مذكرة اختبار الهيئة الاصفر مهم

1.
What is the major concern after administering

phenytoin to a patient with seizure?
o A. Paralysis
o B. Dysrhythmias
o C. Nausea and vomiting
o D. Pain from injection site
2. The Emergency Medical Services team dispatched

for a 27-year-old pregnant woman. Upon arriving in
the scene, they found out that the patient cannot
speak Arabic nor English.
Which of the following is the most appropriate way to

communicate with the patient?
o A. Ask for assistance from a person who can
translate
o B. Speak more softly with numerous hand
movements
o C. Do not speak while administering care to the
patient
o D. Talk slowly to help the patient understand
English or Arabic
3. The Emergency Medical Services team was called

for a 24-year-old woman who is 36-weeks pregnant.
The patient was supine in bed complaining of severe
weakness, dizziness, and nausea.
Which of the following is the first priority?

o A. Place the patient on her left side
o B. Assess the patient's blood glucose level
o C. Determine the patient's SAMPLE history
o D. Ask the patient about the expected date of
delivery
4. Which of the following conditions is most likely to

show pallor (white) skin?
o A. Anemia
o B. Liver disease
o C. Urinary tract infection
o D. Carbon monoxide poisoning
5. Which of the following conditions is most likely to

show unequal pupils?
o A. Stroke
o B. Poisoning
o C. Cardiac arrest
o D. Cocaine overdose
6. A 60-year-old diabetic woman presents with

drowsiness and vomiting. She is sweating and her
skin is pale and cold. She is breathing shallow and
fast. She missed taking her morning insulin injection
before breakfast for a few days now (see lab result).
Blood pressure 121/72 mmHg

Heart rate 112 /min
Respiratory rate 20 /min
Temperature 36.6 °C
Oxygen saturation 95 %
Test Result Normal Value

Random Glucose 13 3.9 5.5 mmol/L
PH 7.2 7.35-7.45
HCo3 10 14-22 mmol/L
PCO2 36 35-45 mmhg
What is the most likely diagnosis?

o A. Thyrotoxicosis
o B. Cushing's disease
o C. Diabetic ketoacidosis
o D. Hyperosmolar hyperglycemic nonketotic coma
7. A 65-year-old man with a neuro-muscular disease

has the following arterial blood gas result (see lab
results).
Test Result Normal Values

HCO3- 24 22-28 mmol/L
PCO2 3.7 4.7-6.0 kPa
pH 7.49 7.36-7.45
PO2 7.1 10.6-14.2 kPa
Which of the following is the primary acid-base

disorder?
o A. Metabolic acidosis
o B. Metabolic alkalosis
o C. Respiratory acidosis
o D. Respiratory alkalosis
8. According to the Cincinnati prehospital stroke

scale, which of the following findings indicates the
presence of a stroke?
o A. No feet drops
o B. Both arms move symmetrically
o C. Facial drop in one side of the face
o D. Patient can speak without slurring
9. A 65-year-old woman, known to have

hypothyroidism, had sudden loss consciousness.
She is drowsy, has weak pulse and her skin is cold,
dry with delayed capillary refill. She has generalized
edema and swelling especially in the periorbital area.
She also complains of fatigue, constipation and
generalized weakness.

Heart rate 56 /min
Which of the following is the most likely diagnosis?

o A. Thyrotoxicosis
o B. Myxedema coma
o C. Pheochromocytoma
o D. Hyperaldosteronism
10. A 65-year-old known asthmatic is complaining of

severe shortness of breath. He is distressed, sitting in
a tripod position with a silent chest on auscultation.
The paramedic gave salbutamol with ipratropium
nebulizers 3 times with no improvement.
Blood pressure 81/53mmHg

Heart rate 113 /min
Which of the following is the most appropriate course

of action?
o A. Endotracheal intubation
o B. Intravenous normal saline
o C. Intramuscular epinephrine
o D. Intravenous magnesium sulfate
11. A paramedic team was called for a 55-year-old

woman with difficulty of breathing. Examination
revealed that she had difficulty of breathing with
crackles on chest auscultation at the lower lobes of
the lungs, and she had peripheral edema. She is
taking ACE inhibitor and diuretics.

o A. Asthma
o B. Bronchitis
o C. Pulmonary edema
o D. Pulmonary embolism
12. A 70-year-old man complains of sudden shortness

of breath. He is in a tripod position, speaks in short
sentences and using accessory muscles to breathe.
There is bilateral wheezing on chest auscultation.

Heart rate 76 /min
Temperature 36.6 ◦ C
Which of the following is the most appropriate initial

course of action?
o A. Nebulize with salbutamol
o B. Subcutaneous epinephrine
o C. Intravenous dexamethasone
o D. Intravenous magnesium sulfate
13. A paramedic is responding to a 69-year-old

woman who had an episode of seizure. She has a
history of epilepsy for 3 years. On examination and
while the paramedic is taking the blood pressure
reading she has another seizure activity.
What is the most appropriate course of action?

o A. Rapid sequence intubation
o B. Intramuscular midazolam
o C. Intramuscular diazepam
o D. Intravenous phenytoin
14. A paramedic responds to a 69-year-old diabetic

mar who develops drowsiness. Upon arrival, the man
is unresponsive. Examination reveals that he has a
pulse and breathing on his own. His skin is pale and
cold. The paramedic cannot get an intravenous access
to give dextrose (see lab result).

Heart rate 76 /min
Test Result Normal Value

Random Glucose 2.5 3.9-5.5 mmol/L
Which of the following is the most appropriate course

of action?
o A. Give oral glucose
o B. Transport to the hospital
o C. Give intramuscular glucagon
o D. Give subcutaneous epinephrine
15. A paramedic responds to a 65-year-old woman

who is having generalized seizure activity. Her son
says that she had a seizure that lasted about 4
minutes.
After the episode, she remained unconscious for
about 7 minutes and then started having another
seizure activity. Examination reveals that she has
peripheral cyanosis and oral secretions.
Which of the following is the next most appropriate

course of action?
o A. Give intravenous phenytoin
o B. Give intravenous lorazepam
o C. Start rapid sequence intubation
o D. Suctioning and start bag-valve-mask
ventilation
16. What is the most common cause of cardiac arrest
in pediatrics?
o A. Trauma
o B. Poisoning
o C. Respiratory arrest
o D. Ventricular fibrillation
17. Which of the following suffixes represents blood?

o A. Emia
o B. Algia
o C. Plasty
o D. Phasia
18. Which of the following does the dispatcher need to

get from a caller first?
o A. Scene safety
o B. Road condition
o C. Weather condition
o D. Name and call back number
19. Which of the following is most likely mistaken for a

seizure, in an elderly patient?
o A. Stroke
o B. Syncope
o C. Dementia
o D. Arrhythmia
20. The paramedic is called to a 32-year-old pregnant

woman with a viable 21-week-old fetus. Examination
reveals swelled feet, legs and hands. The patient has a
history of excessive protein in the urine.
Which of the following is the most common diagnosis
of this patient presentation?
o A. Epilepsy
o B. Eclampsia
o C. Preeclampsia
o D. HELLP syndrome
21. A 38-year-old man found to be unconscious in a

room without ventilation. It is winter and there is a
wood fire next to him.

Heart rate 134 /min
Which of the following is most likely the initial

diagnosis?
o A. Methanol toxicity
o B. Ammonia poisoning
o C. Carbon monoxide poisoning
o D. Organophosphate poisoning
22. A 32-year-old with a history of preeclampsia to be
transported from a small clinic to an academic medical
Centre.
Which of the following should be done during the
transfer?
o A. Bolus of anticonvulsant
o B. Bolus of diuretic medication
o C. Drive the ambulance without lights and sirens
o D. Increase the ambulance cabinet lights to the
maximum
23. Which of the following is the most appropriate size

catheter in gauge for a 2-year-old needing fluid
resuscitation?
o A. 22
o B. 18
o C. 16
o D. 14
24. A 2-year-old baby is in hypovolemic shock.
Which of the following is the most appropriate fluid
resuscitation bolus?
o A. 20 ml/kg
o B. 15 ml/kg
o C. 10 ml/kg
o D. 5 ml/kg
25. Which of the following valves is present between

the right atrium and the right ventricle?
o A. Mitral
o B. Pulmonic
o C. Tricuspid
o D. Semilunar
26. Image (s)

