10 free Paramedic practice questions: Ambulance Operations and Equipment Readiness

A rigid pharyngeal suction tip: the delivery end of the suction system. The tip makes no vacuum on its own, so it does nothing once the power is gone.

A large-bore suction catheter: another delivery part. The catheter only works with a powered or manual unit pulling vacuum behind it.

A spare collection canister and tubing: A spare canister and tubing replace the parts that collect and carry what you suction. Neither part makes suction if the powered unit fails.

Tighten the yoke screw with an adjustable wrench: Tightening the yoke screw with a wrench tries to force a seal the gasket is supposed to make. With a bad or missing gasket, extra tightening does not fix the seal. The yoke only needs to be hand-tightened once a good gasket is in place.

Apply a thin film of lubricant to the fitting: Lubricant at an oxygen fitting is a fire hazard. Oxygen supports combustion, and any petroleum product at a pressurized oxygen fitting can ignite. Lubricant does nothing to fix the leak either.

Wrap the connection with waterproof tape: Waterproof tape over the connection does not rebuild the seal at the valve outlet. The tape also adds another fire risk at a fitting carrying oxygen under high pressure.

Use the expired strips because they are stored in a sealed container: A sealed container helps protect strips that are still in date. Sealing does not change the expiration date. This container has also been open for two months.

Try the expired strips; if the result is abnormal, recheck per medical control guidance: Rechecking an abnormal result per medical control makes sense when the strips are good. These strips can give a normal number on a hypoglycemic patient. A normal number never sets off the recheck, so that patient gets missed. Trying the strips also keeps expired equipment in service.

Use the expired strips only for screening; if they show normal glucose, proceed without further assessment: Screening with a quick glucose check works when you can trust the strips. A normal reading from these strips can be wrong. Proceeding without further assessment means nobody checks that glucose again, and a low blood sugar gets missed.

Install the spare in the unit and charge the battery removed: Rotating batteries on a schedule is a real practice. Rotation moves current batteries into service, not expired ones. The installed battery is fully charged and has 8 months left. Swapping them takes a good battery out of the unit and puts the expired one in.

Record the date on the check sheet and repeat the self-test: Repeating the self-test makes sense when the self-test showed an error. This self-test already ran without an error. The self-test only checks the battery installed in the unit. The self-test cannot read the date printed on a spare in the carry case, so running it again gives you the same result.

Keep the spare and recheck its charge at the next shift check: Rechecking the charge would matter if the problem were a low charge. The spare is already fully charged, and the problem is the expired date. Holding a charge for another shift does not make an expired battery current.

Replace the battery, then repeat the vacuum test: A new battery is the fix when the unit is not getting enough power. This unit charged overnight, the indicator reads full, and the motor runs. A unit with a running motor is getting power. A weak battery does not explain a gauge that climbs to 180 mm Hg and stops.

Read the gauge again with the tubing unclamped: Unclamping would make sense if the clamp were holding the reading down. The test is written the other way. You test the unit with the tubing clamped, because an open line cannot build vacuum at all. Unclamping only gives you a lower reading.

Attach a rigid tonsil-tip catheter and retest: A rigid tonsil tip is the catheter you would actually use on a patient. Adding the tip narrows the path, so the reading drops even more. The test is already being run the standard way, with the unit running and the tubing clamped.

Place the storeroom splint on the unit and read its instructions en route: Reading the instructions is one way to learn a device. Instruction has to happen before the device goes on the ambulance. Reading directions on the way to the call that needs the splint is the exact situation the requirement is there to prevent.

Place the storeroom splint on the unit after the crew practices with it: Hands on practice covers the instruction condition. The medical director's approval is a separate condition. The question says the medical director has not approved that model, so the splint still cannot be carried.

Place the storeroom splint on the unit until the missing one is returned: A temporary substitute sounds acceptable until the real splint comes back. Nothing in the standard depends on how long the device stays on the unit. A splint the crew has not been instructed in and the medical director has not approved is not made acceptable by calling it temporary.

Place it in service, since the gauge reads full: A full gauge is the right check for how much oxygen is in a cylinder. Pressure does not tell you when the cylinder was last tested. A cylinder can read 2,000 psi and still be overdue for the test that shows it is safe to hold that pressure.

Crack the valve to confirm it holds pressure: Cracking the valve clears debris from the opening before you attach the regulator. Holding pressure for a few seconds on the station floor is not the test the collar stamp records.

Keep it as the backup and use the newer one: A backup cylinder still gets used. The backup is the one you reach for with a second patient or a long transport. Making an overdue cylinder the backup does not take it out of use.

Blood pressure and dressings at the head; suction unit and airways at the side: The head cabinet is the easiest one to reach from the attendant seat. Placement follows where you do each intervention, not which items seem most important. Bleeding control and blood pressures are done from the side of the patient. Putting the cuffs and dressings at the head moves the suction and airways away from the seat where you manage the airway.

Suction unit and dressings at the head; airways and blood pressure cuffs at the side: Splitting the suction unit from the airways breaks up the airway group. Airway equipment is packed together so you are not reaching into two cabinets for one intervention. With this setup, you would get suction from the head and airways from the side.

Airways and blood pressure at the head; suction unit and dressings at the side: Moving the suction unit to the side splits the airway group the same way option B does. Suction is the item you most often need without warning. You would be reaching away from the attendant seat to get suction.

Remove the cervical collar, since the head blocks now hold the head in position: The cervical collar does come off at some point. The hospital makes that decision after imaging or a formal clearance protocol, not the paramedic in the back of the ambulance. The collar and the head blocks do different jobs. The blocks and tape stop the head from turning and tipping side to side. The collar stops the head from nodding forward and back. Take the collar off and the patient can still nod inside the blocks.

Leave the straps loosely fastened so the patient can reposition if uncomfortable: Comfort is a real concern, because a rigid board is miserable to lie on. Loose straps let the patient move, and movement is what the whole setup is there to prevent. Loose straps also will not hold the patient if the ambulance stops hard or swerves. Fix comfort by padding the space behind the head, the small of the back, and the knees.

Begin transport without straps as long as the patient remains calm and cooperative: A calm patient still moves. The body jerks when the ambulance brakes or hits a pothole, and the head turns toward a sudden noise. Hypoxia, a head injury, pain, or a falling blood sugar can make the patient agitated at any point. The mechanism of injury is why the patient is on the board, and the mechanism has not changed because the patient is cooperative.

Transport to the closest hospital because minimizing transport time takes priority: Going to the closest hospital is the right call when that hospital can give the same care. The closest hospital here has no cath lab. Saving 10 minutes does not help if the patient still needs a transfer to get the artery opened.

Transport to the closest hospital and request a later transfer if needed: Going to the closest hospital and transferring later only makes sense when no cath center is within reasonable reach. A cath center 10 minutes farther away is within reach. Stopping first at a hospital without a cath lab and transferring later adds delay. This plan only adds a second transport and stretches out the door-to-balloon time.

Ask the patient which hospital they would prefer, and transport there instead: A stable patient's choice of hospital is honored when that hospital can treat the problem. A patient with a STEMI goes where the problem can be fixed. The hospital is chosen by what it can do, and this patient needs a cath lab.