NREMT EMT Practice Examination – Airway,
Respiration, Trauma, Medical Emergencies,
Operations and Patient Assessment
1. A 68-year-old male is found unresponsive in his chair. He is breathing 6 times per minute
and has a weak radial pulse. Which of the following is your most immediate priority?
A. Apply high-flow oxygen via a non-rebreather mask at 15 L/min.
B. Insert an oropharyngeal airway and perform a secondary assessment.
C. Begin positive pressure ventilations with a bag-valve mask.
D. Check for a carotid pulse and initiate chest compressions.
Correct Answer: C
Explanation: The patient is in respiratory failure indicated by a dangerously low
respiratory rate of 6 breaths per minute, necessitating immediate positive pressure
ventilation. While oxygen is needed, a non-rebreather is inappropriate for a patient who is
not breathing adequately to maintain minute volume. A common NREMT trap is selecting
passive oxygenation when the patient’s rate or depth is insufficient, requiring active
ventilation instead.
2. You are treating a 24-year-old female who was stabbed in the right side of the chest. She is
conscious but distressed, with a visible hole in the chest wall that bubbles when she exhales.
What is the most appropriate initial intervention?
A. Apply a bulky dressing secured on all four sides to stop the bleeding.
,B. Pack the wound with hemostatic gauze and apply direct pressure.
C. Apply an occlusive dressing taped on three sides.
D. Perform a needle decompression to prevent a tension pneumothorax.
Correct Answer: C
Explanation: This patient has a sucking chest wound (open pneumothorax), which
requires an occlusive dressing to prevent air from entering the pleural space while
allowing it to escape, hence taping it on three sides or using a vented seal. Immediate seal
of the wound is a life-saving step in the primary assessment for trauma. A common trap is
using a standard absorbent dressing, which allows air to pass through, worsening the
pneumothorax.
3. A 45-year-old male complains of crushing chest pain and diaphoresis. He has a history of
angina and a prescription for nitroglycerin. His blood pressure is 88/50 mmHg. What should
be your next action regarding medication administration?
A. Administer one tablet of nitroglycerin sublingually.
B. Assist the patient in taking his nitroglycerin and call for ALS.
C. Administer 324 mg of aspirin and withhold nitroglycerin.
D. Wait 5 minutes, reassess blood pressure, then give nitroglycerin if it rises.
Correct Answer: C
,Explanation: Nitroglycerin is contraindicated in patients with a systolic blood pressure
below 90-100 mmHg as it can cause dangerous hypotension. Aspirin should still be
administered if there are no contraindications to it, as it prevents further clot formation.
NREMT exams often test the ‘contraindications’ of common medications like Nitro,
especially the blood pressure threshold.
4. You arrive at the scene of a motor vehicle collision where a car has struck a utility pole. A
power line is draped across the hood of the vehicle. The driver appears conscious and is
waving for help. What is your first priority?
A. Quickly approach the car to assess the patient’s level of consciousness.
B. Tell the patient to jump clear of the vehicle without touching the car and the ground at
the same time.
C. Use a wooden pole to move the wire away from the vehicle.
D. Stay back and establish a safety perimeter until the power company arrives.
Correct Answer: D
Explanation: Scene safety is the absolute first priority in any EMS call, and downed power
lines represent an immediate threat to the rescuers. You must wait for professionals (the
power company) to de-energize the lines before approaching. A common trap is attempting
to rescue the patient or move the wire using non-conductive materials, which is still
extremely dangerous.
, 5. A 7-year-old child is found in the kitchen with a high-pitched, ‘seal-like’ barking cough and
inspiratory stridor. The parents report a low-grade fever for two days. The child is alert and
breathing adequately. You suspect:
A. Croup
B. Epiglottitis
C. Asthma
D. Foreign body airway obstruction
Correct Answer: A
Explanation: The ‘barking’ cough and stridor in a pediatric patient with a low-grade fever
are classic signs of Croup (laryngotracheobronchitis). Epiglottitis typically presents with
high fever, drooling, and a ‘tripod’ position without the barking cough. NREMT questions
frequently require differentiating between these two common pediatric respiratory
conditions based on specific clinical signs.
6. While assessing a patient who fell from a ladder, you note paradoxical movement of a
segment of the chest wall. The patient is complaining of severe pain and difficulty breathing.
