NREMT TEST BANK EXAMS WITH CORRECT
SOLUTIONS
A 3-year-old boy is found to be in cardiopulmonary arrest. As you begin one-rescuer CPR, your
partner prepares the AED. The appropriate compression to ventilation ratio for this child is:
• A:3:1
• B:30:2
• C:5:1
• D:15:2 - -ANSWER-You selected B; This is correct!
Reason:A universal compression to ventilation ratio of 30:2 is used for all one-rescuer CPR
(adult, child, and infant), with the exception of the newborn. A compression to ventilation ratio
of 3:1 is used for newborns (one- and two-rescuer). Two-rescuer infant and child CPR is
performed at a compression to ventilation ratio of 15:2. In this scenario, you are performing
one-rescuer CPR as your partner prepares the AED; therefore, you should give 30 compressions
and 2 breaths. However, when you and your partner resume CPR, give 15 compressions and 2
breaths.-ANSWER-A 3-year-old child has a sudden onset of respiratory distress. The mother
denies any recent illnesses or fever. You should suspect:
• A:lower respiratory infection.
• B:foreign body airway obstruction.
• C:croup.
• D:epiglottitis. - -ANSWER-You selected B; This is correct!
Reason:You should suspect a foreign body airway obstruction in any child who presents with an
acute onset of respiratory distress in the absence of fever. Croup, epiglottitis, and lower airway
infections (ie, bronchiolitis, bronchitis) commonly present with a fever. If the child is
experiencing a mild airway obstruction, in which he or she is moving adequate air, has a normal
level of consciousness, and pink skin, do not attempt to relieve the airway obstruction; doing so
may result in a severe airway obstruction. Offer oxygen and transport the child to the hospital
without delay. If signs of a severe airway obstruction are present (ie, ineffective cough,
,decreased level of consciousness, cyanosis), you should perform abdominal thrusts until the
object is expelled or the child becomes unresponsive. If the child becomes unresponsive,
perform chest compressions.-ANSWER-A 3-year-old female presents with respiratory distress.
She is conscious, crying, and clinging to her mother. She has mild intercostal retractions and an
oxygen saturation of 93%. The MOST effective way of delivering oxygen to her involves:
• A:ventilations with a flow-restricted, oxygen-powered device.
• B:gently restraining her and assisting her ventilations.
• C:asking the mom to hold an oxygen mask near her face.
• D:a nonrebreathing mask with the flow rate at 6 to 8 L/min. - -ANSWER-You selected C; This is
correct!
Reason:Do not assume that a child will simply allow you to administer oxygen to him or her as
you would to an adult. The child in this scenario, who is in respiratory distress and is mildly
hypoxemic (SpO2 of 93%), should receive supplemental oxygen; however, it should be given in a
nonthreatening manner. Agitating a sick or injured child causes an increase in oxygen
consumption and demand, which may cause the child's condition to deteriorate. In this
scenario, ask the child's mother to hold an oxygen mask near the child's face (blow-by oxygen).
Closely monitor her condition and be prepared to assist her ventilations with a bag-mask device
if she deteriorates. An oxygen flow rate of 6 to 8 L/min is too low for a nonrebreathing mask; a
flow-rate of 12 to 15 L/min should be used. Do NOT use a flow-restricted, oxygen-powered
ventilation device (FROPVD) on any child; doing so may cause severe gastric distention and lung
injury. Allow the child to assume a position of comfort and transport.-ANSWER-A 4-year-old boy
ingested an unknown quantity of drain cleaner. He is alert, has a patent airway, and has
adequate breathing. You should:
• A:administer 1 g/kg of activated charcoal.
• B:give 15 mL of ipecac and contact medical control.
• C:contact poison control and give him oxygen.
• D:give oxygen and perform a head-to-toe exam. - -ANSWER-You selected C; This is correct!
Reason:Once you determine that a poisoning has occurred, and have identified the poison, you
should contact the poison control center at once: (800) 222-1222. Give the patient high-flow
oxygen or assist his or her ventilations if necessary. Induction of vomiting with syrup of ipecac is
,no longer recommended because of the risk of aspiration. Activated charcoal is contraindicated
in patients who have ingested a corrosive substance (eg, drain cleaner) or a petroleum product
(eg, gasoline, motor oil). A head-to-toe exam is not practical in this situation, at least initially.
