CCEMTP

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  1. The first use of helicopters for air medical transport occured as a result of:
    the Korean conflict of 1950
  2. Which of the following is not considered routine equipment on-board a Critical Care Transport unit?
    • a. IV infusion pumps
    • b. Portable ABG machine
    • c. Neonatal isolette
    • d. Central venous line kit
    • c. Neonatal isolette
  3. The law requiring that patients are provided written information on the right to make medical decisions is the:
    Patient Self Determination Act
  4. Which of the following areas are often cited in litigation involving malpractice?
    Failure to adequately monitor the patient's condition, adequately document findings, and advise more highly trained individuals of abnormalities
  5. A common problem of specimen collection associated with the breakdown of red blood cells and subsequent release of hemoglobin is known as:
    hemolysis
  6. Which of the following IS NOT seen with a normal or increased hematocrit and hemoglobin?
    • a. dehydration
    • b. copd
    • c. anemia
    • d. severe diarrhea
    • c. anemia
  7. A 16-yo female presents with the following signs and symptoms: nervousness, anxiety, dizziness, with numbness and tingling of the extremities. The pt's ABG analysis shows the following values.
    • pH=7.50
    • PO2=100
    • PCO2=30
    • HCO3=24
    • BE= -7
    • a. respiratory acidosis
    • b. respiratory alkalosis
    • c. metabolic acidosis
    • d. metabolic alkalosis
    • b. respiratory alkalosis
  8. The primary intracellular cation important for repolarization of cardiac cells is:
    potassium
  9. The urine ouput of an average adult should be:
    30-70 cc/hr
  10. A test used to identify an organism
    Culture
  11. A test used to determine the best antibiotic to use against the organism.
    Sensitivity
  12. Which of the following is CORRECT with regard to shock?
    • a. a degenerativve condition leading to death
    • b. a physiologic state of tachycardia and diaphoresis
    • c. general systemic response to inadequate tissue perfusion
    • d. irreversible hypotension
    • c. general systemic response to inadequate tissue perfusion
  13. As a result of Neurogenic shock, which of the following will occur?
    peripheral vasoconstriction and vasodilation
  14. A 31yo female is experiencing anaphylaxis. What is the CORRECT medication to give to promote vasoconstriction, bronchodilation, and inhibit further relese of further biochemical mediators?
    • a. decadron
    • b. epinephrine
    • c. solumedrol
    • d. benadryl
    • b. epinephrine
  15. Gram negative and gram positive bacteria have been implicated as the causative factors of:
    sepsis
  16. What is the proper infection control measures while caring for a tuberculosis pt?
    micron filter face mask
  17. In which of the following would the blood oxygen saturation be high, yet the pt still dies from hypoxia?
    • a. carbon monoxide poisoning
    • b. hypovolemia
    • c. hypothermia
    • d. all of the above
    • d. carbon monoxide poisoning, hypovolemia and hypothermia
  18. PaCO2
    35-45
  19. FiO2 of Room Air
    21%
  20. After pleural decompression, assessment observations would include,
    hemoptysis, signs of hypoxia and lung sounds
  21. Volume of gas inhaled or exhaled during a single respiratory cylce
    tidal volume
  22. What are complications of pleural decompression?
    pneumothorax, infection, and lung contusion
  23. chest tube insertion site for air removal is the
    second intercostal space on the mid axillary line
  24. By increasing ventilation which of the following abnormalities can be corrected?
    • a. metabolic acidosis
    • b. respiratory acidosis
    • c. metabolic alkalosis
    • d. metabolic alkalosis
    • b. respiratory acidosis
  25. Why is a tracheostomy wound not packed or surgically closed?
    to avoid subcutaneous emphysema
  26. When the anterior neck is palpated from superior to inferior, the cricothyroid membrane is
    between the first and second prominent structures
  27. How do you differentiate between a spontaneously wedged catheter to one that is occluded:
    aspirate for blood return
  28. Lack of an identifiable "wedge" waveform may possible be due to:
    Incorrect catheter position, insufficient volume of air used to inflate the balloon, and/or baloon rupture
  29. A disease that would increase the afterload of the heart would result in:
    a decrease in the stroke volume
  30. What would the effect of positive pressure ventilation be on hemodynamic waveforms?
    • a. there would be no effects
    • b. the same as those associated with spontaneous respirations
    • c. hemodynamic pressure waves rise during positive pressure ventilation
    • d. transducer calibration would need to refelect higher pulmonery pressures
    • c. hemodynamic pressure waves wise during positive pressure ventilation
  31. Which of the following is FALSE regarding the Rh factor?
    • a. it is an antigenic substance
    • b. it is present in the blood plasma
    • c. Rh positive blood administered to an Rh negative pt will result in hemolysis
    • d. Rh positive blood administered to an Rh negative pt will result in anemia
    • b. it is present in the blood plasma
  32. Which blood preparation contains the formed elements, clotting factors and antibodies?
    whole blood
  33. Which of the following test results would be the most helpful in assessing a pt with a bleeding disprder?
    • a. red blood cell count
    • b. platelet count
    • c. hematocrit
    • d. differential count
    • b. platelet count
  34. Which of the following is CORRECT regarding diastole?
    • a. the tricuspid and mitral valves are closed; the aortic and pulmonic valves are open
    • b. it is a phase of the cardiac cycle when the myocardium contracts
    • c. it is a phase that is approximately twice as long as systole
    • d. None of the above is true
    • c. it is a phase that is approximately twice as long as systole
  35. The term inotropic refers to the:
    contractile force
  36. QT interval measuring can help in the diagnosis of?
    hyperkalemia
  37. Which of the following statements is/are CORRECT regarding right atrial hypertrophy?
    • a. is often associated with right ventricular hypertrophy
    • b. is often associated with tall, wide P wave morphology
    • c. results from congenital heart disease or pulmonary hypertension
    • d. all of the above
    • d. all of the above
    • often associated with right ventricular hypertrophy, tall, wide P wave morphology, and results from congenital heart disease or pulmonary hypertension
  38. To interpret the heart rhythm, the ICD:
    • a. takes approx 30 seconds to analyze the rhythm
    • b. considers rate, onset of rate increase, and stability of the complex
    • c. requires placedment of 2 endocardial leads in the right and left atria
    • d. all of the above
    • d. all of the above
    • takes approx 30 sec to analyze the rhythm, considers rate, onset of rate increase and stability of the complex and requires placement of 2 endocardial leads in the right and left atria
  39. Placement of the intra-aortic balloon
    thoracic aorta, distal to the left subclavian artery
  40. Theraputic effects of IABP use:
    Positively affect afterload, preload, contractility and rate
  41. The effects of beta 2 stimulation include:
    • a. histamine inhibition
    • b. increased inotropic activity
    • c. vasoconstriction
    • d. bronchodilation
    • d. bronchodilation
  42. Murphy's sign
    referred pain
  43. Which of the following IS NOT considered abnormal findings in urine?
    • a. leukocytes
    • b. erythrocytes
    • c urochromes
    • d. albumin
    • c. urochromes
  44. diffusion is defined as:
    movement of particles from higher concentration to lower concentration
  45. a "fistula" is a
    surgically creasted anastomosis between an artery and a vein
  46. Romberg test
    A test used to check for cerebellar function. Conducted by having Pt stand with feet together, eyes open and then closed, observing for any sway or loss of balance
  47. Monroe-Kellie Doctrine, what compromises intracranial volume?
    • 10% CSF
    • 10% Blood
    • 80% Brain Mass
  48. Normal ICP
    0 and 15 mmHG
  49. What medications with help decrease ICP?
    • Mannitol
    • Thiopental
  50. Pediatric Narcan dosage
    0.1 mg/kg
  51. Pregnancy produces changes to the cardiovascular system, such as:
    • increased blood volume and cardiac output
    • decrease in peripheral vascular resistance and blood pressure
  52. Pregnancy-induced hypertension can cause what fetal complications:
    • growth retardation
    • fetal distress
    • abruptio placenta
    • fetal death
  53. What are the major components of the immune system?
    • Leukocytes
    • Lymphocytes
    • Antibodies
  54. PaO2 will assist in obtaining information of what nature?
    the efficiency of gas exchange
  55. In regard to pleural decompression, the "angle of louis" is used to
    locate the second intercostal spac
  56. The ideal position for transporting a Pt with a chest tube
    Fowler's
  57. To preform retrograde intubation, the guide wire must be:
    approximately 70cm in length
  58. Non-tunneled catheters:
    • single or double lumens
    • inserted centrally or peripherally
    • used for short term therapy
  59. When a pulmonary artery catheter is wedged, what information is available?
    left ventricular end-diastolic pressure
  60. What is the purpose of zero referencing?
    It balances the transducer to atmospheric pressure
  61. How do you calculate MAP?
    • Systolic + (Diastolic x 2)
    • 3
  62. What would result in low values on the monitor?
    • Transducer above phlebostatic level
    • Air bubbles or clot in the catheter
  63. What type of blood preparation would eliminate disease transmission and the possibility of transfusion reaction?
    Autologous
  64. What should you give to reduce the risk of volume overload, when multiple units of blood are to be infused?
    Packed Red Blood Cells
  65. Hemolytic transfusions can occur as long as ____ after transfusion:
    14 days
  66. What criteria do you use to diagnose bifasicular blocks?
    • Widened QRS, "rabbit ears" in V1 aV2
    • A negative deflection lead AVF
  67. Indications for Intra-Aortic Balloon Pump
    • Cardiogenic shock secondary to infarction
    • Postoperative left ventricular failure
    • Severe unstable angina
  68. Contraindiction for the use of IABP
    • Aortic aneurysm
    • severe peripheral vascular occlusive disease
  69. What is a complication associated with IABPs?
    • arterial insufficiency
    • infection
    • gas ebolism
  70. What must be in place to monitor proper timin of the balloon pump?
    an arterial catheter
  71. What is the mechanism of action for benzodiazepines
    Inhibiting pre and post synaptic dopamine
  72. What is the Classification of Albumin and Dextran?
    Colloids
  73. Which of the following IS NOT a vasopressor?
    • a. Norepinephrine
    • b. Epinephrine
    • c. Dopamine
    • d. Dobutamine
    • d. Dobutamine
  74. Similarities between Streptokinase and TPA include:
    Both convert plaminogen to plasmin
  75. A colostomy is a surgical procedure likely to required for patients with:
    • Obstruction of the small intestine
    • Rectal Cancer
    • Blood accumulation in the stomach
  76. An inappropriate motor response in a comatose patient characterized by flexion of the arms, wrists, and fingers, adduction of the upper extremities, and extension, medial rotation and plantar flexion of the lower extremities is known as:
    Decorticate Posture
  77. When documenting deep muscle reflex response, a grade of ____ is used to indicate a normal or expected response.
    2
  78. The intracranial volume-pressure curve demonstrates the relationship between:
    changes in volume and intracranial pressure
  79. Advantages of using an interventricular catheter
    • Ability to drain CSF to lower ICP
    • Increased accuracy in ICP monitoring
    • Reliability
  80. Mean Arterial Pressure (MAP) - Intracranial Pressure (ICP) =
    Cerebral Perfusion Pressure (CPP)
  81. What drugs will cause an increase in ICP?
    • Ketamine
    • Diazepam
    • Nitroprusside
  82. How much circulating blood volume should a neonate have?
    85-90 cc/kg
  83. In a pediatric patient with a fever, the heart rate increases ___ BPM for every 1 degree C above 37 degrees C
    20
  84. The antihypertensive medication of choice for managing severe pre-eclampsia is:
    Hydralazine
  85. What can cause fetal tachycardia?
    • Parasymatholytic drugs
    • Sympathomimetic drugs
    • Chorioamnionitis
    • Maternal fever
    • Fetal hypoxia
  86. Which of the following chemicals would produce the most serious burns?
    • a. an alkali solution
    • b. acetic acid
    • c. dry lye
    • d. diesel fuel
    • a. an alkali solution
  87. What is Boyle's Law?
    • Volume of a gas is inversely proportional to the pressure of a gas at a constant temperature
    • (P1)(V1)=(P2)(V2)
    • Balloon...
  88. Boyle's Law effects during ascent and descent?
    • Ascent - Expansion of Gas
    • Descent - Contraction of Gas
  89. Boyle's Law effects on Pts
    • Barotitis media - Descent
    • Barondontalgia - Ascent
    • Barosinusitis - Ascent
    • Barobariatrauma (Bends) - Ascent
    • GI Complications
  90. Boyle's Law effects on equipment
    • ETT Cuffs
    • MAST pants
    • IV drip rates
  91. What is Charles' Law?
    • At a constant pressure, the volume of a gas is directly proportional to the absolute temperature of a gas
    • V1/T1 = V2/T2
  92. Charles' Law effects on Pt's/equipment
    • Gas volume expands as temperature increases.
    • Gas volume shrinks as temperature decreases.
  93. Gay-Lussac's Law
    • Directly proportional relationship between temperature and pressure
    • P1/T1 = P2/T2
  94. What is Dalton's Law?
    The total pressure of a gas mixture is the sum of the partial pressures of all the gases in the mixture.

