NREMT Practice Test Bank - Multiple Choice UPDATED
ACTUAL Questions and CORRECT Answers
Hypoglycemia and acute ischemic stroke • A:both oxygen and glucose are needed for brain function.
can present similarly because:
Reason: Although stroke and hypoglycemia are two distinctly
• A:both oxygen and glucose are needed different conditions, their signs and symptoms are often
for brain function. similar. This is because the brain requires both oxygen and
• B:the majority of stroke patients have a glucose to function normally. An acute ischemic stroke is
history of diabetes. caused by a lack of oxygen to a part of the brain due to a
• C:the most common cause of a stroke is blocked cerebral artery, whereas hypoglycemia (low blood
hypoglycemia. glucose level) deprives the entire brain of glucose. In either
• D:they are both caused by low levels of case, the patient presents with signs of impaired brain function
glucose in the blood. (ie, slurred speech, weakness, altered mental status). Both
conditions may lead to permanent brain damage or death if
not treated promptly.
When dealing with an emotionally disturbed You selected C; This is correct!
patient, you should be MOST concerned
with: Reason: When managing any patient with an emotional or
• A:gathering all of the patient's medications. psychiatric crisis, your primary concern is your own safety.
• B:safely transporting to the hospital. Safely transporting the patient to the hospital is your ultimate
• C:whether the patient could harm you. goal. If possible, you should attempt to obtain a medical
• D:obtaining a complete medical history. history and should take any of the patient's prescribed
medications to the hospital. However, this should not
supercede your own safety or interfere with safely
transporting the patient.
,You are at the scene where a man panicked You selected B; This is correct!
while swimming in a small lake. Your initial
attempt to rescue him should include: Reason: General rules to follow when attempting to rescue a
• A:rowing a small raft to the victim. patient from the water include "reach, throw, row, and then
• B:reaching for the victim with a long stick. go." In this case, you should attempt to reach the victim by
• C:throwing a rope to the victim. having him grab hold of a large stick or similar object. If this is
• D:swimming to the victim to rescue him. unsuccessful, throw the victim a rope or flotation device (if
available). If these are not available, row to the patient in a
small raft (if available). Going into the water to retrieve the
victim is a last resort. The rescuer must be a strong swimmer
because patients who are in danger of drowning are in a state
of blind panic and will make every attempt to keep themselves
afloat, even if it means forcing the rescuer underwater.
How should you classify a patient's nature of The correct answer is B;
illness if he or she has a low blood glucose
level, bizarre behavior, and shallow Reason: The nature of illness (NOI) is the medical equivalent
breathing? to mechanism of injury (MOI). Altered mental status should be
• A:Behavioral emergency the suspected NOI in any patient with any fluctuation in level
• B:Altered mental status of consciousness, which can range from bizarre behavior to
• C:Respiratory emergency complete unresponsiveness. Causes of an altered mental
• D:Cardiac compromise status include hypo- or hyperglycemia, head trauma, stroke,
behavioral crises, drug overdose, and shock, among others.
A young female is unresponsive after The correct answer is C;
overdosing on an unknown type of drug.
Her respirations are slow and shallow and Reason: Of the drugs listed, cocaine would be the least likely
her pulse is slow and weak. Which of the cause of the patient's condition. Cocaine is a central nervous
following drugs is the LEAST likely cause of system (CNS) stimulant; you would expect her to be
her condition? hypertensive, tachycardic, tachypneic, and perhaps even
• A:Seconal violent. Heroin, Valium, and Seconal are all CNS depressants
• B:Heroin and could explain her condition. Heroin is an illegal narcotic
• C:Cocaine (opiate), Valium is a benzodiazepine sedative-hypnotic drug,
• D:Valium and Seconal is a barbiturate. Narcotics, benzodiazepines, and
barbiturates are all CNS depressants. When taken in excess,
they cause a decreased level of consciousness, respiratory
depression, bradycardia, and hypotension.
