100%
NREMT Exam Success Guide with
Practice Tests and Study Tips 2025
Which major blood vessel carries deoxygenated (oxygen-poor) blood to the heart?
a) Pulmonary artery
b) Pulmonary vein
c) Aorta
d) Vena cava
Rationale: The vena cava carries deoxygenated blood from the body to the right atrium of the
heart. The pulmonary artery carries blood from the heart to the lungs, the pulmonary vein returns
oxygenated blood from the lungs, and the aorta distributes oxygenated blood to the body.
Which of the following is not a sign of internal bleeding into the gastrointestinal tract?
a) Bloody vomit
b) Dark, tarry stools
c) Bright red blood in stool
d) Bloody urine
Rationale: Bloody urine (hematuria) indicates urinary tract injury. Gastrointestinal bleeding
manifests as bloody vomit (hematemesis), bright red stool (hematochezia), or dark tarry stool
(melena).
Melena refers to:
a) Bright red blood in vomit
b) Dark or tarry stools
c) Bright red blood in stool
d) Coffee ground emesis
Rationale: Melena indicates upper gastrointestinal bleeding that causes dark, tarry stools. Bright
red blood indicates a lower GI source, while coffee-ground vomitus also comes from the upper
GI tract but with a different appearance.
An adult patient is bleeding profusely from a puncture wound on his upper left leg near the groin.
Bleeding is not controlled with direct fingertip pressure. What should you do next?
a) Elevate the leg
b) Apply ice packs
c) Apply a pressure dressing
d) Apply a tourniquet immediately
,100%
Rationale: After direct pressure fails, the next appropriate step is a pressure dressing. A
tourniquet is reserved for persistent bleeding. Elevation and ice are ineffective in emergency
bleeding control.
Which of the following actions should be taken if the stomach appears to be distending during
assisted ventilation?
a) Press on the abdomen to relieve pressure
b) Recheck and reposition the head, watching for chest rise
c) Insert an orogastric tube immediately
d) Withhold further ventilation
Rationale: Gastric distension may occur from improper airway alignment. Repositioning the
head and ensuring proper ventilation technique corrects this. Pressing the abdomen risks
aspiration; orogastric insertion is advanced care.
A man covered in dry lime powder complains of severe pain to his hands and face. What is the
most appropriate first step?
a) Apply sterile saline
b) Brush off the dry chemical from the skin and clothing
c) Cover the burns with moist dressings
d) Apply oxygen by nonrebreather
Rationale: Dry chemicals like lime should be brushed off before irrigation to prevent activation
and worsening burns. Moist dressings or oxygen are secondary considerations after
decontamination.
Which of the following represents a normal set of vital signs for a healthy eight-year-old child?
a) Respirations 12, pulse 70, BP 118/80 mmHg
b) Respirations 20, pulse 98, BP 104/73 mmHg
c) Respirations 28, pulse 130, BP 90/60 mmHg
d) Respirations 40, pulse 150, BP 85/50 mmHg
Rationale: Normal for an 8-year-old includes respirations 18–30, pulse 70–120, and systolic BP
above 80 mmHg. The selected values fall within these limits. The others are too extreme for a
stable child.
Patients with COPD typically have which of the following characteristics?
a) Elements of both chronic bronchitis and emphysema
b) Pure emphysema without inflammation
c) Reversible airway obstruction only
d) Lack of airflow limitation
,100%
Rationale: COPD involves both chronic bronchitis (airway inflammation) and emphysema
(alveolar destruction). It causes persistent airflow limitation and is not fully reversible.
How does nitroglycerin relieve cardiac-related chest pain?
a) Constricts coronary arteries
b) Increases heart rate
c) Increases myocardial oxygen demand
d) Relaxes peripheral arteries and veins
Rationale: Nitroglycerin is a vasodilator that reduces myocardial oxygen demand by decreasing
preload and afterload through venous and arterial relaxation. It does not increase heart rate or
oxygen demand.
What is the name of the cartilaginous ridge where the trachea divides into the right and left
bronchi?
a) Cricoid cartilage
b) Pharynx
c) Epiglottis
d) Carina
Rationale: The carina marks the bifurcation of the trachea into the main bronchi. It is a key
airway landmark during intubation. The cricoid and epiglottis are higher in the airway.
A 28-year-old female in a vehicle crash is unresponsive and apneic. Jaw-thrust maneuver has
failed. What is the next step?
a) Use the head-tilt/chin-lift maneuver
b) Insert an oropharyngeal airway
c) Begin chest compressions
d) Apply a cervical collar first
Rationale: When the jaw-thrust fails to open the airway, use the head-tilt/chin-lift, even in
suspected spinal injury. Airway patency takes priority over spinal precautions.
