NRCME TEST BANK 2025
NREMT TEST BANK VERIFIED
QUESTIONS AND ANWERS WITH
DETAILED RATIONALES 2025/2026
COMPLETE 600 QUESTIONS AND
CORRECT ANSWERS WITH
RATIONALES | ALREADY GRADED A+
A 48-year-old male became acutely hypoxic, experienced a seizure, and is now postictal. The MOST
effective way to prevent another seizure is to:
• A:dim the lights in the back of the ambulance.
• B:place him in the recovery position.
• C:administer high-flow supplemental oxygen.
• D:give him oral glucose if he can swallow.
You selected C; This is correct!
Reason:You should administer high-flow oxygen to all patients who are actively seizing and to
patients who experienced a seizure and are postictal. This is especially true if the seizure was caused
by hypoxia. Increasing the oxygen content of the blood, which minimizes hypoxia, may prevent
another seizure. The recovery position is appropriate for uninjured patients with a decreased level of
consciousness and adequate breathing; it will help maintain the airway and facilitate drainage of
secretions from the mouth, but will not prevent another seizure. Oral glucose may prevent another
seizure if hypoglycemia was the cause of the seizure. You should dim the lights in the back of the
ambulance to help prevent any seizure, not just those that are caused by hypoxia.
Which of the following conditions would be the LEAST likely to be present in a patient who was
submerged in water?
• A:Spinal injury
• B:Gastric distention
• C:Hyperglycemia
• D:Laryngospasm
You selected C; This is correct!
Reason: Many factors can contribute to or result from a submersion injury (eg, drowning, near-
drowning). It is not uncommon for a person to experience a spinal injury after diving head first into
A+ TEST BANK 1
, NRCME TEST BANK 2025
shallow water, especially if he or she is under the influence of alcohol. When a swimmer panics, he or
she initially swallows large amounts of water, resulting in gastric distention. Gastric distention can
cause aspiration if the patient regurgitates water during rescue breathing; protect the airway! During
the panic phase, the victim expends a tremendous amount of energy (and glucose) from flailing
around in the water, possibly resulting in hypoglycemia. Inhaling even a small amount of fresh or salt
water can severely irritate the larynx, which sends the muscles of the larynx and vocal cords into
spasm (laryngospasm), resulting in airway blockage and hypoxia.
A 42-year-old male presents with fever, a severe headache, and a stiff neck. He is conscious, but
confused. His wife tells you that he does not have any medical problems and does not take any
medications. You should be MOST suspicious for:
• A:acute stroke.
• B:influenza.
• C:meningitis.
• D:tuberculosis.
(
You selected C; This is correct!
Reason:Meningitis is an inflammation of the protective coverings of the brain and spinal cord
(meninges). Common signs and symptoms of meningitis include fever, headache, neck stiffness
(nuchal rigidity), and vomiting. An altered mental status is common in severe cases. Meningococcal
meningitis, caused by a bacterium, is the most contagious and potentially fatal type of meningitis.
The patient's signs and symptoms are not consistent with acute stroke, tuberculosis (TB), or
influenza (the flu). Although fever is common with both TB and the flu, neither causes neck stiffness.
Acute stroke may be associated with a headache, especially a hemorrhagic stroke; however, stroke
patients typically do not have a fever.
All of the following are signs of gastrointestinal bleeding, EXCEPT:
• A:melena.
• B:hematemesis.
• C:tachycardia.
• D:hemoptysis.
You selected D; This is correct!
Reason:Signs and symptoms of gastrointestinal (GI) bleeding include abdominal pain; vomiting blood
(hematemesis); the passage of dark, tarry stools (melena); and bright red rectal bleeding
(hematochezia). If blood loss is significant, the patient may have signs of shock (eg, tachycardia,
diaphoresis, tachypnea, hypotension). Hemoptysis (coughing up blood) is a sign of a pulmonary
injury, not GI bleeding.