What is the approximate heart rate for this ECG strip
(see image)?
o A. 20 beats/minute
o B. 40 beats/minute
o C. 80 beats/minute
o D. 100 beats/minute
27. Which of the following cardiac valves is present

between the left atrium and the left ventricle?
o A. Mitral
o B. Pulmonic
o C. Tricuspid
o D. Semilunar
28. What is the most important factor in determining

stroke volume in a healthy heart?
o A. Preload
o B. Afterload
o C. Heart rate
o D. Myocardial contraction
29. Which of the following terms describes the

relaxation of the heart?
o A. Systole
o B. Diastole
o C. Venous return
o D. Stroke volume
30. In a 12-lead ECG, which of the following leads

shows changes in a case of posterior wall myocardial
infarction?
o A. V1 to V2
o B. V3 to V4
o C. V5 to V6
o D. V8 to V9
31. Image(s)
What does the ECG rhythm show (see image)?
o A. Asystole
o B. Normal sinus rhythm
o C. Ventricular fibrillation
o D. Ventricular tachycardia
32. Image(s)
What is the shown rhythm (see image)?
o A. Atrial flutter
o B. Atrial fibrillation
o C. Ventricular fibrillation
o D. Ventricular tachycardia
33. Image(s)
A 39-year-old man presented with chest pain. He is
conscious. The cardiac monitor showed this rhythm
(see image).
o A. Left Bundle Branch Block

o B. Lateral myocardial infarction
o C. Inferior myocardial infarction
o D. Anterior myocardial infarction
34. Image(s)
A 69-year-old woman complains of palpitation.
Examination reveals an altered mental status and
hypotension (see image).
Which of the following is the most appropriate
management?
o A. Synchronized cardio version 100 joules
o B. Synchronized cardio version 300 joules
o C. Unsynchronized cardio version 100 joules
o D. Unsynchronized cardio version 300 joules
35. A paramedic team is dispatched to a 48-year-old

man experiencing substernal chest pain that is
radiating to his jaw. On arrival, the paramedics
examined the patient and recorded the ECG and
decided to give the patient the first dose of
nitroglycerin.
What is the first dose of nitroglycerin?
o A. 100 mcg
o B. 200 mcg
o C. 300 mcg
o D. 400 mcg
36. An adult patient presented with chest pain. A
cardiac monitor was connected which showed an ECG
suggestive of inferior wall myocardial infarction.
management?
o A. Oxygen, aspirin, lidocaine, and morphine
o B. Oxygen, aspirin, nitroglycerin, and morphine
o C. Oxygen, aspirin, and contact medical director
o D. Oxygen, aspirin, nitroglycerin, and magnesium
sulfate
37. What is the initial dose of aspirin to be given to a

68-year-old patient with substernal chest pain that is
radiating to the jaw?
o A. 100 mg
o B. 150 mg
o C. 200 mg
o D. 300 mg
38. Which of the following information will change the
fluid resuscitation management with a cardiac patient?
o A. Asthma
o B. Morphine allergy
o C. Socioeconomic status
o D. History of congestive heart failure
39. Which of the following types of consent to

treatment is done with verbal communication from the
patient?
o A. Implied
o B. Informed
o C. Expressed
o D. Involuntary
40. Which of the following is the most important

information to be mentioned in a radio report?
o A. Patient dress
o B. Patient address
o C. Patient initial rhythm
o D. Patient marital status
41. A 46-year-old patient is calling the ambulance to

infuse a medication that is given by a local doctor.
The medication is not within the scope of practice.
action?
o A. Refuse to give the infusion
o B. Read about the drug, if confident give it
o C. Call the prescribing doctor for instructions
o D. Start the drug infusion as shown in the order
42. What is a deviation from an accepted standard of

care?
o A. Assault
o B. Ignorance
o C. Negligence
o D. False imprisonment
43. A 6-year-old girl is complaining of a left clavicle
fracture. Upon examination, the patient had signs of
previous burn marks and multiple contusions.
Who should paramedic report to when child abuse is
suspected?
o A. Dispatcher
o B. Police officer
o C. Child's parent
o D. Medical director
44. What is the most important resource of

information in malpractice cases?
o A. Patient
o B. Witnesses
o C. Medical record
o D. Clinical provider
45. Which of the following a cause of medication

errors in health care?
o A. Negligence
o B. Lack of knowledge
o C. Provider carelessness
o D. Medication look alike and sound a like
46. A 68-year-old with end-stage cancer. The patient

is in cardiac arrest and the family informed the crew
that they have a Do Not Resuscitate order but they
could not find it.
action?
o A. Start resuscitation
o B. Call the treating physician
o C. Do not attempt resuscitation
o D. Call dispatcher for instruction
47. A 62-year-old man mentally competent with a

history of hypertension, diabetes, and hyperlipidemia.
He is complaining of a headache but he refused to go
to the hospital. The ambulance crew took him by
force to the hospital.
Which of the following represents the definition of the
ambulance crew action?
o A. Negligence
o B. Abandonment
o C. Intent to harm
48. What is the fundamental ethical question when

performing a procedure on a patient?
o A. What does the patient want
o B. Can you handle the procedure complications
o C. Can this procedure have a legal consequences
o D. Is the procedure done for the best interest of
the patient
49. A clean and organized uniform represents what

type of a paramedic?
o A. Skilled
o B. Patient care
o C. Professional
o D. Knowledgeable
50. A 40-year-old man is complaining of severe

abdominal pain since last midnight. The patient
appeared alert and oriented. The paramedics refused
to transport the patient and informed the dispatcher
that their shift has ended 5 minutes ago, therefore the
team on duty should be dispatched.
Which of the following describes the action of leaving
a patient without medical care?
o A. Assault
o B. Negligence
o C. Abandonment
51. A consent to treat a pediatric patient should be

obtained from which of the following?
o A. Patient
o B. Parents
o C. Dispatcher
52. Which of the following is part of the Emergency

Medical Services system?
o A. Fire fighter
o B. Police officer
o C. Traffic officer
53. What is the primary role of paramedics?

o A. Research
o B. Patient care
o C. Public health
o D. Disaster planning
54. A paramedic team was dispatched to a 9-year-old
boy who was struck by a car. The policemen and
dispatchers are unable to contact his parents.
Which of the following types of consent will allow the
paramedics to treat this patient?
o A. Implied
o B. Informed
o C. Expressed
o D. Involuntary
55. A paramedic team is dispatched to the scene for a

10-year-old boy who has been struck by a car. Police
are unable to reach his parents.
What is the type of consent that will give the ability to
treat the patient?
o A. Expressed
o B. Informed
o C. Revoked
o D. Implied
56. The Emergency Medical Services team dispatched
for a 35-year-old woman complaining of severe
headache. She is 32 weeks pregnant. She is also
complaining of nausea, blurred vision and swelling in
her lower limbs.
Blood pressure 165/95mmHg

Heart rate 105 /min
Temperature 36.6 ◦C

o A. Migraine
o B. Eclampsia
o C. Pre-eclampsia
o D. Absence seizure
57. A paramedic team was responding to a lethargic

child. Examination revealed tachypnea and
tachycardia. Stridor sound was also audible.
Which of the following is the most likely diagnoses?
o A. Lung tissue disease
o B. Upper airway obstruction
o C. Lower airway obstruction
o D. Disordered control of breathing
58. A paramedic team is responding to a 2-year-old

baby who was eating and suddenly choked on a piece
of food. Upon arrival, the baby is semi-conscious and
has a strong brachial pulse.
o A. Start CPR
o B. Endotracheal intubation
o C. Subcutaneous epinephrine
o D. 5 chest thrusts and 5 back slaps
59. An ambulance unit is dispatched to a 9-year-old

boy who woke up from his sleep complaining of a sore
throat. Upon arrival, the child is sitting upright,
leaning forward and drooling saliva from his mouth.
The child looks ill, feverish and has a muffled voice.
o A. Croup
o B. Epiglottitis
o C. Pneumonia
o D. Lower airway obstruction
60. A 12-year-old boy presented with respiratory

distress. Examination shows that the boy has
cyanosed skin and a gurgling sound.
Heart rate 120/ min

Oxygen saturation 90%

management?
o A. High flow O2
o B. Airway suction
o C. Albuterol nebulization
o D. Epinephrine nebulization
61. A 6-year-old boy presented with anaphylaxis.

Examination revealed an upper airway swelling and a
very low respiratory rate. The paramedic team
decided to intubate the patient using an uncuffed
endotracheal tube which was the only option they
had.
Which of the following is the most appropriate tube
size?
o A. 4.0 mm
o B. 4.5 mm
o C. 5.0 mm
o D. 5.5 mm
62. A paramedic team was called for 30-year-old man

who suffered from a heat stroke. On scene, the
paramedic team has controlled adequate airway and
ensured breathing and circulatory support to the
patient.
What is the next immediate action?
o A. Administer fluid
o B. Start active cooling
o C. Administer diazepam
o D. Move the patient to a cool environment
63. A paramedic team was called to attend a

20-year-old woman with acid burns. A 23-year-old
man threw acid on her following an argument.
What is the most appropriate action?
o A. Ask for more paramedics
o B. Start treating the patient
o C. Call the police for security
o D. Try to find the reasons of incident
64. Which of the following drugs is administered to

pediatric patient through an endotracheal tube
during resuscitation?
o A. Dopamine
o B. Epinephrine
o C. Magnesium sulfate
o D. Sodium bicarbonate
65. A paramedic team was called for a 34-year-old
man who had a frostbite injury in the right foot.
What is the next important action?
o A. Rapid transport
o B. Massage the affected foot and rapid transport
o C. Slow rewarming the affected foot then
transport
o D. Vigorous rubbing the affected foot and rapid
transport
66. Which of the following does a paramedic need to

consider first in any toxic substance overdose?
o A. Paramedic safety
o B. Quantity of exposed agent
o C. Identify the best treatment
o D. Time for symptoms to appear
67. A paramedic is treating a 27-year-old man who

had been climbing mountains with his friend and is
now complaining of a headache, generalized fatigue
and shortness of breath. He is coughing with frothy
sputum. Chest auscultation reveals mild crepitations.
o A. Heart failure
o B. Cerebral edema
o C. Pulmonary embolism
o D. High altitude pulmonary edema
68. A 70-year-old man presents with cardiac arrest.