A patient in cardiac arrest has no DNR, but the rescuer discontinues CPR despite medical
direction instructing to continue during transport. What has occurred?
a) Negligence
b) Abandonment
c) Battery
d) Scope of practice violation
Rationale: Stopping care without patient consent or proper transfer to another qualified provider
constitutes abandonment. Negligence involves poor-quality care, not stopping it altogether.
, 100%
Where should abdominal thrusts be performed in a conscious child with airway obstruction?
a) Below the umbilicus
b) Above the umbilicus and below the lower tip of the sternum
c) Over the xiphoid process
d) At the level of the rib cage
Rationale: Thrusts must be placed above the navel but below the sternum to generate upward
pressure that expels the obstruction without causing organ damage.
A 12-year-old has a bee stinger embedded in the skin. What is the correct removal method?
a) Pull it out with tweezers
b) Scrape it away with a rigid object
c) Pinch and twist the skin
d) Flush the site with saline before removal
Rationale: Scraping prevents additional venom injection. Tweezing or squeezing can force more
toxin into the wound, worsening symptoms.
A patient is pulseless and apneic. Three rescuers are on scene. What is the best course of action?
a) One rescuer retrieves the AED while others wait
b) Two rescuers start CPR while the third applies the AED
c) Begin rescue breathing only
d) Wait for ALS arrival before compressions
Rationale: High-quality CPR and early defibrillation are critical. Two rescuers performing
compressions while the third prepares the AED ensures minimal delay in care.
A 48-year-old hypertensive man reports severe chest and back pain radiating to the scapula.
After high-flow oxygen, what should be the next step?
a) Obtain a 12-lead ECG
b) Rapid transport to a higher-level facility
c) Give nitroglycerin immediately
d) Monitor and observe
Rationale: Sudden chest and back pain suggest possible aortic dissection. Rapid transport is
essential for definitive diagnosis and surgical management. Nitroglycerin may worsen
hypotension in such cases.
A 4-year-old child is in septic shock with poor perfusion and low blood pressure despite fluid
boluses. What is the next appropriate medication to initiate?
A. Dopamine infusion
B. Amiodarone IV
NREMT Exam Success Guide with
Practice Tests and Study Tips 2025
Which major blood vessel carries deoxygenated (oxygen-poor) blood to the heart?
a) Pulmonary artery
b) Pulmonary vein
c) Aorta
d) Vena cava
Rationale: The vena cava carries deoxygenated blood from the body to the right atrium of the
heart. The pulmonary artery carries blood from the heart to the lungs, the pulmonary vein returns
oxygenated blood from the lungs, and the aorta distributes oxygenated blood to the body.
Which of the following is not a sign of internal bleeding into the gastrointestinal tract?
a) Bloody vomit
b) Dark, tarry stools
c) Bright red blood in stool
d) Bloody urine
Rationale: Bloody urine (hematuria) indicates urinary tract injury. Gastrointestinal bleeding
manifests as bloody vomit (hematemesis), bright red stool (hematochezia), or dark tarry stool
(melena).
Melena refers to:
a) Bright red blood in vomit
b) Dark or tarry stools
c) Bright red blood in stool
d) Coffee ground emesis
Rationale: Melena indicates upper gastrointestinal bleeding that causes dark, tarry stools. Bright
red blood indicates a lower GI source, while coffee-ground vomitus also comes from the upper
GI tract but with a different appearance.
An adult patient is bleeding profusely from a puncture wound on his upper left leg near the groin.
Bleeding is not controlled with direct fingertip pressure. What should you do next?
a) Elevate the leg
b) Apply ice packs
c) Apply a pressure dressing
d) Apply a tourniquet immediately
,100%
Rationale: After direct pressure fails, the next appropriate step is a pressure dressing. A
tourniquet is reserved for persistent bleeding. Elevation and ice are ineffective in emergency
bleeding control.
Which of the following actions should be taken if the stomach appears to be distending during
assisted ventilation?
a) Press on the abdomen to relieve pressure
b) Recheck and reposition the head, watching for chest rise
c) Insert an orogastric tube immediately
d) Withhold further ventilation
Rationale: Gastric distension may occur from improper airway alignment. Repositioning the
head and ensuring proper ventilation technique corrects this. Pressing the abdomen risks
aspiration; orogastric insertion is advanced care.
