Free SCFHS Paramedic Specialist mock test

Paramedic Specialist sample questions with answers

10 more original exam-style Paramedic Specialist questions, worked in full. They are not real or recalled exam questions, and none of them is in the diagnostic above, so sit that first if you have not.

1. Question 1 · Fundamentals and Operations

   A patient reports coughing up blood from the lungs. Which medical term describes this?

   1. AHaemoptysis
   2. BHaematemesis
   3. CHaematuria
   4. DMelaena
   Show answer and explanation

   Correct answer: A. Haemoptysis

   Haemoptysis means expectoration of blood originating from the respiratory tract. Haematemesis is vomiting of blood, haematuria is blood in the urine and melaena is black tarry stool from digested upper gastrointestinal bleeding.

   Reference: Emergency Care in the Streets, 9th ed. (Nancy Caroline, Jones & Bartlett Learning, 2023), Medical terminology

2. Question 2 · Disaster

   Casualties from a nerve agent attack have each received an auto-injector from the crew. What does the standard kit contain?

   1. AAtropine and pralidoxime chloride
   2. BNaloxone and flumazenil
   3. CHydroxocobalamin and sodium thiosulfate
   4. DCalcium gluconate and glucagon
   Show answer and explanation

   Correct answer: A. Atropine and pralidoxime chloride

   Nerve agents inhibit acetylcholinesterase, so atropine antagonises muscarinic effects while pralidoxime reactivates the enzyme at the junction. The other pairings are antidotes for opioids and benzodiazepines, cyanide, and calcium channel blocker or beta-blocker toxicity.

   Reference: Emergency Care in the Streets, 9th ed. (Nancy Caroline, Jones & Bartlett Learning, 2023), Chemical, biological and nuclear incidents

3. Question 3 · Trauma

   A worker has an alkali splash to both eyes. What is the correct initial management?

   1. ACover both eyes firmly with dry gauze pads and transport
   2. BApply a neutralising acid solution drop by drop
   3. CWait for a physician to attend and examine the eyes before any irrigation is started at the scene
   4. DIrrigate continuously with water or saline for at least 20 to 30 minutes during transport
   Show answer and explanation

   Correct answer: D. Irrigate continuously with water or saline for at least 20 to 30 minutes during transport

   Alkali burns penetrate deeply and continue to damage tissue, so immediate, prolonged irrigation is the most important treatment and must not be delayed. Neutralising agents produce heat and further injury, and dry dressings leave the chemical in contact with the cornea.

   Reference: PHTLS: Prehospital Trauma Life Support, 10th ed. (NAEMT, 2023), Facial and eye trauma

4. Question 4 · Shock and Resuscitation

   A 10 kg infant is in hypovolaemic shock after severe diarrhoea. What is the appropriate first fluid bolus?

   1. A200 mL of isotonic crystalloid, which is 20 mL/kg
   2. B100 mL of isotonic crystalloid, which is 10 mL/kg
   3. C500 mL of isotonic crystalloid, which is 50 mL/kg
   4. D1,000 mL of isotonic crystalloid, which is 100 mL/kg
   Show answer and explanation

   Correct answer: A. 200 mL of isotonic crystalloid, which is 20 mL/kg

   The first bolus in paediatric shock is 20 mL/kg of isotonic crystalloid given quickly, then the child is reassessed for perfusion and signs of overload before repeating. Giving 50 mL/kg or more at once would risk pulmonary oedema.

   Reference: AHA PALS Provider Manual (2020), Shock management

5. Question 5 · Environmental and Toxicology

   A person rescued from a house fire has a headache and nausea, and the pulse oximeter reads 99%. What is the most likely diagnosis and treatment?

   1. ACyanide poisoning, treated with nitroglycerin and room air
   2. BCarbon monoxide poisoning, treated with 100% oxygen by non-rebreather mask
   3. CAnxiety, treated with reassurance and no further oxygen
   4. DThermal bronchospasm, treated with salbutamol alone and without oxygen therapy
   Show answer and explanation

   Correct answer: B. Carbon monoxide poisoning, treated with 100% oxygen by non-rebreather mask

   Standard pulse oximeters cannot tell carboxyhaemoglobin from oxyhaemoglobin, so a normal reading is falsely reassuring in smoke exposure. High-concentration oxygen shortens the half-life of carbon monoxide and should be given to all suspected cases.

