Complete NREMT Exam Preparation and Practice Question Review 2025

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Complete NREMT Exam Preparation
and Practice Question Review 2025

A client presents with hypotension, pulmonary crackles, cool clammy skin, and jugular vein
distension after an acute myocardial infarction. Which type of shock does this presentation
indicate?

 Hypovolemic shock
 Neurogenic shock
 Cardiogenic shock
 Septic shock

Rationale: Cardiogenic shock occurs when the heart fails to pump effectively after myocardial
damage, leading to low cardiac output, pulmonary congestion, and elevated jugular venous
pressure. Hypovolemic shock lacks fluid volume; neurogenic has bradycardia and warm skin;
septic shock presents with vasodilation and fever.



A trauma patient presents with hypotension, distended neck veins, and muffled heart sounds.
Which type of shock is this consistent with?

 Obstructive shock
 Hypovolemic shock
 Distributive shock
 Cardiogenic shock

Rationale: These findings describe Beck’s triad—JVD, hypotension with narrow pulse pressure,
and muffled heart sounds—indicating cardiac tamponade, a form of obstructive shock.
Hypovolemic shock shows flat neck veins; distributive shock has vasodilation and warm skin;
cardiogenic shock presents with pulmonary edema.



Beck’s triad consists of which clinical findings?

 Jugular vein distention, muffled heart sounds, and narrowing pulse pressure
 Tachycardia, bounding pulse, and warm skin
 Bradycardia, hypotension, and sweating
 Cyanosis, tachypnea, and hypothermia

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Rationale: Beck’s triad defines cardiac tamponade. It reflects decreased venous return and
impaired cardiac filling due to pericardial pressure. The other sets of signs describe unrelated
hemodynamic states.



A patient presents with warm, flushed skin, bounding pulse, and hypotension due to severe
infection. Which type of shock is most likely?

 Cardiogenic shock
 Hypovolemic shock
 Distributive shock (septic)
 Obstructive shock

Rationale: Septic shock, a distributive type, results from widespread vasodilation due to
inflammatory mediators. Cardiogenic shock presents with pulmonary congestion; hypovolemic
with cold clammy skin; obstructive with mechanical interference of cardiac output.



Which of the following best defines hypovolemic shock?

 The heart fails to contract effectively
 There is inadequate circulating blood volume to maintain perfusion
 Widespread dilation of blood vessels causes blood pooling
 Mechanical obstruction reduces cardiac output

Rationale: Hypovolemic shock results from blood or fluid loss, reducing venous return and
cardiac output. Cardiogenic relates to heart pump failure; distributive to vasodilation; obstructive
to mechanical barriers.



The most effective immediate intervention for any type of shock is:

 Administering antibiotics
 Giving sedatives
 Providing high-flow oxygen and controlling the cause (bleeding, obstruction, etc.)
 Encouraging ambulation

Rationale: High-flow oxygen improves tissue perfusion, while managing the underlying cause
stabilizes circulation. Antibiotics only help in sepsis; sedatives worsen hypotension; ambulation
decreases venous return.

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If the brain is deprived of oxygen, what occurs after approximately 6 minutes?

 Full recovery of brain function
 Permanent brain damage
 Mild confusion
 Cardiac arrhythmia

Rationale: After 4 minutes without oxygen, brain cells begin dying; by 6 minutes, irreversible
brain injury develops. At 10 minutes, death is likely.



During management of a conscious choking adult, which sequence of actions should the rescuer
follow?

 Chest compressions followed by rescue breaths
 Five back blows followed by five abdominal thrusts, alternating until object
expulsion or collapse
 Heimlich maneuver only
 Blind finger sweep and rescue breathing

Rationale: Alternating back blows and abdominal thrusts generates pressure changes to clear the
airway. Finger sweeps risk pushing the object deeper unless it is visible. Rescue breathing is only
for unresponsive patients.



In a choking infant who remains conscious, which steps are correct?

 Blind finger sweeps after each back blow
 Five back blows with the infant’s head lower than the body, followed by five chest
thrusts using two fingers
 Five abdominal thrusts and then five rescue breaths
 Chest compressions only

Rationale: Infants cannot receive abdominal thrusts due to organ injury risk. Use alternating
back blows and chest thrusts until the obstruction clears or the infant becomes unresponsive.



During CPR, which of the following compression-to-ventilation ratios is correct for a two-
rescuer pediatric team?

 30:2
 10:1
 15:2

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 20:5

Rationale: In children and infants, two-rescuer CPR uses a 15:2 ratio to deliver more frequent
ventilations. The 30:2 ratio applies to single rescuers regardless of age.



A client with chest trauma has absent breath sounds on the right side, tracheal deviation to the
left, and severe respiratory distress. What is the likely diagnosis?

 Pulmonary embolism
 Tension pneumothorax
 Hemothorax
 Cardiac tamponade

Rationale: Tension pneumothorax causes increased intrathoracic pressure that collapses a lung
and shifts the mediastinum, impairing cardiac output. Pulmonary embolism and hemothorax do
not cause tracheal deviation.



Which findings are consistent with a pulmonary embolism?

 Sudden dyspnea, chest pain, hemoptysis, and tachycardia
 Cyanosis, absent breath sounds, and hypotension
 Productive cough and fever
 Stridor and bradycardia

Rationale: Pulmonary embolism causes acute ventilation-perfusion mismatch resulting in
dyspnea, pleuritic pain, hemoptysis, and tachycardia. Fever and productive cough suggest
infection, not embolism.



According to the adult Rule of Nines for burn assessment, what percentage of total body surface
area does one leg represent?

 9%
 18%
 27%
 36%

Rationale: Each leg accounts for 18% (9% anterior, 9% posterior) in adults. The head is 9%,
each arm 9%, front torso 18%, back 18%, and perineum 1%.