    Pt=P1+P2+P3+P4.....
  95. Stressors of Flight
    • Decreased partial pressure of oxygen
    • Barometric pressure
    • Thermal and Hydration
    • Noise and Vibration
    • Fatigue
    • G-forces
  96. Factors effecting flgiht stressors
    • D-Drugs
    • E-Exhaustion
    • A-Alcohol
    • T-Tobacco
    • H-Hypoglycemia
  97. Which of the following abnormal labs is indicative of DIC?

    a. Serum glucose level
    b. Clotting tests
    c. Liver function tests
    d. Renal function tests
    Clotting tests
  98. Which of the following is correct in regard to changing a patient's oxygen deliverey system prior to obtaining an ABG sample?

    a. Should not be done
    b. Can be done if noted on the sample
    c. May require 15 minutes for the patient to adapt
    d.  Requires the sample be tested on two machines, and results compared
    May require 15 minutes for the patient to adapt
  99. Which of the following is/are true with regard to the indications for clamping a chest tube?

    a. to locate the source of a water leak
    b. replacing the drainage unit
    c. suspicion the the tube has been accidentally dislodged
    d. all the above
    all of the above
  100. A dyspneic patient complains of sharp chest pain in the upper right chest.  It becomes worse on deep inspiration.  Which condition would you suspect?

    a. acute bronchospasm
    b. pleuritic irritation
    c. acute myocardial infarction
    d. bronchial obstruction
    pleuritic irritation
  101. choose the blood gas sequence that indicates the need for mechanical ventilation?
    • a. decreasing PO2, decreasing PCO2, normal pH
    • b. increasing PO2, decreasing PCO2, increasing pH
    • c. decreasing PO2, increasing PCO2, decreasing pH
    • d. increasing PO2, decreasing PCO2, decreasing pH
    • Decreasing PO2, Increasing PCO2, decreasing pH
  102. Which of the following is not an indication for ETT sunctioning?

    a. the normal cough mechanism is lost
    b.  production of secrations increase
    c. to maintain patency of the device
    d. monitor tube position
    monitor tube position
  103. Which of the following is not a standard ventilator setting?
    • a. peak inspiratory pressure less than 40lpm
    • b. flow rate 80-100 lpm
    • c. tidal volume 12ml/kg body weight
    • d. respiratory rate 10-15 breaths per minute
    • flow rate 80-100 lpm
  104. Which statement is FALSE regarding the use of Sellick's manuever?
    • a. pressure is applied over the cricoid cartilage
    • b. it cannot be used on children
    • c. it serves to occlude the esophagus in the vomiting patient
    • d. aids in visualization of the airway structures for intubation
    • it cannot be used on children
  105. What is the correct order of steps for rapid sequence intubation in chronological order?

    Apply a cardiac monitor and pulse oximeter
    Pre-oxygenate the patient
    Medicate the patient with succinylcholine
    Medicate the pantient with pancuronium or vecuronium if necessary
    intubate the patient
    post intubation sedation/paralytic
    • cardiac monitor/pulse oximeter
    • pre-oxygenate
    • pancuronium/vecuronium
    • succinylcholine
    • intubate
    • post intubation sedate
  106. Which of the following is correct regarding why a tracheostomy wound is not packed or surgically closed?

    To allow rapid removal of the tube if neccesary
    To avoid subcutaneous emphysema
    To avoid the possiblity of infection
    The neck tape adequately secures the tube; no other stability is needed
    to avoid subcutaneous emphysema
  107. Which of the following is the correct procedure for a cricothyrotomy incision?

    a. a transverse incidion is made through the superficial cricothyroid membrane
    b. a transverse incision is made 1 cm superior to the suprasternal notch
    c. a transverse incision is made between the fourth and fifth ribs
    d. the subcutaneous tissues are infiltrated with lidocaine prior to starting the incision
    a transverse incision is made throught the superficial cricothyroid membrane
  108. Which of the following is not an indication for needle cricothyrotomy?

    a.  obstruction below the cricothyroid membrane
    b. manual measures for airway maintenance have failed
    c. central cyanosis
    d. endotracheal intubation is not possible
    obstruction below the cricothyroid membrane
  109. Which procedure allows rapid entrance into the airway by making a horizontal incision?

    a. percutaneous transtracheal jet insufflation
    b. needle cricothyrotomy
    c. surgical cricothyrotomy
    d. retrograde surgical intubation
    surgical cricothyrotomy
  110. Which of the following is correct is regarding an indication for retrograde intubation?

    a.  inability to fully open the patient's mouth
    b. a patient less than 5 years old
    c. lack of a laryngoscope
    d. the presence of subcutaneous emphysema
    inability to fully open the patient's mouth
  111. Which of the following are potential side effects or complications of retrograde intubation?