Monitoring showed asystole. He receives good
ventilation and 2 doses of epinephrine with efficient
chest compression. As a result, his pulse returns but
he is still in respiratory arrest.
What is the next step in management?
o A. 1 breath every 5-6 seconds
o B. 1 breath every 8-10 seconds
o C. 2 breaths every 5-6 seconds
o D. 2 breaths every 8-10 seconds
69. An 18-year-old man becomes lethargic and
confused while swimming in a pool for 2 hours. He is
taken out of the pool.
Temperature 34 °C
What is the next immediate action?
o A. Apply ECG monitor
o B. Initiate intravascular line
o C. Remove cold and wet clothing
o D. Apply active external rewarming
70. A paramedic team was called to a 34-year-old

man in a new building construction scene who was
complaining of chest pain. His co-worker informed
the paramedic that the patient cannot speak either
Arabic or English. While communicating with the
patient directly, the paramedic notices that he was
avoiding eye contact.
Which of the following is the most likely reason?
o A. Sign of embarrassment
o B. Signs of severe head injury
o C. Cultural differences expressed by this patient
o D. Patient has taken a distinct dislike to the
paramedic
71. Which of the following is the most important

information a paramedic should document on the ECG
paper before handing over the patient to the hospital?
o A. Patient's weight
o B. Treatment given
o C. Assessment results
o D. Patient's name and age
72. A 26-year-old man presented to paramedic team

with mild decreased mental activity. His blood sugar
was 42 mg/dL. The patient admitted that he has taken
an extra dose of a medicine.

Heart rate 48 /min
Which of the following drugs leads to this
presentation?
o A. Salicylates
o B. Beta blockers
o C. Tricyclic antidepressants
o D. Calcium channel blockers
73. A 3-year-old boy presented in a confused mental

state. Examination shows signs of poor perfusion and a
heart rate of 50 /min despite effective ventilation.
What is the next step in management?
o A. Treat underlying causes
o B. Start chest compression
o C. Administer 0.5 mg of atropine
o D. Administer 0.5 mg of epinephrine
74. A paramedic team is attending to a patient with

ventricular fibrillation. The senior paramedic asked his
junior to give the patient adrenaline every 3-5 minutes.
What is the appropriate dose?
o A. 1 mg
o B. 2 mg
o C. 3 mg
o D. 5 mg
75. A paramedic team is attending to a patient with

ventricular fibrillation. They decided to give shock to
the patient using biphasic defibrillator.
What is the appropriate dose for the first shock?
o A. 120 joules
o B. 200 joules
o C. 300 joules
o D. 360 joules
76. What is the recommended replacement (normal

saline/ringer lactate) volume for a child with
hemorrhagic shock?
o A. 5 ml/kg
o B. 10 ml/kg
o C. 15 ml/kg
o D. 20 ml/kg
77. Image(s)
A paramedic team responded to a call for a cardio
arrest case. Chest compression was in progress.
Image(s)
A paramedic team is attending to a patient with

ventricular fibrillation. 2 shocks have already been
given to the patient using biphasic defibrillator.
What is the appropriate dose for the third shock?
o A. 50 joules
o B. 120 joules
o C. 200 joules
o D. 360 joules
78. A 53-year-old man presented with vomiting and
diarrhea. He had severe diarrhea for 3 days. His skin is
pale and clammy, and has a delayed capillary refill.

Heart rate 110 /min
Which of the following is the most appropriate first

step in management?
o A. Resuscitation blood
o B. Antibiotic medication
o C. Antiemetic medication
o D. 1-2 Liter of Isotonic IV fluid
79. A 35-year-old man collapsed and went to cardiac

arrest. Bystanders started CPR right away, and the
paramedics arrived with a cardiac defibrillator.
What is the best next step in management?
o A. Stop bystanders check pulse
o B. Connect patient to monitor for analysis
o C. Continue chest compression for 5 cycles
o D. Connect patient to monitor delivery shock
80. A 50-year-old man presented with chest pain. The

patient was put on a cardiac monitor which showed
tall and peaked T waves.
o A. Low serum sodium
o B. High serum sodium
o C. Low serum potassium
o D. High serum potassium
81. An adult patient presented with cardiac arrest.

Arterial blood gases were done immediately after
history and examination (see lab results).
ABG1 HCO3- 23 22-28 mmol/L
ABG PCO2 7.5 4.7-6.0 kPa
pH 6.9 7.36-7.45



ABG PCO2 4.9 4.7-6.0 kPa
pH 8.0 7.36-7.45
Which of the following is the most likely

interpretation?


ABG PCO2 3.8 4.7-6.0 kPa
pH 7.9 7.36-7.45
What is the most likely interpretation?

84. A 2-year-old boy is presented with fever and in a
confused mental state. An ECG was done which
revealed normal rhythm.
Heart rate 180 /min
o A. Sinus tachycardia
o B. Supraventricular tachycardia
o C. Ventricular tachycardia polymorphic
o D. Ventricular tachycardia monomorphic
85. Which of the following is a recommended sedation

for synchronized cardioversion?
o A. Morphine
o B. Midazolam
o C. Sodium bicarbonate
o D. Potassium carbonate
86. A paramedic team was responding to an adult

cardiac patient. The biphasic cardiac monitor was
connected which showed ventricular fibrillation. The
paramedic started charging the defibrillator to deliver
a shock.
Which of the following is the maximum shock dose?
o A. 150 joules
o B. 200 joules
o C. 300 joules
o D. 360 joules
87. Which of the following is the best source of

information to ask about the mechanism of injury if the
patient is unconscious at the scene of a car accident?
o A. Policeman
o B. Ambulance dispatcher
o C. Bystander who saw the accident
o D. Bystander who attended after the accident
88. A paramedic team was responding to a 68-year-old

unconscious woman. Radial pulse is not palpable.
Heart rate 45 /min

o A. Non-shock stage
o B. Irreversible shock
o C. Compensated shock
o D. Decompensated shock
89. A 40-year-old woman is brought to the Emergency

Department after being in a car accident. Her level of
consciousness has decreased, the bleeding stopped,
the patient is immobilized and oxygen was given.

Heart rate 117 /min
Which of the following is the most appropriate next

step in management?
o A. 1-2 litter bolus of blood products
o B. 1-2 litter bolus of hypotonic solutions
o C. 1-2 litter bolus of hypertonic solutions
o D. 1-2 litter bolus of isotonic crystalloid solutions
90. Which of the following is the best source of

information to ask about the mechanism of injury at
the scene of a car accident?
o A. Patient
o B. Bystander
o C. Dispatcher
o D. Police man
91. Which of the following is the most appropriate

emergency care management for amputations?
o A. Keep the amputated part warm
o B. Remove any gross contamination
o C. Wrap the amputated part with foil
o D. Complete the amputation if the part is still
attached
92. Which nerve provides the parasympathetic control

of the heart?
o A. Vagus
o B. Phrenic
o C. Subclavian
o D. Fourth cranial
93. What is the most effective initial method of

controlling external bleeding?
o A. Elevation
o B. Tourniquets
o C. Direct pressure
o D. Pressure points
94. Which of the following fractures is an indication of
the use of a traction splint?
o A. Tibia
o B. Hip bone
o C. Fibula head
o D. Femur shaft
95. A paramedic team unit is dispatched to a