Activated charcoal is contraindicated for a You selected D; This is correct!
patient who is:
• A:conscious and alert and has ingested a Reason:Activated charcoal adsorbs (sticks to) many ingested
large amount of Motrin. substances, preventing them from being absorbed into the
• B:emotionally upset and has ingested two body by the stomach or intestines. In some cases, you may
bottles of aspirin. give activated charcoal to patients who have ingested certain
• C:agitated and claims to have ingested a substances, if approved by medical control or local protocol.
bottle of Tylenol. Activated charcoal is contraindicated for patients who have
• D:awake and alert and has swallowed a ingested an acid or alkali (ie, drain cleaner) or a petroleum
commercial drain cleaner. product (ie, gasoline), who have a decreased level of
consciousness and cannot protect their own airway, or who
are unable to swallow.
,The MOST obvious way to reduce heat loss you selected D; This is correct!
from radiation and convection is to:
• A:move away from a cold object. Reason:In a cold environment, the body has two ways of
• B:increase metabolism by shivering. staying warm: generating heat (thermogenesis) and reducing
• C:wear a thick wind-proof jacket. heat loss. Radiation is the transfer of heat by radiant energy.
• D:move to a warmer environment. The body can lose heat by radiation, such as when a person
stands in a cold room. Convection occurs when heat is
transferred to circulating air, as when cool air moves across
the body's surface. A person standing in windy cold weather,
wearing lightweight clothing, is losing heat to the environment
mostly by convection. The quickest and most obvious way to
decrease heat loss from radiation and convection is to move
out of the cold environment and seek shelter from wind.
Shivering increases the body's metabolism and is a mechanism
for generating heat, not reducing heat loss. Layers of clothing
trap air and provide excellent insulation; thus, layered clothing
decreases heat loss better than a single, thick jacket.
Conduction is the direct transfer of heat from a part of the
body to a colder object by direct contact, as when a warm
hand touches cold metal or ice. The most obvious way to
decrease heat loss by conduction is to remove your hand
from the cold object.
A near-drowning is MOST accurately You selected C; This is correct!
defined as:
• A:complications within 24 hours following Reason:Collectively, drowning and near-drowning are
submersion in water. referred to as submersion injuries. Drowning is defined as
• B:immediate death due to prolonged death after submersion in a liquid medium, usually water. In a
submersion in water. drowning, death is either immediate or occurs within 24 hours
• C:survival for at least 24 hours following following submersion. Near-drowning is defined as survival, at
submersion in water. least temporarily (24 hours), after submersion. It should be
• D:death greater than 24 hours following noted, however, that complications such as pneumonia and
submersion in water. pulmonary edema can cause death greater than 24 hours
following submersion. For this reason, all patients with a
submersion injury should be transported to the hospital, even
if they appear fine at the scene.
A young woman reports significant weight You selected B; This is correct!
loss over the last month, persistent fever,
and night sweats. When you assess her, you Reason:Weight loss, fever, and night sweats could indicate
note the presence of dark purple lesions tuberculosis or HIV/AIDS; however, the dark purple lesions on
covering her trunk and upper extremities. the skin, which are called Kaposi's sarcoma, are malignant skin
You should suspect: tumors and are a classic finding in patients in the later stages
• A:end-stage cancer. of AIDS.
• B:HIV/AIDS.
• C:tuberculosis.
• D:rheumatic fever.
, A 48-year-old male became acutely You selected C; This is correct!
hypoxic, experienced a seizure, and is now
postictal. The MOST effective way to Reason:You should administer high-flow oxygen to all patients
prevent another seizure is to: who are actively seizing and to patients who experienced a
• A:dim the lights in the back of the seizure and are postictal. This is especially true if the seizure
ambulance. was caused by hypoxia. Increasing the oxygen content of the
• B:place him in the recovery position. blood, which minimizes hypoxia, may prevent another seizure.
• C:administer high-flow supplemental The recovery position is appropriate for uninjured patients
oxygen. with a decreased level of consciousness and adequate
• D:give him oral glucose if he can swallow. breathing; it will help maintain the airway and facilitate
drainage of secretions from the mouth, but will not prevent
another seizure. Oral glucose may prevent another seizure if
hypoglycemia was the cause of the seizure. You should dim
the lights in the back of the ambulance to help prevent any
seizure, not just those that are caused by hypoxia.
