NREMT Certification Practice Exam – 120
Questions
1. A toddler has a barking, seal-like cough, stridor, and a low-grade fever after
a cold. This presentation is most consistent with:
A. Epiglottitis
B. Pulmonary edema
C. Tension pneumothorax
D. Croup
Correct Answer: D. Croup
Rationale: Croup is a viral upper airway infection in young children with a barking
cough. Epiglottitis presents with drooling, tripod positioning, and muffled voice and
the airway should not be agitated.
2. At a suspected crime scene, what is the EMT's primary responsibility?
A. Provide patient care while preserving evidence as much as possible
B. Collect evidence for police
C. Clean the scene
D. Move the victim's belongings
Correct Answer: A. Provide patient care while preserving evidence as much as
possible
Rationale: Patient care takes priority, but minimize disturbance of the scene and
document anything that is moved or cut, such as clothing.
Page 1
,3. Which finding suggests acute pulmonary edema from congestive heart
failure?
A. Barking cough and stridor in a toddler
B. Unilateral absent breath sounds with tracheal deviation
C. Bilateral crackles, jugular vein distention, and difficulty breathing when lying
flat
D. Sudden pleuritic chest pain after long-distance travel
Correct Answer: C. Bilateral crackles, jugular vein distention, and difficulty
breathing when lying flat
Rationale: Fluid backing up into the lungs causes crackles, orthopnea, and
sometimes pink frothy sputum. Position the patient upright, give oxygen, and
consider CPAP per protocol.
4. What is the proper management of a hypothermic patient?
A. Rub the extremities vigorously
B. Give alcohol to warm the patient
C. Immerse the patient in a hot bath
D. Handle gently, remove wet clothing, and insulate the patient
Correct Answer: D. Handle gently, remove wet clothing, and insulate the
patient
Rationale: Rough handling can trigger ventricular fibrillation in a cold heart. Remove
wet clothing, insulate, and apply heat to the trunk.
5. Which type of respiratory protection should be worn when caring for a
patient with suspected tuberculosis?
A. N95 or HEPA respirator
B. A surgical mask on the EMT only
C. Eye protection only
D. No special protection
Correct Answer: A. N95 or HEPA respirator
Rationale: Tuberculosis is airborne, so an N95-level respirator is required for
providers. A surgical mask on the patient helps limit spread.
Page 2
,6. An oropharyngeal airway is contraindicated in which patient?
A. An unresponsive patient with no gag reflex
B. A patient with an intact gag reflex
C. A patient in cardiac arrest
D. An unresponsive patient who cannot maintain an open airway
Correct Answer: B. A patient with an intact gag reflex
Rationale: An OPA can trigger vomiting and laryngospasm in a patient with a gag
reflex. An NPA is better tolerated in responsive or semi-responsive patients.
7. What should the EMT do for an abdominal evisceration?
A. Push the organs back into the abdomen
B. Apply a dry, tight bandage
C. Cover the exposed organs with a moist sterile dressing and an occlusive
covering
D. Wash the organs with large amounts of water and leave uncovered
Correct Answer: C. Cover the exposed organs with a moist sterile dressing
and an occlusive covering
Rationale: Do not replace organs. Keep them moist and warm to prevent drying and
heat loss, and avoid pressure on the organs.
8. You arrive at a scene where a patient in cardiac arrest has a DNR order.
What is the best action?
A. Ignore it and begin CPR in every case
B. Leave the scene immediately
C. Verify the order is valid and follow local protocol and medical direction
D. Ask bystanders to decide
Correct Answer: C. Verify the order is valid and follow local protocol and
medical direction
Rationale: A valid DNR directs EMS not to start resuscitation. Verify the document
and contact medical direction if there is any doubt.
Page 3
, 9. Which is NOT part of the Cincinnati Prehospital Stroke Scale?
A. Facial droop
B. Arm drift
C. Pupillary response
D. Speech abnormality
Correct Answer: C. Pupillary response
Rationale: The Cincinnati scale evaluates facial droop, arm drift, and speech.
Establishing the time the patient was last known well is also critical for treatment
decisions.
10. A 5-year-old child is in cardiac arrest and only adult AED pads are
available. What should you do?
A. Do not use the AED and continue CPR only
B. Use the AED with the adult pads, placing them so they do not touch
C. Cut the adult pads in half
D. Wait for ALS before applying any pads
Correct Answer: B. Use the AED with the adult pads, placing them so they do
not touch
Rationale: Pediatric pads or a dose attenuator are preferred for children under 8,
but using the AED with adult pads is better than no defibrillation. Use front and back
placement if the pads would touch.
11. Which finding is a contraindication to giving nitroglycerin?
A. Use of sildenafil (Viagra) within the last 24 hours
B. Pain radiating to the left arm
C. A history of hypertension
D. A heart rate of 88 bpm
Correct Answer: A. Use of sildenafil (Viagra) within the last 24 hours
Rationale: Nitrates combined with phosphodiesterase-5 inhibitors can cause
profound hypotension (24 hours for sildenafil, 48 hours for tadalafil). Also avoid nitro
in hypotension or suspected right ventricular infarction.