    Bleeding
    Hypoxemia
    Coagulation disorder
    The lack of a local anesthetic for the puncture site
    Bleeding and Hypoxemia
  112. Which of the following is FALSE regarding invasive line complications?

    a. Sluggish infusion is pften associated with catheter kinks
    b. If unable to withdraw blood, flush with 20ml of normal saline
    c. Infection of the exit site requires dressing changes every 2 days
    d. You can avoid catheter damage by keeping the catheter looped on the chest wall
    Infection of the exit site requires dressing changes every 2 days
  113. Which of the following is CORRECT regarding CVP monitoring?

    a. Allows accurate assessment of left ventricular function
    b. Allows rapid assessment of left ventricular end diastolic pressure (LVEDP)
    c. CVP fluctuates with right ventricular compliance
    d. Accurately measures PCWP
    CVP fluctuates with right ventricular compliance
  114. PCWP stands for

    a. The pulmonary capillary wedge pressure
    b. The right atrial afterload
    c. The left atrial pressure
    d. The pulmonary artery diastolic pressure
    The pulmonary capillary wedge pressure
  115. Which of the following is CORRECT when trying to differentiate between a spontaneously wedged catheter to one that is occluded:

    a. Aspirate for blood return
    b. Inflate the balloon
    c. Excessive catheter lengths are more prone to occlusion
    d. Reconfirm proper transducer placement at the phlebostatic axis
    Aspirate for blood return
  116. Lack of an identifable "wedge" waveform may possibly be due to:
    • a. Incorrect catheter position
    • b. Insufficient volume of air used to inflate the baloon
    • c. balloon rupture
    • d. All of the above
    • All of the above
  117. A disease that would increase the afterload of the heart would result in a/an:

    a. Increase in the cardiac index
    b. Decrease in the stroke volume
    c. Increase in myocardial contractility
    d. decrease in arterial pressure
    Decrease in the stroke volume
  118. What would the effect of positive pressure ventilation be on hemodynamic waveforms?

    a. There would be no effects
    b. The same as those associated with spontaneous respirations
    c. Hemodynamic pressure waves rise during positive pressure ventilation
    d. Transducer calibration would need to reflect higher pulmonary pressures
    Hemodynamic pressure waves rise during positive pressure ventilation
  119. Which of the following statements is CORRECT with regard to decreasing the danger of transfusion reactions?

    a. Administering a fluid bolus of normal saline
    b. Adding normal saline to the transfusion
    c. Monitoring the urine output
    d. Slowly infusing blood during the first 15 minutes
    Slowly infusing blood during the first 15 minutes
  120. If a patient experienced a transfusion reaction, which of the following would be carried out INITIALLY?

    a. Notify medical control
    b. Administer high flow oxygen
    c. Discontinue the transfusion
    d. Raise the patient's head and monitor vital signs
    Discontinue the transfusion
  121. Which of the following is FALSE regarding components of the electrocardiogram?

    a. Intervals are measured in fractions of seconds
    b. Waveforms are captured on ECG paper have three primary characteristics: amplitude, duration and configuration
    c. The first half of the P wave reflects right atrial depolarization
    d. The absolute refractory period is represented by the second half of the T wave
    The absolute refractory period is represented by the second half of the T wave
  122. Which of the following is/are CORRECT with regard to the QRS complex?

    A.  B and C
    B. Has a normal duration in excess of 0.12 seconds
    C.  Marks the approximate beginning of mechanical systole
    D.  Produces a 50-100mV electrical signal
    A. B and C
    (this multiple choice question has been scrambled)
  123. Which of the following is/are FALSE in regard to the electrical axis of the QRS complex?

    a.  The QRS complex is always upright in leads V1-V6
    b.  The axis is abnormal is the QRS complex is upright in leads 1 and AVF
    c.  The QRS complex will be negative in leads 1 and AVF if the axis is between 0 and 90
    d.  All of the above
    d.  All of the Above
  124. Which of the following statements is/are CORRECT regarding how to differentiate a right bundle branch block from a left bundle branch block?
    • a.  RBBB has a characteristic RSR pattern in V1
    • b.  RBBB has a characteristic QS pattern in V1
    • c.  RBBB has a negative deflection of the QRS, while LBBB has a positive deflection
    • d.  All of the above
    • a.  RBBB has a characteristic RSR pattern in V1
  125. In regard to the deactivation of an ICD, which of the following is FALSE?
    • a.  A critical care transport team can deactivate the device without a physician's order
    • b. Deactivation requires the use of a magnet
    • c. The margins of the ICD should be palpated to determine precise location before deactivation
    • d. Synchronous tones indicate the device is tracking the R wave
    • a.  A critical care transport team can deactivate the device without a physician's order
  126. Which of the following is CORRECT regarding the proper timing of the balloon pump?

    a. A patient with a heart rate of 80 bpm requires balloon inflation during diastole for 1450-1500 msec.
    b.  An arterial catheter must be in place to monitor timing
    c. The dicrotic notch identifies the point of balloon deflation during systole
    d.  The final step in timing is the identification of the begining of systole and diastole on the arterial waveform
    An arterial catheter must be in place to monitor timing
  127. Which of the following is/are a complication associated with IABPs?

    a.  Arterial insufficiency
    b.  Infection
    c.  Gas embolism
    d. All of the above
    d.  All of the above
  128. Which of the following is/are correct regarding diastolic augmentation?

    a.  The diastolic waveform may not be larger than the systolic waveform
    b.  Augmentation helps increase coronary perfusion
    c.  Augmentation occurs with inflation of the IABP during diastole
    d. All of the above
    d.  All of the above
  129. Which of the following statements is/are CORRECT regarding the proper positioning of the intra-aortic balloon?
    • a.  Is often achieved by using the Seldinger technique for catheter placement
    • b.  Requires balloon placement beneath the renal arteries
    • c.  Requires balloon placement in the thoracic aorta, distal to the left subclavian artery
    • d. B and C
    • c. Requires balloon placement in the thoracic aorta, distal to the left subclavian artery
  130. A significant concern for prolonged paralysis is

    a.  Patients with renal failure
    b.  Elderly patients
    c.  Patients receiving positive chronotropic drugs
    d.  All of the above
    d. All of the above
  131. Which of the following is INCORRECT regarding the use of Theophylline?

    A.  It can cause an allergic reaction
    B.  Administration at a rate of greater than 10ml/min will result in hypertension
    C.  Toxicity may be exhibited by nausea, vomiting, ventricular dysrhythmias and death
    D.  It has a long half-life
    C.  Administration at a rate of greater than 10ml/min will result in hypertension
    (this multiple choice question has been scrambled)
  132. Which of the following is CORRECT regarding the administration of Dopamine?

    A.  It results in renal dilation at low dose
    B.  It results in significant vasoconstriction at low dose
    C.  It results in predominantly alph effects at moderate dose
    D.  It stimulates dopaminergic receptors at high dose
    A.  It results in renal dilation at low dose
    (this multiple choice question has been scrambled)
  133. Which of the following is/are CORRECT regarding the use of plasmanate?

    1.  It contains albumin, sodium, and globulin
    2.  It is given at a rate of 100ml/min
    3.  It expands 1 ml per every ml administered
    4.  It causes severe hypertension
    1, 3
  134. A 55-year-old female is experiencing a hypertensive emergency.  You may adminsiter a calsium channel blocker known as ____, or an ACE inhibitor, known as _____.

    A.  Clonidine, Captopril
    B.  Captopril, Nifedipine
    C.  Nifedipine, Clonidine
    D.  Nifedipine, Captopril
    D.  Nifedipine, Captopril
    (this multiple choice question has been scrambled)
  135. Which of the folloing is CORRECT with regard to Magnesium sulfate?

    A.  Used after beta agonists have failed to correct bronchoconstriction
    B.  The first line medication for the treatment of bronchoconstriction
    C.  Able to inhibit cellular sodium uptake
    D. Administered 100-200 mg in 50ml, over 20 minutes
    A.  Used after beta agonists have failed to correct bronchoconstriction
    (this multiple choice question has been scrambled)
  136. Which of the following is/are CORRECT regarding Class III Antidysrhythmics?