Follow the directions given to you by the poison control center, transport the child without
delay, and monitor his condition en route.-ANSWER-A 4-year-old girl fell from a third-story
window and landed on her head. She is semiconscious with slow, irregular breathing and is
bleeding from her mouth and nose. You should:
• A:suction her oropharynx, open her airway with the jaw-thrust maneuver, insert an
oropharyngeal airway, and assist her ventilations.
• B:open her airway with the jaw-thrust maneuver while manually stabilizing her head, suction
her oropharynx, and assist her ventilations.
• C:open her airway by carefully tilting her head back, suction her oropharynx, and administer
high-flow oxygen via nonrebreathing mask.
• D:manually stabilize her head, open her airway with the jaw-thrust maneuver, insert a
nasopharyngeal airway, and suction her oropharynx. - -ANSWER-The correct -ANSWER- is B;
Reason:In any semi- or unconscious patient with a head injury, you should manually stabilize the
head and open the airway with the jaw-thrust maneuver. If there are any secretions in the
mouth, suction the oropharynx. If possible, insert a simple airway adjunct. The patient in this
scenario is semiconscious and likely has an intact gag reflex; therefore, you should not attempt
to insert an oropharyngeal airway. Conversely, you should not insert a nasopharyngeal airway in
patients with a head injury, especially if there is fluid or blood draining from the nose (a sign of
a skull fracture). After ensuring a patent airway, you should turn your attention to the patient's
breathing. Slow, irregular breathing will not provide adequate minute volume and should be
treated with ventilatory assistance.-ANSWER-A 5-year-old boy was struck by a car when he ran
out into the street. When you arrive at the scene and approach the child, you see him lying
supine approximately 15 feet from the car. Based on the child's age and mechanism of injury,
which of the following should you suspect to be his PRIMARY injury?
• A:Head injury
• B:Upper thorax injury
• C:Lower leg injury
• D:Pelvic injury - -ANSWER-The correct -ANSWER- is D;
, Reason:Children are smaller than adults; therefore, when they are injured by the same
mechanism of injury as an adult, the location of their injuries may differ from those of an adult.
For example, when an adult is struck by a vehicle, the primary injury typically occurs at or below
the knees, depending on the height of the bumper at the time of impact. Because the child is
shorter, initial impact typically occurs at or near the pelvis. Secondary injury occurs when child's
chest collides with the vehicle's grille. Tertiary injury occurs when the child strikes the side of his
or her head on the pavement after being propelled away from the vehicle. In some cases, the
child is pulled underneath the vehicle and is dragged.-ANSWER-A 6-year-old boy complains of
pain to the right lower quadrant of his abdomen. Assessment of this child's abdomen should
include:
• A:palpating the right lower quadrant first.
• B:auscultating bowel sounds for 2 minutes.
• C:avoiding palpation of the abdomen.
• D:palpating the left upper quadrant first. - -ANSWER-You selected D; This is correct!
Reason: When assessing the abdomen of any patient, you should determine the location of the
pain and palpate that area last. Begin by palpating the abdomen furthest away from the area of
pain; in this case, the left upper quadrant is furthest away from the right lower quadrant.
Palpating the painful area first will interfere with the rest of your assessment because the
patient will be in significant pain and will likely not remain still during the remainder of the
assessment. This is especially true in children. Auscultation of bowel sounds is generally not
performed in the prehospital setting; little, if any, information will be gained from doing so.-
ANSWER-A 7-year-old child has an altered mental status, high fever, and a generalized rash. You
perform your assessment and administer supplemental oxygen. En route to the hospital, you
should be MOST alert for:
• A:respiratory distress.
• B:combativeness.
• C:hypotension.
