National Registry of Emergency Medical Technicians
(NREMT EXAM LATEST 480 QUESTIONS AND 100%
Verified ANSWERS JUST RELEASED
Which of the following is MOST indicative of decompensated shock in a trauma patient with internal
bleeding?
• A:Restlessness
• B:Hypotension
• C:Clammy skin
• D:Tachycardia - answer>>You selected B; This is correct!
Reason:
In compensated shock, the body is able to maintain blood pressure, usually above 90 to 100 mm Hg,
through the physiologic responses of tachycardia and shunting of blood from the skin to the vital
organs of the body. Signs of compensated shock include restlessness; pallor; tachycardia; tachypnea;
and cool, clammy (diaphoretic) skin. If the signs of compensated shock are not recognized and
treatment is delayed, the body's compensatory mechanisms will fail and blood pressure will fall
(hypotension). At this point, the patient is said to be in decompensated shock. Do not wait for a
trauma patient's blood pressure to fall before initiating treatment; it may be too late.
If the level of carbon dioxide in the arterial blood increases:
• A:a reduction in tidal volume will occur.
• B:the respiratory rate and depth decrease.
• C:the respiratory rate slows significantly.
• D:the respiratory rate and depth increase. - answer>>You selected D; This is correct!
Reason:
,Special receptors, called chemoreceptors, sense the levels of oxygen and carbon dioxide in the arterial
blood. The central chemoreceptors are located in the brain; the peripheral chemoreceptors are
located in the aorta and carotid arteries. The level of carbon dioxide in the arterial blood stimulates the
healthy patient to breathe (primary respiratory drive). If the carbon dioxide level rises above normal,
the chemoreceptors send messages to respiratory centers in the brain, resulting in an increase in
respiratory rate and depth (tidal volume). Conversely, if the level of carbon dioxide is too low,
respiratory rate and depth decrease accordingly.
Which of the following injuries or conditions should be managed FIRST?
• A:Fluid drainage from both ears
• B:A large open abdominal wound
• C:Bilateral fractures of the femurs
• D:Bleeding within the oral cavity - answer>>You selected D; This is correct!
Reason:
Any injury or condition that jeopardizes the airway has priority over all else. If blood or other
secretions within the mouth are not suctioned immediately, aspiration may occur; this significantly
increases mortality. After securing a patent airway, control any external bleeding. Ideally, you and your
partner should treat airway problems and external bleeding at the same time.
Which of the following patients is the BEST candidate for an oropharyngeal airway?
• A:An unresponsive trauma patient with blood draining from the nose
• B:Any patient that you suspect of being acutely hypoxemic
• C:An unresponsive patient with uncontrolled oropharyngeal bleeding
• D:A semiconscious patient who ingested a large quantity of aspirin - answer>>You selected A; This is
correct!
Reason:
The oropharyngeal airway is used to keep the tongue off of the posterior pharynx and is indicated for
unresponsive patients without a gag reflex. If an unresponsive patient has severe, uncontrolled
oropharyngeal bleeding, your priority is to suction his or her airway in order to prevent aspiration and
,transport rapidly. Semiconscious patients typically have a gag reflex, although it may be somewhat
depressed. Oxygen should be administered to any patient with suspected hypoxemia.
A young woman who overdosed on heroin is unresponsive with slow, shallow breathing. As you
attempt to insert an oropharyngeal airway, she begins to gag. You should:
• A:place her on her side until she stops gagging and then suction her mouth.
• B:remove the oropharyngeal airway and be prepared to suction her mouth.
• C:suction the patient's oropharynx as you insert a nasopharyngeal airway.
• D:make sure you are using the most appropriate size of oropharyngeal airway. - answer>>You
selected B; This is correct!
Reason:
Although uncommon, an unresponsive patient may have an active gag reflex. If an unresponsive
patient begins to gag as you are attempting to insert an oropharyngeal airway, you must remove the
airway immediately and be prepared to suction if vomiting should occur. Turn the patient on his or her
side to facilitate drainage of secretions. Once the airway has been cleared, a nasopharyngeal airway,
which is better tolerated in patients with a gag reflex, should be inserted.
You are dispatched to the scene of a motorcycle crash. Upon arrival, you find the patient lying
facedown approximately 25 feet from his bike. He is not wearing a helmet and is moaning. You should:
• A:log roll him to a supine position.
• B:apply a cervical collar.
• C:stabilize his head manually.