    A.  Are used to treat ventricular tachycardia
    B. B and C
    C.  Includes Amiodarone
    D.  Can effectively shorten PR, QRS and QT intervals
    B.  B and C
    (this multiple choice question has been scrambled)
  137. Calcium Channel Blockers:

    A.  Are used to treat wide complex SVT
    B. Can aid patients with sick sinus syndrome
    C.  Include Diltiazem
    D.  Increase conduction velocity and automaticity in the SA and AV nodes
    C.  Include Diltiazem
    (this multiple choice question has been scrambled)
  138. Which of the following is/are CORRECT regarding thrombolytic therapy?

    A.  Patients younger than 75 years of age are at greater risk for bleeding complications
    B.  Their use can result in early reperfusion and limited infarct size
    C.  Patients younger than 75 years of age derive thrombolytic
    d.  All of the above
    B.  Their use can result in early reperfusion and limited infarct size
    (this multiple choice question has been scrambled)
  139. You need to adminsiter a loading dose of 5mg/kg of Aminophylline to a 110 pound adult female with asthma.  This dose is to be administered over 30 minutes.  You have a 250ml bag of normal saline, a 500 mg vial of Aminophylline, and a 10 gtts/ml administration set.  What is the concentration of the Aminophylline when mixed in the bag?

    A.  1 mg/ml
    B.  2 mg/ml
    C.  3 mg/ml
    D.  4 mg/ml
    B. 2mg/ml
    (this multiple choice question has been scrambled)
  140. What is the actual dose of Aminophylline to be administered to the patient?

    A.  250 mg
    B.  400 mg
    C.  500 mg
    D.  100 mg
    A. 250 mg
    (this multiple choice question has been scrambled)
  141. How many mililiters of Aminophylline must be administer?

    a.  50 ml
    b.  100 ml
    c.  125 ml
    d.  250 ml
    125 ml
  142. How many drops would you run this initial drip?

    A.  42 gtts/min
    B.  83 gtts/min
    C.  33 gtts/min
    D.  66 gtts/min
    A.  42 gtts/min
    (this multiple choice question has been scrambled)
  143. A trauma patient presents with left upper quadrant pain, and referred pain to the scapulae.  These complaints mist likely are from an injury to the:

    a.  Liver
    b.  Aortic arch
    c.  Gall bladder
    d.  Spleen
    Spleen
  144. Which of the following is/are CORRECT with regard to the presentation of patients with liver ailments?

    A.  Inability to tolerate low-fat diets
    B.  Jaundice
    C.  Clotting disorders
    D.  A and B
    D.  A and B
    (this multiple choice question has been scrambled)
  145. What is/are the diagnostic phenomenon known as when signals arising from nerves in one part of the body are mistaken by the central nervous for signals from another area:

    A.  Rebound tenderness
    B.  Referred pain
    C.  B and C
    D.  Murphy's sign
    B.  Referred pain
    (this multiple choice question has been scrambled)
  146. Which of the following patients would be a good candidate for placement of a nasogastric tube?

    A. A patient with a perforated esophagus
    B.  A patient with a nasal fracture and deviated septum
    C. A patient with a distended abdomen
    D.  A trauma patient with a suspected basilar skull fracture
    C.  A patient with a distended abdomen
    (this multiple choice question has been scrambled)
  147. After inserting a nasogastric tube 10 centimeters, you suddenly meet resistance and cannot further advance the tube.  Your next action should be

    A.  Remove the tube and reattempt placement
    B. Twist the tube and advance it more forcefully
    C.  Add lubricate to the tube
    D.  Have the patient continue swallow
    A.  Remove the tube and reattempt placement
    (this multiple choice question has been scrambled)
  148. Which of the following patients IS NOT a candidate for placement of a Foley catheter?

    A.  a 49-year-old male, just admitted to ICU, still unconscious following open-heart bypass surgery
    B.  a 78-year-old male complaining of a urinary retention secondary to prostatic hypertrophy
    C.  a 6-year-old male, in the ER for acute epiglottitis
    D.  a 221-year-old female about to undergo emergency surgery following a high-speed motor vehicle accident
    C.  a 6-year-old male, in the ER for acute epiglottitis
    (this multiple choice question has been scrambled)
  149. Which of the following is FALSE regarding assessment methods following the insertion of a Foley catheter?

    A.  Palpation of the kidneys
    B.  Adjusting tube for patient comfort
    C.  Checking tube urine drainage
    D.  Inflating balloon for adequate security of catheter
    A.  Palpation of the kidneys
    (this multiple choice question has been scrambled)
  150. During transport, the collection bag for the Foley catheter should be

    A.  Hung at a lower level than the patient's bladder
    B.  Hung on the edge of cot, with the tubing clamped securely
    C.  Hung above the patient, preferably at the same level as the patient's IV bag
    D.  Removed, since the Foley catheter should be discontinued during transport
    A.  Hung at lower level than the patient's bladder
    (this multiple choice question has been scrambled)
  151. Which of the following is CORRECT regarding the inclusion of risk factors for renal failure?

    A.  Stomach Ulcers
    B.  Diverticulitis
    C.  Diabetes
    D.  High Cholesterol
    C.  Diabetes
    (this multiple choice question has been scrambled)
  152. Which of the following IS NOT a major component of a Neurological Examination?

    A.  Mental status
    B.  sensory nerve function
    C.  Receptive nerve function
    D.  Cranial nerve function
    C.  Receptive nerve function
    (this multiple choice question has been scrambled)
  153. The point at which displaced volume has been exhausted and a severe rise is ICP is caused by a small increase in volume is seen on an ICP monitor as

    A.  a vertical inflection point
    B.  a curved line
    C.  a flat line
    d.  none of the above
    A.  a vertical inflection point
    (this multiple choice question has been scrambled)
  154. What is an abnormal wave formation involving plateau waves (resembling a pattern similar to ventricular fibrillation), and indication impending herniation and neurological deterioration?

    A.  D waves
    B.  A waves
    C.  C waves
    D.  B waves
    B.  A waves
    (this multiple choice question has been scrambled)
  155. You are transporting a patient with an ICP monitor, and the patient starts to become restless, disoriented, and agitated.  The heart monitor shows a sinus rhythm with occasional PVCs.  Your initial treatment should include

    A.  100% of oxygen to reverse hypoxia
    B.  25g of D50 to reverse hypoglycemia
    C.  40mg of Lasix to cause the desired diuretic effect
    D.  0.2mg of Fentanyl to achieve a sedative effect, causing hypotension and reducing ICP
    A.   100% of oxygen to reverse hypoxia
    (this multiple choice question has been scrambled)
  156. Which of the following is/are CORRECT with regard to the results of an increase in intracranial pressure?

    a.  seizures
    b.  brain herniation
    c.  stroke
    d.  all of the above
    d.  all of the above
  157. Which patient presentation would MOST concern you?

    A.  a 13 month old with a heart rate of 135, skin rash, hot moist skin, and a blood pressure of 80/52
    B.  An 8 month old infant with a respiratory rate of 60, nasal flaring, warm dry skin, and capillary refill time under 1 second.
    C.  A 5 year old with a respiratory rate of 12, severe intercostals retractions, abdominal breathing, mottled upper and lower extremities, and cool dry skin
    D.  a 2 year old with a respiratory rate of 44, nasal flaring, mild sternal restrictions, and blood pressure of 86/50
    C.  a 5 year old with a respiratory rate of 12, sever intercostals retractions, abdominal breathing, mottled upper and lower extremities, and cool dry skin
    (this multiple choice question has been scrambled)
  158. Which of the following statements is FALSE when trying to reduce fear in the pediatric patient?

    A.  Allow parents to remain with the child
    B.  Tower over the child when talking to him/her
    C.  Use age appropriate words
    D.  Always tell children the truth about procedures and pain
    B.  Tower over the child when talking to him/her
    (this multiple choice question has been scrambled)
  159. Which of the following is/are CORRECT with regard to the pediatric cardiovascular system?

    1.  immature sympathetic system
    2.  Hypotension is an early sign of shock
    3.  Cardiac output is rate dependent
    4.  Heart is proportionally larger than in an adult
    1, 3, 4
  160. When administering Colloids to a pediatric patient, what is the CORRECT flow rate?

    A.  10ml/kg
    B.  5ml/kg
    C.  1-2ml/kg
    D.  20ml/kg
    A.  10ml/kg
    (this multiple choice question has been scrambled)
  161. Which of the following is/are CORRECT when assessing VP of VA shunt mechanical malfunctions?

