Paramedic Science Review Questions
Course Introduction
Paramedic Science is an interdisciplinary course that equips students with the theoretical knowledge, clinical skills, and practical experience necessary to become competent paramedics. Covering a broad range of topics, including human anatomy and physiology, pathophysiology, pharmacology, trauma and medical emergency management, and advanced life support, the course emphasizes evidence-based practice and patient-centered care. Through a combination of classroom learning, simulation exercises, and supervised placements in real-world healthcare settings, students develop critical thinking, decision-making, communication, and teamwork skills essential for responding to emergencies and providing high-quality pre-hospital care in diverse and dynamic environments.
Recommended Textbook
ECGs Made Easy 6th Edition by Barbara J Aehlert
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Page 2
Chapter 1: Anatomy and Physiology
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Sample Questions
Q1) Electrolyte very important in cardiac muscle contraction.
A)Acute coronary syndromes
B)Chronotropic
C)Tamponade
D)Chemoreceptors
E)Mediastinum
F)Myocardial ischemia
G)Venous return
H)Baroreceptors
I)Calcium
Answer: I
Q2) Briefly describe parasympathetic innervation of the heart.
Answer: Parasympathetic (inhibitory) nerve fibers supply the sinoatrial node, atrial muscle, and the atrioventricular junction of the heart by the vagus nerves.
Q3) List two factors that may affect the heart's efficiency as a pump. Answer: Abnormalities of cardiac muscle, the valves, or the conduction system.
Q4) The _____ are the heart chambers that pump blood. Answer: ventricles
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Chapter 2: Basic Electrophysiology
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Sample Questions
Q1) A line between waveforms is called a(n) _____.
Answer: segment
Q2) _____ is the ability of cardiac pacemaker cells to spontaneously initiate an electrical impulse without being stimulated from another source, such as a nerve.
A) Excitability
B) Conductivity
C) Automaticity
D) Contractility
Answer: C
Q3) Leads I, aVL, V?, and V? view the _____ surface of the left ventricle.
A) anterior
B) septal
C) inferior
D) lateral
Answer: D
Q4) Name the first positive deflection seen after the P wave on the ECG.
Answer: R wave
Q5) List four major electrolytes that influence cardiac function.
Answer: Sodium, potassium, calcium, and chloride.
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Chapter 3: Sinus Mechanisms
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Sample Questions
Q1) An ECG rhythm strip shows a ventricular rate of 46 beats/min, a regular rhythm, a PR interval of 0.14 second, a QRS duration of 0.06 second, and one upright P wave before each QRS. This rhythm is _____.
A) sinus rhythm
B) sinus bradycardia
C) sinus arrest
D) sinoatrial block
Answer: B
Q2) Which of the following are possible causes of sinus tachycardia?
A) Hypothermia, hypovolemia
B) Hypoxia, calcium channel blocker overdose
C) Fever, pain, anxiety
D) Vomiting, vagal maneuvers
Answer: C
Q3) Which of the following correctly reflects the ECG criteria for a sinus rhythm?
A) More P waves than QRS complexes
B) P waves that look alike and upright in lead II, one before each QRS complex
C) Irregular atrial and ventricular rhythm
D) PR interval exceeding 0.20 second
Answer: B
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Chapter 4: Atrial Rhythms
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Sample Questions
Q1) The ventricular rhythm in atrial fibrillation is usually "irregularly irregular."
A)True
B)False
Q2) How are frequent PACs usually managed?
A) Defibrillation
B) Synchronized cardioversion
C) Correcting the underlying cause
D) Administration of medications such as atropine or epinephrine
Q3) Atrial fibrillation is characterized by _____.
A) one P wave before each QRS and a regular ventricular rate of 60 to 100 beats/min
B) an erratic, wavy baseline and irregular ventricular rhythm
C) "saw-tooth"- or "picket-fence"-shaped waveforms preceding each QRS
D) P waves occurring before, during, or after the QRS complex; when seen, they are inverted
Q4) An accessory pathway that has one end attached to normal conductive tissue is called a(n) __________.
Q5) Delivery of an electrical current timed for delivery during the QRS complex is called
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Chapter 5: Junctional Rhythms
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Sample Questions
Q1) The pacemaker cells in the AV junction are located near the nonbranching portion of the bundle of His.
A)True
B)False
Q2) Common causes of junctional dysrhythmias may include acute coronary syndromes and _____.
A) hyperthyroidism
B) hypovolemia
C) digitalis toxicity
D) hypoxia
Q3) In a junctional rhythm viewed in lead II, where is the location of the P wave on the ECG if atrial and ventricular depolarization occur simultaneously?