• D:evaluate the status of his airway. - answer>>You selected B; The correct answer is C;
Reason:
The mechanism of injury for this patient was significant. In his present position (prone), you cannot
effectively assess his airway. Therefore, your first action should be to manually stabilize his head. Then,
you must log roll him into a supine position, keeping his head in an in-line position. If possible, log roll
him directly onto a long backboard. After the patient is supine, assess the status of his airway, assess
his breathing adequacy, administer high-flow oxygen or begin assisted ventilations if needed, and
, continue with your primary assessment. Apply a cervical collar as soon as possible, but assess his
posterior neck first.
Following blunt trauma to the chest, a 33-year-old male has shallow, painful breathing. On assessment,
you note that an area to the left side of his chest collapses during inhalation and bulges during
exhalation. These are signs of a/an:
• A:flail chest.
• B:isolated rib fracture.
• C:pneumothorax.
• D:pulmonary contusion. - answer>>You selected A; This is correct!
Reason:
If two or more ribs are fractured in two or more places or if the sternum is fractured along with several
ribs, a segment of chest wall may be detached from the rest of the thoracic cage. This injury is called a
flail chest. In a flail chest, the detached portion of the chest wall moves opposite of normal. It moves in
during inhalation and out during exhalation (paradoxical motion). Isolated (single) rib fractures are not
associated with paradoxical motion because they are usually only fractured in one place. In a
pneumothorax, the patient's respirations are often labored; in severe cases, an entire side of the chest
may not move at all (asymmetrical chest movement). A pulmonary contusion (bruising of the lung
tissue) does not cause paradoxical chest motion unless associated with a flail chest
Oxygen that is administered through a nasal cannula would be of LEAST benefit to a patient who:
• A:is breathing greater than 12 times per minute.
• B:breathes through his or her mouth.
• C:has COPD and an oxygen saturation of 94%.
• D:is in need of long-term oxygen therapy. - answer>>You selected B; This is correct!
Reason:
A patient who breathes through the mouth or has a nasal obstruction will get little or no benefit from a
nasal cannula. Many patients with COPD (eg, emphysema, chronic bronchitis) require long-term, low-
flow oxygen therapy; the nasal cannula is ideal in this situation. Considering their chronic respiratory
problem, an oxygen saturation of 94% in a COPD patient is good; in fact, many COPD patients maintain
(NREMT EXAM LATEST 480 QUESTIONS AND 100%
Verified ANSWERS JUST RELEASED
Which of the following is MOST indicative of decompensated shock in a trauma patient with internal
bleeding?
• A:Restlessness
• B:Hypotension
• C:Clammy skin
• D:Tachycardia - answer>>You selected B; This is correct!
Reason:
In compensated shock, the body is able to maintain blood pressure, usually above 90 to 100 mm Hg,
through the physiologic responses of tachycardia and shunting of blood from the skin to the vital
organs of the body. Signs of compensated shock include restlessness; pallor; tachycardia; tachypnea;
and cool, clammy (diaphoretic) skin. If the signs of compensated shock are not recognized and
treatment is delayed, the body's compensatory mechanisms will fail and blood pressure will fall
(hypotension). At this point, the patient is said to be in decompensated shock. Do not wait for a
trauma patient's blood pressure to fall before initiating treatment; it may be too late.
If the level of carbon dioxide in the arterial blood increases:
• A:a reduction in tidal volume will occur.
• B:the respiratory rate and depth decrease.
• C:the respiratory rate slows significantly.
• D:the respiratory rate and depth increase. - answer>>You selected D; This is correct!
Reason:
,Special receptors, called chemoreceptors, sense the levels of oxygen and carbon dioxide in the arterial
blood. The central chemoreceptors are located in the brain; the peripheral chemoreceptors are
located in the aorta and carotid arteries. The level of carbon dioxide in the arterial blood stimulates the
healthy patient to breathe (primary respiratory drive). If the carbon dioxide level rises above normal,
the chemoreceptors send messages to respiratory centers in the brain, resulting in an increase in
respiratory rate and depth (tidal volume). Conversely, if the level of carbon dioxide is too low,
respiratory rate and depth decrease accordingly.
Which of the following injuries or conditions should be managed FIRST?
• A:Fluid drainage from both ears
• B:A large open abdominal wound
• C:Bilateral fractures of the femurs
• D:Bleeding within the oral cavity - answer>>You selected D; This is correct!
Reason:
Any injury or condition that jeopardizes the airway has priority over all else. If blood or other
secretions within the mouth are not suctioned immediately, aspiration may occur; this significantly
increases mortality. After securing a patent airway, control any external bleeding. Ideally, you and your
partner should treat airway problems and external bleeding at the same time.
