NREMT FINAL EXAM QUESTIONS AND ANSWERS 2026 NEWEST UPDATE ACTUAL
EXAM WITH CORRECT SOLUTIONS.
Question 1
Which of the following is true regarding a patient who relies on the hypoxic drive to breathe?
A) The primary gas affecting the respiratory rate is Carbon Dioxide
B) The central chemoreceptors are the primary influence on the respiratory rate
C) The respiratory rate is set according to the level of Oxygen in the body
D) The peripheral chemoreceptors have become less sensitive to Oxygen levels
E) The patient requires high-flow oxygen regardless of their saturation levels
Correct Answer: C) The respiratory rate is set according to the level of Oxygen in the body
Rationale: In healthy individuals, the primary stimulus to breathe is an increase in Carbon
Dioxide (CO2) levels, sensed by central chemoreceptors. However, in patients with chronic
lung diseases like COPD, the body becomes accustomed to high CO2 levels, and the central
chemoreceptors become desensitized. As a result, the body shifts to the "hypoxic drive,"
where peripheral chemoreceptors in the aortic and carotid bodies trigger breathing based
on low levels of Oxygen (O2) rather than high levels of CO2.
Question 2
Beta-2 specific medications, such as Albuterol, benefit patients primarily by:
A) Eliminating acute myocardial chest pain
B) Diminishing the systemic need for supplemental Oxygen
C) Slowing the respiratory rate and decreasing the heart rate
D) Dilating the small airways within the lungs
E) Constricting peripheral blood vessels to increase blood pressure
Correct Answer: D) Dilating the small airways
Rationale: Beta-2 adrenergic receptors are located primarily in the smooth muscles of the
bronchioles. When these receptors are stimulated by "Beta-2" agonists, they cause
bronchodilation, which opens the small airways and makes it easier for patients with
conditions like asthma or COPD to breathe. Beta-1 receptors, by contrast, are located in
the heart and increase heart rate and contractility.
Question 3
On the scene of a Mass Casualty Incident (MCI), you notice another EMT has become
overwhelmed and is emotionally incapacitated. Which action is most appropriate?
A) Closely monitor the EMT for signs of improper patient care
B) Remove the EMT from the scene immediately
C) Instruct the EMT to go home and rest
D) Assess the EMT for a possible head injury or stroke
E) Assign the EMT to the triage officer for a more active role
, 2
Correct Answer: B) Remove EMT from scene
Rationale: In a high-stress environment like an MCI, an emotionally incapacitated provider
becomes a liability to themselves, their team, and the patients. The most appropriate
immediate action is to remove them from the stressful environment to a safe area. This
protects the integrity of the rescue operation and allows the provider to receive support
without interfering with patient care.
Question 4
What information is most critical for an EMT to provide to CHEMTREC after a hazardous
materials tanker spill?
A) The specific type of vehicle/car involved in the crash
B) The name of the railroad carrier or trucking company
C) The four-digit UN identification number
D) The precise location and train identification number
E) The weather conditions and wind direction at the site
Correct Answer: C) UN identification number
Rationale: The United Nations (UN) four-digit identification number is the international
standard for identifying hazardous materials. Providing this number to CHEMTREC
(Chemical Transportation Emergency Center) allows experts to immediately identify the
chemical involved and provide specific guidance on evacuation distances, firefighting
techniques, and medical treatment for exposure.
Question 5
Which of the following would be a direct physiological result of increasing a patient's preload?
A) Increased cardiac output
B) Decreased myocardial contraction force
C) Increased oxygen delivery specifically to the lungs
D) Decreased systemic blood pressure
E) Increased resistance within the peripheral arteries
Correct Answer: A) increased cardiac output
Rationale: Preload is the amount of blood returning to the heart (ventricular end-diastolic
volume). According to the Starling Law of the Heart, as preload increases, the muscle fibers
of the heart are stretched more, leading to a more forceful contraction. This increase in
stroke volume results in an overall increase in cardiac output (Cardiac Output = Stroke
Volume x Heart Rate).
