NREMT EXAM QUESTIONS WITH ACCURATE ANSWERS
cardiogenic shock Accurate Answer - -the type of shock caused by
inadequate function of the heart. This develops when the heart cannot
maintain sufficient output to meet the demands of the body
-caused by any disease or event which prevents heart pumping
-can occur directly after AMI up to 24 hours
Obstructive shock Accurate Answer - The type of shock that results
when conditions that cause mechanical obstruction of the cardiac muscle also
impact pump function
ex. cardiac tamponade, tension pneumothorax
Beck's triad Accurate Answer - Signs of a cardiac tamponade. JVD,
narrowing BP pressures, muffled heart sounds
Distributive shock Accurate Answer - The type of shock when there is
widespread dilation of the small arterioles, venules, or both. Blood pools in
the expanded vascular beds and tissue perfusion decreases
Types of distributive shock Accurate Answer - Septic shock caused by
severe infections; neurogenic shock caused by damage to the spinal cord
(bradycardia, low BP, warm skin); anaphylactic shock caused by allergic
reaction; psychogenic shock
Hypovolemic shock Accurate Answer - The type of shock that results
from an inadequate amount of fluid or volume in the system
-15% of blood volume
How do you treat for shock? Accurate Answer - Keep the patient warm,
control bleeding, put the patient in a position of comfort, and administer high-
flow oxygen
brain damage without oxygen Accurate Answer - -without enough
oxygen, cardiac arrest or brain damage occurs within about 4 minutes
-permanent brain damage within 6 minutes
-death likely within 10 minutes
,FBAO Accurate Answer - -signs of blockage include inability to cough
or speak or inability to ventilate patient
-bending patient forward at the waist, support chest with one hand, use heel
of hand to give 5 back blows between shoulder blades
-then 5 abdominal thrusts
-alternate between the two until object is dislodged
-if patient loses consciousness, give CPR starting with chest compressions
-given even if patient has a pulse, so don't check
-before giving breaths, look inside mouth for any visible objects
FBAO in children Accurate Answer - -using thigh for support, lay facing
down along forearm; ensure head is lower than the body
-give 5 firm back blows between blades
-5 chest thrusts; place 2 to 3 fingers in the middle of the chest just below the
nipples. push down 1.5 inches.
-alternate, unless lose consciousness, then CPR
mouse to mouth/mouth to nose Accurate Answer - -mouth to mouth
performed when patient does not have adequate breathing and artificial
ventilation not available
-open airway
-place barrier device
-pinch nose and form seal around patient's mouth
-check for FBAO if you do not see chest rise and fall
-give 1 breath every 5 to 6 seconds for adults and 1 every 3 for peds
Steps of CPR Accurate Answer - Determine unresponsiveness. Check
for breathing for up to 10 seconds. Check carotid pulse for up to 10 seconds.
Begin CPR until AED is available. Give 30 compressions at 100 beats/min and
then 2 breaths over the course of 1 second. Once an advanced airway is
inserted, ventilate at a rate of 8-10 breaths/min and do not stop
compressions.
This is exactly the same for children, except two-rescuer CPR is 15:2. If patient
experiences a return of spontaneous circulation, ventilate at a rate of 10-12
breaths/min.
compression to breath ratios Accurate Answer - under 8 years old:
-2 provider: 15:2
,-1 provider: 30:2
-one third of chest diameter
older:
-30:2 always
-2 inches
AED procedure Accurate Answer - -if cardiac arrest was not seen by
EMS, give 5 cycles of 30:2 before defibrillating
-if cardiac arrest was seen, one EMT begins compressions and the other
applies AED
-if only one EMT available, apply AED immediately
-check for pulse 2 minutes after defib
-if no shockable rhythm, wait 2 minutes and re-analyze
When to place left lateral Accurate Answer - If patient has adequate
breathing and is uninjured. To maintain a patent airway in an unresponsive
patient.
What to do if you fail to ventilate Accurate Answer - If the breath
doesn't go in successfully, reposition the patient and try again. If there is still
nothing, assume there is a foreign body obstruction and begin CPR on an
unresponsive apneic patient. Continue to attempt ventilations and open the
mouth and look in every time.
Pneumothorax signs Accurate Answer - -dyspnea, pleuritic chest pain
that worsens during inspiration and expiration, absent or decreased breath
sounds
-rupture of visceral lining
Pulmonary embolism signs Accurate Answer - -dyspnea, acute chest
pain, hemoptysis, cyanosis, tachypnea, hypoxia, tachycardia?**
GCS Eye Opening Accurate Answer - Spontaneous = 4
To voice = 3
To pain = 2
None = 1
GCS Verbal Response Accurate Answer - Oriented = 5
, Confused = 4
Inappropriate words = 3
Incomprehensible words = 2
None = 1
GCS Motor Response Accurate Answer - Obeys commands = 6
Localizes pain = 5
Withdraws (pain) = 4
Flexion (pain) = 3
Extension (pain) = 2
None = 1
Rule of nines (adults) Accurate Answer - Head = 9%
Front = 18%
Back = 18%
Each arm = 9%
Groin = 1%
Each leg = 18%
Rule of nines (child) Accurate Answer - Head = 18%
Front = 18%
Back = 18%
Each arm = 9%
Each leg = 14%
Cushing's triad Accurate Answer - Sign there might be an increase in
intracranial pressure. Hypertension, bradycardia, and abnormal breathing.