A man covered in dry lime powder complains of severe pain to his hands and face. What is the
most appropriate first step?
a) Apply sterile saline
b) Brush off the dry chemical from the skin and clothing
c) Cover the burns with moist dressings
d) Apply oxygen by nonrebreather
Rationale: Dry chemicals like lime should be brushed off before irrigation to prevent activation
and worsening burns. Moist dressings or oxygen are secondary considerations after
decontamination.
Which of the following represents a normal set of vital signs for a healthy eight-year-old child?
a) Respirations 12, pulse 70, BP 118/80 mmHg
b) Respirations 20, pulse 98, BP 104/73 mmHg
c) Respirations 28, pulse 130, BP 90/60 mmHg
d) Respirations 40, pulse 150, BP 85/50 mmHg
Rationale: Normal for an 8-year-old includes respirations 18–30, pulse 70–120, and systolic BP
above 80 mmHg. The selected values fall within these limits. The others are too extreme for a
stable child.
Patients with COPD typically have which of the following characteristics?
a) Elements of both chronic bronchitis and emphysema
b) Pure emphysema without inflammation
c) Reversible airway obstruction only
d) Lack of airflow limitation
,100%
Rationale: COPD involves both chronic bronchitis (airway inflammation) and emphysema
(alveolar destruction). It causes persistent airflow limitation and is not fully reversible.
How does nitroglycerin relieve cardiac-related chest pain?
a) Constricts coronary arteries
b) Increases heart rate
c) Increases myocardial oxygen demand
d) Relaxes peripheral arteries and veins
Rationale: Nitroglycerin is a vasodilator that reduces myocardial oxygen demand by decreasing
preload and afterload through venous and arterial relaxation. It does not increase heart rate or
oxygen demand.
What is the name of the cartilaginous ridge where the trachea divides into the right and left
bronchi?
a) Cricoid cartilage
b) Pharynx
c) Epiglottis
d) Carina
Rationale: The carina marks the bifurcation of the trachea into the main bronchi. It is a key
airway landmark during intubation. The cricoid and epiglottis are higher in the airway.
A 28-year-old female in a vehicle crash is unresponsive and apneic. Jaw-thrust maneuver has
failed. What is the next step?
a) Use the head-tilt/chin-lift maneuver
b) Insert an oropharyngeal airway
c) Begin chest compressions
d) Apply a cervical collar first
Rationale: When the jaw-thrust fails to open the airway, use the head-tilt/chin-lift, even in
suspected spinal injury. Airway patency takes priority over spinal precautions.
A patient in cardiac arrest has no DNR, but the rescuer discontinues CPR despite medical
direction instructing to continue during transport. What has occurred?
a) Negligence
b) Abandonment
c) Battery
d) Scope of practice violation
Rationale: Stopping care without patient consent or proper transfer to another qualified provider
constitutes abandonment. Negligence involves poor-quality care, not stopping it altogether.
, 100%
Where should abdominal thrusts be performed in a conscious child with airway obstruction?
a) Below the umbilicus
b) Above the umbilicus and below the lower tip of the sternum
c) Over the xiphoid process
d) At the level of the rib cage
Rationale: Thrusts must be placed above the navel but below the sternum to generate upward
pressure that expels the obstruction without causing organ damage.
A 12-year-old has a bee stinger embedded in the skin. What is the correct removal method?
a) Pull it out with tweezers
b) Scrape it away with a rigid object
c) Pinch and twist the skin
d) Flush the site with saline before removal
Rationale: Scraping prevents additional venom injection. Tweezing or squeezing can force more
toxin into the wound, worsening symptoms.
A patient is pulseless and apneic. Three rescuers are on scene. What is the best course of action?
a) One rescuer retrieves the AED while others wait
b) Two rescuers start CPR while the third applies the AED
c) Begin rescue breathing only
d) Wait for ALS arrival before compressions
Rationale: High-quality CPR and early defibrillation are critical. Two rescuers performing
compressions while the third prepares the AED ensures minimal delay in care.
A 48-year-old hypertensive man reports severe chest and back pain radiating to the scapula.
After high-flow oxygen, what should be the next step?
a) Obtain a 12-lead ECG
b) Rapid transport to a higher-level facility
c) Give nitroglycerin immediately
d) Monitor and observe
Rationale: Sudden chest and back pain suggest possible aortic dissection. Rapid transport is
essential for definitive diagnosis and surgical management. Nitroglycerin may worsen
hypotension in such cases.
A 4-year-old child is in septic shock with poor perfusion and low blood pressure despite fluid
boluses. What is the next appropriate medication to initiate?
A. Dopamine infusion
B. Amiodarone IV
