EMT Practice Test

1. Question Content...

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Question1: Your patient, a 25-year-old G1P0 female at 26 weeks gestation presents due to an abnormal glucose tolerance test. One week prior, she was given 50 g of oral glucose and demonstrate a venous plasma glucose level of 156 mg/dL one hour later.
Which of the following is the most appropriate next step of management?

Question2: JK is a 67 years old African American man who presents to your clinic for his blood pressure management. His past medical history includes Peptic ulcer disease and hypertension. His two BP readings are 160/98, 159/96 and HR 85. He says he has been adherent to his medication and lifestyle. He currently takes 12.5mg Chlorthalidone and Prilosec 20mg daily.
Which of the following is the best strategy to manage his blood pressure?

Question3: JT is a 58-year-old women who is on vancomycin empirically for pyomyositis confirmed by MRI. Surgical debridement has successfully removed infected tissue and pus. C&S of the infected tissue comes back MSSA sensitive to everything on the panel. JT is allergic to PCN (rash), she has had cephalosporin for her UTI in the past with no problem.
What would be the most appropriate antibiotics to switch to while JT is still in the hospital?

Question4: MT is 47-year-old man who presents to the ER with painful, red, swollen area on his left leg. His temperature is 38.4, respiratory rate 30 and heart rate 95. He has been taking cephalexin day 4 today, as prescribed by his primary care physician. His CMP is normal a CBC shows elevated WBC of 16,000/mm3.
What would be the most appropriate antibiotic/s to initiate on MT empirically?

Question5: If LN receives Dextrose 5% half Normal Saline with 20 meq of Potassium as IVF at 125mls/hour. How much dextrose is he getting in 24hrs?

Question6: An order is received for 0.03 units /min of vasopressin for Sepsis to maintain MAP >65. The standard mixed in your hospital for vasopressin is 40 units in 100ml NS.
What is the rate in mLs/hr should the vasopressin be infused at?

Question7: If a patient is getting NS IVF at 120mls/hr, how much Sodium Chloride in grams is this patient getting in 24 hours? NS is 0.9% sodium chloride.

Question8: Which of the following is/are a risk factor for myopathy with statin therapy?

Question9: A physician orders 300gms of albumin post paracentesis, how many milliliters of 25% albumin do you need to give 300gms?

Question10: A 22-year-old woman adopted a cat. Shortly thereafter, she developed itchy eyes and persistent rhinorrhea.
She was clearly allergic to the pet, but desperately wanted to keep it. She tried taking diphenhydramine, but it had intolerable side effects.
Which of the following is a common effect of this type of medication?

Question11: According to the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to ReduceAtherosclerotic Cardiovascular Risk in Adults, which of the following LDL cholesterol thresholds is an indication for high- intensity statin therapy?

Question12: Which of the following is/are ordinal data?

Question13: Which of the following are complication associated with long term use of proton pump inhibitors?

Question14: After talking to the physician you find out her labs. Her labs reveled albumin level of 2.1gm/dL, calcium of
7.8mg/dL, glucose 120mg/dL , sodium 138 mmol/L, phenytoin level of 17.8.
Based on the given data which of the following best interprets phenytoin concentration?

Question15: A 23-year-old female presents to your clinic complaining of intermittent throbbing headaches that usually last for several hours and are made worse by the presence of light. She endorses occasional nausea without vomiting during the most severe episodes. Physical examination is unrevealing, and she has no significant past medical history.
Which of the following treatments is considered an abortive therapy for this patient's underlying condition?

Question16: Which of the following should be monitored when a patient is on SGLT2 inhibitor?

Question17: LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram
20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS with
20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1mg. lock-out every
6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/dl, K
5.0mmol/L, Na 135mmol/L.
What is the reason for holding metformin in patients with reduced renal function?

Question18: Which of the following medication may increase LDL?

Question19: When does the newer chronic kidney disease (CKD) guidelines recommend stopping metformin?

Question20: If a patient is getting NS IVF at 120mls/hr, how much Sodium Chloride in grams is this patient getting in 24 hours? NS is 0.9% sodium chloride.