    1.  vomiting
    2.  seizures
    3.  normothermic
    4.  signs of increased intracranial pressure
    1, 2, 3, 4
  162. When using a Buretrol to administer medications to a pediatric patient, which of the following would be the CORRECT way to calculate the dosage

    A.  5mg of drug x a child's weight (kg) in 50ml fluid
    B.  6 mg of drug x a child's weight (kg) in 100ml fluid
    C.  3 mg of drug x a child's weight (kg) in 75 ml fluid
    D.  1mg of drug x a child's weight (lbs) in 100ml fluid
    B. 6 mg of drug x a child's weight (kg) in 100ml fluid
    (this multiple choice question has been scrambled)
  163. You are caring for a 3 year old, 15 kg child who requires reversal of a narcotic.  The CORRECT size ET tube to select is

    A.  5.0 cuffed
    B.  4.5 uncuffed
    C.  4.0 uncuffed
    D.  5.5 cuffed
    B.  4.5 uncuffed
    (this multiple choice question has been scrambled)
  164. DIC may develop in pregnancy when the following conditions exist

    A.  Abruptio placentae, severe preeclampsia, sepsis, or fetal  death
    B.  Hemorrhage, sepsis or preterm
    C.  Hemorrhage, sepsis, mild pre-eclampsia or fetal death
    D. Trauma, sepsis or placenta previa
    A.  Abruptio placentae, severe preeclampsia, sepsis or fetal death
    (this multiple choice question has been scrambled)
  165. All of the following characterize rupture of membranes EXCEPT

    A.  rupture of membranes prior to 37 weeks
    B.  fluid is brownish in color and foul-smelling
    C.  results in a high risk of infection
    d. none of the above
    B.  fluid is brownish in color and foul-smelling
    (this multiple choice question has been scrambled)
  166. Prior to interfacility transport of a patient in pre-term labor, the Critical Care Professional should obtain which of the following

    1.  fundal height
    2. dilitation
    3. effacement
    4. allergies
    5. station
    1, 2, 3, 4, 5
  167. With regard to major complications of electrical burns, which of the following IS NOT correct?

    A.  Causes compartment syndrome
    B.  causes cardiac dysrhythmias
    C.  extent of burn predicted by BSA
    D.  results in fractures
    C.  Extent of burn predicted by BSA
    (this multiple choice question has been scrambled)
  168. Inhalation injuries are characterized by which of the following?

    a.  singed nasal hairs
    b.  soot in or around the mouth
    c.  dyspnea
    d. all of the above
    d.  all of the above
  169. When caring for a critical burn patient, which of the following is of greatest concern within the first 24 hours?

    A.  septic shock
    B.  hypovolemic shock
    C.  hyperglycemia
    D.  hypertension
    B. hypovolemic shock
    (this multiple choice question has been scrambled)
  170. Morphine is the drug of choice for pain management in the burn patient? Whihc of the following is MOST appropriate route of administration?

    A.  IV
    B.  SQ
    C.  ET
    D.  IM
    A. IV
    (this multiple choice question has been scrambled)
  171. What is fluid resuscitation of a burn patient based upon?

    A.  Severity and location of the burns
    B.  Parkland formula
    C.  Total body surface are burned
    D.  Administration of 20 ml/kg
    B.  Parkland formula
    (this multiple choice question has been scrambled)
  172. A Critical Care Transport Team is composed of

    A.  EMT driver, RN, Paramedic
    B.  Physician, Paramedic
    C.  LPN, Paramedic, First Responder
    D.  Paramedic, RN, Phlebotomist
    A.  EMT driver, RN, Paramedic
    (this multiple choice question has been scrambled)
  173. Which of the following advanced procedures can be utilized by a Critical Care Transport Team?

    a.  rapid sequence induction
    b.  monitoring an arterial line
    c.  needle and surgical cricothyrotomy
    d.  all of the above
    d.  all of the above
  174. If a patient needs to be transported to a facility approximately 110 miles away, the preferred mode of transport is

    A.  mobile
    B.  rotor
    C.  fixed wing
    D.  personal vehicle
    B.  rotor
    (this multiple choice question has been scrambled)
  175. An effective method for reducing the risk of liability is

    A.  b and c
    B.  adequately documenting all procedures
    C.  being knowledgeable about the professional standards of care that apply to you
    D.  avoiding high risk patients likely to file a lawsuit
    A.  b and c
    (this multiple choice question has been scrambled)
  176. Patient diagnosis and treatment should be based on

    a.  current laboratory data for the patient
    b.  thorough patient history
    c. findings of the physical examination
    d. all of the above
    d.  all of the above
  177. a 35 year old female patient has been admitted with a chief complaint of severe headache, nausea and vomiting, and photophobia.  What do the following CBC values indicate?  HCT 40, Hgb 14, RBC 4.5 WBC 5000

    A. abnormally high hematocrit
    B.  normal values
    C.  abnormally high hemoglobin
    D.  abnormally low RBC and WBC counts
    B.  normal values
    (this multiple choice question has been scrambled)
  178. PO2 and PCO2 measure the ____ component of blood gases, while HCO3,  and base excess measure the _____ component.


    A. normal, abnormal
    B.  respiratory, metabolic
    C.  excess, deficit
    D. nonrespiratory, respiratory
    B. respiratory, metabolic
    (this multiple choice question has been scrambled)
  179. Which of the following blood gas values reflects compensation?

    A.  pH 7.38, PCO2 60, HCO3 30
    B.  pH 7.30, PCO2 32, HCO3 18
    C.  pH 7.26, pCO2 55, HCO3 24
    D.  pH 7.48, pCO2 30, HCO3 22
    A.  pH 7.38, PCO260, HCO3 30
    (this multiple choice question has been scrambled)
  180. As a critical care professional, you are legally obligated to a patient to

    A.  have knowledge of policies
    B.  provide a maximum level of competency
    C.  distinguish what is right or wrong for the patient
    D.  provide reasonable and prudent care
    D.  provide reasonable and prudent care
    (this multiple choice question has been scrambled)
  181. Increased liver enzymes can indicate

    A.  flu
    B.  HIV
    C.  hepatitis
    D.  TB
    C.  hepatitis
    (this multiple choice question has been scrambled)
  182. a 26 year old has undergone extensive surgery requiring blood transfusions.  Urinalysis reveals the presence of hemoglobinuria, a condition in which

    A.  hemoglobin is present in the urine, unattached to red blood cells
    B.  there is an abnormal presence of blood in the urine
    C.  excessive hemoglobin is present for oxygen transport
    D.  a and b
    A.  hemoglobin is present in the urine, unattached to red blood cells
    (this multiple choice question has been scrambled)
  183. A test used to determine the presence of occult blood in the GI tract is

    A.  Guaiac
    B.  prothrombin
    C.  CSF
    D.  thromboplastin
    A.  Guaiac
    (this multiple choice question has been scrambled)
  184. Shock can occur as a result of fluid shifting from the intravascular space to the extravascular space.  This can result from

    A.  decreased colloidal osmotic pressure
    B. loss of extravascular integrity
    C.  decreased capillary membrane permeability
    d.  none of the above
    A.  decreased colloidal osmotic pressure
    (this multiple choice question has been scrambled)
  185. The initial signs and symproms of ____ shock will be hindered if the patient is taking beta-blockers

    A.  compensated
    B.  decompensated
    C.  irreversible
    D.  superficial
    A.  compensated
    (this multiple choice question has been scrambled)
  186. Which of the following is LEAST likely to develop multiple system organ failure?

    A.  a farmer suffering from organophosphate poisoning
    B. a 26 year old male that is HIV positive
    C.  an 86 year old female in septic shock
    D.  a 12 year old with a spiral fracture of the left radius/ulna
    D.  a 12 year old with a spiral fracture of the left radius/ulna
    (this multiple choice question has been scrambled)
  187. Which of the following physiologic data is useful in diagnosing sepsis?

    a.  cultures of blood, urine, sputum or wounds
    b.  arterial blood gases reflecting hypoxia and respiratory alkalosis
    c.  CBC reflecting elevated WBC counts
    d.  All of the above
    d.  all of the above
  188. Transmission of the Herpes Zoster virus results in a disease known as

    A.  Karposi Sarcoma
    B.  HIV
    C.  Hepatitis B
    D.  Shingles
    D.  Shingles
    (this multiple choice question has been scrambled)
  189. Which of the following statements is FALSE regarding right to left cardiac shunting?

    A.  the heart is strong enough to circulate the blood
    B.  the lungs fail to fully oxygenate the blood
    C.  some venous blood never passes throught the lungs
    D.  there is enough hemoglobin to carry the oxygen
    B.  the lungs fail to fully oxygenate the blood
    (this multiple choice question has been scrambled)
  190. which of the following IS NOT a component of an arterial blood gas measurement?

    A.  acid-base balance
    B.  hemoglobin
    C.  the degree of dyspnea
    D.  the efficiency of gas exchange
    B.  hemoglobin
    (this multiple choice question has been scrambled)
  191. which of the following is/are CORRECT regarding a tension pneumothorax?