29-year-old man who sustained a burn injury.
Examination reveals full-thickness burns on both of his
arms. His airway is patent and chest is clear.
Weight 70 kg
What is the estimated amount of fluid to be given over
24 hours?
o A. 4L
o B. 5L
o C. 6L
o D. 7L
woman who fell down from the ladder. She has an
open mid-shaft right femur fracture with significant
bleeding. She is conscious and alert.
Which of the following ways of management is
contraindicated in this case?
o A. Board splint
o B. Traction splint
o C. Long back board
o D. Controlling the bleeding

man who fell down badly on the ground after sky
diving. The patient has a closed mid-shaft left femoral
fracture.
While managing the fracture with the traction splint,
the paramedics must do which of the following?
o A. Maintain manual stabilization after traction
splint application
o B. Apply the traction splint even if the patient
has a fractured pelvis
o C. Check motor, pulse and sensation before and
after traction splint applying
o D. Apply the traction splint after placing the
patient in the ambulance to speed up transport

man with a chest wound and signs and symptoms of
shock.
In what position should the patient be placed?
o A. Prone
o B. Supine
o C. Recovery
o D. Trendelenburg
99. What is the first step in the management of burn

patients?
o A. Stop the burning process
o B. Pain management with narcotics
o C. Start fluid therapy with ringer's solution
o D. Secure airway with nasotracheal intubation
100. The Emergency Medical Services team is

transferring a patient with a head injury after a motor
vehicle crash. The patient is opening his eyes to verbal
command and shouting abusive words to the team. He
also pulls his limbs away from the pain.
What is the Glasgow Coma Scale score?
o A. 8
o B. 10
o C. 12
o D. 14
101. The Emergency Medical Services team was

dispatched to a 14-year-old boy who was involved in a
motorbike crash. He was not wearing a helmet and is
responsive to painful stimuli. He has snoring
respiration and deformity in the left ankle.
Which of the following should be the first step?
o A. Splinting the injured ankle
o B. Securing the patient to a long spinal board
o C. Open the airway using jaw thrust maneuver
o D. Suction the mouth and insert oropharyngeal
airway
102. A paramedic team was responding to a cardiac

arrest patient who was involved in a car accident. The
cardiac monitor showed a slow heart rate and narrow
complex. Peripheral pulses are not palpable even after
cardiopulmonary resuscitation.
Which of the following is the reversible cause of
pulseless electrical activity?
o A. Toxins
o B. Heart thrombosis
o C. Pulmonary contusion
o D. Tension pneumothorax
103. An ambulance unit was dispatched to an
18-year-old man who sustained a second-degree burn
to the anterior aspect of his chest, as well as total
burns to arms and legs.
What is the approximate percentage of the patient's
total body surface affected area?
o A. 18%
o B. 36%
o C. 72%
o D. 82%
104. The ambulance team is transferring a patient with

multiple abdominal stab wounds. He is conscious, alert
but mildly anxious.
What type of shock most likely represents his
condition?
o A. Decompensated
o B. Compensated
o C. Irreversible
o D. Reversible
105. What is the most common type of shock seen by

the emergency medical service crew?
o A. Obstructive
o B. Distributive
o C. Cardiogenic
o D. Hypovolemic
106. In assessing unresponsive patients after blunt

trauma.
Which of the following is the first priority in
management?
o A. Check glucose level
o B. Assess respiratory rate
o C. Perform SAMPLE history
o D. Determine if the CPR is needed
107. A 25-year-old man is a victim of motor vehicle
crash, at the scene, the patient is complaining of chest
pain and shortness of breath. Examination reveals no
obvious bleeding and multiple bruising on the right
side of the chest associated with absent breath sound
on the right side and right side jugular vein distention.
After securing the IV lines and stabilizing the cervical
spine, which of the following is the most appropriate
next step?
o A. Oropharyngeal intubation
o B. Nasopharyngeal intubation
o C. 2 Liters of Normal Saline as a fluid bolus
o D. Needle decompression on the right side of the
chest
108. Which of the following formulas is used to

estimate fluid replacement in burn patients?
o A. 2 × Weight in kg × percentage of bum
o B. 4 × Weight in kg × percentage of bum
o C. 6 × Weight in kg × percentage of bum
o D. 8 × Height in meters x percentage of bum
109. What is the difference between adults and infants

when using the rule of nines in a burn injury?
o A. Lower extremities accounts for the same in
both
o B. Head of the infant accounts for more than
adult
o C. Head of the infant accounts for less than adult
o D. Upper extremities accounts for more in adult
110. The Emergency Medical Services team was

dispatched to a patient who was ejected from the car
during a motor vehicle crash. The patient responds
incoherently to verbal commands.
step?
o A. Determine the heart rate
o B. Asses the patient's airway
o C. Perform the secondary survey
o D. Log roll the patient into a spinal board
111. A paramedic team was dispatched to a structural

collapse. On scene, many injured patients were
present. The paramedic team was the first responding
unit.
o A. Call medical director
o B. Start triaging patients
o C. Start treating patients
o D. Establish an incident command system
112. A paramedic team has been dispatched to a mass

causality incident. On scene, the paramedic was
assigned to assess 12 patients. The first patient had no
respiration. The paramedic opened the airway but the
patient did not breathe.
What is the best next immediate action?
o A. Check pulse
o B. Ventilate by bag valve mask
o C. Tag with red tag then move to next
o D. Tag with black tag then move to next
113. Which of the following colors is used to tag a

patient who needs immediate care in a disaster?
o A. Red
o B. Blue
o C. Black
o D. Yellow
114. Which of the following is the outermost layer that

encloses the brain?
o A. Cranium
o B. Pia mater
o C. Arachnoid
o D. Dura mater
115. Which assessments should the paramedic focus
on when triaging patients?
o A. Respiratory effort and pulses/perfusion
o B. Respiratory effort, pulses/perfusion and
neurological status
o C. Ability to walk, respiratory effort,
pulses/perfusion and neurological status
o D. Past medical history, respiratory effort,
pulses/perfusion and neurological status
116. What does green colored tag refer to in a

disaster triage?
o A. Minor
o B. Delayed
o C. Deceased
o D. Immediate
117. A paramedic team was called to a multiple
causality incident. On scene, there were 15 patients.
The paramedic decided to triage these patients. One
of the patients had severe bleeding with low
perfusion.
What is the best next immediate action?
o A. Tag patient with red tag then move to next
o B. Tag patient with yellow tag then move to next
o C. Control bleeding and tag with red tag then
move to next
o D. Control bleeding and tag with yellow tag then
move to next
118. A paramedic team was called for a mass

casualty incident. On scene, the paramedic team
found that they are the first paramedic unit to arrive.
What is the most appropriate immediate action?
o A. Treat life-threatening patients
o B. Transport life-threatening patients
o C. Quick and rapid assessment of the situation
o D. Wait until help comes then make a treatment
plan

man who is unresponsive. On arrival, the paramedics
could feel carotid pulse, but the respiratory rate is
less than 5 per minute.
What should the paramedics do in this stage?
o A. Transport the patient
o B. Continue assessing the patient
o C. Give oxygen by non-rebreather mask
o D. Start bagging the patient at rate 10-12 breath
per minute

woman who complains of difficulty in breathing. She
worsens when she lies down, and has coarse crackles
on both lungs. The paramedics decide to use CPAP.
During transportation, the patient starts vomiting.
Which of the following is recommended?
o A. Administer IV antiemetic
o B. Directly remove the CPAP
o C. Decrease airway pressure to 0 cm H2O
o D. Increase airway pressure by 10 cm H2O

woman who complains of difficulty in breathing. On
arrival, the patient is unable to say full sentences.
The paramedics asked family permission to perform
a physical examination but her brother refused all
requests.
What should the paramedics do in this situation?
o A. Contact police
o B. Transport patient
o C. Ask to get her vitals especially oxygen
saturation
o D. Ignore her brother and perform a physical
examination
122. Which of the following information must be
documented in the PCR during the transference of an
intubated patient?
o A. Tube colour
o B. Tube depth and size 40
o C. Tube manufacture date and origin
o D. Amount of lubricant used during insertion
123. A 55-year-old patient with a history of COPD

has dyspnea.
Heart rate 124 /min

Which of the following is the most appropriate mask

for delivering oxygen?
o A. Simple face
o B. Nasal cannula
o C. Non-rebreather
o D. Partial rebreathing
man who complains of difficulty breathing. The
patient has a clear airway but is using accessory
muscles.
step in management?
o A. Give oxygen
o B. Initiate IV access
o C. Intubate the patient
o D. Continue assessment without giving anything
125. A paramedic team intubated an unconscious

patient. A gurgling sound over the epigastrium is
heard upon auscultation to confirm the Endotracheal
Tube (ETT) placement.
What is the most appropriate intervention?
o A. Remove the ETT
o B. Secure the ETT in its position
o C. Advance the ETT till bilaterally breath sound
is heard
o D. Withdraw the ETT till bilaterally breath sound
is heard
126. A paramedic team was dispatched to a

66-year-old man with increasing difficulty in
breathing. He has a high-grade fever, productive
cough with dark sputum for 3 days.