Appendicitis pain Accurate Answer - -pain to the RLQ
-rebounding pain
-fever
peritonitis Accurate Answer - -inflammation of peritoneum
-abdominal pain, lack of appetite, markle test
markle heel drop Accurate Answer - markle test; used to assess a
patient with abdominal pain, patient drops down onto heels, pain will be felt
in region of pain source
cardiogenic shock Accurate Answer - -the type of shock caused by
inadequate function of the heart. This develops when the heart cannot
maintain sufficient output to meet the demands of the body
-caused by any disease or event which prevents heart pumping
-can occur directly after AMI up to 24 hours
Obstructive shock Accurate Answer - The type of shock that results
when conditions that cause mechanical obstruction of the cardiac muscle also
impact pump function
ex. cardiac tamponade, tension pneumothorax
Beck's triad Accurate Answer - Signs of a cardiac tamponade. JVD,
narrowing BP pressures, muffled heart sounds
Distributive shock Accurate Answer - The type of shock when there is
widespread dilation of the small arterioles, venules, or both. Blood pools in
the expanded vascular beds and tissue perfusion decreases
Types of distributive shock Accurate Answer - Septic shock caused by
severe infections; neurogenic shock caused by damage to the spinal cord
(bradycardia, low BP, warm skin); anaphylactic shock caused by allergic
reaction; psychogenic shock
Hypovolemic shock Accurate Answer - The type of shock that results
from an inadequate amount of fluid or volume in the system
-15% of blood volume
How do you treat for shock? Accurate Answer - Keep the patient warm,
control bleeding, put the patient in a position of comfort, and administer high-
flow oxygen
brain damage without oxygen Accurate Answer - -without enough
oxygen, cardiac arrest or brain damage occurs within about 4 minutes
-permanent brain damage within 6 minutes
-death likely within 10 minutes
,FBAO Accurate Answer - -signs of blockage include inability to cough
or speak or inability to ventilate patient
-bending patient forward at the waist, support chest with one hand, use heel
of hand to give 5 back blows between shoulder blades
-then 5 abdominal thrusts
-alternate between the two until object is dislodged
-if patient loses consciousness, give CPR starting with chest compressions
-given even if patient has a pulse, so don't check
-before giving breaths, look inside mouth for any visible objects
FBAO in children Accurate Answer - -using thigh for support, lay facing
down along forearm; ensure head is lower than the body
-give 5 firm back blows between blades
-5 chest thrusts; place 2 to 3 fingers in the middle of the chest just below the
nipples. push down 1.5 inches.
-alternate, unless lose consciousness, then CPR
mouse to mouth/mouth to nose Accurate Answer - -mouth to mouth
performed when patient does not have adequate breathing and artificial
ventilation not available
-open airway
-place barrier device
-pinch nose and form seal around patient's mouth
-check for FBAO if you do not see chest rise and fall
-give 1 breath every 5 to 6 seconds for adults and 1 every 3 for peds
Steps of CPR Accurate Answer - Determine unresponsiveness. Check
for breathing for up to 10 seconds. Check carotid pulse for up to 10 seconds.
Begin CPR until AED is available. Give 30 compressions at 100 beats/min and
then 2 breaths over the course of 1 second. Once an advanced airway is
inserted, ventilate at a rate of 8-10 breaths/min and do not stop
compressions.
This is exactly the same for children, except two-rescuer CPR is 15:2. If patient
experiences a return of spontaneous circulation, ventilate at a rate of 10-12
breaths/min.
compression to breath ratios Accurate Answer - under 8 years old:
-2 provider: 15:2
,-1 provider: 30:2
-one third of chest diameter
older:
-30:2 always
-2 inches
AED procedure Accurate Answer - -if cardiac arrest was not seen by
EMS, give 5 cycles of 30:2 before defibrillating
-if cardiac arrest was seen, one EMT begins compressions and the other
applies AED
-if only one EMT available, apply AED immediately
-check for pulse 2 minutes after defib
-if no shockable rhythm, wait 2 minutes and re-analyze
When to place left lateral Accurate Answer - If patient has adequate
breathing and is uninjured. To maintain a patent airway in an unresponsive
patient.
What to do if you fail to ventilate Accurate Answer - If the breath
doesn't go in successfully, reposition the patient and try again. If there is still
nothing, assume there is a foreign body obstruction and begin CPR on an
unresponsive apneic patient. Continue to attempt ventilations and open the
mouth and look in every time.
Pneumothorax signs Accurate Answer - -dyspnea, pleuritic chest pain
that worsens during inspiration and expiration, absent or decreased breath
sounds
-rupture of visceral lining
Pulmonary embolism signs Accurate Answer - -dyspnea, acute chest
pain, hemoptysis, cyanosis, tachypnea, hypoxia, tachycardia?**
GCS Eye Opening Accurate Answer - Spontaneous = 4
To voice = 3
To pain = 2
None = 1
GCS Verbal Response Accurate Answer - Oriented = 5
, Confused = 4
Inappropriate words = 3
Incomprehensible words = 2
None = 1
GCS Motor Response Accurate Answer - Obeys commands = 6
Localizes pain = 5
Withdraws (pain) = 4
Flexion (pain) = 3
Extension (pain) = 2
None = 1
Rule of nines (adults) Accurate Answer - Head = 9%
Front = 18%
Back = 18%
Each arm = 9%
Groin = 1%
Each leg = 18%
Rule of nines (child) Accurate Answer - Head = 18%
Front = 18%
Back = 18%
Each arm = 9%
Each leg = 14%
Cushing's triad Accurate Answer - Sign there might be an increase in
intracranial pressure. Hypertension, bradycardia, and abnormal breathing.
Appendicitis pain Accurate Answer - -pain to the RLQ
-rebounding pain
-fever
peritonitis Accurate Answer - -inflammation of peritoneum
-abdominal pain, lack of appetite, markle test
markle heel drop Accurate Answer - markle test; used to assess a
patient with abdominal pain, patient drops down onto heels, pain will be felt
in region of pain source
