Paramedics Exam Special Patient Populations 2 — Questions and Answers
Question 1: A 7-year-old is in respiratory distress with stridor and a barking cough after a recent URI. What is the most likely diagnosis?
- Epiglottitis
- Croup (laryngotracheobronchitis) (Correct answer)
- Foreign body aspiration
- Asthma exacerbation
Correct answer: Croup (laryngotracheobronchitis)
Croup causes a characteristic barking cough and stridor due to subglottic inflammation, typically following a viral URI.
Question 2: When assessing a neonate, which finding is MOST concerning and requires immediate intervention?
- Heart rate of 110 bpm
- Acrocyanosis of the hands and feet
- Central cyanosis with poor muscle tone (Correct answer)
- Respiratory rate of 40 breaths per minute
Correct answer: Central cyanosis with poor muscle tone
Central cyanosis with poor muscle tone in a neonate indicates inadequate oxygenation and requires immediate positive-pressure ventilation.
Question 3: A pregnant patient at 32 weeks gestation presents with painless, bright red vaginal bleeding. What condition should be suspected?
- Abruptio placentae
- Placenta previa (Correct answer)
- Ectopic pregnancy
- Uterine rupture
Correct answer: Placenta previa
Placenta previa causes painless bright red bleeding because the placenta overlies the cervical os and bleeds as the cervix changes.
Question 4: Which of the following best describes the Apgar score assessment timing?
- At 1 and 5 minutes after birth (Correct answer)
- At 2 and 10 minutes after birth
- At birth and 5 minutes after birth
- At 3 and 7 minutes after birth
Correct answer: At 1 and 5 minutes after birth
The Apgar score is assessed at 1 minute and 5 minutes after birth to evaluate the neonate's transition to extrauterine life.
Question 5: A bariatric patient (350 lbs) in cardiac arrest requires defibrillation. Which adjustment is most appropriate?
- Increase energy to maximum joules available
- Use standard energy settings; body weight does not affect defibrillation
- Place pads in anterior-posterior position if standard placement is ineffective (Correct answer)
- Double the standard energy dose for every 100 lbs over 200 lbs
Correct answer: Place pads in anterior-posterior position if standard placement is ineffective
Anterior-posterior pad placement can improve transthoracic current delivery in obese patients when standard placement yields poor contact.
Question 6: When transporting a patient who is deaf and uses sign language, what is the paramedic's FIRST priority?
- Contact medical control for a translator before proceeding
- Write all questions on paper and hand to the patient
- Use visual cues, written notes, or a family interpreter while maintaining rapport (Correct answer)
- Treat the patient without communication until hospital arrival
Correct answer: Use visual cues, written notes, or a family interpreter while maintaining rapport
Using available tools—written notes, visual cues, family interpreters—allows immediate communication while maintaining the therapeutic relationship.
Question 7: A 4-year-old with known seizure disorder has been seizing for 8 minutes. Parents give weight as 18 kg. What is the correct dose of rectal diazepam (0.5 mg/kg)?
- 4.5 mg
- 9 mg (Correct answer)
- 18 mg
- 36 mg
Correct answer: 9 mg
0.5 mg/kg × 18 kg = 9 mg rectal diazepam, which is within the pediatric dosing range for status epilepticus.
Paramedics Exam Special Patient Populations 2
A 7-year-old is in respiratory distress with stridor and a barking cough after a recent URI.
What is the most likely diagnosis?