NATIONAL REGISTRY OF EMERGENCY
MEDICAL TECHNICIANS COGNITIVE EXAM
WITH GRADED SOLUTIONS AND RATIONALES
How should you classify a patient's nature of
illness if he or she has a low blood glucose
level, bizarre behavior, and shallow breathing?
• A:Behavioral emergency
• B:Altered mental status
• C:Respiratory emergency
• D:Cardiac compromise - answer-The correct
answer is B;
Reason: The nature of illness (NOI) is the
medical equivalent to mechanism of injury
(MOI). Altered mental status should be the
suspected NOI in any patient with any
fluctuation in level of consciousness, which can
range from bizarre behavior to complete
unresponsiveness. Causes of an altered mental
status include hypo- or hyperglycemia, head
,trauma, stroke, behavioral crises, drug
overdose, and shock, among others.
Hypoglycemia and acute ischemic stroke can
present similarly because:
• A:both oxygen and glucose are needed for
brain function.
• B:the majority of stroke patients have a history
of diabetes.
• C:the most common cause of a stroke is
hypoglycemia.
• D:they are both caused by low levels of
glucose in the blood. - answer-• A:both oxygen
and glucose are needed for brain function.
Reason: Although stroke and hypoglycemia are
two distinctly different conditions, their signs
and symptoms are often similar. This is
because the brain requires both oxygen and
glucose to function normally. An acute ischemic
,stroke is caused by a lack of oxygen to a part of
the brain due to a blocked cerebral artery,
whereas hypoglycemia (low blood glucose
level) deprives the entire brain of glucose. In
either case, the patient presents with signs of
impaired brain function (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
patient, you should be MOST concerned with:
• A:gathering all of the patient's medications.
• B:safely transporting to the hospital.
• C:whether the patient could harm you.
• D:obtaining a complete medical history. -
answer-You selected C; This is correct!
Reason: When managing any patient with an
emotional or psychiatric crisis, your primary
concern is your own safety. Safely transporting
, the patient to the hospital is your ultimate goal.
If possible, you should attempt to obtain a
medical 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
while swimming in a small lake. Your initial
attempt to rescue him should include:
• A:rowing a small raft to the victim.
• B:reaching for the victim with a long stick.
• C:throwing a rope to the victim.
• D:swimming to the victim to rescue him. -
answer-You selected B; This is correct!
Reason: General rules to follow when
attempting to rescue a patient from the water
include "reach, throw, row, and then go." In this
case, you should attempt to reach the victim by
MEDICAL TECHNICIANS COGNITIVE EXAM
WITH GRADED SOLUTIONS AND RATIONALES
How should you classify a patient's nature of
illness if he or she has a low blood glucose
level, bizarre behavior, and shallow breathing?
• A:Behavioral emergency
• B:Altered mental status
• C:Respiratory emergency
• D:Cardiac compromise - answer-The correct
answer is B;
Reason: The nature of illness (NOI) is the
medical equivalent to mechanism of injury
(MOI). Altered mental status should be the
suspected NOI in any patient with any
fluctuation in level of consciousness, which can
range from bizarre behavior to complete
unresponsiveness. Causes of an altered mental
status include hypo- or hyperglycemia, head
,trauma, stroke, behavioral crises, drug
overdose, and shock, among others.
Hypoglycemia and acute ischemic stroke can
present similarly because:
• A:both oxygen and glucose are needed for
brain function.
• B:the majority of stroke patients have a history
of diabetes.
• C:the most common cause of a stroke is
hypoglycemia.
• D:they are both caused by low levels of
glucose in the blood. - answer-• A:both oxygen
and glucose are needed for brain function.
Reason: Although stroke and hypoglycemia are
two distinctly different conditions, their signs
and symptoms are often similar. This is
because the brain requires both oxygen and
glucose to function normally. An acute ischemic
,stroke is caused by a lack of oxygen to a part of
the brain due to a blocked cerebral artery,
whereas hypoglycemia (low blood glucose
level) deprives the entire brain of glucose. In
either case, the patient presents with signs of
impaired brain function (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
patient, you should be MOST concerned with:
• A:gathering all of the patient's medications.
• B:safely transporting to the hospital.
• C:whether the patient could harm you.
• D:obtaining a complete medical history. -
answer-You selected C; This is correct!
Reason: When managing any patient with an
emotional or psychiatric crisis, your primary
concern is your own safety. Safely transporting
, the patient to the hospital is your ultimate goal.
If possible, you should attempt to obtain a
medical 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
while swimming in a small lake. Your initial
attempt to rescue him should include:
• A:rowing a small raft to the victim.
• B:reaching for the victim with a long stick.
• C:throwing a rope to the victim.
• D:swimming to the victim to rescue him. -
answer-You selected B; This is correct!
Reason: General rules to follow when
attempting to rescue a patient from the water
include "reach, throw, row, and then go." In this
case, you should attempt to reach the victim by
