using which

of the following?

Back 650

A. Heat escape-lessening posture (HELP)

Front 651

32. The total pressure of a gas mixture is the sum of the partial pressures of all gases.

Which gas law best describes?

Back 651

C. Dalton’s law

Front 652

33. Malpractice is based on a professional standard of care. The elements that must be

proved for a malpractice case include all of the following, except?

Back 652

C. Abandonment

Front 653

34. Air medical programs that frequently fly over large bodies of water need to be

familiar with emergency egress procedure in the event of a forced water landing. All of

the following are correct regarding the emergency egress, except?

Back 653

A . During surface ascent, exhalation should be done rapidly to prevent serious lung

injury

Front 654

35. Administration of the wrong medication to a patient best describes which element of

malpractice?

Back 654

A. Breach of duty as a result of malfeasance

Front 655

36. During descent, gas will

Back 655

B. Contract

Front 656

37. The radio signal that follows the curvature of the earth and has the greatest range

is?

Back 656

C. VHF low-band FM

Front 657

38. The ELT takes a minimum of ____________ g’s to activate.

Back 657

B. 4

Front 658

39. A repeater system is a type of which of the following radio systems?

Back 658

C. Half duplex

Front 659

40. In aviation, “You may fly instrument flight rules (IFR) in visual meteorological

conditions (VMC), you cannot fly VFR in _________.”

Back 659

C. Instrument meteorological conditions (IMC)

Front 660

41. Decompression illness is mostly attributed to which gas law?

Back 660

C. Henry’s law

Front 661

42. During flight, you notice that the IV drip rate has increased. Which gas law is

responsible for this to occur?

Back 661

D. Boyle’s law

Front 662

43. The number one cause of aero-medical crashes is

Back 662

A. Pushing the weather (weather-related)

Front 663

44. Unless it is acted on by a force, a body at rest will remain at rest and a body in

motion will move at a constant speed in a straight line best describes which of the

following laws?

Back 663

B. Newton’s law

Front 664

45. Four basic variables that affect gas volumetric relationships include all of the

following, except?

Back 664

B. Altitude

Front 665

46. CAMTS requires a minimum of _____________ successful live intubations during

initial flight training.

Back 665

C. 5

Front 666

47. During an in-flight emergency procedure, all of the following are correct, except

Back 666

A. Place patient in high-fowlers position

Front 667

48. CAMTS requires that helipads must have all of the following, except

Back 667

D. Evidence of adequate security

Front 668

49. Which of the following is a leading cause of death among scuba divers?

Back 668

A. AGE

Front 669

50. All of the following are considered stressors of flight, except?

Back 669

B. Increased partial pressure of oxygen