Question 6
An unresponsive 54-year-old male went to bed with chest pain. He has no prior medical history.
Your primary assessment reveals no immediate life threats. When performing the secondary
assessment, you should:
, 3
A) Contact the patient's primary care doctor for a history
B) Focus the physical exam exclusively on the chest and heart
C) Determine whether chest pain still exists by applying painful stimuli
D) Start the exam by assessing the patient's head
E) Immediately administer 324mg of Aspirin before the physical exam
Correct Answer: D) start by examining patient's head
Rationale: When a patient is unresponsive and unable to provide a history or direct the
provider to a specific complaint, the EMT must perform a rapid, systematic head-to-toe
physical assessment. Because the patient cannot communicate, you must look for signs of
trauma, medical alert jewelry, or other physiological clues that may be hidden outside of
the chest area.
Question 7
You are transporting an 18-year-old male with a decreased LOC and injuries to the head, chest,
and leg from a motor vehicle crash. During your reassessment of the head and neck, which action
is most appropriate?
A) Placing a sterile dressing inside the ear canal to stop blood flow
B) Carefully re-palpating the patient's face and scalp for changes
C) Removing the C-collar entirely to reassess the back of the neck
D) Maintaining the airway with a head-tilt, chin-lift maneuver
E) Applying direct pressure to the carotid artery to slow bleeding
Correct Answer: B) re-palpate patient's face and scalp
Rationale: Reassessment is designed to identify changes in the patient's condition. For a
patient with a head injury, re-palpating the scalp and face allows you to find new areas of
swelling (hematomas) or crepitus that were not initially apparent. You should never pack
an ear canal with a dressing, as this could increase intracranial pressure if the blood is from
a skull fracture.
Question 8
While assessing a 9-month-old infant, you find the child is extremely irritable, crying weakly,
and resistant to being touched. What is this infant's mental status?
A) Obtunded
B) Alert
C) Verbal
D) Lethargic
E) Painful
Correct Answer: B) alert
Rationale: In pediatrics, an infant who is crying and actively resisting the EMT—even if
irritable or weak—is considered "Alert" on the AVPU scale. They are aware of their
, 4
environment and reacting to the presence of a stranger. A "Lethargic" or "Obtunded"
child would show little to no interest in the environment or the EMT's touch.
Question 9
By definition, a Weapon of Mass Destruction (WMD) is any:
A) Agent used to cause indiscriminate death and destruction
B) Weapon used specifically to create fear and panic among a population
C) Agent intended to kill a specific ethnic segment of the population
D) Biological agent that kills animals but does not destroy property
E) Explosive device with a blast radius of over 100 yards
Correct Answer: A) age used to cause indiscriminate death and destruction
Rationale: While WMDs certainly create fear and panic (terrorism), the technical definition
focuses on their capacity to cause large-scale, indiscriminate death and destruction. This
includes chemical, biological, radiological, nuclear, and high-yield explosive (CBRNE)
agents.
Question 10
You encounter a highly agitated combat veteran yelling in a restaurant. He has a known history
of PTSD. Which statement indicates proper initial management?
A) "Let me see if I can establish rapport and calm him."
B) "We need to contact ALS immediately for chemical restraints."
C) "This is strictly a police matter; we should wait in the ambulance."
D) "We must determine if he has a weapon before we attempt to physically restrain him."
E) "Approach him from behind to secure his arms quickly."
Correct Answer: A) establish rapport and try to calm him
Rationale: Initial management of a behavioral emergency involves de-escalation.
Establishing rapport and using a calm, non-threatening approach is the safest first step.
Physical or chemical restraints should be reserved for when the patient poses an immediate
threat to themselves or others and de-escalation has failed.
Question 11
How can an EMT best protect themselves and ensure appropriate resources are sent to an MCI
involving a suspected WMD?
A) Providing a rough estimation of the number of fatalities
B) Identification of the specific agent or mechanism used
C) Overall determination of the number and types of injuries
D) Turning over control of the incident to Homeland Security immediately
E) Establishing a treatment area within the "Hot Zone"
EXAM WITH CORRECT SOLUTIONS.