   Reference: Emergency Care in the Streets, 9th ed. (Nancy Caroline, Jones & Bartlett Learning, 2023), Toxicology

6. Question 6 · Medical Emergency

   During an asthma attack, the chest becomes silent on auscultation in an exhausted patient. What does this indicate?

   1. AImprovement as the airways have started to open
   2. BA mucus plug in one airway only, with no risk of respiratory failure
   3. CResolution of the attack requiring no further treatment
   4. DSeverely reduced airflow, indicating imminent respiratory failure
   Show answer and explanation

   Correct answer: D. Severely reduced airflow, indicating imminent respiratory failure

   A silent chest in severe asthma is an ominous sign because airflow is too low to produce wheeze, and it often precedes respiratory arrest. Immediate bronchodilators, magnesium and preparation for assisted ventilation are required.

   Reference: Emergency Care in the Streets, 9th ed. (Nancy Caroline, Jones & Bartlett Learning, 2023), Respiratory emergencies

7. Question 7 · Cardiac Emergency

   A 12-lead ECG shows ST elevation in leads V1 to V4. Which coronary artery is most likely involved?

   1. AThe right coronary artery
   2. BThe left anterior descending artery
   3. CThe left circumflex artery
   4. DThe posterior descending coronary artery
   Show answer and explanation

   Correct answer: B. The left anterior descending artery

   ST elevation in the anterior precordial leads reflects injury to the septum and anterior wall of the left ventricle, supplied by the left anterior descending artery. Inferior changes point to the right coronary artery, and lateral changes to the circumflex.

   Reference: AHA ACLS Provider Manual (2020), Acute coronary syndromes

8. Question 8 · Patient Safety

   After a transfer, a paramedic realises that an incorrect dose of a medication was given. What is the correct first response?

   1. ASay nothing about the error, so as to avoid causing the patient or the family any unnecessary alarm
   2. BMonitor and treat the patient, inform the receiving clinician, and report via the incident system
   3. CAlter the record to match the intended dose before handover
   4. DWait to see whether symptoms appear before telling anyone
   Show answer and explanation

   Correct answer: B. Monitor and treat the patient, inform the receiving clinician, and report via the incident system

   Patient safety comes first, so the patient is monitored and treated and the receiving team is told so they can manage any effects. Open reporting through the incident system allows learning, whereas concealment or altering the record is dishonest and may lead to harm.

   Reference: WHO Patient Safety Curriculum Guide (2011)

9. Question 9 · Airway

   In which situation is a surgical cricothyroidotomy indicated?

   1. AAny patient with a difficult view of the vocal cords
   2. BA conscious patient with mild stridor who is anxious
   3. CFailed intubation with failed rescue ventilation, when the patient cannot be oxygenated
   4. DA patient who is maintaining a good saturation through a correctly placed supraglottic airway
   Show answer and explanation

   Correct answer: C. Failed intubation with failed rescue ventilation, when the patient cannot be oxygenated

   The failed-airway pathway ends in a front-of-neck access when the clinician cannot intubate and cannot oxygenate by mask or supraglottic device. A difficult view alone is managed with other adjuncts, and a patient who is oxygenating needs no surgical airway.

   Reference: Emergency Care in the Streets, 9th ed. (Nancy Caroline, Jones & Bartlett Learning, 2023), Advanced airway management

10. Question 10 · Pediatrics and Neonates

    An infant has a heart rate of 50 per minute, poor perfusion and is receiving effective oxygenation and ventilation. What is the next step?

    1. AGive atropine alone and observe
    2. BContinue observation and reassess in ten minutes
    3. CStart chest compressions
    4. DGive adenosine 0.1 mg/kg by rapid push
    Show answer and explanation

    Correct answer: C. Start chest compressions

    A heart rate below 60 with poor perfusion in an infant, despite effective ventilation, is treated as cardiac arrest and needs compressions. Bradycardia in children is usually caused by hypoxia, and adenosine is for tachycardia.

    Reference: AHA PALS Provider Manual (2020), Bradycardia with a pulse