Which of the following conditions would be You selected C; This is correct!
the LEAST likely to be present in a patient
who was submerged in water? Reason: Many factors can contribute to or result from a
• A:Spinal injury submersion injury (eg, drowning, near-drowning). It is not
• B:Gastric distention uncommon for a person to experience a spinal injury after
• C:Hyperglycemia diving head first into shallow water, especially if he or she is
• D:Laryngospasm under the influence of alcohol. When a swimmer panics, he or
she initially swallows large amounts of water, resulting in
gastric distention. Gastric distention can cause aspiration if the
patient regurgitates water during rescue breathing; protect
the airway! During the panic phase, the victim expends a
tremendous amount of energy (and glucose) from flailing
around in the water, possibly resulting in hypoglycemia.
Inhaling even a small amount of fresh or salt water can
severely irritate the larynx, which sends the muscles of the
larynx and vocal cords into spasm (laryngospasm), resulting in
airway blockage and hypoxia.
A 42-year-old male presents with fever, a You selected C; This is correct!
severe headache, and a stiff neck. He is
conscious, but confused. His wife tells you Reason:Meningitis is an inflammation of the protective
that he does not have any medical problems coverings of the brain and spinal cord (meninges). Common
and does not take any medications. You signs and symptoms of meningitis include fever, headache,
should be MOST suspicious for: neck stiffness (nuchal rigidity), and vomiting. An altered mental
• A:acute stroke. status is common in severe cases. Meningococcal meningitis,
• B:influenza. caused by a bacterium, is the most contagious and potentially
• C:meningitis. fatal type of meningitis. The patient's signs and symptoms are
• D:tuberculosis. not consistent with acute stroke, tuberculosis (TB), or influenza
( (the flu). Although fever is common with both TB and the flu,
neither causes neck stiffness. Acute stroke may be associated
with a headache, especially a hemorrhagic stroke; however,
stroke patients typically do not have a fever.
ACTUAL Questions and CORRECT Answers
Hypoglycemia and acute ischemic stroke • A:both oxygen and glucose are needed for brain function.
can present similarly because:
Reason: Although stroke and hypoglycemia are two distinctly
• A:both oxygen and glucose are needed different conditions, their signs and symptoms are often
for brain function. similar. This is because the brain requires both oxygen and
• B:the majority of stroke patients have a glucose to function normally. An acute ischemic stroke is
history of diabetes. caused by a lack of oxygen to a part of the brain due to a
• C:the most common cause of a stroke is blocked cerebral artery, whereas hypoglycemia (low blood
hypoglycemia. glucose level) deprives the entire brain of glucose. In either
• D:they are both caused by low levels of case, the patient presents with signs of impaired brain function
glucose in the blood. (ie, slurred speech, weakness, altered mental status). Both
conditions may lead to permanent brain damage or death if
not treated promptly.
When dealing with an emotionally disturbed You selected C; This is correct!
patient, you should be MOST concerned
with: Reason: When managing any patient with an emotional or
• A:gathering all of the patient's medications. psychiatric crisis, your primary concern is your own safety.
• B:safely transporting to the hospital. Safely transporting the patient to the hospital is your ultimate
• C:whether the patient could harm you. goal. If possible, you should attempt to obtain a medical
• D:obtaining a complete medical history. history and should take any of the patient's prescribed
medications to the hospital. However, this should not
supercede your own safety or interfere with safely
transporting the patient.
,You are at the scene where a man panicked You selected B; This is correct!
while swimming in a small lake. Your initial
attempt to rescue him should include: Reason: General rules to follow when attempting to rescue a
• A:rowing a small raft to the victim. patient from the water include "reach, throw, row, and then
• B:reaching for the victim with a long stick. go." In this case, you should attempt to reach the victim by
• C:throwing a rope to the victim. having him grab hold of a large stick or similar object. If this is
• D:swimming to the victim to rescue him. unsuccessful, throw the victim a rope or flotation device (if
available). If these are not available, row to the patient in a
small raft (if available). Going into the water to retrieve the
victim is a last resort. The rescuer must be a strong swimmer
because patients who are in danger of drowning are in a state
of blind panic and will make every attempt to keep themselves
afloat, even if it means forcing the rescuer underwater.