Question21: What is the mEq/ml (Milliequivalents) of 50% Magnesium Sulfate? (Molecular weight of MgSO4 is
120.4g/mol.)

Question22: Which of the following antidiabetic medication may cause cyanocobalamin deficiency?

Question23: A 7-year-old boy has been suffering from influenza and had been given a drug by his father to decrease his high fever. A few hours later, his father brought him to the emergency room in a comatose state with a papulovesicular rash all over the body, moderate hepatomegaly, and asterixis. Laboratory studies reveal elevated levels of blood ammonia, AST, ALT, and PT. CT scan findings are suggestive for generalized cerebral edema.
The drug the father gave his son is most likely which of the following drugs?

Question24: Which of the following medication should be avoided if a patient is on lithium to avoid lithium toxicity?

Question25: A 54-year-old male with a long history of mild persistent asthma on daily fluticasone therapy has been using his albuterol inhaler every day for the past month, and presents requesting a refill. What changes should be made to his current regimen?

Question26: What vitamin should the a patient receive to avoid Wernicke- Korsakoff syndrome?

Question27: A Physician orders Dobutamine HCl IV infusion at 5 mcg/kg/min. Dobutamine HCl is available as 500 mg in
250 mL of D5W. The patient weighs 68 kg. Calculate the infusion rate in mL/hr.

Question28: Which of these cardiovascular drug classes is most associated with tachyphylaxis?

Question29: RL is a 54 YOM who's calculated 10-year atherosclerotic cardiovascular disease (ASCVD) risk is 18 %.
Which of the following is the most appropriate pharmacotherapy recommendation for CR?

Question30: Injectable Sulfamethoxazole/Trimethoprim comes as 400mg/80mg/5ml. Physician requests you to dose a Sulfamethoxazole/Trimethoprim intravenously for PCP. You know the dose is 15mg/kg/day (based on TMP component) divided q6h.
How many milliliters of Sulfamethoxazole/Trimethoprim of 400mg/80mg/5ml would you need for single dose? Patient weighs 80kg.

Question31: Which H2-receptor blocker may cause gynecomastia in men due to its antiandrogenic effects?

Question32: Which of the following medication should be avoided if a patient is on lithium to avoid lithium toxicity?

Question33: Octreotide 50mcg/hr is ordered for a patient with esophageal varices, nurses prepared by mixing 1ml of concentration 0.5mg/ml of octreotide in 50mls NS. What rate should the bag be infused?

Question34: FT is a 23-year-old newly diagnosed type I diabetes admitted to the hospital due to diabetes ketoacidosis. 2 days after being on insulin drip, anion gap is closed. Physician would like your help in transitioning her to subcutaneous insulin. She suggests using insulin glargine once a day and Insulin lispro three time a day at ratio of 70:30. 70 % of long and 30 % of short acting insulin. FT received average of 70 units of insulin in
24hrs.
Which of the following would be the best insulin regimen?

Question35: Which of these is an example of postrenal acute kidney injury (AKI)?

Question36: Which of the following NSAIDs is an Enolic acid derivative?

Question37: LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA. His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain.
Post-op day 1, LN's medication includes Dexamethasone 8 mg iv q6h with taper dosing, Ondansetron 4 mg iv q6h prn for N/V, Levothyroxine 0.075 mg po daily, Lisinopril 10 mg po daily, Citalopram 20 mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10 mg suppository daily prn for constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10 mg iv q6h, Metformin 500 mg po bid, D51/2NS with 20 K at
125 mls/hour and Hydromorphone PCA at 0.2 mg/hour of basal rate, demand dose 0.1 mg. lock-out every 6 min, one hour limit 2.2 mg/hour. Pertinent morning labs includes serum creatinine 1.4 mg/dl, Mg 1.5 mg/dl, K
5.0 mmol/L, Na 135 mmol/L.
Which of the following medication may increase LN's Blood glucose?