• D:convulsions. - -ANSWER-The correct -ANSWER- is D;
Reason:High fever and an alerted mental status indicate sepsis (severe infection). A generalized
rash should alert you to the possibility of meningitis—a condition caused by infection and
SOLUTIONS
A 3-year-old boy is found to be in cardiopulmonary arrest. As you begin one-rescuer CPR, your
partner prepares the AED. The appropriate compression to ventilation ratio for this child is:
• A:3:1
• B:30:2
• C:5:1
• D:15:2 - -ANSWER-You selected B; This is correct!
Reason:A universal compression to ventilation ratio of 30:2 is used for all one-rescuer CPR
(adult, child, and infant), with the exception of the newborn. A compression to ventilation ratio
of 3:1 is used for newborns (one- and two-rescuer). Two-rescuer infant and child CPR is
performed at a compression to ventilation ratio of 15:2. In this scenario, you are performing
one-rescuer CPR as your partner prepares the AED; therefore, you should give 30 compressions
and 2 breaths. However, when you and your partner resume CPR, give 15 compressions and 2
breaths.-ANSWER-A 3-year-old child has a sudden onset of respiratory distress. The mother
denies any recent illnesses or fever. You should suspect:
• A:lower respiratory infection.
• B:foreign body airway obstruction.
• C:croup.
• D:epiglottitis. - -ANSWER-You selected B; This is correct!
Reason:You should suspect a foreign body airway obstruction in any child who presents with an
acute onset of respiratory distress in the absence of fever. Croup, epiglottitis, and lower airway
infections (ie, bronchiolitis, bronchitis) commonly present with a fever. If the child is
experiencing a mild airway obstruction, in which he or she is moving adequate air, has a normal
level of consciousness, and pink skin, do not attempt to relieve the airway obstruction; doing so
may result in a severe airway obstruction. Offer oxygen and transport the child to the hospital
without delay. If signs of a severe airway obstruction are present (ie, ineffective cough,
,decreased level of consciousness, cyanosis), you should perform abdominal thrusts until the
object is expelled or the child becomes unresponsive. If the child becomes unresponsive,
perform chest compressions.-ANSWER-A 3-year-old female presents with respiratory distress.
She is conscious, crying, and clinging to her mother. She has mild intercostal retractions and an
oxygen saturation of 93%. The MOST effective way of delivering oxygen to her involves:
• A:ventilations with a flow-restricted, oxygen-powered device.
• B:gently restraining her and assisting her ventilations.
• C:asking the mom to hold an oxygen mask near her face.
• D:a nonrebreathing mask with the flow rate at 6 to 8 L/min. - -ANSWER-You selected C; This is
correct!
Reason:Do not assume that a child will simply allow you to administer oxygen to him or her as
you would to an adult. The child in this scenario, who is in respiratory distress and is mildly
hypoxemic (SpO2 of 93%), should receive supplemental oxygen; however, it should be given in a
nonthreatening manner. Agitating a sick or injured child causes an increase in oxygen
consumption and demand, which may cause the child's condition to deteriorate. In this
scenario, ask the child's mother to hold an oxygen mask near the child's face (blow-by oxygen).
Closely monitor her condition and be prepared to assist her ventilations with a bag-mask device
if she deteriorates. An oxygen flow rate of 6 to 8 L/min is too low for a nonrebreathing mask; a
flow-rate of 12 to 15 L/min should be used. Do NOT use a flow-restricted, oxygen-powered
ventilation device (FROPVD) on any child; doing so may cause severe gastric distention and lung
injury. Allow the child to assume a position of comfort and transport.-ANSWER-A 4-year-old boy
ingested an unknown quantity of drain cleaner. He is alert, has a patent airway, and has
adequate breathing. You should:
• A:administer 1 g/kg of activated charcoal.
• B:give 15 mL of ipecac and contact medical control.
• C:contact poison control and give him oxygen.
• D:give oxygen and perform a head-to-toe exam. - -ANSWER-You selected C; This is correct!
Reason:Once you determine that a poisoning has occurred, and have identified the poison, you
should contact the poison control center at once: (800) 222-1222. Give the patient high-flow
oxygen or assist his or her ventilations if necessary. Induction of vomiting with syrup of ipecac is
,no longer recommended because of the risk of aspiration. Activated charcoal is contraindicated
in patients who have ingested a corrosive substance (eg, drain cleaner) or a petroleum product
(eg, gasoline, motor oil). A head-to-toe exam is not practical in this situation, at least initially.