Question 1
Which of the following is true regarding a patient who relies on the hypoxic drive to breathe?
A) The primary gas affecting the respiratory rate is Carbon Dioxide
B) The central chemoreceptors are the primary influence on the respiratory rate
C) The respiratory rate is set according to the level of Oxygen in the body
D) The peripheral chemoreceptors have become less sensitive to Oxygen levels
E) The patient requires high-flow oxygen regardless of their saturation levels
Correct Answer: C) The respiratory rate is set according to the level of Oxygen in the body
Rationale: In healthy individuals, the primary stimulus to breathe is an increase in Carbon
Dioxide (CO2) levels, sensed by central chemoreceptors. However, in patients with chronic
lung diseases like COPD, the body becomes accustomed to high CO2 levels, and the central
chemoreceptors become desensitized. As a result, the body shifts to the "hypoxic drive,"
where peripheral chemoreceptors in the aortic and carotid bodies trigger breathing based
on low levels of Oxygen (O2) rather than high levels of CO2.
Question 2
Beta-2 specific medications, such as Albuterol, benefit patients primarily by:
A) Eliminating acute myocardial chest pain
B) Diminishing the systemic need for supplemental Oxygen
C) Slowing the respiratory rate and decreasing the heart rate
D) Dilating the small airways within the lungs
E) Constricting peripheral blood vessels to increase blood pressure
Correct Answer: D) Dilating the small airways
Rationale: Beta-2 adrenergic receptors are located primarily in the smooth muscles of the
bronchioles. When these receptors are stimulated by "Beta-2" agonists, they cause
bronchodilation, which opens the small airways and makes it easier for patients with
conditions like asthma or COPD to breathe. Beta-1 receptors, by contrast, are located in
the heart and increase heart rate and contractility.
Question 3
On the scene of a Mass Casualty Incident (MCI), you notice another EMT has become
overwhelmed and is emotionally incapacitated. Which action is most appropriate?
A) Closely monitor the EMT for signs of improper patient care
B) Remove the EMT from the scene immediately
C) Instruct the EMT to go home and rest
D) Assess the EMT for a possible head injury or stroke
E) Assign the EMT to the triage officer for a more active role
, 2
Correct Answer: B) Remove EMT from scene
Rationale: In a high-stress environment like an MCI, an emotionally incapacitated provider
becomes a liability to themselves, their team, and the patients. The most appropriate
immediate action is to remove them from the stressful environment to a safe area. This
protects the integrity of the rescue operation and allows the provider to receive support
without interfering with patient care.
Question 4
What information is most critical for an EMT to provide to CHEMTREC after a hazardous
materials tanker spill?
A) The specific type of vehicle/car involved in the crash
B) The name of the railroad carrier or trucking company
C) The four-digit UN identification number
D) The precise location and train identification number
E) The weather conditions and wind direction at the site
Correct Answer: C) UN identification number
Rationale: The United Nations (UN) four-digit identification number is the international
standard for identifying hazardous materials. Providing this number to CHEMTREC
(Chemical Transportation Emergency Center) allows experts to immediately identify the
chemical involved and provide specific guidance on evacuation distances, firefighting
techniques, and medical treatment for exposure.
Question 5
Which of the following would be a direct physiological result of increasing a patient's preload?
A) Increased cardiac output
B) Decreased myocardial contraction force
C) Increased oxygen delivery specifically to the lungs
D) Decreased systemic blood pressure
E) Increased resistance within the peripheral arteries
Correct Answer: A) increased cardiac output
Rationale: Preload is the amount of blood returning to the heart (ventricular end-diastolic
volume). According to the Starling Law of the Heart, as preload increases, the muscle fibers
of the heart are stretched more, leading to a more forceful contraction. This increase in
stroke volume results in an overall increase in cardiac output (Cardiac Output = Stroke
Volume x Heart Rate).
