Part of the Cardiology and Resuscitation practice questions exam area.
This page holds 200 free practice questions for Chapter 41, Management and Resuscitation of the Critical Patient, covering recognizing the critical patient and early warning scores, the pathophysiology of poor perfusion and lactate, hypovolemic, distributive, cardiogenic, and obstructive shock, fluid and blood resuscitation, vasopressors and push-dose epinephrine, the physiologically difficult airway, team leadership and closed-loop communication, and monitoring and destination decisions. They are written for paramedic and EMT students working through Nancy Caroline's Emergency Care in the Streets, 9th edition. Every question shows the correct answer with a short explanation as soon as you tap, so you learn while you test rather than waiting until the end.
Study it two ways: the 10 Question Blitz, a quick round where every right answer lights a siren and any misses lead into Lights & Sirens, a 5-in-a-row drill on that section, or the full 100-question test drawn at random from the whole chapter. After each test you get a score and a section-by-section breakdown. Progress on the full test is saved on your device, so you can stop and pick up later.
The main purpose of the 'sick or not sick' decision made in the first moments of patient contact is to:
Answer: C. Set the pace and urgency of the rest of the call
The early sick-versus-not-sick judgment tells you whether to move fast, call for help, and treat as you assess. It is a triage decision, not a diagnosis, and vital signs are still obtained on every patient.
A 70-year-old in cardiogenic shock has an SpO2 of 97%, a normal hemoglobin, and a very low cardiac output. The tissue hypoxia he has is best described as:
Answer: C. Stagnant hypoxia from low blood flow
Tissue hypoxia has four broad mechanisms. With a normal saturation and hemoglobin, the blood leaving the lungs carries plenty of oxygen, but a failing pump moves too little of it, so the problem is stagnant (circulatory) hypoxia, the basic mechanism of shock. Hypoxemic hypoxia means low arterial oxygen from a lung or ventilation problem, which an SpO2 of 97% argues against. Anemic hypoxia means too little hemoglobin to carry oxygen, but his hemoglobin is normal. Histotoxic hypoxia means cells cannot use delivered oxygen, as in cyanide poisoning.
A 78-year-old has a heart rate of 32 with a wide escape rhythm, a BP of 70/40 mmHg, cool skin, and clear lungs. The shock is best classified as:
Answer: A. Cardiogenic, from a rate too slow to perfuse
Cardiac output is heart rate times stroke volume, so a heart rate of 32 can produce pump failure even when the muscle and volume are normal; this is cardiogenic shock from a rate problem, treated with pacing or a chronotropic drug per protocol. Clear lungs do not exclude cardiogenic shock. Hypovolemia would cause a fast, not slow, rate. Distributive shock causes vasodilation with warm skin, and his skin is cool. Obstructive shock needs a mechanical block such as tamponade or tension pneumothorax, and nothing here suggests one.
Most students use the 10 Question Blitz for daily practice and take the full 100-question test in the days before a class exam or NREMT practice. Lights & Sirens after a blitz is the fastest way to close gaps the night before a test.
Every question in this chapter is also listed by section, with answers, on the topic pages above. See all paramedic topics or take the NREMT paramedic practice test.
Ch. 1 Ch. 2 Ch. 3 Ch. 4 Ch. 5 Ch. 6 Ch. 7 Ch. 8 Ch. 9 Ch. 10 Ch. 11 Ch. 12 Ch. 13 Ch. 14 Ch. 15 Ch. 16 Ch. 17 Ch. 18 Ch. 19 Ch. 20 Ch. 21 Ch. 22 Ch. 23 Ch. 24 Ch. 25 Ch. 26 Ch. 27 Ch. 28 Ch. 29 Ch. 30 Ch. 31 Ch. 32 Ch. 33 Ch. 34 Ch. 35 Ch. 36 Ch. 37 Ch. 38 Ch. 39 Ch. 40 Ch. 41 Ch. 42 Ch. 43 Ch. 44 Ch. 45 Ch. 46 Ch. 47 Ch. 48 Ch. 49 Ch. 50 Ch. 51 Ch. 52 Ch. 53
These practice questions were written for this site. They are not the publisher's test bank and are not affiliated with or endorsed by Jones & Bartlett Learning, the American Academy of Orthopaedic Surgeons, or the National Registry of Emergency Medical Technicians. Use them alongside your textbook and your instructor's objectives.