Heart rate 112 /min
Temperature 38 ◦C
Which of the following is the most likely condition?

o A. Pneumonia
o B. Emphysema
o C. Asthma attack
127. What should the paramedic consider when

applying an oropharyngeal airway in an elderly
patient?
o A. T-shirt
o B. Dignity
o C. Dentures
o D. Appearance
128. A paramedic team is dispatched to a

59-year-old woman who complains of having trouble
breathing. On arrival, they find the patient
unresponsive with agonal respiration.
Which of the following represents agonal respiration?
o A. Irregular breathing pattern
o B. Breathing pattern of gasping followed by apnea
o C. Persistent respiratory rate slower than 12
breaths/minute
o D. Irregular respirations varying in-depth and
interrupted by intervals of apnea

man who was involved in a motor vehicle accident.
On arrival, the patient is agitated and there is obvious
head trauma. The paramedics decide to intubate the
patient by RSI. They successfully intubate the patient
and attach him to a capnography. During
transportation, the following waveform presents on
the monitor (see image).
Which of the following is highly suspected?

o A. Fever
o B. Sepsis
o C. Hypoventilation
o D. Airway obstruction or leak
130. Part of a paramedic's daily duty is to assure that

the ambulance mechanical status is good and the
supply checklists are checked off.
When is the ambulance mechanical status and supply
check-up performed?
o A. At the end of the shift
o B. When the time is permit
o C. On the way to a scene call
o D. At the start of every work shift
131. A 64-year-old man was trapped in his car that

crashed into a lake. The patient is responsive and
shouting for help. There was no specialized rescue
team on the scene, and the car started to sink into the
deep water.
action?
o A. Begin extrication
o B. Encourage bystanders to help
o C. Wait for the specialized team arrival
o D. Swim toward the patient and provide
medication aid.
132. Which of the following abnormal breathing

sounds is expected in a patient with epiglottitis?
o A. Stridor
o B. Visceral
o C. Crackles
o D. Wheezing

man who complains of difficulty breathing. On
arrival, the patient sits in a tripod position and looks
very sick. Examination reveals bilateral lung
wheezing, and paramedics directly apply a
non-rebreather mask.
In an optical setting, what is the percentage of oxygen
that should be delivered to the patient by using a
non-rebreather mask?
o A. 10-25
o B. 31-45
o C. 51-75
o D. 80-95
134. What does labored breathing pattern in a

patient indicate?
o A. Needs CPR
o B. Needs cardiac shock
o C. Working hard to breath
o D. Ready to be discharged
135. Which of the following departments should be

notified if the paramedic team encounter a
mechanical problem en-route to a motor vehicle crash
site?
o A. Police
o B. Fire-fighter
o C. EMS dispatcher
o D. Another EMS unit
136. Which of the following should the paramedic

ask about the severity of pain?
o A. Ask the patient if the pain is killing him
o B. Ask the patient if he can handle the pain
o C. Ask the patient if the pain radiates to another
place
o D. Ask the patient to determine the pain from a
scale of 0 to 10
137. A 19-year-old woman is complaining of a severe

headache. She confessed that she took an extra
amount of medication, which she bought over the
counter, but she cannot recall the name of the
medicine. Past medical history reveals depression and
suicide attempts.
Which of the following is the most appropriate to
document in the patient care report?
o A. Overdose of unknown medicine
o B. Overdose of any medicine she is carrying
o C. Assume the overdose is of paracetamol
o D. Consumed unknown amount of unknown
medicine

woman who complains of difficulty in breathing. On
arrival, the patient is unable to say full sentences.
The paramedics asked family permission to perform
a physical examination but her brother refused all
requests.
What should the paramedics do in this situation?
o A. Contact police
o B. Transport patient
o C. Ask to get her vitals especially oxygen
saturation
o D. Ignore her brother and perform a physical
examination
139. What is the normal range of respiratory rate for

adults?
o A. 6 - 8 breaths/min
o B. 9 - 11 breaths/min
o C. 12 - 20 breaths/min
o D. 21 - 28 breaths/min

woman who complains of having trouble breathing.
On arrival, they find the patient unresponsive with
agonal respiration.
Which of the following represents agonal respiration?
o A. Irregular breathing pattern
o B. Breathing pattern of gasping followed by apnea
o C. Persistent respiratory rate slower than 12
breaths/minute
o D. Irregular respirations varying in-depth and
interrupted by intervals of apnea
141. A paramedic team was responding to a

68-year-old unconscious woman. Radial pulse is not
palpable.

Heart rate 45 /min

o A. Non-shock stage
o B. Irreversible shock
o C. Compensated shock
o D. Decompensated shock
142. A paramedic team was responding to an adult

cardiac patient. The biphasic cardiac monitor was
connected which showed ventricular fibrillation. The
paramedic started charging the defibrillator to
deliver a shock.
Which of the following is the maximum shock dose?
o A. 150 joules
o B. 200 joules
o C. 300 joules
o D. 360 joules
143. A 2-year-old boy is presented with fever and in

a confused mental state. An ECG was done which
revealed normal rhythm.
Heart rate 180 /min
o A. Sinus tachycardia
o B. Supraventricular tachycardia
o C. Ventricular tachycardia polymorphic
o D. Ventricular tachycardia monomorphic


ABG PCO2 3.8 4.7-6.0 kPa
pH 7.9 7.36-7.45
What is the most likely interpretation?

145. A 50-year-old man presented with chest pain.

The patient was put on a cardiac monitor which
showed tall and peaked T waves.
o A. Low serum sodium
o B. High serum sodium
o C. Low serum potassium
o D. High serum potassium
146. Which of the following best describes the action

of chlorpheniramine?
o A. Antibiotic
o B. Antihistamine
o C. Reduces clot formation
o D. Reverses effects of vagal overdrive
147. A 61 year-old man, known to have a brain

tumor, suddenly collapses in his house. On
examination, he is confused with irregular
respiration. On auscultation, heart and lungs sounds
are normal

Heart rate 56 /min
Which of the following triads explain this
presentation?
o A. Beck's triad
o B. Saint's triad
o C. Charcot's triad
o D. Cushing's triad
148. What is the major concern after administering

phenytoin to a patient with seizure?
o A. Paralysis
o B. Dysrhythmias
o C. Nausea and vomiting
o D. Pain from injection site
149. Which of the following is the compression /

ventilation rate for neonatal resuscitation?
o A. 3:1
o B. 10:2
o C. 15:2
o D. 30:2
150. A paramedic team has been called for a 34
year-old man who had a frostbite injury in the right
foot.
o A. Rapid transport
o B. Massage the affected foot and rapid transport
o C. Slow rewarming the affected foot and rapid
transport
o D. Vigorous rubbing the affected foot and rapid
transport
151. An ambulance unit is dispatched to a nine

year-old boy who woke up from his sleep complaining
of a sore throat. Upon arrival, the child is sitting
upright, leaning forward and drooling saliva from his
mouth.
On examination, the child looks ill, feverish and has a
muffled voice.
o A. Croup
o B. Epiglottitis
o C. Pneumonia
o D. Lower airway obstruction
152. What is the lowest score in Glasgow Coma Scale

(GCS)?
o A. 0
o B. 1
o C. 2
o D. 3
153. A 70 year-old male was found at his home in

cardiac arrest. On examination, the cardiac monitor
showed asystole. The paramedics decided to start
cardiopulmonary resuscitation but the family
disagreed because the patient had signed a DNR1
form. On evaluation, it was revealed that the form
was expired three weeks ago.
What immediate action should be taken?
o A. Call the hospital to confirm expiry date
o B. Follow family request and stop resuscitation
o C. Confirm asystole and announce patient's death
o D. Inform the family about the rules and start
chest compression
1
Do Not Resuscitate
154. According to the Cincinnati prehospital stroke

scale, which of the following findings indicates
presence of a stroke?
o A. Both arms move the same
o B. Both sides of face move equally
o C. Both sides of the face do not move
o D. Patient can speak without slurring
155. A 53 year-old male presented with vomiting and

diarrhea. Examination shows that he had severe
diarrhea for three days. His skin is pale and clammy,
and he has a delayed capillary refill.

Heart rate 110 /min
What would be the first step in management?

o A. Give resuscitation blood
o B. Give antibiotic medication
o C. Give resuscitation IV fluid
o D. Give antiemetic medication
156. What is a sprain?

o A. Joint dislocation
o B. Injury to muscle and tendon
o C. Joint injury with ligament damage
o D. Disruption in the continuity of a bone
157. What is the best way to estimate the amount of

blood loss for an injured patient?
o A. Body temperature
o B. Blood volume on the ground
o C. Severity of signs and symptoms
o D. Blood volume on clothing of the patient
158. A paramedic team is transporting a 32 year-old
pregnant woman after sustaining a motor vehicle
accident. She is in her second trimester. On
examination, she appears anxious and has a patent
airway. Her chest is clear, and she tells the paramedic
that she is having vaginal bleeding.
What is the recommended next step regarding the
vaginal bleeding?
o A. Insert tampons
o B. Examine the vagina
o C. Attempt to control the vaginal bleeding
o D. Avoid vaginal exam and document the amount
and colour of vaginal bleeding
159. A paramedic team is dispatched to a 68 year-old

homeless man in cardiac arrest.
Core temperature 29° C
Which of the following should the paramedic
consider?
o A. No resuscitation
o B. Full code on scene
o C. Assess the pupils size
o D. Contact medical director, resuscitate and
transport regardless of cardiopulmonary status
160. A paramedic responds to a 72 year-old man with

suspected head injury. The paramedic has obtained
the blood pressure and wants to calculate the MAP1

Heart rate 111 /min
What is the calculated mean arterial blood pressure?

o A. 70
o B. 80
o C. 90
o D. 100
1
Mean Arterial blood Pressure
161. What does the black colour tag in a patient
tagging system mean?
o A. Deceased, no priority
o B. Lowest, third priority, minor
o C. Highest, first priority, immediate
o D. Medium, second priority, delayed
162. A 29 year-old male was stabbed in his right

upper back with a small pocket knife. He is alert and
oriented with minimal bleeding, and he refused to go
to the hospital.

