NREMT Certification Examination: Practice
Questions with Answers & Rationales
1. A 45-year-old male is unresponsive with snoring respirations. What is the MOST appropriate initial action?
A) Insert a nasopharyngeal airway
B) Perform a head-tilt, chin-lift maneuver
C) Suction the airway
D) Insert an oropharyngeal airway
Correct Answer: B
Rationale: Snoring respirations in an unresponsive patient indicate partial airway obstruction by the tongue. The head-tilt, chin-lift maneuver is the initial,
non-invasive method to open the airway and relieve this obstruction. Suction is used for fluids/secretions, and airway adjuncts are used after manual
maneuvers are performed and if the patient remains unable to maintain their own airway.
2. Which of the following is a CONTRAINDICATION for using an oropharyngeal airway (OPA)?
,A) Unresponsive patient with no gag reflex
B) A patient with a suspected skull fracture
C) A patient with a clenched jaw
D) A responsive patient with an intact gag reflex
Correct Answer: D
Rationale: An OPA should only be used in unresponsive patients without a gag reflex. In a responsive patient or one with an intact gag reflex, the OPA
can stimulate vomiting and aspiration. A clenched jaw is an indication for a nasopharyngeal airway instead. A suspected skull fracture is a relative
contraindication for an NPA (due to risk of penetrating the brain), not an OPA.
3. What is the normal range for capnography (EtCO2) in a healthy adult?
A) 0-10 mmHg
B) 20-25 mmHg
C) 35-45 mmHg
D) 50-60 mmHg
Correct Answer: C
Rationale: End-tidal CO2 (EtCO2) measures the partial pressure of carbon dioxide at the end of exhalation. Normal values are 35-45 mmHg. Low EtCO2
indicates hyperventilation, while high EtCO2 indicates hypoventilation or inadequate perfusion.
4. A patient has been breathing at a rate of 6 breaths per minute. You should FIRST:
A) Administer oxygen via non-rebreather mask
,B) Assist ventilations with a bag-valve mask (BVM)
C) Insert a nasal airway
D) Check for a pulse
Correct Answer: B
Rationale: A respiratory rate of 6 breaths per minute is significantly bradypneic and indicates inadequate ventilation. The priority is to assist ventilations
with a BVM to support breathing. Continuous positive airway pressure (CPAP) may be used in patients who are breathing spontaneously but have respiratory
distress, not bradypnea.
5. An adult patient has a respiratory rate of 24, heart rate of 110, and SPO2 of 89%. What oxygen delivery method is MOST appropriate?
A) Nasal cannula at 2 LPM
B) Non-rebreather mask at 15 LPM
C) Simple face mask at 8 LPM
D) Bag-valve mask with supplemental oxygen
Correct Answer: B
Rationale: SPO2 of 89% indicates hypoxia. The patient is breathing at 24 breaths/min, and a non-rebreather mask at high flow (10-15 LPM) delivers up to
90% oxygen, making it appropriate for this hypoxic patient. A BVM is for patients in respiratory failure who are not breathing adequately.
6. Which of the following sounds is associated with a severe upper airway obstruction?
A) Wheezing
B) Stridor
, C) Rhonchi
D) Crackles
Correct Answer: B
Rationale: Stridor is a high-pitched, musical sound heard on inspiration that indicates a partial obstruction in the upper airway (e.g., croup, epiglottitis,
foreign body). Wheezing is lower airway (bronchioles), rhonchi suggests mucus in larger airways, and crackles indicate fluid in the alveoli.
## Section 2: Cardiology & Resuscitation
7. What is the proper sequence for using an AED on a cardiac arrest patient?
A) Turn on, apply pads, analyze rhythm, deliver shock if indicated
B) Apply pads, turn on, analyze rhythm, deliver shock
C) Analyze rhythm, turn on, apply pads, deliver shock
D) Turn on, analyze rhythm, apply pads, deliver shock
Correct Answer: A
Rationale: The correct sequence is to first turn on the AED to prepare it, then apply the pads to the patient's bare chest, allow the AED to analyze the
rhythm, and deliver a shock if advised by the machine.