A+ TEST BANK 2
, NRCME TEST BANK 2025
A 24-year-old female presents with a rash to her left leg and swollen, painful knee joints. She tells you
that she and her friends returned from a hiking trip in the mountains a week ago. She is conscious
and alert with a blood pressure of 112/62 mm Hg, a pulse of 84 beats/min, and respirations of 14
breaths/min. Her symptoms are MOST likely the result of:
• A:Rocky Mountain spotted fever.
• B:tetanus.
• C:Lyme disease.
• D:a localized allergic reaction.
You selected C; This is correct!
Reason:The patient's symptoms and her history of a recent hiking trip are consistent with Lyme
disease, which was the result of a tick bite. Ticks can carry two infectious diseases: Lyme disease and
Rocky Mountain spotted fever. Both are spread through the tick's saliva, which is injected into the
skin when the tick attaches itself. The first symptom of Lyme disease, a rash that may spread to
several parts of the body, begins about 3 days after the bite of an infected tick. The rash may
eventually resemble a target bull's-eye pattern in one third of patients. After a few more days or
weeks, painful swelling of the joints, particularly the knees, occurs. If recognized and treated
promptly with antibiotics, many patients recover completely. Rocky Mountain spotted fever, which
is not limited to the Rocky Mountains, occurs within 7 to 10 days after being bitten by an infected
tick. Its symptoms include nausea, vomiting, headache, weakness, paralysis, and possibly
cardiopulmonary failure.
!
A 50-year-old woman who is conscious and alert complains of a severe migraine headache. When
caring for her, you should generally avoid:
• A:transporting her in a supine position.
• B:shining a light into her pupils.
• C:dimming the lights in the ambulance.
• D:applying ice packs to her forehead.
You selected B; This is correct!
Reason:Patients with migraine or cluster headaches typically have photophobia (light sensitivity).
Any type of bright light, especially if shone directly into the eyes, will cause the patient with a
headache unnecessary severe pain. Dimming the lights in the ambulance and making the patient as
comfortable as possible are the treatments of choice for a patient with a headache. Some patients
benefit from ice packs applied to the forehead; just be sure to wrap the ice pack with roller gauze.
Oxygen also should be administered as needed. Typically, the patient will prefer to lie supine or on
the side
A patient who overdosed on heroin would be expected to present with:
• A:tachycardia.
A+ TEST BANK 3
, NRCME TEST BANK 2025
• B:hyperpnea.
• C:hypotension.
• D:dilated pupils.
The correct answer is C;
Reason:Heroin is a Schedule I (illegal) narcotic that is typically injected. As with all narcotics, legal or
illegal, overdose causes depression of the central nervous system (CNS), resulting in a decreased
level of consciousness; bradycardia; hypotension; and slow, shallow (reduced tidal volume)
breathing. Hyperpnea (deep breathing) would not be present in a patient who overdosed on a
narcotic. In a narcotic overdose, the pupils are typically constricted (miosis). Barbiturates, such as
phenobarbital, are also CNS depressants and cause the same symptoms seen with narcotic overdose.
The patient's pupils, however, are typically dilated (mydriasis), not constricted.
When caring for any patient with a decreased level of consciousness, your primary concern should be
the:
• A:potential for airway compromise.
• B:patient's blood glucose level.
• C:possibility of a spinal injury.
• D:possibility of a drug overdose.
You selected A; This is correct!
Reason:Altered mental status could be caused by a high or low blood glucose level, drug overdose,
or head injury, among other causes. Furthermore, the possibility of a spinal injury should be
considered if the patient was injured. However, your primary concern should be the status of the
patient's airway. Patients with a decreased level of consciousness are at risk for aspiration if vomiting
occurs. Unless spinal trauma is present or the patient is breathing inadequately (eg, fast or slow rate,
shallow breathing [reduced tidal volume]), place him or her in the recovery position to facilitate
drainage if vomiting occurs. Remember this: no airway, no patient!
A 16-year-old, 125-pound male ingested a bottle of aspirin approximately 20 minutes ago. Medical
control orders you to administer activated charcoal in a dose of 1 g/kg. How much activated charcoal
should you administer?
• A:54 g
• B:60 g
• C:51 g
• D:57 g
You selected D; This is correct!