Page 4
Questions
1. A toddler has a barking, seal-like cough, stridor, and a low-grade fever after
a cold. This presentation is most consistent with:
A. Epiglottitis
B. Pulmonary edema
C. Tension pneumothorax
D. Croup
Correct Answer: D. Croup
Rationale: Croup is a viral upper airway infection in young children with a barking
cough. Epiglottitis presents with drooling, tripod positioning, and muffled voice and
the airway should not be agitated.
2. At a suspected crime scene, what is the EMT's primary responsibility?
A. Provide patient care while preserving evidence as much as possible
B. Collect evidence for police
C. Clean the scene
D. Move the victim's belongings
Correct Answer: A. Provide patient care while preserving evidence as much as
possible
Rationale: Patient care takes priority, but minimize disturbance of the scene and
document anything that is moved or cut, such as clothing.
Page 1
,3. Which finding suggests acute pulmonary edema from congestive heart
failure?
A. Barking cough and stridor in a toddler
B. Unilateral absent breath sounds with tracheal deviation
C. Bilateral crackles, jugular vein distention, and difficulty breathing when lying
flat
D. Sudden pleuritic chest pain after long-distance travel
Correct Answer: C. Bilateral crackles, jugular vein distention, and difficulty
breathing when lying flat
Rationale: Fluid backing up into the lungs causes crackles, orthopnea, and
sometimes pink frothy sputum. Position the patient upright, give oxygen, and
consider CPAP per protocol.
4. What is the proper management of a hypothermic patient?
A. Rub the extremities vigorously
B. Give alcohol to warm the patient
C. Immerse the patient in a hot bath
D. Handle gently, remove wet clothing, and insulate the patient
Correct Answer: D. Handle gently, remove wet clothing, and insulate the
patient
Rationale: Rough handling can trigger ventricular fibrillation in a cold heart. Remove
wet clothing, insulate, and apply heat to the trunk.
5. Which type of respiratory protection should be worn when caring for a
patient with suspected tuberculosis?
A. N95 or HEPA respirator
B. A surgical mask on the EMT only
C. Eye protection only
D. No special protection
Correct Answer: A. N95 or HEPA respirator
Rationale: Tuberculosis is airborne, so an N95-level respirator is required for
providers. A surgical mask on the patient helps limit spread.
Page 2
,6. An oropharyngeal airway is contraindicated in which patient?
A. An unresponsive patient with no gag reflex
B. A patient with an intact gag reflex
C. A patient in cardiac arrest
D. An unresponsive patient who cannot maintain an open airway
Correct Answer: B. A patient with an intact gag reflex
Rationale: An OPA can trigger vomiting and laryngospasm in a patient with a gag
reflex. An NPA is better tolerated in responsive or semi-responsive patients.
7. What should the EMT do for an abdominal evisceration?
A. Push the organs back into the abdomen
B. Apply a dry, tight bandage
C. Cover the exposed organs with a moist sterile dressing and an occlusive
covering
D. Wash the organs with large amounts of water and leave uncovered
Correct Answer: C. Cover the exposed organs with a moist sterile dressing
and an occlusive covering
Rationale: Do not replace organs. Keep them moist and warm to prevent drying and
heat loss, and avoid pressure on the organs.
8. You arrive at a scene where a patient in cardiac arrest has a DNR order.
What is the best action?
A. Ignore it and begin CPR in every case
B. Leave the scene immediately
C. Verify the order is valid and follow local protocol and medical direction
D. Ask bystanders to decide
Correct Answer: C. Verify the order is valid and follow local protocol and
medical direction
Rationale: A valid DNR directs EMS not to start resuscitation. Verify the document
and contact medical direction if there is any doubt.
Page 3
, 9. Which is NOT part of the Cincinnati Prehospital Stroke Scale?
A. Facial droop
B. Arm drift
C. Pupillary response
D. Speech abnormality
Correct Answer: C. Pupillary response
Rationale: The Cincinnati scale evaluates facial droop, arm drift, and speech.
Establishing the time the patient was last known well is also critical for treatment
decisions.
10. A 5-year-old child is in cardiac arrest and only adult AED pads are
available. What should you do?
A. Do not use the AED and continue CPR only
B. Use the AED with the adult pads, placing them so they do not touch
C. Cut the adult pads in half
D. Wait for ALS before applying any pads
Correct Answer: B. Use the AED with the adult pads, placing them so they do
not touch
Rationale: Pediatric pads or a dose attenuator are preferred for children under 8,
but using the AED with adult pads is better than no defibrillation. Use front and back
placement if the pads would touch.
11. Which finding is a contraindication to giving nitroglycerin?
A. Use of sildenafil (Viagra) within the last 24 hours
B. Pain radiating to the left arm
C. A history of hypertension
D. A heart rate of 88 bpm
Correct Answer: A. Use of sildenafil (Viagra) within the last 24 hours
Rationale: Nitrates combined with phosphodiesterase-5 inhibitors can cause
profound hypotension (24 hours for sildenafil, 48 hours for tadalafil). Also avoid nitro
in hypotension or suspected right ventricular infarction.
Page 4