    A.  it occurs when air leaks into the pleural space during inspiration and is trapped
    B.  there should be adequate breath sounds on the affected side
    C. occurs as a result of penetrating, not blunt trauma
    D.  absence of tracheal deviation would rule out pleural decompression
    A. it occurs when air leaks into the pleural space during inspiration and is trapped
    (this multiple choice question has been scrambled)
  192. Which of the following is FALSE with regard to the indications for the placement of a chest tube?

    A.  hemothorax
    B.  pneumothorax
    C.  pleural effusion
    D.  pulmonary embolus
    D.  pulmonary embolism
    (this multiple choice question has been scrambled)
  193. Which of the following is the best way to determine proper chest tube positioning?

    A.  oxygen saturation will increase
    B.  Lung sounds are ascultated
    C.  ABG's are drawn
    D.  a chest  x-ray is performed
    D.  a chest x-ray is performed
    (this multiple choice question has been scrambled)
  194. which of the following is CORRECT regarding the use of automatic ventilators?

    A.  some units can be safely used in all age groups
    B.  most units deliver controlled ventilation only
    C.  the pop-off valves should be disengaged
    D.  they are incapable of delivering higher minute volumes than the bag-valve mask
    A.  some units can be safely used in all age groups
    (this multiple choice question has been scrambled)
  195. A patient on a portable ventilator suddenly develops dyspnea and unilateral chest pain. Lung sounds are absent on one side. Hypotension and tracheal deviation are also present.  Which of the following is the CORRECT action for these findings?

    A.  reposition the endotracheal tube
    B.  suction the patient
    C.  suspect a tension pneumothorax
    D.  increase the tidal volume on the ventilator until bilateral lung sounds return
    C.  suspect a tension pneumothorax
    (this multiple choice question has been scrambled)
  196. Which of the following is the most serious drawback of using positive pressure/demand valves?

    A.  high airway pressures are created
    B.  lung compliance cannot be felt
    C.  they consume a high volume of oxygen
    D.  they require an external power source
    A.  high airway pressures are created
    (this multiple choice question has been scrambled)
  197. Which of the following statements is CORRECT regarding ET suctioning?

    A.  suction should be intermittently applied during catheter insertion
    B.  sterile technique is indicated when using a whistle-tip catheter
    C.  rigid suction catheters should not be used in trauma patients
    D.  The maximum length of time for suctioning is 30 seconds
    B.  sterile technique is indicated when using a whistle-tip catheter
    (this multiple choice question has been scrambled)
  198. Which of the following IS NOT a goal of rapid sequence induction?

    A.  rapid airway control with minimal trauma
    B.  allows visualization of airway anatomy for the intubation of c-spine injurer patients
    C.  prevent rise in intracranial pressure
    D.  prevention of aspiration and regurgitation
    B.  allows visualization of airway anatomy for the intubation of c-spine injurer patients
    (this multiple choice question has been scrambled)
  199. Which of the following is FALSE regarding the use of succinylcholine?

    a.  it effects can be reversed with narcan
    b.  it is administered at 1.5mg
    c.  it is contraindicated in patients with agonal respirations
    d.  It is a nondepolarizing muscle relaxant
    a, b, c, and d
  200. Which of the following IS NOT an indication for a tracheostomy?

    A.  when intubation is delayed
    B.  to protect the lower airway from aspiration
    C. long term mechanical ventilation
    D.  reduce anatomical dead space
    A.  when intubation is delayed
    (this multiple choice question has been scrambled)
  201. Proper lung auscultation includes listening to breath sounds

    A.  for a full breath at the apex and base, anterior and posterior ( 6 places)
    B.  every 3-5 minutes in critical patients
    C.  where the suspected problem lies
    D.  for a full minute at the apex and base
    A.  for a full breath at the apex and base, anterior and posterior (6 places)
    (this multiple choice question has been scrambled)
  202. Which of the following is CORRECT regarding the most lethal early complication of tracheostomy?

    A.  accidental displacement of the tube
    B.  previous intubation
    C.  tracheal stenosis
    D.  pneumonia
    A.  accidental displacement of the tube
    (this multiple choice question has been scrambled)
  203. Which of the following is CORRECT with regard to needle cricothyrotomy?

    A.  retrograde airflow through the mouth and nose are not a concern
    B.  it requires more time as compared to a surgical cricothyrotomy
    C.  it requires minimal equipment
    D.  a more definitive airway is urgently warranted
    D.  a more definitive airway is urgently warranted
    (this multiple choice question has been scrambled)
  204. Airflow into the lungs during inspiration depends on all of the following EXCEPT

    A.  relaxation of the diaphragm
    B.  concentration of the muscles of respiration
    C.  lowered intrathoracic pressure
    D.  enlargement of the thoracic cavity
    A. relaxation of the diaphragm
    (this multiple choice question has been scrambled)
  205. Which of the following procedures should be attempted prior to establishing a surgical airway?

    a.  needle cricothyrotomy
    b.  heimlich maneuver
    c.  intubation
    d.  mechanical removal of an obstruction with forceps
    b, c, d
  206. A Swan-Ganz catheter is in place.  Which of the following would be an inappropriate action if no waveform shows on the monitor?

    A.  check the monitor calibration
    B.  flush the catheter
    C.  check the position of the stopcock
    D.  check for loose connections
    B.  flush the catheter
    (this multiple choice question has been scrambled)
  207. Which of the following is CORRECT regarding the nature of an abnormal SVR?

    A.  1400 dynes/sec/cm^5
    B.  1200 dynes/sec/cm^5
    C.  1000 dynes/sec/cm^5
    D.  400 dynes/sec/cm^5
    D.  400 dynes/sec/cm^5
    (this multiple choice question has been scrambled)
  208. Which of the following is CORRECT in regard to reducing the risk of volume overload, when multiple units of blood are to be infused?

    A.  hemoglobin and hematocrit
    B.  age and sex of donor and recipient
    C.  ABO blood groups and the Rh system
    D.  type of blood product
    C.  ABO blood groups and the Rh system
    (this multiple choice question has been scrambled)
  209. Which of the following is CORRECT regarding the primary importance when preparing to administer blood?

    A.  documenting baseline vital signs
    B.  asking a second professional to confirm blood compatibility
    C.  obtaining a written order for the transfusion
    D.  administering normal saline
    B.  asking a second professional to confirm blood compatibility
    (this multiple choice question has been scrambled)
  210. Which of the following statements is/are FALSE?

    a.  The muscular layer of the heart is the endocardium
    b.  The two-layered sac surrounding the heart is the pericardium
    c.  The lining of the heart chambers is the epicardium
    d.  One of the three layers of tissue that form the wall of the heart is the endometrium
    a, c, d
  211. Which of the following is CORRECT is regard to the nervous system control of the heart?

    A.  The sympathetic nervous system innervates the heart through the cardiac plexus
    B.  The vagus nerve acts as a cardiac accelerator
    C.  norepinephrine is the chemical neurotransmitter for the parasympathetic nervous system
    D.  the release of acetylcholine speeds the heart rate
    A.  The sympathetic nervous system innervates the heart through the cardiac plexus
    (this multiple choice question has been scrambled)
  212. Which of the following is FALSE in regard to electrophysiology of the heart?

    A.  there are three types of cardiac cells: pacemaker, electrical conducting, and myocardial
    B.  when sodium ions rush into a cell, the cell becomes positively chrged
    C.  the normal electrical state of cardiac cells is known as the action potentional
    D.  when myocardial cells are stimulated, there is a rapid influx of sodium ions
    C.  the normal electrical state of cardiac cells is known as the action potential
    (this multiple choice question has been scrambled)
  213. Which of the following is CORRECT regarding lead placement fro the 12 lead ECG?

    A.  b and c
    B.  leads AVR, AVL, AVF are unipolar limb leads
    C.  leads I, II, III are unipolar chest leads
    D.  leads V1-V6 are bipolar chest leads
    B.  leads AVR, AVL, AVF are unipolar limb leads
    (this multiple choice question has been scrambled)
  214. Which of the following is CORRECT in regard to the components of the electrocardiogram?

    A.  The ST segment reflects the time from the end of ventricular depolarization to the beginining of ventricular depolarization
    B.  The shape and appearance of a waveform is referred to as the morphology
    C.  The horizontal axis on ECG paper measures voltage, while the vertical axis measures time
    D.  The normal PR interval is 0.10-0.12 seconds
    B.  The shape and appearance of a waveform is referred to as the morphology
    (this multiple choice question has been scrambled)
  215. A 59 year old male has been diagnosed with an inferior wall infarction.  Which of the following statements is CORRECT regarding his 12 Lead interpretation?

    a.  Indicative changes in Leads II, III, and AVF suggest the infarct is due to right coronary artery occlusion
    b.  Indicative changes in leads viewing the septal, anterior, or lateral walls of the left
    c.  Lead AVR is not critical to this diagnosis
    d.  all of the above
    d.  all of the above
  216. Which of the following IS NOT a primary component of 12 lead ECG interpretation?