Question 6
An unresponsive 54-year-old male went to bed with chest pain. He has no prior medical history.
Your primary assessment reveals no immediate life threats. When performing the secondary
assessment, you should:
, 3
A) Contact the patient's primary care doctor for a history
B) Focus the physical exam exclusively on the chest and heart
C) Determine whether chest pain still exists by applying painful stimuli
D) Start the exam by assessing the patient's head
E) Immediately administer 324mg of Aspirin before the physical exam
Correct Answer: D) start by examining patient's head
Rationale: When a patient is unresponsive and unable to provide a history or direct the
provider to a specific complaint, the EMT must perform a rapid, systematic head-to-toe
physical assessment. Because the patient cannot communicate, you must look for signs of
trauma, medical alert jewelry, or other physiological clues that may be hidden outside of
the chest area.
Question 7
You are transporting an 18-year-old male with a decreased LOC and injuries to the head, chest,
and leg from a motor vehicle crash. During your reassessment of the head and neck, which action
is most appropriate?
A) Placing a sterile dressing inside the ear canal to stop blood flow
B) Carefully re-palpating the patient's face and scalp for changes
C) Removing the C-collar entirely to reassess the back of the neck
D) Maintaining the airway with a head-tilt, chin-lift maneuver
E) Applying direct pressure to the carotid artery to slow bleeding
Correct Answer: B) re-palpate patient's face and scalp
Rationale: Reassessment is designed to identify changes in the patient's condition. For a
patient with a head injury, re-palpating the scalp and face allows you to find new areas of
swelling (hematomas) or crepitus that were not initially apparent. You should never pack
an ear canal with a dressing, as this could increase intracranial pressure if the blood is from
a skull fracture.
Question 8
While assessing a 9-month-old infant, you find the child is extremely irritable, crying weakly,
and resistant to being touched. What is this infant's mental status?
A) Obtunded
B) Alert
C) Verbal
D) Lethargic
E) Painful
Correct Answer: B) alert
Rationale: In pediatrics, an infant who is crying and actively resisting the EMT—even if
irritable or weak—is considered "Alert" on the AVPU scale. They are aware of their
, 4
environment and reacting to the presence of a stranger. A "Lethargic" or "Obtunded"
child would show little to no interest in the environment or the EMT's touch.
Question 9
By definition, a Weapon of Mass Destruction (WMD) is any:
A) Agent used to cause indiscriminate death and destruction
B) Weapon used specifically to create fear and panic among a population
C) Agent intended to kill a specific ethnic segment of the population
D) Biological agent that kills animals but does not destroy property
E) Explosive device with a blast radius of over 100 yards
Correct Answer: A) age used to cause indiscriminate death and destruction
Rationale: While WMDs certainly create fear and panic (terrorism), the technical definition
focuses on their capacity to cause large-scale, indiscriminate death and destruction. This
includes chemical, biological, radiological, nuclear, and high-yield explosive (CBRNE)
agents.
Question 10
You encounter a highly agitated combat veteran yelling in a restaurant. He has a known history
of PTSD. Which statement indicates proper initial management?
A) "Let me see if I can establish rapport and calm him."
B) "We need to contact ALS immediately for chemical restraints."
C) "This is strictly a police matter; we should wait in the ambulance."
D) "We must determine if he has a weapon before we attempt to physically restrain him."
E) "Approach him from behind to secure his arms quickly."
Correct Answer: A) establish rapport and try to calm him
Rationale: Initial management of a behavioral emergency involves de-escalation.
Establishing rapport and using a calm, non-threatening approach is the safest first step.
Physical or chemical restraints should be reserved for when the patient poses an immediate
threat to themselves or others and de-escalation has failed.
Question 11
How can an EMT best protect themselves and ensure appropriate resources are sent to an MCI
involving a suspected WMD?
A) Providing a rough estimation of the number of fatalities
B) Identification of the specific agent or mechanism used
C) Overall determination of the number and types of injuries
D) Turning over control of the incident to Homeland Security immediately
E) Establishing a treatment area within the "Hot Zone"