How should you classify a patient's nature of The correct answer is B;
illness if he or she has a low blood glucose
level, bizarre behavior, and shallow Reason: The nature of illness (NOI) is the medical equivalent
breathing? to mechanism of injury (MOI). Altered mental status should be
• A:Behavioral emergency the suspected NOI in any patient with any fluctuation in level
• B:Altered mental status of consciousness, which can range from bizarre behavior to
• C:Respiratory emergency complete unresponsiveness. Causes of an altered mental
• D:Cardiac compromise status include hypo- or hyperglycemia, head trauma, stroke,
behavioral crises, drug overdose, and shock, among others.
A young female is unresponsive after The correct answer is C;
overdosing on an unknown type of drug.
Her respirations are slow and shallow and Reason: Of the drugs listed, cocaine would be the least likely
her pulse is slow and weak. Which of the cause of the patient's condition. Cocaine is a central nervous
following drugs is the LEAST likely cause of system (CNS) stimulant; you would expect her to be
her condition? hypertensive, tachycardic, tachypneic, and perhaps even
• A:Seconal violent. Heroin, Valium, and Seconal are all CNS depressants
• B:Heroin and could explain her condition. Heroin is an illegal narcotic
• C:Cocaine (opiate), Valium is a benzodiazepine sedative-hypnotic drug,
• D:Valium and Seconal is a barbiturate. Narcotics, benzodiazepines, and
barbiturates are all CNS depressants. When taken in excess,
they cause a decreased level of consciousness, respiratory
depression, bradycardia, and hypotension.
Activated charcoal is contraindicated for a You selected D; This is correct!
patient who is:
• A:conscious and alert and has ingested a Reason:Activated charcoal adsorbs (sticks to) many ingested
large amount of Motrin. substances, preventing them from being absorbed into the
• B:emotionally upset and has ingested two body by the stomach or intestines. In some cases, you may
bottles of aspirin. give activated charcoal to patients who have ingested certain
• C:agitated and claims to have ingested a substances, if approved by medical control or local protocol.
bottle of Tylenol. Activated charcoal is contraindicated for patients who have
• D:awake and alert and has swallowed a ingested an acid or alkali (ie, drain cleaner) or a petroleum
commercial drain cleaner. product (ie, gasoline), who have a decreased level of
consciousness and cannot protect their own airway, or who
are unable to swallow.
,The MOST obvious way to reduce heat loss you selected D; This is correct!
from radiation and convection is to:
• A:move away from a cold object. Reason:In a cold environment, the body has two ways of
• B:increase metabolism by shivering. staying warm: generating heat (thermogenesis) and reducing
• C:wear a thick wind-proof jacket. heat loss. Radiation is the transfer of heat by radiant energy.
• D:move to a warmer environment. The body can lose heat by radiation, such as when a person
stands in a cold room. Convection occurs when heat is
transferred to circulating air, as when cool air moves across
the body's surface. A person standing in windy cold weather,
wearing lightweight clothing, is losing heat to the environment
mostly by convection. The quickest and most obvious way to
decrease heat loss from radiation and convection is to move
out of the cold environment and seek shelter from wind.
Shivering increases the body's metabolism and is a mechanism
for generating heat, not reducing heat loss. Layers of clothing
trap air and provide excellent insulation; thus, layered clothing
decreases heat loss better than a single, thick jacket.
Conduction is the direct transfer of heat from a part of the
body to a colder object by direct contact, as when a warm
hand touches cold metal or ice. The most obvious way to
decrease heat loss by conduction is to remove your hand
from the cold object.
