NREMT PRACTICE TEST BANK - MULTIPLE CHOICE
WELL VERIFIED
A 60-year-old male complains of a tearing sensation in his abdomen. He tells you
the pain began suddenly and feels like someone is sticking a knife into his
abdomen. He is conscious and alert with a blood pressure of 148/88 mm Hg, a
pulse of 120 beats/min, and respirations of 22 breaths/min. In addition to
administering high-flow oxygen, you should:
• A: perform a rapid head to toe assessment and prepare for transport.
• B: auscultate over his epigastrium to assess for bowel sounds.
• C: vigorously palpate his abdomen to assess for a pulsating mass.
• D: transport at once and be prepared to treat him for severe shock. - ANS ... The
correct answer is D;
Reason: Given the onset and nature of the patient's pain (eg, sudden onset, tearing
sensation), you should suspect that he has an acute dissection of the abdominal
aorta. Administer high-flow oxygen and transport him at once. Acute aortic
dissection can quickly cause an aneurysm, which could rupture and cause profound
shock. Therefore, you must carefully monitor him and be prepared to treat him
accordingly. Unnecessary or vigorous palpation of his abdomen could cause his
aorta to rupture and should be avoided. A rapid head-to-toe assessment is
indicated for trauma patients with a significant mechanism of injury and
unresponsive medical patients; this patient falls into neither of these categories.
Auscultating bowel sounds in the field is time-consuming, will yield little information,
and only delays transport.
Which of the following statements regarding the function of insulin is correct?
• A:It stimulates the liver to release glucose into the bloodstream.
• B:It facilitates the uptake of glucose from the bloodstream into the cell.
,• C:It causes the pancreas to produce glucose based on the body's demand.
• D:It promotes the entry of glucose from the cell into the bloodstream. - ANS ... You
selected B; This is correct!
Reason:Insulin is a hormone produced by the beta cells in the Islets of Langerhans of
the pancreas. It promotes the uptake of glucose from the bloodstream into the cells
where it is used in the production of energy. Glucagon, a hormone produced by the
alpha cells in the pancreas, facilitates the conversion of glycogen to glucose
(glycogenolysis) in the liver. The liver does not produce glucose; it produces
glycogen, a complex sugar that the body cannot utilize until it has been converted
to glucose, a simple sugar.
A 72-year-old woman is found unresponsive in her poorly ventilated home. Her skin
is flushed, hot, and dry, and her respirations are rapid and shallow. She is wearing
a medical alert bracelet that states she is a diabetic and is allergic to sulfa drugs.
You should be MOST suspicious for:
• A:acute ischemic stroke.
• B:a diabetic complication.
• C:heat stroke.
• D:anaphylactic shock. - ANS ... You selected C; This is correct!
Reason: The patient's signs and symptoms are consistent with classic heat stroke.
Unlike exertional heat stroke, which usually affects otherwise healthy people who
exert themselves in the heat for long periods of time, classic heat stroke commonly
affects children and older adults, and typically occurs when the patient is in a hot,
poorly ventilated space for a prolonged period of time. Significant underlying
medical problems (eg, hypertension, diabetes, heart disease) increase the patient's
risk for classic heat stroke. Both exertional and classic heat stroke present with hot,
flushed skin; however, patients with exertional heat stroke may have moist skin,
usually from residual perspiration, whereas patients with classic heat stroke
typically have dry skin.
,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. - ANS ... • 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. - ANS ... 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. - ANS ... 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 having him grab hold of a large stick or similar object. If this is
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 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 - ANS ... 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.
WELL VERIFIED
A 60-year-old male complains of a tearing sensation in his abdomen. He tells you
the pain began suddenly and feels like someone is sticking a knife into his
abdomen. He is conscious and alert with a blood pressure of 148/88 mm Hg, a
pulse of 120 beats/min, and respirations of 22 breaths/min. In addition to
administering high-flow oxygen, you should:
• A: perform a rapid head to toe assessment and prepare for transport.
• B: auscultate over his epigastrium to assess for bowel sounds.
• C: vigorously palpate his abdomen to assess for a pulsating mass.
• D: transport at once and be prepared to treat him for severe shock. - ANS ... The
correct answer is D;
Reason: Given the onset and nature of the patient's pain (eg, sudden onset, tearing
sensation), you should suspect that he has an acute dissection of the abdominal
aorta. Administer high-flow oxygen and transport him at once. Acute aortic
dissection can quickly cause an aneurysm, which could rupture and cause profound
shock. Therefore, you must carefully monitor him and be prepared to treat him
accordingly. Unnecessary or vigorous palpation of his abdomen could cause his
aorta to rupture and should be avoided. A rapid head-to-toe assessment is
indicated for trauma patients with a significant mechanism of injury and
unresponsive medical patients; this patient falls into neither of these categories.
Auscultating bowel sounds in the field is time-consuming, will yield little information,
and only delays transport.
Which of the following statements regarding the function of insulin is correct?
• A:It stimulates the liver to release glucose into the bloodstream.
• B:It facilitates the uptake of glucose from the bloodstream into the cell.
,• C:It causes the pancreas to produce glucose based on the body's demand.
• D:It promotes the entry of glucose from the cell into the bloodstream. - ANS ... You
selected B; This is correct!
Reason:Insulin is a hormone produced by the beta cells in the Islets of Langerhans of
the pancreas. It promotes the uptake of glucose from the bloodstream into the cells
where it is used in the production of energy. Glucagon, a hormone produced by the
alpha cells in the pancreas, facilitates the conversion of glycogen to glucose
(glycogenolysis) in the liver. The liver does not produce glucose; it produces
glycogen, a complex sugar that the body cannot utilize until it has been converted
to glucose, a simple sugar.
A 72-year-old woman is found unresponsive in her poorly ventilated home. Her skin
is flushed, hot, and dry, and her respirations are rapid and shallow. She is wearing
a medical alert bracelet that states she is a diabetic and is allergic to sulfa drugs.
You should be MOST suspicious for:
• A:acute ischemic stroke.
• B:a diabetic complication.
• C:heat stroke.
• D:anaphylactic shock. - ANS ... You selected C; This is correct!
Reason: The patient's signs and symptoms are consistent with classic heat stroke.
Unlike exertional heat stroke, which usually affects otherwise healthy people who
exert themselves in the heat for long periods of time, classic heat stroke commonly
affects children and older adults, and typically occurs when the patient is in a hot,
poorly ventilated space for a prolonged period of time. Significant underlying
medical problems (eg, hypertension, diabetes, heart disease) increase the patient's
risk for classic heat stroke. Both exertional and classic heat stroke present with hot,
flushed skin; however, patients with exertional heat stroke may have moist skin,
usually from residual perspiration, whereas patients with classic heat stroke
typically have dry skin.
,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. - ANS ... • 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. - ANS ... 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. - ANS ... 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 having him grab hold of a large stick or similar object. If this is
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 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 - ANS ... 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.