Reason: First, you must determine the patient's weight in kilograms (kg). Either of the following
A+ TEST BANK 4
NREMT TEST BANK VERIFIED
QUESTIONS AND ANWERS WITH
DETAILED RATIONALES 2025/2026
COMPLETE 600 QUESTIONS AND
CORRECT ANSWERS WITH
RATIONALES | ALREADY GRADED A+
A 48-year-old male became acutely hypoxic, experienced a seizure, and is now postictal. The MOST
effective way to prevent another seizure is to:
• A:dim the lights in the back of the ambulance.
• B:place him in the recovery position.
• C:administer high-flow supplemental oxygen.
• D:give him oral glucose if he can swallow.
You selected C; This is correct!
Reason:You should administer high-flow oxygen to all patients who are actively seizing and to
patients who experienced a seizure and are postictal. This is especially true if the seizure was caused
by hypoxia. Increasing the oxygen content of the blood, which minimizes hypoxia, may prevent
another seizure. The recovery position is appropriate for uninjured patients with a decreased level of
consciousness and adequate breathing; it will help maintain the airway and facilitate drainage of
secretions from the mouth, but will not prevent another seizure. Oral glucose may prevent another
seizure if hypoglycemia was the cause of the seizure. You should dim the lights in the back of the
ambulance to help prevent any seizure, not just those that are caused by hypoxia.
Which of the following conditions would be the LEAST likely to be present in a patient who was
submerged in water?
• A:Spinal injury
• B:Gastric distention
• C:Hyperglycemia
• D:Laryngospasm
You selected C; This is correct!
Reason: Many factors can contribute to or result from a submersion injury (eg, drowning, near-
drowning). It is not uncommon for a person to experience a spinal injury after diving head first into
A+ TEST BANK 1
, NRCME TEST BANK 2025
shallow water, especially if he or she is under the influence of alcohol. When a swimmer panics, he or
she initially swallows large amounts of water, resulting in gastric distention. Gastric distention can
cause aspiration if the patient regurgitates water during rescue breathing; protect the airway! During
the panic phase, the victim expends a tremendous amount of energy (and glucose) from flailing
around in the water, possibly resulting in hypoglycemia. Inhaling even a small amount of fresh or salt
water can severely irritate the larynx, which sends the muscles of the larynx and vocal cords into
spasm (laryngospasm), resulting in airway blockage and hypoxia.
A 42-year-old male presents with fever, a severe headache, and a stiff neck. He is conscious, but
confused. His wife tells you that he does not have any medical problems and does not take any
medications. You should be MOST suspicious for:
• A:acute stroke.
• B:influenza.
• C:meningitis.
• D:tuberculosis.
(
You selected C; This is correct!
Reason:Meningitis is an inflammation of the protective coverings of the brain and spinal cord
(meninges). Common signs and symptoms of meningitis include fever, headache, neck stiffness
(nuchal rigidity), and vomiting. An altered mental status is common in severe cases. Meningococcal
meningitis, caused by a bacterium, is the most contagious and potentially fatal type of meningitis.
The patient's signs and symptoms are not consistent with acute stroke, tuberculosis (TB), or
influenza (the flu). Although fever is common with both TB and the flu, neither causes neck stiffness.
Acute stroke may be associated with a headache, especially a hemorrhagic stroke; however, stroke
patients typically do not have a fever.
All of the following are signs of gastrointestinal bleeding, EXCEPT:
• A:melena.
• B:hematemesis.
• C:tachycardia.
• D:hemoptysis.
You selected D; This is correct!
Reason:Signs and symptoms of gastrointestinal (GI) bleeding include abdominal pain; vomiting blood
(hematemesis); the passage of dark, tarry stools (melena); and bright red rectal bleeding
(hematochezia). If blood loss is significant, the patient may have signs of shock (eg, tachycardia,
diaphoresis, tachypnea, hypotension). Hemoptysis (coughing up blood) is a sign of a pulmonary
injury, not GI bleeding.
A+ TEST BANK 2
, NRCME TEST BANK 2025
A 24-year-old female presents with a rash to her left leg and swollen, painful knee joints. She tells you
that she and her friends returned from a hiking trip in the mountains a week ago. She is conscious
and alert with a blood pressure of 112/62 mm Hg, a pulse of 84 beats/min, and respirations of 14
breaths/min. Her symptoms are MOST likely the result of:
• A:Rocky Mountain spotted fever.