Heart rate 110 /min
What should the paramedic do?

o A. Take the patient to the hospital against his will
o B. Ensure the patient is aware of the
consequences
o C. Call the police to force the patient to accept
medical care
o D. Try to convince him, and if he insists let him
sign the refusal form
163. Which of the following is a characteristic feature

of a partial thickness burn injury?
o A. Dry skin
o B. Pink or red skin
o C. Blistering and intense pain
o D. Pain on peripheral edges of burns
164. Who is the best source of information to ask

about the mechanism of injury at the scene of a car
accident?
o A. Patient
o B. Bystander
o C. Dispatcher
o D. Police man
165. A paramedic was dispatched to a multi-vehicle
accident. On scene, there were oil leaking, some
dangerous substances and ten patients.
What is the most important action?
o A. Treat the patients
o B. Triage the patients
o C. Control the hazards as possible
o D. Control every hazard at the scene
166. A 54 year-old male was found unconscious in

his office. The primary assessment reveals that
patient has adequate breathing and a strong radial
pulse.
Which of the following should be checked first?
o A. A 12 leads ECG
o B. Blood glucose level
o C. Systolic blood pressure
o D. Core body temperature
167. A paramedic team transferred an intubated
child with bradycardia. The patient has received good
ventilation, and the paramedics decided to give
epinephrine but an intravenous access could not be
established. It was decided to give the patient
epinephrine via endotracheal tube.
What is the most appropriate dose of epinephrine?
o A. 0.10 mg/kg (1:1000)
o B. 0.01 mg/kg (1:1000)
o C. 0.10 mg/kg (1:10,000)
o D. 0.01 mg/kg (1:10,000)
168. A paramedic team has been dispatched to a

four year-old boy who burnt his hand from the living
room fireplace. The assessment shows dark brown,
dry, hard, and leathery skin of the child's hand that is
not very painful to touch.
Which of the following types of burns is this?
o A. Superficial
o B. Full thickness
o C. Deep partial thickness
o D. Superficial partial thickness
169. Which of the following medications will cause

vasodilation?
o A. Dobutamine
o B. Nitroglycerin
o C. isoproterenol
o D. Phenylephrine
170. While attending a case of a symptomatic

tachycardia with a palpable pulse, what is the
recommended dose for an intravenous procainamide
injection?
o A. 10-30 mg/min
o B. 10-30 mcg/min
o C. 20-50 mg/min
o D. 20-50 mcg/min
171. A paramedic team is responding to a two
year-old baby who was eating and suddenly choked
on a piece of food. Upon arrival, the baby is
unconscious and has a strong brachial pulse.
o A. Start CPR
o C. Subcutaneous epinephrine
o D. Five chest thrusts and five back slaps
172. A paramedic responds to a domestic violence

scene in a house. Upon arrival, the paramedic hears
yelling, shouting and sounds of breaking glass from
the house.
o A. Enter the house and look for the patient
o B. Call the neighbours then enter the house
o C. Do not enter the house and wait for the police
o D. Do not enter the house and ask the patient to
come out from the house
173. A patient with 70% burns is being transported
by the paramedics.
Weight 100 kg
According to the Parkland formula, how much fluids
should the patient receive in the first eight hours?
o A. 6000 ml
o B. 14000 ml
o C. 19000 ml
o D. 20000 ml
174. What is the "raccoon sign"?

o A. Leakage of blood or fluids from the nose
o B. Bruising of the mastoid area behind the ear
o C. One eye positioned downward and outward
o D. Bruising of the soft tissues around one or both
eyes
175. A three year-old female presented with spa

sudden onset of respiratory distress, fever, dysphagia
and drooling. She is also experiencing pain while
swallowing.
What should be suspected?
o A. Croup
o B. Bronchitis
o C. Epiglottitis
o D. Foreign body obstruction
176. A paramedic team has been called for an

unresponsive 55 year-old woman. On scene, she was
lying on the bed and her family was standing around.
The paramedic decided that she was dead for some
time.
o A. Start CPR for few minutes then announce
death to the family
o B. Be honest with the family and tell them that the
patient is dead
o C. Tell the family that the patient is fine but needs
to be transported to hospital
o D. Be sympathetic with the family and try to
transport the patient without telling the family the
truth
177. Which of the following is considered a wide

complex tachycardia?
o A. Atrial fibrillation
o B. Multifocal atrial tachycardia
o C. Supraventricular tachycardia
o D. Polymorphic ventricular tachycardia
178. How should the paramedics communicate with

the medical director when they call for an advice?
o A. Speak quickly
o B. Call back to verify
o C. Repeat the orders back
o D. Question all verbal orders
179. A paramedic team has been dispatched to a 22
year-old man who was found on the street with a
sucking chest wound after being stabbed with a sharp
metal.
What type of dressing should be used to cover the
injury?
o A. Triangle bandage
o B. 4 × 4 gauze patch
o C. Pressure bandage
o D. Occlusive dressing
180. When should a paramedic wear a seat belt?

o A. Only when driving
o B. Whenever a paramedic feels unsafe
o C. Whenever the ambulance is on motion
o D. Never because it hinders the medical care

male who sustained snakebite. Upon arrival at the
scene, he is unresponsive and lying on the ground.
What is the next course of action?
o A. Call for back-up
o B. Check the patient's pulse
o C. Initiate airway intervention
o D. Survey scene before providing patient care
182. Mc Burney's point is a land mark for which of

following?
o A. Gastritis
o B. Pancreatitis
o C. Appendicitis
o D. Cholecystitis

year-old woman who tried to commit suicide at home
by drinking sulfuric acid bottle (car battery acid). On
assessment, she is unconscious and extremely
intoxicated.
Which of the following would be the best position for
transporting this patient?
o A. Supine
o B. Fowler
o C. Recovery
o D. Trendelenburg
184. Image(s)
Many patients require emergency airway
management (see image).
Which of the following airway tubes is shown?

o A. ETT
o B. LMA
o C. King tube
o D. Combitube
185. A paramedic team is dispatched to a patient
who is intubated. The patient is still in distress. On
examination, air entry can only be heard on the right
lung.
What is the next appropriate management for this
patient?
o A. Inflate the cuff more
o B. Increase the bagging rate
o C. Remove the tube immediately
o D. Deflate the cuff, withdraw the ETT 1-2 cm and
reassess
186. On arrival to a patient's home, the paramedics

found a 70 year-old man in a semiconscious state.
Examination was done and the patient was put on a
cardiac monitor

Heart rate 41 /min

o A. Tachycardia
o B. Bradycardia
o C. Hypertensive
o D. Hypotensive
187. Which of the following methods is used to

evaluate new-borns?
o A. SAMPLE
o B. Apgar score
o C. Glasgow coma scale
o D. Cincinnati scoring system

pregnant woman in her second trimester complaining
of a headache and blurred vision. On examination,
she has generalized oedema and lower limbs pitting
oedema. She tells the paramedic that her urine is
foamy.

Heart rate 105 /min
Temperature 36.2° C
What is the most likely the diagnosis?

o A. Stroke
o B. Eclampsia
o C. Hypertension
o D. Preeclampsia

definition of pulse pressure?
o A. Heart rate times the stroke volume
o B. Heart rate times the blood pressure
o C. Difference between the systolic and diastolic
pressure
o D. Cardiac output times the systemic vascular
resistance

pregnant women in her third trimester complaining
of abdominal pain and sudden vaginal bleeding. The
pain started suddenly and on examination, there is
localized uterine tenderness. She was previously
diagnosed with maternal hypertension

Heart rate 110 /min
Temperature 36.2° C

o A. Missed abortion
o B. Ectopic pregnancy
o C. Abruptio placentae
o D. Spontaneous abortion
191. A paramedic team has been called for a woman

who was complaining of Ibuprofen overdose. On
scene, the patient was lying down and confused. On
assessment, the patient had CNS and other
disturbances. The family said that the patient
ingested a lot of Ibuprofen 30 minutes ago. The
paramedic team has administered activated charcoal.
What are the secondary complications that the
paramedic has to monitor?
o A. Hypoglycemia and bradycardia
o B. Hypotension and dysrhythmias
o C. Hypotension and hypoglycemia
o D. Hypertension and dysrhythmias
192. What is the approximate heart rate for this ECG

strip (see Image)?
o A. 100 beats/minute
o B. 120 beats/minute
o C. 140 beats/minute
o D. 180 beats/minute
193. What is the major neurotransmitter secreted by

the postganglionic fibers of the sympathetic nervous
system?
o A. Atropine
o B. Dopamine
o C. Acetylcholine
o D. Norepinephrine
194. A paramedic team has been called for 37

year-old female who was complaining of heat stroke.
On scene, the paramedic team has managed the
airway, respiration and circulation. The paramedic
team has started the cooling process.
How often should the paramedic team record and
document the temperature during the cooling process
in a patient with heat stroke?
o A. At least every 5 minutes
o B. At least every 10 minutes
o C. At least every 12 minutes
o D. At least every 15 minutes
195. What is the most common cardiac medication
associated with fatal poisoning in both children and
adults?
o A. Aspirin
o B. Digoxin
o C. Epinephrine
o D. Amiodarone
196. A 23 year-old male suffers from a contusion over

his chest following a head on collision while driving a
car. The paramedic noticed that the steering wheel
was also damaged. Other evidences indicate that the
patient did not fasten the seat belt. On examination,
the patient is disoriented and dizzy, has a shallow and
rapid breathing. An obvious jugular vein distention
and muffled heart sounds were observed.