Question38: LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4 mg iv q6h prn for N/V, Levothyroxine 0.075 mg po daily, Lisinopril 10 mg po daily, Citalopram 20 mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10 mg iv q6h, Metformin 500 mg po bid, D51/2NS with 20K at 125 mls/hour and Hydromorphone PCA at 0.2 mg/hour of basal rate, demand dose 0.1 mg. lock- out every 6min, one hour limit 2.2 mg/hour. Pertinent morning labs includes serum creatinine 1.4 mg/dl, Mg 1.5 mg/dl, K 5.0 mmol/L, Na 135 mmol/L.
Which of the following medication may increase LN's potassium?

Question39: A 54-year-old male with a long history of mild persistent asthma on daily fluticasone therapy has been using his albuterol inhaler every day for the past month, and presents requesting a refill. What changes should be made to his current regimen?

Question40: Which of the following illnesses is an example of a type III hypersensitivity reaction?

Question41: LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain.
Post-op day 1, LN's medication includes Dexamethasone 8 mg iv q6h with taper dosing, Ondansetron 4 mg iv q6h prn for N/V, Levothyroxine 0.075 mg po daily, Lisinopril 10 mg po daily, Citalopram 20 mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10 mg suppository daily prn for constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10 mg iv q6h, Metformin 500 mg po bid, D51/2NS with 20 K at
125 mls/hour and Hydromorphone PCA at 0.2 mg/hour of basal rate, demand dose 0.1 mg. lock-out every 6 min, one hour limit 2.2 mg/hour. Pertinent morning labs includes serum creatinine 1.4 mg/dl, Mg 1.5 mg/dl, K
5.0 mmol/L, Na 135 mmol/L.
Which of the following medication may cause tardive dyskinesia when given at a higher dose and for a long duration?

Question42: Your patient is a 43-year-old male who is experiencing post-operative voiding difficulty after an elective inguinal hernia repair. His post void residual volume was 280 cc.
Which of the following medications is the most appropriate choice of therapy for this patient?

Question43: Which of the following is dichotomous variable?

Question44: What is the Osmolarity of NS with KCL 40 meq/L? (MW of KCl: 74.55 g/mol) (MW of NaCl: 58.44 g/mol)

Question45: In Normal distribution, what percentage of the sample is found within 2 standard deviation of the mean?

Question46: A patient takes 1gm of Calcium Carbonate salt three times a day. How much elemental calcium, in grams, is he getting in 24hrs? (MW of Ca: 40.078 g/mol, MW of CaCO3: 100.087 g/mol)

Question47: A 67-year-old female presents to your clinic complaining of fatigue, diarrhea, headaches and a loss of appetite.
Upon examination you find that she is having some cognitive difficulty. Laboratory results reveal: MCV: 109fL; Hgb: 9g/dL; MMA and homocystine are both elevated. Shilling test is positive.
What is the next best step in the management of this patient?

Question48: LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram
20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1mg. lock-out every 6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/ dl, K 5.0mmol/L, Na 135mmol/L. The bioavailability of levothyroxine is roughly 50%.
The physician requests you for a dose recommendation to convert her home dose of 75mcg po daily to intravenous.
What would be the appropriate intravenous dose?

Question49: All of the following may increase triglycerides except:

Question50: What is the active ingredient of the medicine Lyrica?

Question51: Which of the following antidiabetic medication works by decreasing glucose reabsorption?

Question52: JM is a 32-year-old women who comes to your diabetic clinic with complain of several episodes of hypoglycemia. She is on Insulin NPH/regular 70/30, 22 units twice a day with breakfast and dinner. 8 units with lunch.
After discussing with physician you decide to decrease the total daily insulin by 10% and change to insulin glargine once a day and Insulin Lispro three time a day at ratio of 50:50 - 50 % of long and 50 % of short acting insulin.
What is her new insulin regimen? Round down to the nearest 1 unit.

