NREMT PRACTICE EXAM: 300 QUESTIONS
AND ANSWERS WITH DETAILED
RATIONALES
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Question 1
A 45-year-old male is found unresponsive in a parked car on a hot summer day.
The windows are rolled up, and the engine is off. His skin is hot and dry, and his
core temperature is 104°F (40°C). What is the priority intervention?
A. Apply cold packs to the groin and axillae
B. Begin active external rewarming
C. Administer cold intravenous fluids
D. Remove the patient from the environment and begin rapid cooling
Correct Answer: D
Rationale: This patient is experiencing severe heat stroke, characterized by a core
temperature >104°F with hot, dry skin and altered mental status. The priority is to
remove the patient from the hot environment and initiate rapid cooling. While
cold packs to groin/axillae (A) and cold IV fluids (C) are cooling methods, the
immediate priority is scene removal and initiation of cooling. Active external
rewarming (B) is contraindicated in heat stroke as it would worsen the condition.
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,Question 2
A 6-year-old child is choking and cannot speak, cough, or breathe. What
maneuver should be performed?
A. Back blows and chest thrusts
B. Abdominal thrusts
C. Blind finger sweeps
D. Head-tilt chin-lift
Correct Answer: A
Rationale: For a conscious choking child (1-8 years), the American Heart
Association recommends alternating back blows and chest thrusts. Abdominal
thrusts (B) are used for adults and children over 8 years. Blind finger sweeps (C)
are contraindicated as they can push the object further into the airway. Head-tilt
chin-lift (D) is an airway opening maneuver, not a treatment for foreign body
airway obstruction.
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Question 3
You are assessing a patient with chest pain. Which of the following is a
contraindication to administering nitroglycerin?
A. Systolic blood pressure <100 mmHg
B. Heart rate >100 beats per minute
C. The patient has taken sildenafil within the past 24 hours
D. The patient is allergic to aspirin
,Correct Answer: C
Rationale: Nitroglycerin is contraindicated in patients who have taken
phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil, vardenafil) within the
past 24-48 hours due to the risk of severe hypotension. While low blood pressure
(A) and tachycardia (B) are relative contraindications, sildenafil use is an absolute
contraindication. Aspirin allergy (D) does not contraindicate nitroglycerin use.
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Question 4
A 28-year-old female is 38 weeks pregnant and experiencing vaginal bleeding with
moderate pain. She is in active labor. What is the most likely cause?
A. Placenta previa
B. Abruptio placentae
C. Ectopic pregnancy
D. Normal labor with bloody show
Correct Answer: B
Rationale: Abruptio placentae (placental abruption) is characterized by vaginal
bleeding accompanied by pain (often severe). Placenta previa (A) typically
presents with painless vaginal bleeding. Ectopic pregnancy (C) would present
earlier in pregnancy with severe abdominal pain. Bloody show (D) is normal and
involves minimal bleeding without significant pain.
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Question 5
, Which of the following is the correct compression-to-ventilation ratio for a single
rescuer performing CPR on an adult?
A. 15:2
B. 30:2
C. 30:1
D. 15:1
Correct Answer: B
Rationale: For single-rescuer adult CPR, the compression-to-ventilation ratio is
30:2. This allows for adequate perfusion while providing necessary ventilations.
15:2 (A) is the ratio for two-rescuer CPR in children. 30:1 (C) and 15:1 (D) are not
standard ratios.
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Question 6
A patient is experiencing anaphylaxis after a bee sting. Which medication should
be administered first?
A. Diphenhydramine
B. Albuterol
C. Epinephrine
D. Methylprednisolone
Correct Answer: C
Rationale: Epinephrine is the first-line treatment for anaphylaxis. It counteracts
the severe vasodilation and bronchoconstriction that occur during anaphylactic
AND ANSWERS WITH DETAILED
RATIONALES
---
Question 1
A 45-year-old male is found unresponsive in a parked car on a hot summer day.
The windows are rolled up, and the engine is off. His skin is hot and dry, and his
core temperature is 104°F (40°C). What is the priority intervention?
A. Apply cold packs to the groin and axillae
B. Begin active external rewarming
C. Administer cold intravenous fluids
D. Remove the patient from the environment and begin rapid cooling
Correct Answer: D
Rationale: This patient is experiencing severe heat stroke, characterized by a core
temperature >104°F with hot, dry skin and altered mental status. The priority is to
remove the patient from the hot environment and initiate rapid cooling. While
cold packs to groin/axillae (A) and cold IV fluids (C) are cooling methods, the
immediate priority is scene removal and initiation of cooling. Active external
rewarming (B) is contraindicated in heat stroke as it would worsen the condition.
---
,Question 2
A 6-year-old child is choking and cannot speak, cough, or breathe. What
maneuver should be performed?
A. Back blows and chest thrusts
B. Abdominal thrusts
C. Blind finger sweeps
D. Head-tilt chin-lift
Correct Answer: A
Rationale: For a conscious choking child (1-8 years), the American Heart
Association recommends alternating back blows and chest thrusts. Abdominal
thrusts (B) are used for adults and children over 8 years. Blind finger sweeps (C)
are contraindicated as they can push the object further into the airway. Head-tilt
chin-lift (D) is an airway opening maneuver, not a treatment for foreign body
airway obstruction.
---
Question 3
You are assessing a patient with chest pain. Which of the following is a
contraindication to administering nitroglycerin?
A. Systolic blood pressure <100 mmHg
B. Heart rate >100 beats per minute
C. The patient has taken sildenafil within the past 24 hours
D. The patient is allergic to aspirin
,Correct Answer: C
Rationale: Nitroglycerin is contraindicated in patients who have taken
phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil, vardenafil) within the
past 24-48 hours due to the risk of severe hypotension. While low blood pressure
(A) and tachycardia (B) are relative contraindications, sildenafil use is an absolute
contraindication. Aspirin allergy (D) does not contraindicate nitroglycerin use.
---
Question 4
A 28-year-old female is 38 weeks pregnant and experiencing vaginal bleeding with
moderate pain. She is in active labor. What is the most likely cause?
A. Placenta previa
B. Abruptio placentae
C. Ectopic pregnancy
D. Normal labor with bloody show
Correct Answer: B
Rationale: Abruptio placentae (placental abruption) is characterized by vaginal
bleeding accompanied by pain (often severe). Placenta previa (A) typically
presents with painless vaginal bleeding. Ectopic pregnancy (C) would present
earlier in pregnancy with severe abdominal pain. Bloody show (D) is normal and
involves minimal bleeding without significant pain.
---
Question 5
, Which of the following is the correct compression-to-ventilation ratio for a single
rescuer performing CPR on an adult?
A. 15:2
B. 30:2
C. 30:1
D. 15:1
Correct Answer: B
Rationale: For single-rescuer adult CPR, the compression-to-ventilation ratio is
30:2. This allows for adequate perfusion while providing necessary ventilations.
15:2 (A) is the ratio for two-rescuer CPR in children. 30:1 (C) and 15:1 (D) are not
standard ratios.
---
Question 6
A patient is experiencing anaphylaxis after a bee sting. Which medication should
be administered first?
A. Diphenhydramine
B. Albuterol
C. Epinephrine
D. Methylprednisolone
Correct Answer: C
Rationale: Epinephrine is the first-line treatment for anaphylaxis. It counteracts
the severe vasodilation and bronchoconstriction that occur during anaphylactic