Heart rate 137 /min
EtCO2 47 mmHg
What is most likely the diagnosis?

o A. Cardiac tamponade
o B. Pulmonary contusion
o C. Myocardial contusion
197. What is the P-R interval in a normal ECG

rhythm?
o A. 0.01 - 0.05 second
o B. 0.06 - 0.10 second
o C. 0.12 - 0.20 second
o D. 0.22 - 0.30 second
198. In a 12-lead ECG, which of the following leads

shows changes in a case of anterior wall myocardial
infarction?
o A. V1 to V4
o B. V1 to V6
o C. V2 to V4
o D. V2 to V6
199. A paramedic team is evaluating a new-born
immediately after birth. On examination he looks
blue and is not crying.

Heart rate 50 /min
Temperature 35.6°C
Based on the calculated Apgar score, what is the most

appropriate next course of action?
o A. Immediate resuscitation
o B. Administer dopamine infusion
o C. Stimulate crying by rubbing the back
o D. Transport and observe for any changes
200. A paramedic team arrives at a scene to transport

a 14 year-old boy who was hit by a car while driving
his bicycle. On examination, he is alert and oriented.
The airway is patent and there is bilateral equal air
entry on auscultation. The patient states that he
landed on his back. He has asymmetric flaccid
paralysis, asymmetric loss of reflexes and he can feel
pressure.
o A. Neurogenic shock
o B. Autonomic dysreflexia
o C. Complete cord transection
o D. Incomplete cord transection
201. Image(s)
A paramedic team is attending to a patient with a
cardiac problem. ECG was done (see image).
What is the most appropriate dose of epinephrine to

be given?
o A. 1 mg
o B. 2 mg
o C. 3 mg
o D. 5 mg
202. Which of the following should be used in the
patient care report?
o A. Personal opinion
o B. Informal language
o C. Medical terminology
o D. Personal abbreviation

anatomical landmark for the placement of ECG
V1-lead on the chest?
o A. Fourth intercostal space just left of the sternum
o B. Second intercostal space just left of the
sternum
o C. Fourth intercostal space just right of the
sternum
o D. Second intercostal space just right of the
sternum
204. Which of the following is considered as a

gynecological emergency?
o A. Pregnancy
o B. Menopause
o C. Ectopic pregnancy
o D. Non-infectious vaginitis
205. Which of the following is a contraindication use of

1
CPAP?
o A. Kidney stones
o B. Pneumothorax
o C. Multiple myeloma
o D. Chronic pancreatitis
1
Continues Positive Airway Pressure.

year-old female with difficulty of breathing. On
examination, she had difficulty of breathing with
crackles on chest auscultation at the lower lobes of the
lungs, and she had peripheral edema. She is taking ACE
inhibitor and diuretics.
o A. Asthma
o B. Bronchitis
o C. Pulmonary edema
o D. Pulmonary embolism
207. Which of the following happens during

expiration?
o A. Active motion
o B. Contracting of diaphragm
o C. Relaxation of abdominal muscles
o D. Relation of diaphragm and intercostal muscles
208. Which of the following drugs can be administered

to a pediatric patient through an endotracheal tube
during resuscitation?
o A. Dopamine
o B. Epinephrine
o C. Magnesium sulfate
o D. Sodium bicarbonate
209. A 29 year-old woman is pregnant in her third

trimester. This is her third pregnancy and she has
delivered two healthy girls in the previous two
pregnancies.
Which of the following terms best describe her
pregnancy status?
o A. Gravida 3 para 2
o B. Gravida 2 para 3
o C. Gravida 3 para 3
o D. Gravida 4 para 2
210. While transporting a 29 year-old pregnant woman

who was in her third trimester, the care provider
noticed a sudden drop in her blood pressure. The
patient was lying in a supine position with an oxygen
mask on.
Which of the following should be attempted first to
elevate the patient's blood pressure?
o A. Five litters of ringer lactate
o B. Four litters of normal saline
o C. Intravenous norepinephrine
o D. Changing the patients position to left lateral
211. A three year-old boy presents with severe

coughing and a high grade fever for two days. The
assessment shows inspiratory stridor and a seal-bark
cough.
Which type of pathogen may cause this condition?
o A. Virus
o B. Fungus
o C. Bacteria
o D. Parasite
212. Which of the following best describes the action

of chlorpheniramine?
o A. Antibiotic
o B. Antihistamine
o C. Reduces clot formation
o D. Reverses effects of vagal overdrive
213. A 66 year-old man is eating in a restaurant and

suddenly he appears to be choking. The paramedic
approaches the man who is trying to cough.
o A. Give five backslaps
o B. Perform abdominal thrust
o C. Provide water for drinking
o D. Observe and encourage coughing

year-old man who was under arrest by the law. The
law enforcement personnel directed the paramedic to
treat the patient. The patient refused to be treated.
o A. Treat the patient as implied consent
o B. Leave the patient without treatment
o C. Treat the patient as involuntary consent
o D. Explain the risks to the patient, document it
and ask the patient to sign

year-old female who fell down from the ladder. She
has an open mid-shaft right femur fracture with
significant bleeding. She is conscious and alert.
Which of the following managements is
contraindicated in this case?
o A. Board splint
o B. Traction splint
o C. Long back board
o D. Controlling the bleeding
216. A paramedic team respond to a disaster scene.

During triage, the paramedic finds a patient walking
with a minor laceration on the forehead.
Which of the following is the most appropriate patient
status?
o A. Minor
o B. Delayed
o C. Deceased
o D. Immediate
217. A paramedic is evaluating a new-born

immediately after delivery. On examination, the baby
looks pink, crying and in a flexed position. Back
examination shows a small opening at the lumber
spine with a cyst-like structure.
o A. Lipoma
o B. Spina bifida
o C. Omphalocele
o D. Necrotizing fasciitis
year-old man with a chest wound and signs and
symptoms of shock.
In what position should the patient be placed?
o A. Supine
o B. Recovery
o C. Trendelenburg
o D. Supine with legs elevated
219. Which of the following is released by the nervous

system to enhance glycogenolysis in response to
decrease the level of glucose?
o A. Insulin
o B. Glucose
o C. Atropine
o D. Epinephrine
220. A 34 year-old male is involved in a motor vehicle

accident. He sustains injuries to his head, chest and
pelvis. The paramedic starts assessing the patient
with the initial assessment.
What is the purpose of the initial assessment?
o A. Package and transport faster
o B. Help identify the chief complain
o C. Ascertain the history of present injuries
o D. Recognize and treat life threatening injuries

man who is unresponsive. On arrival, the paramedics
could feel carotid pulse, but the respiratory rate is
less than 5 per minute.
What should the paramedics do in this stage?
o A. Transport the patient
o B. Continue assessing the patient
o C. Give oxygen by non-rebreather mask
o D. Start bagging the patient at rate 10-12 breath
per minute
222. A 61 year-old man, known to have a brain
tumor, suddenly collapses in his house. On
examination, he is confused with irregular
respiration. On auscultation, heart and lungs sounds
are normal.

Heart rate 56 /min
Which of the following triads explain this

presentation?
o A. Beck's triad
o B. Saint's triad
o C. Charcot's triad
o D. Cushing's triad

woman who is unresponsive. On examination, there is
abnormal upper airway sounds. The paramedics
decide to intubate the patient.
After intubating the patient, where should the
paramedic auscultate to check for correct tube
placement?
o A. Epigastric
o B. Upper lungs
o C. Epigastrium and upper left and right lungs
o D. Epigastrium and upper and lower left and right
lungs
224. Which of the following is the second layer that

encloses the brain?
o A. Cranium
o B. Pia mater
o C. Arachnoid
o D. Dura mater
225. What is the main use of a stair chair?

o A. Spinal immobilization
o B. Moving the patient between two floors
o C. Moving the patient through narrow areas
o D. Upper and lower extremities immobilization
226. A six year-old boy presented with anaphylaxis.