• B:tetanus.
• C:Lyme disease.
• D:a localized allergic reaction.
You selected C; This is correct!
Reason:The patient's symptoms and her history of a recent hiking trip are consistent with Lyme
disease, which was the result of a tick bite. Ticks can carry two infectious diseases: Lyme disease and
Rocky Mountain spotted fever. Both are spread through the tick's saliva, which is injected into the
skin when the tick attaches itself. The first symptom of Lyme disease, a rash that may spread to
several parts of the body, begins about 3 days after the bite of an infected tick. The rash may
eventually resemble a target bull's-eye pattern in one third of patients. After a few more days or
weeks, painful swelling of the joints, particularly the knees, occurs. If recognized and treated
promptly with antibiotics, many patients recover completely. Rocky Mountain spotted fever, which
is not limited to the Rocky Mountains, occurs within 7 to 10 days after being bitten by an infected
tick. Its symptoms include nausea, vomiting, headache, weakness, paralysis, and possibly
cardiopulmonary failure.
!
A 50-year-old woman who is conscious and alert complains of a severe migraine headache. When
caring for her, you should generally avoid:
• A:transporting her in a supine position.
• B:shining a light into her pupils.
• C:dimming the lights in the ambulance.
• D:applying ice packs to her forehead.
You selected B; This is correct!
Reason:Patients with migraine or cluster headaches typically have photophobia (light sensitivity).
Any type of bright light, especially if shone directly into the eyes, will cause the patient with a
headache unnecessary severe pain. Dimming the lights in the ambulance and making the patient as
comfortable as possible are the treatments of choice for a patient with a headache. Some patients
benefit from ice packs applied to the forehead; just be sure to wrap the ice pack with roller gauze.
Oxygen also should be administered as needed. Typically, the patient will prefer to lie supine or on
the side
A patient who overdosed on heroin would be expected to present with:
• A:tachycardia.
A+ TEST BANK 3
, NRCME TEST BANK 2025
• B:hyperpnea.
• C:hypotension.
• D:dilated pupils.
The correct answer is C;
Reason:Heroin is a Schedule I (illegal) narcotic that is typically injected. As with all narcotics, legal or
illegal, overdose causes depression of the central nervous system (CNS), resulting in a decreased
level of consciousness; bradycardia; hypotension; and slow, shallow (reduced tidal volume)
breathing. Hyperpnea (deep breathing) would not be present in a patient who overdosed on a
narcotic. In a narcotic overdose, the pupils are typically constricted (miosis). Barbiturates, such as
phenobarbital, are also CNS depressants and cause the same symptoms seen with narcotic overdose.
The patient's pupils, however, are typically dilated (mydriasis), not constricted.
When caring for any patient with a decreased level of consciousness, your primary concern should be
the:
• A:potential for airway compromise.
• B:patient's blood glucose level.
• C:possibility of a spinal injury.
• D:possibility of a drug overdose.
You selected A; This is correct!
Reason:Altered mental status could be caused by a high or low blood glucose level, drug overdose,
or head injury, among other causes. Furthermore, the possibility of a spinal injury should be
considered if the patient was injured. However, your primary concern should be the status of the
patient's airway. Patients with a decreased level of consciousness are at risk for aspiration if vomiting
occurs. Unless spinal trauma is present or the patient is breathing inadequately (eg, fast or slow rate,
shallow breathing [reduced tidal volume]), place him or her in the recovery position to facilitate
drainage if vomiting occurs. Remember this: no airway, no patient!
A 16-year-old, 125-pound male ingested a bottle of aspirin approximately 20 minutes ago. Medical
control orders you to administer activated charcoal in a dose of 1 g/kg. How much activated charcoal
should you administer?
• A:54 g
• B:60 g
• C:51 g
• D:57 g
You selected D; This is correct!
Reason: First, you must determine the patient's weight in kilograms (kg). Either of the following
A+ TEST BANK 4