Your treatment should include:
A. Applying a sandbag to the area to stabilize the segment.
B. Providing high-flow oxygen and considering positive pressure ventilation.
C. Securing a bulky dressing over the segment with tape.
D. Encouraging the patient to take deep breaths to prevent atelectasis.
Respiration, Trauma, Medical Emergencies,
Operations and Patient Assessment
1. A 68-year-old male is found unresponsive in his chair. He is breathing 6 times per minute
and has a weak radial pulse. Which of the following is your most immediate priority?
A. Apply high-flow oxygen via a non-rebreather mask at 15 L/min.
B. Insert an oropharyngeal airway and perform a secondary assessment.
C. Begin positive pressure ventilations with a bag-valve mask.
D. Check for a carotid pulse and initiate chest compressions.
Correct Answer: C
Explanation: The patient is in respiratory failure indicated by a dangerously low
respiratory rate of 6 breaths per minute, necessitating immediate positive pressure
ventilation. While oxygen is needed, a non-rebreather is inappropriate for a patient who is
not breathing adequately to maintain minute volume. A common NREMT trap is selecting
passive oxygenation when the patient’s rate or depth is insufficient, requiring active
ventilation instead.
2. You are treating a 24-year-old female who was stabbed in the right side of the chest. She is
conscious but distressed, with a visible hole in the chest wall that bubbles when she exhales.
What is the most appropriate initial intervention?
A. Apply a bulky dressing secured on all four sides to stop the bleeding.
,B. Pack the wound with hemostatic gauze and apply direct pressure.
C. Apply an occlusive dressing taped on three sides.
D. Perform a needle decompression to prevent a tension pneumothorax.
Correct Answer: C
Explanation: This patient has a sucking chest wound (open pneumothorax), which
requires an occlusive dressing to prevent air from entering the pleural space while
allowing it to escape, hence taping it on three sides or using a vented seal. Immediate seal
of the wound is a life-saving step in the primary assessment for trauma. A common trap is
using a standard absorbent dressing, which allows air to pass through, worsening the
pneumothorax.
3. A 45-year-old male complains of crushing chest pain and diaphoresis. He has a history of
angina and a prescription for nitroglycerin. His blood pressure is 88/50 mmHg. What should
be your next action regarding medication administration?
A. Administer one tablet of nitroglycerin sublingually.
B. Assist the patient in taking his nitroglycerin and call for ALS.
C. Administer 324 mg of aspirin and withhold nitroglycerin.
D. Wait 5 minutes, reassess blood pressure, then give nitroglycerin if it rises.
Correct Answer: C
,Explanation: Nitroglycerin is contraindicated in patients with a systolic blood pressure
below 90-100 mmHg as it can cause dangerous hypotension. Aspirin should still be
administered if there are no contraindications to it, as it prevents further clot formation.
NREMT exams often test the ‘contraindications’ of common medications like Nitro,
especially the blood pressure threshold.
4. You arrive at the scene of a motor vehicle collision where a car has struck a utility pole. A
power line is draped across the hood of the vehicle. The driver appears conscious and is
waving for help. What is your first priority?
A. Quickly approach the car to assess the patient’s level of consciousness.
B. Tell the patient to jump clear of the vehicle without touching the car and the ground at
the same time.
C. Use a wooden pole to move the wire away from the vehicle.
D. Stay back and establish a safety perimeter until the power company arrives.
Correct Answer: D
Explanation: Scene safety is the absolute first priority in any EMS call, and downed power
lines represent an immediate threat to the rescuers. You must wait for professionals (the
power company) to de-energize the lines before approaching. A common trap is attempting
to rescue the patient or move the wire using non-conductive materials, which is still
extremely dangerous.
, 5. A 7-year-old child is found in the kitchen with a high-pitched, ‘seal-like’ barking cough and
inspiratory stridor. The parents report a low-grade fever for two days. The child is alert and
breathing adequately. You suspect:
A. Croup
B. Epiglottitis
C. Asthma
D. Foreign body airway obstruction
Correct Answer: A
Explanation: The ‘barking’ cough and stridor in a pediatric patient with a low-grade fever
are classic signs of Croup (laryngotracheobronchitis). Epiglottitis typically presents with
high fever, drooling, and a ‘tripod’ position without the barking cough. NREMT questions
frequently require differentiating between these two common pediatric respiratory
conditions based on specific clinical signs.
6. While assessing a patient who fell from a ladder, you note paradoxical movement of a
segment of the chest wall. The patient is complaining of severe pain and difficulty breathing.
Your treatment should include:
A. Applying a sandbag to the area to stabilize the segment.
B. Providing high-flow oxygen and considering positive pressure ventilation.
C. Securing a bulky dressing over the segment with tape.
D. Encouraging the patient to take deep breaths to prevent atelectasis.