    A.  calculation of the electrical axis of the T wave and P wave
    B.  assessment of ST segment for elevation or depression
    C.  inspection of p waves for hypertrophy
    D.  Assessing Q wave presence and morphology
    A.  calculation of the electrical axis of the T wave and P wave
    (this multiple choice question has been scrambled)
  217. Which of the following is CORRECT in regard to aberrant conduction?

    A.  It results in a supraventricular beat conducted through the ventricles in a delayed manner
    B.  It is east to destinguish PJCs with aberrancy from PVCs in Lead II
    C.  It represents a normal finding
    D.  It is an atrial conduction disturbance
    A.  It results in a supraventricular bear conducted through the ventricles in a delayed manner
    (this multiple choice question has been scrambled)
  218. Myocardial injury can be indicated on an ECG by

    A.  the absence of a P wave
    B.  an elevated ST segment
    C.  a depressed ST segment
    D.  The presence of U waves
    B.  An elevated ST segment
    (this multiple choice question has been scrambled)
  219. Which of the following statements is CORRECT with regard to patients with an ICD?

    A.  include those with recurrent inducible heart blocks refractory to medical therapy
    B.  should avoid hand held metal detectors
    C.  can lead a normal life in regard to activity level or travel
    D.  have a one year mortality rate from SCD of only 10%
    B.  should avoid hand held metal detectors
    (this multiple choice question has been scrambled)
  220. Which of the following represents information that should be obtained to help troubleshoot a pacemaker problem

    a.  pacemaker rate, output, and sensitivity parameters
    b.  the patient's present underlying rhythm
    c.  the type and position of the leads
    d.  all of the above
    d.  all of the above
  221. The IABP catheter is attached to a machine which

    A.  Has an electronic trigger mechanism for the balloon pump
    B.  displays the patient's ECG and arterial waveform
    C.  B and C
    D.  removes gas from the aorta
    C.  b and c
    (this multiple choice question has been scrambled)
  222. Place the following steps in appropriate order to assess proper balloon pump timing:

    a.  identify the dicrotic notch, and determine that inflation occurs at this point
    b.  deflate the balloon just before systole
    c.  compare the slopes of systolic upstroke and diastolic augmentation
    d.  identify the beginining of systole and diastole on the arterial waveform
    e.  evaluate the systolic pressure peak to determine that is lower than the unassisted systolic pressure peak
    d, a, c, b, e
  223. Which of the following statements is/are CORRECT with regard to the proper positioning of the intra-aortic balloon?

    A.  b and c
    B.  requires balloon placement in the thoracic aorta, distal to the left subclavian artery
    C.  requires balloon placement beneath the renal arteries
    D.  is often achieved by using the Seldinger technique for catheter technique
    B.  requires balloon placement in the thoracic aorta, distal to the left subclavian artery
    (this multiple choice question has been scrambled)
  224. Haloperidol is indicated for

    A.  substernal chest pain
    B.  coma
    C.  acute psychotic episodes
    D.  depression
    C. acute psychotic episodes
    (this multiple choice question has been scrambled)
  225. The mechanism of action for Benzodiazepines includes

    A.  inhibiting postaglandin synthesis
    B.  inhibiting pre and post synaptic dopamine
    C.  stimulates beta 1 and beta 2 adrenergic receptors
    d.  all of the above
    B.  inhibiting pre and post synaptic dopamine
    (this multiple choice question has been scrambled)
  226. Which of the following statements is CORRECT in regard to how Flumazenil works?

    A.  increasing systemic vascular resistance
    B.  antagonizing barbituate and opiate receptor sites
    C.  antagonizing benzodiazepine receptor sites
    D.  exerting a positive inotropic effect on the heart
    C.  antagonzing benzodiazepine receptor sites
    (this multiple choice question has been scrambled)
  227. Which of the following is/are true about Morphine?
    • a.  it is a central nervous system stimulant
    • b.  it binds with opiate receptors in the brain
    • c.  nausea and Vomiting frequently accompany administration
    • d.  its duration is 3-7 hours
    • b, c, and d
  228. A nondepolarizing neuromuscular blocking agent used to maintain paralysis following intubation, and lasting approximately 30 minutes

    A.  pancuronium
    B.  vecuronium
    C.  succinylcholine
    D.  diazepam
    B.  vecuronium
    (this multiple choice question has been scrambled)
  229. Which of the following is/are true regarding the use of dextran


    a.  it is a glucose polymer in normal saline or D5W
    b.  it has more colloid properties than albumin
    c.  it expands 3 ml per every 1 ml administered
    d.  it is administered at a rate of 2 gm/kg in the first 24 hours
    a and d
  230. Which of the following is FALSE regarding the use of Dobutamine?

    A.  it can result in hypotension and tachycardia at 15-20 mcg/kg/min
    B.  it has significant chronotropic effects
    C.  it increases cardiac output and urine output
    D.  it improves the force of cardiac contraction
    B.  it has significant chronotropic effects
    (this multiple choice question has been scrambled)
  231. Which of the following is FALSE regarding the use of albuterol?

    A.  it is adminsitered via nebulizer at a dose of 0.25 mg
    B.  it is a very potent bronchodilator
    C.  it is commonly available in aerosol form
    D.  it can last for 4-8 hours
    A.  it is administered via nebulizer at a dose of 0.25mg
    (this multiple choice question has been scrambled)
  232. Which of the following is CORRECT in regard to anticholinergics?

    A.  produce bronchodilation in cholinergic medicated bronchoconstriction
    B.  are more potent than beta agonists
    C.  have a more rapid onset
    D.  have a longer duration
    A.  produce bronchodilation in cholinergic mediated bronchoconstriction
    (this multiple choice question has been scrambled)
  233. An example of a Class III antiarrhythmics would be

    A.   adenosine
    B.  verapamil
    C.  propranolol
    D.  amiodarone
    D.  amiodarone
    (this multiple choice question has been scrambled)
  234. Which of the following is CORRECT in regard to the use of amiodarone?

    A.  it can be used in lower doses to improve renal function
    B.  it has a short half life
    C.  it is administered in an initial dose of 300mg for cardiac arrest due to shock resistant v-fib
    d.  all of the above
    C.  it is administered in an initial dose of 300mg for cardiac arrest due to shock resistant v-fib
    (this multiple choice question has been scrambled)
  235. Which of the following is/are CORRECT regarding the use of beta blockers?

    a.  The higher the dose, the more they lose selectivity
    b.  their adverse effects include fatigue and malaise
    c.  they are indicated for hypertension
    d.  caution should be exercised when giving to CHF patients
    a, b, c, and d
  236. You need to administer a loading dose of 5mg/kg of Aminophylline to a 110 pound adult female with asthma.  Their dose is to be administered over 30 minutes.  You have a 250ml bag of normal saline, a 500mg vial of Aminophylline, and a 10 gtts/ml administration set.  

    What will be the concentration of the Aminophylline when mixed in the bag?

    A.  1mg/ml
    B.  4 mg/ml
    C.  2 mg/ml
    D.  3 mg/ml
    C.  2 mg/ml
    (this multiple choice question has been scrambled)
  237. You need to administer a loading dose of 5mg/kg of Aminophylline to a 110 pound adult female with asthma.  Their dose is to be administered over 30 minutes.  You have a 250ml bag of normal saline, a 500mg vial of Aminophylline, and a 10 gtts/ml administration set. 

    What is the actual dose of Aminophylline to be administered to the patient?
     
    A.  250 mg
    B.  100 mg
    C.  500 mg
    D.  400 mg
    A.  250 mg
    (this multiple choice question has been scrambled)
  238. You need to administer a loading dose of 5mg/kg of Aminophylline to a 110 pound adult female with asthma.  Their dose is to be administered over 30 minutes.  You have a 250ml bag of normal saline, a 500mg vial of Aminophylline, and a 10 gtts/ml administration set. 

    How many mililiters of Aminophylline must you adminster?

    A.  100 ml
    B.  250 ml
    C.  50 ml
    D.  125 ml
    D.  125 ml
    (this multiple choice question has been scrambled)
  239. You need to administer a loading dose of 5mg/kg of Aminophylline to a 110 pound adult female with asthma.  Their dose is to be administered over 30 minutes.  You have a 250ml bag of normal saline, a 500mg vial of Aminophylline, and a 10 gtts/ml administration set. 

    How many gtts/min would you run this initial drip?