A) Before the QRS complex
B) During the QRS complex
C) After the QRS complex
Q4) The AV junction consists of the AV node and the nonbranching portion of the bundle of His.
A)True B)False
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Chapter 6: Ventricular Rhythms
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Sample Questions
Q1) What is meant by the term pulseless electrical activity (PEA)?
A) A chaotic rhythm that is likely to degenerate into cardiac arrest
B) An organized rhythm on the cardiac monitor (other than VT), although a pulse is not present
C) A slow rhythm with a wide QRS complex
D) A flat line on the cardiac monitor
Q2) Transcutaneous pacing is the treatment of choice for pulseless ventricular tachycardia or ventricular fibrillation.
A)True
B)False
Q3) List four common causes of premature ventricular complexes.
Q4) Sustained monomorphic VT is often associated with underlying heart disease, particularly myocardial ischemia, and rarely occurs in patients without underlying structural heart disease.
A)True
B)False
Q5) What is the name given to polymorphic VT that occurs in the presence of a long QT interval?
Q6) List three potential sites of origin of ectopic beats.
Page 8
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Chapter 7: Atrioventricular Blocks
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Sample Questions
Q1) Most of the bundle branch tissue is supplied by the _____ coronary artery.
A) right
B) left
Q2) In second-degree AV block type I, the PR interval _____.
A) shortens
B) is absent
C) is inconstant
D) remains constant
Q3) In 2:1 AV block, _____.
A) the atrial rhythm (P-P interval) is regular
B) the ventricular rhythm (R-R interval) is irregular
C) the PR interval lengthens until a P wave appears with no QRS complex
D) there is no PR interval because the atria and ventricles beat independently of each other
Q4) Second-degree AV block type I is characterized by _____ intervals.
A) irregular P to P
B) regular R to R
C) regular P to P intervals and irregular R to R
D) irregular P to P intervals and irregular R to R
Q5) A _____ bundle branch block produces a RSR pattern in lead V<sub>1</sub>.
Page 9
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Chapter 8: Pacemaker Rhythms
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Sample Questions
Q1) Explain the benefits of a dual-chamber pacemaker.
Q2) A(n) __________ is a vertical line on the ECG that indicates the artificial pacemaker has discharged.
Q3) Describe what is meant by the term overdrive pacing.
Q4) Your patient has a VVI pacemaker. Briefly explain the meaning of each of these letters.
Q5) The first letter of the pacemaker identification code represents _____.
A) the chamber sensed
B) the chamber paced
C) the mode of response
D) programmable functions
Q6) Explain the difference between electrical capture and mechanical capture.
Q7) A demand pacemaker is also known as a _____ pacemaker.
Q8) The second letter of the pacemaker identification code represents _____.
A) programmable functions
B) the chamber sensed
C) the mode of response
D) the chamber paced
Q9) Your patient has a DDD pacemaker. Briefly explain the meaning of each of these letters. Page 10
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Chapter 9: Introduction to the 12-Lead Electrocardiogram
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Sample Questions
Q1) Normal electrical axis lies between _____ degrees.
A) -30 and +90
B) +90 and +180
C) -91 and -180
D) -1 and -90
Q2) The chest leads are the only unipolar leads in the standard 12-lead ECG.
A)True
B)False
Q3) Which leads look at adjoining tissue in the inferior region of the left ventricle?
A) I, aVL
B) V1, V2
C) V3, V4, V5
D) II, III, aVF
Q4) Lead I views the _____.
A) septum
B) inferior wall of the left ventricle
C) lateral wall of the left ventricle
D) anterior wall of the right ventricle
Q5) Explain the meaning of the letters in aVR, aVL, and aVF.
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Chapter 10: Posttest
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Sample Questions
Q1) A QRS measuring 0.10 to 0.12 second is called a(n) _____ right or left bundle branch block.
Q2) Your patient has a VVI pacemaker. Briefly explain the meaning of each of these letters.
Q3) A(n) __________ occurs as a result of an electrical impulse from a supraventricular site (such as the SA node) discharging at the same time as an ectopic site in the ventricles.
Q4) In an adult, the normal duration of the QRS complex is _____ seconds.
A) 0.12 to 0.20
B) 0.06 to 0.11
C) 0.04 to 0.14
D) 0.20 to 0.38
Q5) Explain the benefits of a dual-chamber pacemaker.
Q6) A beat originating from the AV junction that appears later than the next expected sinus beat is called a(n) _______________.
Q7) Explain the difference between a PVC and a ventricular escape beat.
Q8) If the AV junction paces the heart, the electrical impulse must travel in a backward direction to activate the atria. This is called _____ conduction.
Q9) What is a biphasic waveform?
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