NREMT Emergency Medical Technician (EMT)
Certification Examination – Comprehensive
Cognitive Practice Questions and Detailed Answers
1. A 67-year-old male presents with sudden shortness of breath and sharp chest pain that
increases with inspiration. He recently had hip surgery. His vitals are BP 110/70, P 110, R 28
and shallow. What should you suspect?
A. Spontaneous pneumothorax
B. Myocardial infarction
C. Pulmonary embolism
D. Pneumonia
Correct Answer: C
Explanation: The patient’s recent surgery and sudden onset of pleuritic chest pain are
classic indicators of a pulmonary embolism. Tachycardia and tachypnea are common
compensatory mechanisms for the ventilation-perfusion mismatch. Recognizing risk
factors like recent immobilization is key to differentiating this from a primary cardiac
event.
2. You are treating a 5-year-old female who is drooling and sitting in a tripod position. She
has a high fever and appears very anxious. What is the most appropriate next step?
A. Inspect the airway with a tongue depressor
B. Initiate positive pressure ventilations
,C. Perform a blind finger sweep
D. Provide blow-by oxygen and immediate transport
Correct Answer: D
Explanation: The clinical presentation suggests epiglottitis, which is a bacterial infection
causing severe swelling of the epiglottis. Agitating the child or inserting anything into the
mouth can cause total airway obstruction. Immediate transport in a position of comfort
while providing supplemental oxygen is the priority.
3. An adult male was involved in a motor vehicle accident. He has paradoxical movement on
the left side of his chest. His breathing is rapid and shallow. What is your immediate
intervention?
A. Stabilize the segment with your hand and provide positive pressure ventilation
B. Apply a bulky dressing and tape it on all four sides
C. Place the patient on his left side to stabilize the ribs
D. Perform a needle decompression of the left chest
Correct Answer: A
Explanation: Paradoxical movement is the hallmark sign of a flail chest, which severely
compromises ventilation. Positive pressure ventilation via BVM is the most effective way to
stabilize the segment internally and improve oxygenation. Taping bulky dressings is no
longer the primary recommendation for flail chest management.
, 4. You arrive at a scene where a 45-year-old female is found unresponsive. You note snoring
respirations. What should be your first action?
A. Perform a head-tilt, chin-lift maneuver
B. Insert an oropharyngeal airway
C. Suction the oropharynx for 15 seconds
D. Start chest compressions
Correct Answer: A
Explanation: Snoring respirations are a sign of a partial airway obstruction, usually by the
tongue in an unresponsive patient. The first step to correct this is a basic airway maneuver
like the head-tilt, chin-lift (or jaw-thrust if trauma is suspected). Only after manual
maneuvers should adjuncts or suction be considered.
5. A 19-year-old male is found with pinpoint pupils, a respiratory rate of 6 breaths per
minute, and cyanosis. Bystanders say he was ‘using’ with friends. What is the priority
treatment?
A. Provide bag-valve-mask ventilations
B. Administer naloxone via intranasal route
C. Perform a secondary assessment to find track marks
D. Apply high-flow oxygen via non-rebreather mask
Correct Answer: A
Certification Examination – Comprehensive
Cognitive Practice Questions and Detailed Answers
1. A 67-year-old male presents with sudden shortness of breath and sharp chest pain that
increases with inspiration. He recently had hip surgery. His vitals are BP 110/70, P 110, R 28
and shallow. What should you suspect?
A. Spontaneous pneumothorax
B. Myocardial infarction
C. Pulmonary embolism
D. Pneumonia
Correct Answer: C
Explanation: The patient’s recent surgery and sudden onset of pleuritic chest pain are
classic indicators of a pulmonary embolism. Tachycardia and tachypnea are common
compensatory mechanisms for the ventilation-perfusion mismatch. Recognizing risk
factors like recent immobilization is key to differentiating this from a primary cardiac
event.
2. You are treating a 5-year-old female who is drooling and sitting in a tripod position. She
has a high fever and appears very anxious. What is the most appropriate next step?
A. Inspect the airway with a tongue depressor
B. Initiate positive pressure ventilations
,C. Perform a blind finger sweep
D. Provide blow-by oxygen and immediate transport
Correct Answer: D
Explanation: The clinical presentation suggests epiglottitis, which is a bacterial infection
causing severe swelling of the epiglottis. Agitating the child or inserting anything into the
mouth can cause total airway obstruction. Immediate transport in a position of comfort
while providing supplemental oxygen is the priority.
3. An adult male was involved in a motor vehicle accident. He has paradoxical movement on
the left side of his chest. His breathing is rapid and shallow. What is your immediate
intervention?
A. Stabilize the segment with your hand and provide positive pressure ventilation
B. Apply a bulky dressing and tape it on all four sides
C. Place the patient on his left side to stabilize the ribs
D. Perform a needle decompression of the left chest
Correct Answer: A
Explanation: Paradoxical movement is the hallmark sign of a flail chest, which severely
compromises ventilation. Positive pressure ventilation via BVM is the most effective way to
stabilize the segment internally and improve oxygenation. Taping bulky dressings is no
longer the primary recommendation for flail chest management.
, 4. You arrive at a scene where a 45-year-old female is found unresponsive. You note snoring
respirations. What should be your first action?
A. Perform a head-tilt, chin-lift maneuver
B. Insert an oropharyngeal airway
C. Suction the oropharynx for 15 seconds
D. Start chest compressions
Correct Answer: A
Explanation: Snoring respirations are a sign of a partial airway obstruction, usually by the
tongue in an unresponsive patient. The first step to correct this is a basic airway maneuver
like the head-tilt, chin-lift (or jaw-thrust if trauma is suspected). Only after manual
maneuvers should adjuncts or suction be considered.
5. A 19-year-old male is found with pinpoint pupils, a respiratory rate of 6 breaths per
minute, and cyanosis. Bystanders say he was ‘using’ with friends. What is the priority
treatment?
A. Provide bag-valve-mask ventilations
B. Administer naloxone via intranasal route
C. Perform a secondary assessment to find track marks
D. Apply high-flow oxygen via non-rebreather mask
Correct Answer: A