    A.  66 gtts/min
    B.  42 gtts/min
    C.  33 gtts/min
    D.  83 gtts/min
    B. 42 gtts/min
    (this multiple choice question has been scrambled)
  240. You must administer a Dopamine infusion at 10mcg/kg/min to a 176 pound male with hypotension associated with cardiogenic shock.  You have a 200 mg of Dopamine, a 250 ml bag of D5W and a 60 gtts/ml administration set.  How many drops per minute should you infuse?

    a.  15
    b.  30
    c.  45
    d.  60
    d
  241. A patient presenting with profuse hematemesis with frank red blood, and a history of significant alcohol abuse is/are mostly likely caused by


    A.  gastric hemorrhage
    B.  kidney stones
    C.  esophageal varice
    D.  b and c
    C. esophageal varice
    (this multiple choice question has been scrambled)
  242. Which of the following IS NOT an abnormal finding in the abdominal assessment

    A.  bowel sounds heard approximately every 15-30 seconds
    B.  shoulder discomfort
    C.  consistent rigidity and guarding of the abdominal wall
    D.  rebound tenderness
    A.  bowel sounds heard approximately every 15-30 seconds
    (this multiple choice question has been scrambled)
  243. A thin female patient is supine on the cot during your assessment.  You palpate a strong pulse at her umbilicus.  This is likely due to:


    A.  An ecoptic pregnancy
    B.  A gross anatomic abnormality
    C.  An abdominal aortic aneurysm
    D.  The normal condition of her abdominal aorta
    D.  The normal condition of her abdominal aorta
    (this multiple choice question has been scrambled)
  244. You have just received a patient with a nasogastric tube already in place.   When you inject air into the tube and auscultate the epigastrium, nothing is heard.  Your next action is to:

    A.  transport the patient; the tube is adequate
    B.  place an additional orogastic tube in the patient prior to transport
    C.  place the patient in the lateral recumbent position for better ausculation
    D.  Remove the tube and reattempt placement
    D.  remove the tube and reattempt placement
    (this multiple choice question has been scrambled)
  245. Which of the following actions can help prevent diarrhea and other gastrointestinal complications associated with enteral feedings?

    A.  increasing the rate of feedings
    B.  administering the feeding as a bolus every 2 hours
    C.  changing the administration set every 24 hours
    D.  decreasing the amount of water being added to the nutritional solution
    C.  changing the adminstration set every 24 hours
    (this multiple choice question has been scrambled)
  246. Which of the following statesments is/are CORRECT with regard to the purpose of a Foley catheter?

    a.  observe the condition of urine for blood and other abnormal contents
    b.  allow urine to freely exit the body
    c.  closely monitor urine volume production
    d.  all of the above
    d.  all of the above
  247. No urine is found in the foley catheter after placement.  This could be caused by

    a.  incorrect placement of the catheter
    b.  an empty urine bladder
    c.  the catheter clamp remains in place
    d.  all of the above
    d.  all of the above
  248. Following placement of a Foley catheter, the patient develops an infection.  Which of the following is not a sign or symptom of that infection?

    A.  Clear urine
    B.  fever
    C.  WBCs in the urine culture
    D.  altered mental status
    A.  clear urine
    (this multiple choice question has been scrambled)
  249. Which of the following will be altered by renal failure?

    a.  pH level
    b.  blood pressure
    c.  hematocrit
    d.  all of the above
    d.  all of the above
  250. Which of the following IS NOT a risk factor for a patient undergoing peritoneal dialysis?

    A.  peritonitis
    B.  elevated white blood cell count
    C.  decreased bowel sounds
    D.  fistula graft rejection
    D.  fistula graft rejection
    (this multiple choice question has been scrambled)
  251. Which of the following is/are a cause of hypotension during or following dialysis?

    a.  disequilibrium syndrome
    b.  anxiety about the procedure
    c.  excessive filtration of the blood
    d.  infectious processes associated with the procedure
    excessive filtration of the blood
  252. A 42 year old patient with serious head trauma has an intracranial pressure of 19 mmhg.  This indicates that his ICP is:

    A.  moderately elevated
    B.  severely elevated
    C.  slightly elevated
    D.  normal
    C.  slightly elevated
    (this multiple choice question has been scrambled)
  253. In order to decrease ICP, the patient's head should be:

    A.  hyperextended
    B.  rotated to the left
    C.  aligned with neck
    D.  hyperflexed
    C.  aligned with neck
    (this multiple choice question has been scrambled)
  254. When comparing the adult and pediatric respiratory systems, which of the following is CORRECT with regard to the pediatric patient?

    A.  pediatrics have smaller tongues
    B.  intercostals and accessory muscles are strong
    C.  children are mouth breathers
    D.  the diaphragm is the chief muscle of respiration
    D.  the diaphragm is the chief muscle of respiration
    (this multiple choice question has been scrambled)
  255. When adminstering medications via the ETT to neonates and pediatrics, which of the following IS NOT given at 2-3 times the usual dose?

    A.  Narcan
    B.  Epinephrine
    C.  Lidocaine
    D.  Atropine
    A.  Epiphrine
    (this multiple choice question has been scrambled)
  256. You are preparing to perform RSI on a 6 year old child with multiple system trauma.  Of the following medications used for RSI which has the CORRECT dosage listed:

    A.  Flumazenil 0.05-0.1 mg/kg IV/IO/IM
    B.  Etomidate 2-6 mg/kg IC/IO/IM
    C.  Succinylcholine 1-4 mg/kg IV/IO
    D.  Vecuronium 0.01-0.5 mg/kg IV/IO
    C.  Succinylcholine 1-4 mg/kg IV/IO
    (this multiple choice question has been scrambled)
  257. An early sign of shock in a pediatric patient is:

    A.  hypotension
    B.  prolonged capillary
    C.  bradycardia
    D.  decreased pulse pressure
    B.  prolonged capillary
    (this multiple choice question has been scrambled)
  258. In regard to third trimester bleeding which of the following is/are CORRECT?

    a.  Dopamine given in low doses will preserve placental blood flow
    b.  The dose for dobutamine is 5-15 mg/kg/min
    c.  Hemodynamic compromise is common
    d.  All of the above
    d.  All of the above
  259. Which of the following is CORRECT with regard to pre-term labor?

    A.  Is defined as uterine contractions without cervical change
    B.  Terbutaline is administered at 0.25mg SQ every 15 mins times 3 doses
    C.  Is defined as greater than 37 weeks gestation
    D.  Magnesium sulfate is not recommended
    B.  Terbutaline is administered at 0.25mg SQ every 15 mins times 3 doses
    (this multiple choice question has been scrambled)
  260. Treatment of a prolapsed umbilical cord includes the following:

    A.   Reinserting the cord in the vagina
    B.  Changing maternal position to knee-chest
    C.  Pulling on the cord to speed up delivery
    D.  Clamping and cutting the cord
    B.  Changing the materal position to knee-chest
    (this multiple choice question has been scrambled)
  261. a 25 year old male has been burned on the anterior portion of his left arm from the elbow to the wrist, on one half of his chest and on his left side of his face.  Based on the "Rule of Nines" what is the percentage of total body surface area burned?

    A.  30%
    B. 25%
    C.   18%
    D.  20%
    C.  18%
    (this multiple choice question has been scrambled)
  262. When transporting a patient with a circumferential burn of the extremity, the Critical Care Professional must be concerned with which of the following:

    a.  The need for an escharotomy
    b.  Compartment syndrome
    c.  The need for a fasciotomy
    d.  All of the above
    d.  All of the above
  263. Which of the following chemicals would produce the most serious burns?

    A.  Diesel fuel
    B.  Dry lye
    C.  An alkali solution
    D.  Acetic acid
    C.  An alkali solution
    (this multiple choice question has been scrambled)
  264. Another method for measuring the percent of total body surface area burned is:

    A.  Injury Severity Scale
    B.  Rule of the Palm
    C.  Parkland Formula
    D.  Ashford formula
    B.  Rule of the palm
    (this multiple choice question has been scrambled)
  265. Severity of a burn is determined by which of the following:
    • 1.  Depth
    • 2.  Age
    • 3.  The color of the flame
    • 4.  History
    • 5.  Method used to extinguish the flame
    • 1, 2 and 4
  266. Which of the following parients meets the criteris for transport to a burn center?

    A.  Superficial burns of >50%
    B.  Partial and full thickness burns of >20% BSA
    C.  A partial thickness burn of 10%
    d.  All of the above
    B.  Partial and full thickness burns of >20% BSA
    (this multiple choice question has been scrambled)
Author:
thom.mccusker@gmail.com
ID:
313538
Card Set:
CCEMTP
Updated:
2015-12-23 19:08:21
Tags:
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Folders:
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