A near-drowning is MOST accurately You selected C; This is correct!
defined as:
• A:complications within 24 hours following Reason:Collectively, drowning and near-drowning are
submersion in water. referred to as submersion injuries. Drowning is defined as
• B:immediate death due to prolonged death after submersion in a liquid medium, usually water. In a
submersion in water. drowning, death is either immediate or occurs within 24 hours
• C:survival for at least 24 hours following following submersion. Near-drowning is defined as survival, at
submersion in water. least temporarily (24 hours), after submersion. It should be
• D:death greater than 24 hours following noted, however, that complications such as pneumonia and
submersion in water. pulmonary edema can cause death greater than 24 hours
following submersion. For this reason, all patients with a
submersion injury should be transported to the hospital, even
if they appear fine at the scene.
A young woman reports significant weight You selected B; This is correct!
loss over the last month, persistent fever,
and night sweats. When you assess her, you Reason:Weight loss, fever, and night sweats could indicate
note the presence of dark purple lesions tuberculosis or HIV/AIDS; however, the dark purple lesions on
covering her trunk and upper extremities. the skin, which are called Kaposi's sarcoma, are malignant skin
You should suspect: tumors and are a classic finding in patients in the later stages
• A:end-stage cancer. of AIDS.
• B:HIV/AIDS.
• C:tuberculosis.
• D:rheumatic fever.
, A 48-year-old male became acutely You selected C; This is correct!
hypoxic, experienced a seizure, and is now
postictal. The MOST effective way to Reason:You should administer high-flow oxygen to all patients
prevent another seizure is to: who are actively seizing and to patients who experienced a
• A:dim the lights in the back of the seizure and are postictal. This is especially true if the seizure
ambulance. was caused by hypoxia. Increasing the oxygen content of the
• B:place him in the recovery position. blood, which minimizes hypoxia, may prevent another seizure.
• C:administer high-flow supplemental The recovery position is appropriate for uninjured patients
oxygen. with a decreased level of consciousness and adequate
• D:give him oral glucose if he can swallow. breathing; it will help maintain the airway and facilitate
drainage of secretions from the mouth, but will not prevent
another seizure. Oral glucose may prevent another seizure if
hypoglycemia was the cause of the seizure. You should dim
the lights in the back of the ambulance to help prevent any
seizure, not just those that are caused by hypoxia.
Which of the following conditions would be You selected C; This is correct!
the LEAST likely to be present in a patient
who was submerged in water? Reason: Many factors can contribute to or result from a
• A:Spinal injury submersion injury (eg, drowning, near-drowning). It is not
• B:Gastric distention uncommon for a person to experience a spinal injury after
• C:Hyperglycemia diving head first into shallow water, especially if he or she is
• D:Laryngospasm under the influence of alcohol. When a swimmer panics, he or
she initially swallows large amounts of water, resulting in
gastric distention. Gastric distention can cause aspiration if the
patient regurgitates water during rescue breathing; protect
the airway! During the panic phase, the victim expends a
tremendous amount of energy (and glucose) from flailing
around in the water, possibly resulting in hypoglycemia.
Inhaling even a small amount of fresh or salt water can
severely irritate the larynx, which sends the muscles of the
larynx and vocal cords into spasm (laryngospasm), resulting in
airway blockage and hypoxia.
A 42-year-old male presents with fever, a You selected C; This is correct!
severe headache, and a stiff neck. He is
conscious, but confused. His wife tells you Reason:Meningitis is an inflammation of the protective
that he does not have any medical problems coverings of the brain and spinal cord (meninges). Common
and does not take any medications. You signs and symptoms of meningitis include fever, headache,
should be MOST suspicious for: neck stiffness (nuchal rigidity), and vomiting. An altered mental
• A:acute stroke. status is common in severe cases. Meningococcal meningitis,
• B:influenza. caused by a bacterium, is the most contagious and potentially
• C:meningitis. fatal type of meningitis. The patient's signs and symptoms are
• D:tuberculosis. not consistent with acute stroke, tuberculosis (TB), or influenza
( (the flu). Although fever is common with both TB and the flu,
neither causes neck stiffness. Acute stroke may be associated
with a headache, especially a hemorrhagic stroke; however,
stroke patients typically do not have a fever.