Question53: LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4 mg iv q6h prn for N/V, Levothyroxine 0.075 mg po daily, Lisinopril 10 mg po daily, Citalopram
20 mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10 mg suppository daily prn for constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500 mg po bid, D51/2NS with 20K at 125 mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1 mg. lock-out every 6min, one hour limit 2.2 mg/hour. Pertinent morning labs includes serum creatinine 1.4 mg/dl, Mg 1.5 mg/dl, K 5.0 mmol/L, Na 135 mmol/L.
Which of the following medication/s should LN be on to prevent the most common side effect of hydromorphone?

Question54: LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA. His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain.
Post-op day 1, LN's medication includes Dexamethasone 8 mg iv q6h with taper dosing, Ondansetron 4 mg iv q6h prn for N/V, Levothyroxine 0.075 mg po daily, Lisinopril 10 mg po daily, Citalopram 20 mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10 mg suppository daily prn for constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10 mg iv q6h, Metformin 500 mg po bid, D51/2NS with 20 K at
125 mls/hour and Hydromorphone PCA at 0.2 mg/hour of basal rate, demand dose 0.1 mg. lock-out every 6 min, one hour limit 2.2 mg/hour. Pertinent morning labs includes serum creatinine 1.4 mg/dl, Mg 1.5 mg/dl, K
5.0 mmol/L, Na 135 mmol/L.
Which of the following medication may cause tardive dyskinesia when given at a higher dose and for a long duration?

Question55: Which of the following are non-pharmacological measure that may control symptoms of gastroesophageal reflux disease?

Question56: Which of the following medication can lower seizures threshold?

Question57: What is the Osmolarity in mOsm/L of 40mEq of KCl in 100ml sterile water? (Molecular weight of KCl is 74.5gm/ mol.)?

Question58: LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram
20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20 mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS with
20K at 125 mls/hour and Hydromorphone PCA at 0.2 mg/hour of basal rate, demand dose 0.1mg. lock-out every 6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/ dl, K 5.0mmol/L, Na 135mmol/L. Day 3 post-operation LN's pain was much better and only used 3 mg of hydromorphone in the 24hrs.
Physician wants to change to oral morphine. What would be your best recommendation?

Question59: LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.
His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram
20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS with
20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1mg. lock-out every
6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/dl, K
5.0mmol/L, Na 135mmol/L.
What is LN's creatinine clearance using Cockcroft and Gault equation based on IBW?

Question60: Which of the following medication should be avoided in patients with heart failure?

Question61: How many millimoles of sodium are in 0.9% sodium chloride?

Question62: Which of the following represents the major route of metabolism for acetaminophen?

Question63: A physician needs your help to calculate the protamine dose on a patient who started hemorrhaging while on heparin. Patient has been receiving heparin at a dose of 13mls/hr for 2 hrs when the physician decides to use protamine to reverse the heparin. Heparin bag says concentration of 50 units/ml. The half-life of heparin is 60 minutes. 1 mg of protamine reverses 100 units of heparin.
How much protamine should be given to this patient?

Question64: Which of the following antidiabetic medication works by inhibiting carbohydrate breakdown?

Question65: The administration of dapsone gel for the topical treatment of acne vulgaris in patients with G6PD deficiency may produce which of these?

Question66: Proportion of people in a population who have a particular disease at a specified point in time or over a specified period of time is definition as which of the following?

Question67: You need 51.3 mEq of NaCl to make 1/3 NS 1 liter bag. How many ml of 23.4% NaCl would you need?
(Molecular weight of Na is 23 and Cl is 35.5)

Question68: Which of the following side effects should LT be made aware of while on Divalproex Sodium?

Question69: Which of the following would be most appropriate to treat infections associated with stenotrophomonas maltophilia?

Question70: In the US Nurses' Health Study (NHS) cohort study, where they looked at association of regular aspirin use (two 325 mg tablets/week) and colorectal cancer in 82,911 women found (RR, 0.77; 95% CI, 0.67-0.88) over
20 years of follow-up.
In an another analysis of the NHS, regular aspirin use, investigator also found (hazard ratio [HR]=0.72, 95% CI 0.56-0.92), what does this say about the mortality from colorectal cancer? How can this data best be interpreted?