8. A patient with chest pain is allergic to aspirin. What should you do?
A) Administer aspirin anyway
Questions with Answers & Rationales
1. A 45-year-old male is unresponsive with snoring respirations. What is the MOST appropriate initial action?
A) Insert a nasopharyngeal airway
B) Perform a head-tilt, chin-lift maneuver
C) Suction the airway
D) Insert an oropharyngeal airway
Correct Answer: B
Rationale: Snoring respirations in an unresponsive patient indicate partial airway obstruction by the tongue. The head-tilt, chin-lift maneuver is the initial,
non-invasive method to open the airway and relieve this obstruction. Suction is used for fluids/secretions, and airway adjuncts are used after manual
maneuvers are performed and if the patient remains unable to maintain their own airway.
2. Which of the following is a CONTRAINDICATION for using an oropharyngeal airway (OPA)?
,A) Unresponsive patient with no gag reflex
B) A patient with a suspected skull fracture
C) A patient with a clenched jaw
D) A responsive patient with an intact gag reflex
Correct Answer: D
Rationale: An OPA should only be used in unresponsive patients without a gag reflex. In a responsive patient or one with an intact gag reflex, the OPA
can stimulate vomiting and aspiration. A clenched jaw is an indication for a nasopharyngeal airway instead. A suspected skull fracture is a relative
contraindication for an NPA (due to risk of penetrating the brain), not an OPA.
3. What is the normal range for capnography (EtCO2) in a healthy adult?
A) 0-10 mmHg
B) 20-25 mmHg
C) 35-45 mmHg
D) 50-60 mmHg
Correct Answer: C
Rationale: End-tidal CO2 (EtCO2) measures the partial pressure of carbon dioxide at the end of exhalation. Normal values are 35-45 mmHg. Low EtCO2
indicates hyperventilation, while high EtCO2 indicates hypoventilation or inadequate perfusion.
4. A patient has been breathing at a rate of 6 breaths per minute. You should FIRST:
A) Administer oxygen via non-rebreather mask
,B) Assist ventilations with a bag-valve mask (BVM)
C) Insert a nasal airway
D) Check for a pulse
Correct Answer: B
Rationale: A respiratory rate of 6 breaths per minute is significantly bradypneic and indicates inadequate ventilation. The priority is to assist ventilations
with a BVM to support breathing. Continuous positive airway pressure (CPAP) may be used in patients who are breathing spontaneously but have respiratory
distress, not bradypnea.
5. An adult patient has a respiratory rate of 24, heart rate of 110, and SPO2 of 89%. What oxygen delivery method is MOST appropriate?
A) Nasal cannula at 2 LPM
B) Non-rebreather mask at 15 LPM
C) Simple face mask at 8 LPM
D) Bag-valve mask with supplemental oxygen
Correct Answer: B
Rationale: SPO2 of 89% indicates hypoxia. The patient is breathing at 24 breaths/min, and a non-rebreather mask at high flow (10-15 LPM) delivers up to
90% oxygen, making it appropriate for this hypoxic patient. A BVM is for patients in respiratory failure who are not breathing adequately.
6. Which of the following sounds is associated with a severe upper airway obstruction?
A) Wheezing
B) Stridor
, C) Rhonchi
D) Crackles
Correct Answer: B
Rationale: Stridor is a high-pitched, musical sound heard on inspiration that indicates a partial obstruction in the upper airway (e.g., croup, epiglottitis,
foreign body). Wheezing is lower airway (bronchioles), rhonchi suggests mucus in larger airways, and crackles indicate fluid in the alveoli.
## Section 2: Cardiology & Resuscitation
7. What is the proper sequence for using an AED on a cardiac arrest patient?
A) Turn on, apply pads, analyze rhythm, deliver shock if indicated
B) Apply pads, turn on, analyze rhythm, deliver shock
C) Analyze rhythm, turn on, apply pads, deliver shock
D) Turn on, analyze rhythm, apply pads, deliver shock
Correct Answer: A
Rationale: The correct sequence is to first turn on the AED to prepare it, then apply the pads to the patient's bare chest, allow the AED to analyze the
rhythm, and deliver a shock if advised by the machine.
8. A patient with chest pain is allergic to aspirin. What should you do?
A) Administer aspirin anyway