Follow the directions given to you by the poison control center, transport the child without
delay, and monitor his condition en route.-ANSWER-A 4-year-old girl fell from a third-story
window and landed on her head. She is semiconscious with slow, irregular breathing and is
bleeding from her mouth and nose. You should:
• A:suction her oropharynx, open her airway with the jaw-thrust maneuver, insert an
oropharyngeal airway, and assist her ventilations.
• B:open her airway with the jaw-thrust maneuver while manually stabilizing her head, suction
her oropharynx, and assist her ventilations.
• C:open her airway by carefully tilting her head back, suction her oropharynx, and administer
high-flow oxygen via nonrebreathing mask.
• D:manually stabilize her head, open her airway with the jaw-thrust maneuver, insert a
nasopharyngeal airway, and suction her oropharynx. - -ANSWER-The correct -ANSWER- is B;
Reason:In any semi- or unconscious patient with a head injury, you should manually stabilize the
head and open the airway with the jaw-thrust maneuver. If there are any secretions in the
mouth, suction the oropharynx. If possible, insert a simple airway adjunct. The patient in this
scenario is semiconscious and likely has an intact gag reflex; therefore, you should not attempt
to insert an oropharyngeal airway. Conversely, you should not insert a nasopharyngeal airway in
patients with a head injury, especially if there is fluid or blood draining from the nose (a sign of
a skull fracture). After ensuring a patent airway, you should turn your attention to the patient's
breathing. Slow, irregular breathing will not provide adequate minute volume and should be
treated with ventilatory assistance.-ANSWER-A 5-year-old boy was struck by a car when he ran
out into the street. When you arrive at the scene and approach the child, you see him lying
supine approximately 15 feet from the car. Based on the child's age and mechanism of injury,
which of the following should you suspect to be his PRIMARY injury?
• A:Head injury
• B:Upper thorax injury
• C:Lower leg injury
• D:Pelvic injury - -ANSWER-The correct -ANSWER- is D;
, Reason:Children are smaller than adults; therefore, when they are injured by the same
mechanism of injury as an adult, the location of their injuries may differ from those of an adult.
For example, when an adult is struck by a vehicle, the primary injury typically occurs at or below
the knees, depending on the height of the bumper at the time of impact. Because the child is
shorter, initial impact typically occurs at or near the pelvis. Secondary injury occurs when child's
chest collides with the vehicle's grille. Tertiary injury occurs when the child strikes the side of his
or her head on the pavement after being propelled away from the vehicle. In some cases, the
child is pulled underneath the vehicle and is dragged.-ANSWER-A 6-year-old boy complains of
pain to the right lower quadrant of his abdomen. Assessment of this child's abdomen should
include:
• A:palpating the right lower quadrant first.
• B:auscultating bowel sounds for 2 minutes.
• C:avoiding palpation of the abdomen.
• D:palpating the left upper quadrant first. - -ANSWER-You selected D; This is correct!
Reason: When assessing the abdomen of any patient, you should determine the location of the
pain and palpate that area last. Begin by palpating the abdomen furthest away from the area of
pain; in this case, the left upper quadrant is furthest away from the right lower quadrant.
Palpating the painful area first will interfere with the rest of your assessment because the
patient will be in significant pain and will likely not remain still during the remainder of the
assessment. This is especially true in children. Auscultation of bowel sounds is generally not
performed in the prehospital setting; little, if any, information will be gained from doing so.-
ANSWER-A 7-year-old child has an altered mental status, high fever, and a generalized rash. You
perform your assessment and administer supplemental oxygen. En route to the hospital, you
should be MOST alert for:
• A:respiratory distress.
• B:combativeness.
• C:hypotension.
• D:convulsions. - -ANSWER-The correct -ANSWER- is D;
Reason:High fever and an alerted mental status indicate sepsis (severe infection). A generalized
rash should alert you to the possibility of meningitis—a condition caused by infection and