On examination, the boy has an upper airway
swelling and a very low respiratory rate. The
paramedic team decided to intubate the patient using
an un-cuffed endotracheal tube which was the only
option they had.
Which of the following would be the proper tube size?
o A. 4.0 mm
o B. 4.5 mm
o C. 5.0 mm
o D. 5.5 mm

woman who is unresponsive. On arrival, the patient is
lying down without any movement. On examination,
the respiratory rate is less than 5 breaths per minutes,
and the pupils are very constricted.
According to the mother, she had a big fight with her
father. There is an empty syringe and vial of
morphine beside the patient. The paramedics start
bagging the patient with high flow oxygen.
What is the next best management for this patient?
o A. Give IV fluid
o B. Check the ECG
o C. Intubate the patient
o D. Administer naloxone
228. Which of the following colours is used to tag a

patient who needs delayed care in a disaster?
o A. Red
o B. Blue
o C. Black
o D. Yellow
229. Which of the following organs is found in the

right lower quadrant of a normal average adult
patient?
o A. Liver
o B. Spleen
o C. Appendix
o D. Gallbladder
230. A five year-old boy was found at his home in a

tripod position. On examination, the boy had
tachypnea and had wheezing sounds.
o A. Lung tissue disease
o B. Upper airway obstruction
o C. Lower airway obstruction
o D. Disordered control of breathing
231. Which the following patients can be treated by

paramedics without taking consent?
o A. Child patient
o B. Drunken patient
o C. Chest pain patient
o D. Foot fracture patient
232. What consideration should the paramedic keep
in mind when caring for a child with suspected
epiglottitis?
o A. Corticosteroids
o B. Epinephrine 1:1000
o C. Endotracheal intubation
o D. Not attempt to visualize the airway nor starting
an IV line
233. Which of the following is an acceptable O2

saturation for a healthy new-born in the first minute
after delivery?
o A. 10%
o B. 20%
o C. 30%
o D. 60%
234. A 68 year-old female complains of chest pain,
dizziness and shortness of breath. On the spot, ECG
revealed anterior wall myocardial infarction. The
patient was immediately moved to the hospital via
ambulance. A receiving hospital was notified of the
condition and estimated the time of arrival. The
receiving physician ordered sublingual nitroglycerin
0.4 mg over the radio.
action?
o A. Give medicine at the hospital
o B. Give 0.4 mg nitroglycerin immediately
o C. Follow writing orders to avoid errors
o D. Repeat what was heard to confirm medicine
and dose

year-old male who has a history of diabetes.
Assessment revealed that the patient's breathing is
shallow. The patient's wife informed them that the he
just took his diabetes medication.
Heart rate 150 /min
Why is the respiratory rate increased?

o A. Due to smoking
o B. Due to dehydration
o C. Due to hospital fear
o D. To compensate acidosis
236. A 19 year-old female was shot twice in her

abdomen following a domestic violence incidence. On
the scene, the police requested medical care for the
patient. On arrival, the paramedics found the patient
lying supine without any movement. On examination,
the patient was bleeding heavily from the abdomen
wounds and was responding to the painful stimuli
only.
action?
o A. Preserve the point of wound when cutting
o B. Cut through clothes to control the bleeding
o C. Remove patient's clothes instead of cutting
o D. Ask police to control the bleeding in crime
Scene
237. What is the "battle's sign"?

o A. Leakage of blood or fluids from the nose
o B. Bruising of the mastoid area behind the ear
o C. One eye positioned downward and outward
o D. Bruising of the soft tissues around one or both
eyes
238. Which of the following conditions will present if

the patient's skin colour is pallor (white)?
o A. Anemia
o B. Liver disease
o C. Urinary tract infection
239. Which of the following can decrease the internal

bleeding in a traumatic patient?
o A. Movement
o B. Intravenous fluids
o C. Warm body temperature
o D. Warfarin and other anticoagulant drugs
240. A seven year-old child was being examined. The

paramedics flexed his neck and in response the child
flexed his arm, hip and knee reflexively.
Which of the following signs has been tested?
o A. Adsons sign
o B. Kernigs sign
o C. Brudzinskis sign
o D. Trendelenburg's sign

year-old man who was in his turned-on car in a closed
garage. He was experiencing dyspnea, dizziness,
fatigue and nausea.
What is the most likely condition?
o A. Asthma
o B. Heart attack
o C. Food poisoning

year-old male who is complaining of shortness of
breath in plastics industry factory. On scene, the
patient was anxious and confused. On assessment, the
patient had shortness of breath, hypotension and
dysrhythmia. The patient had burning sensation of
the mouth and throat. The paramedic has ensured
controlled airway and provided breathing and
circulatory support.
What is the next immediate intervention?
o A. Give naloxone
o B. Give amyl nitrite
o C. Give fluid overload
o D. Give albuterol nebulizer
243. A 72 year-old male presented with second degree
burns involving his entire face, anterior torso and
complete right arm.
Weight 72 kg
Based on the Parkland formula, how much fluid
should this patient receive in the first eight hours?
o A. 3212 ml
o B. 4536 ml
o C. 9236 ml
o D. 9780 ml
244. Which of the following is an initial treatment for

frostbite injuries?
o A. Fasciotomy
o B. Protect the injured area from trauma
o C. Perform active range of motion exercise
o D. Perform passive range of motion exercise
245. A 71 year-old man with a known history of

seizure is having repetitive jerking movement of the
right hand and leg. He is conscious, oriented and
talking back to the paramedic.
What is the most likely type of seizure?
o A. Absence seizure
o B. Simple partial seizure
o C. Complex partial seizure
o D. Generalized tonic clonic seizure
246. A 66 year-old man with a history of congestive

heart failure complains of shortness of breath. On
examination, he is breathing normally. His skin looks
normal with no signs of cyanosis. There is lower limb
edema and course crackles on chest auscultation,

Heart rate 110 /min

o A. Non-rebreather mask
o C. Bag valve mask ventilation
o D. Continues positive airway pressure ventilation
247. What is the updated sequence for CPR?

o A. Airway, breathing, compressions
o B. Airway, compressions, breathing
o C. Breathing, compressions, airway
o D. Compressions, airway, breathing

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1.

What is the major concern after administering

2. The Emergency Medical Services team dispatched

Which of the following is the most appropriate way to

3. The Emergency Medical Services team was called

Which of the following is the first priority?

4. Which of the following conditions is most likely to

5. Which of the following conditions is most likely to

6. A 60-year-old diabetic woman presents with

Blood pressure 121/72 mmHg

Test Result Normal Value

What is the most likely diagnosis?

7. A 65-year-old man with a neuro-muscular disease

Test Result Normal Values

Which of the following is the primary acid-base

8. According to the Cincinnati prehospital stroke

9. A 65-year-old woman, known to have

Blood pressure 88/49 mmHg

Which of the following is the most likely diagnosis?

10. A 65-year-old known asthmatic is complaining of

Blood pressure 81/53mmHg

Which of the following is the most appropriate course

11. A paramedic team was called for a 55-year-old

Which of the following is the most likely diagnosis?

12. A 70-year-old man complains of sudden shortness

Blood pressure 122/88 mmHg

Which of the following is the most appropriate initial

13. A paramedic is responding to a 69-year-old

What is the most appropriate course of action?

14. A paramedic responds to a 69-year-old diabetic

Blood pressure 101/69 mmHg

Test Result Normal Value

Which of the following is the most appropriate course

15. A paramedic responds to a 65-year-old woman

Which of the following is the next most appropriate

17. Which of the following suffixes represents blood?

18. Which of the following does the dispatcher need to

19. Which of the following is most likely mistaken for a

20. The paramedic is called to a 32-year-old pregnant

21. A 38-year-old man found to be unconscious in a

Blood pressure 110/70 mmHg

Which of the following is most likely the initial

23. Which of the following is the most appropriate size

25. Which of the following valves is present between

26. Image (s)

27. Which of the following cardiac valves is present

28. What is the most important factor in determining

29. Which of the following terms describes the

30. In a 12-lead ECG, which of the following leads

o A. Left Bundle Branch Block

35. A paramedic team is dispatched to a 48-year-old

37. What is the initial dose of aspirin to be given to a

39. Which of the following types of consent to

40. Which of the following is the most important

41. A 46-year-old patient is calling the ambulance to

42. What is a deviation from an accepted standard of

44. What is the most important resource of

45. Which of the following a cause of medication

46. A 68-year-old with end-stage cancer. The patient

47. A 62-year-old man mentally competent with a

48. What is the fundamental ethical question when

49. A clean and organized uniform represents what

50. A 40-year-old man is complaining of severe

51. A consent to treat a pediatric patient should be