Which of the following patients is the BEST candidate for an oropharyngeal airway?
• A:An unresponsive trauma patient with blood draining from the nose
• B:Any patient that you suspect of being acutely hypoxemic
• C:An unresponsive patient with uncontrolled oropharyngeal bleeding
• D:A semiconscious patient who ingested a large quantity of aspirin - answer>>You selected A; This is
correct!
Reason:
The oropharyngeal airway is used to keep the tongue off of the posterior pharynx and is indicated for
unresponsive patients without a gag reflex. If an unresponsive patient has severe, uncontrolled
oropharyngeal bleeding, your priority is to suction his or her airway in order to prevent aspiration and
,transport rapidly. Semiconscious patients typically have a gag reflex, although it may be somewhat
depressed. Oxygen should be administered to any patient with suspected hypoxemia.
A young woman who overdosed on heroin is unresponsive with slow, shallow breathing. As you
attempt to insert an oropharyngeal airway, she begins to gag. You should:
• A:place her on her side until she stops gagging and then suction her mouth.
• B:remove the oropharyngeal airway and be prepared to suction her mouth.
• C:suction the patient's oropharynx as you insert a nasopharyngeal airway.
• D:make sure you are using the most appropriate size of oropharyngeal airway. - answer>>You
selected B; This is correct!
Reason:
Although uncommon, an unresponsive patient may have an active gag reflex. If an unresponsive
patient begins to gag as you are attempting to insert an oropharyngeal airway, you must remove the
airway immediately and be prepared to suction if vomiting should occur. Turn the patient on his or her
side to facilitate drainage of secretions. Once the airway has been cleared, a nasopharyngeal airway,
which is better tolerated in patients with a gag reflex, should be inserted.
You are dispatched to the scene of a motorcycle crash. Upon arrival, you find the patient lying
facedown approximately 25 feet from his bike. He is not wearing a helmet and is moaning. You should:
• A:log roll him to a supine position.
• B:apply a cervical collar.
• C:stabilize his head manually.
• D:evaluate the status of his airway. - answer>>You selected B; The correct answer is C;
Reason:
The mechanism of injury for this patient was significant. In his present position (prone), you cannot
effectively assess his airway. Therefore, your first action should be to manually stabilize his head. Then,
you must log roll him into a supine position, keeping his head in an in-line position. If possible, log roll
him directly onto a long backboard. After the patient is supine, assess the status of his airway, assess
his breathing adequacy, administer high-flow oxygen or begin assisted ventilations if needed, and
, continue with your primary assessment. Apply a cervical collar as soon as possible, but assess his
posterior neck first.
Following blunt trauma to the chest, a 33-year-old male has shallow, painful breathing. On assessment,
you note that an area to the left side of his chest collapses during inhalation and bulges during
exhalation. These are signs of a/an:
• A:flail chest.
• B:isolated rib fracture.
• C:pneumothorax.
• D:pulmonary contusion. - answer>>You selected A; This is correct!
Reason:
If two or more ribs are fractured in two or more places or if the sternum is fractured along with several
ribs, a segment of chest wall may be detached from the rest of the thoracic cage. This injury is called a
flail chest. In a flail chest, the detached portion of the chest wall moves opposite of normal. It moves in
during inhalation and out during exhalation (paradoxical motion). Isolated (single) rib fractures are not
associated with paradoxical motion because they are usually only fractured in one place. In a
pneumothorax, the patient's respirations are often labored; in severe cases, an entire side of the chest
may not move at all (asymmetrical chest movement). A pulmonary contusion (bruising of the lung
tissue) does not cause paradoxical chest motion unless associated with a flail chest
Oxygen that is administered through a nasal cannula would be of LEAST benefit to a patient who:
• A:is breathing greater than 12 times per minute.
• B:breathes through his or her mouth.
• C:has COPD and an oxygen saturation of 94%.
• D:is in need of long-term oxygen therapy. - answer>>You selected B; This is correct!
Reason:
A patient who breathes through the mouth or has a nasal obstruction will get little or no benefit from a
nasal cannula. Many patients with COPD (eg, emphysema, chronic bronchitis) require long-term, low-
flow oxygen therapy; the nasal cannula is ideal in this situation. Considering their chronic respiratory
problem, an oxygen saturation of 94% in a COPD patient is good; in fact, many COPD patients maintain
