NREMT EMT Cognitive Exam 2026/2027 | Practice
Questions & Verified Answers
1. What is the first step in managing a patient with a suspected spinal injury?
A) Apply a cervical collar
B) Manual in-line spinal stabilization
C) Log roll the patient onto a backboard
D) Apply a vest-type immobilization device
Answer B: Manual in-line spinal stabilization
Rationale: Manual in-line stabilization is the first priority to prevent movement; then apply a cervical
collar.
2. A patient is in cardiac arrest. The AED advises a shock. Which action should be taken first?
A) Ensure the patient is dry
B) Clear everyone from the patient before delivering the shock
C) Check the patient’s pulse
D) Administer CPR for 2 minutes
Answer B: Clear everyone from the patient before delivering the shock
Rationale: Before delivering a shock, ensure no one is in contact with the patient to prevent injury.
3. A 45-year-old male with chest pain is pale and diaphoretic. He has a history of hypertension.
Which medication is indicated for this patient?
A) Oral glucose
B) Aspirin (chewed)
C) Albuterol
D) Nitroglycerin (without first checking if contraindicated)
,Answer B: Aspirin (chewed)
Rationale: Aspirin reduces mortality in ACS. It should be given unless contraindicated (allergy, bleeding).
Nitroglycerin may be given if systolic BP >100.
4. What is the most reliable indicator of adequate ventilation in an intubated patient?
A) Pulse oximetry reading
B) Skin color
C) End-tidal CO₂ (capnography)
D) Chest rise
Answer C: End-tidal CO₂ (capnography)
Rationale: Waveform capnography confirms endotracheal tube placement and adequacy of ventilation.
5. A 60-year-old female is unresponsive with a respiratory rate of 6 breaths/min. What is the most
appropriate initial action?
A) Place in recovery position
B) Assist ventilations with a BVM and 100% oxygen
C) Administer naloxone
D) Check blood glucose
Answer B: Assist ventilations with a BVM and 100% oxygen
Rationale: Inadequate respiratory rate requires immediate ventilatory support. Address airway/breathing
before further assessment.
6. A patient with a suspected overdose of opioids has pinpoint pupils, bradypnea, and lethargy.
What is the treatment?
A) Activated charcoal
B) Naloxone (Narcan)
C) Flumazenil
D) Dextrose 50%
,Answer B: Naloxone (Narcan)
Rationale: Naloxone is a competitive opioid antagonist that reverses respiratory depression and
sedation.
7. A 22-year-old male has a knife impaled in his right lower quadrant. What is the appropriate
management?
A) Remove the knife and apply pressure
B) Stabilize the knife in place with bulky dressings
C) Pack the wound around the knife
D) Apply a tourniquet
Answer B: Stabilize the knife in place with bulky dressings
Rationale: Never remove an impaled object; stabilize it to prevent further injury.
8. A 3-year-old child is choking and unable to cough. What is the next step?
A) Back slaps and chest thrusts
B) Abdominal thrusts (Heimlich maneuver) – for children >1 year, use abdominal thrusts; for infants, use
back slaps/chest thrusts. For a 3-year-old, abdominal thrusts are appropriate.
C) Blind finger sweep
D) Oxygen via non-rebreather
Answer B: Abdominal thrusts (Heimlich maneuver)
Rationale: For a conscious child >1 year, perform abdominal thrusts until the object is expelled.
9. A patient with severe anaphylaxis has stridor and hypotension. Which medication should be
given first?
A) Diphenhydramine
B) Albuterol
C) Epinephrine IM
D) Methylprednisolone
, Answer C: Epinephrine IM
Rationale: Epinephrine is first-line for anaphylaxis; it reverses bronchospasm, hypotension, and stridor.
10. Which of the following is a sign of a tension pneumothorax?
A) Absent breath sounds on the affected side
B) Tracheal deviation away from the affected side
C) Subcutaneous emphysema
D) Hypotension
Answer B: Tracheal deviation away from the affected side
Rationale: Tracheal deviation is a late sign of tension pneumothorax. Other signs include absent breath
sounds, hypotension, and distended neck veins.
11. A patient is in ventricular fibrillation. What is the immediate treatment?
A) CPR for 2 minutes
B) Defibrillation (as soon as possible)
C) Epinephrine IV
D) Amiodarone
Answer B: Defibrillation (as soon as possible)
Rationale: Defibrillation is the treatment of choice for VF/pulseless VT; early shock improves survival.
12. A 65-year-old male with a history of COPD is in respiratory distress. He is speaking in short
phrases. What is the most appropriate oxygen delivery device?
A) Nasal cannula at 2 L/min
B) Venturi mask (to deliver precise FiO₂)
C) Non-rebreather mask at 15 L/min
D) Simple face mask at 10 L/min
Answer B: Venturi mask (to deliver precise FiO₂)
Questions & Verified Answers
1. What is the first step in managing a patient with a suspected spinal injury?
A) Apply a cervical collar
B) Manual in-line spinal stabilization
C) Log roll the patient onto a backboard
D) Apply a vest-type immobilization device
Answer B: Manual in-line spinal stabilization
Rationale: Manual in-line stabilization is the first priority to prevent movement; then apply a cervical
collar.
2. A patient is in cardiac arrest. The AED advises a shock. Which action should be taken first?
A) Ensure the patient is dry
B) Clear everyone from the patient before delivering the shock
C) Check the patient’s pulse
D) Administer CPR for 2 minutes
Answer B: Clear everyone from the patient before delivering the shock
Rationale: Before delivering a shock, ensure no one is in contact with the patient to prevent injury.
3. A 45-year-old male with chest pain is pale and diaphoretic. He has a history of hypertension.
Which medication is indicated for this patient?
A) Oral glucose
B) Aspirin (chewed)
C) Albuterol
D) Nitroglycerin (without first checking if contraindicated)
,Answer B: Aspirin (chewed)
Rationale: Aspirin reduces mortality in ACS. It should be given unless contraindicated (allergy, bleeding).
Nitroglycerin may be given if systolic BP >100.
4. What is the most reliable indicator of adequate ventilation in an intubated patient?
A) Pulse oximetry reading
B) Skin color
C) End-tidal CO₂ (capnography)
D) Chest rise
Answer C: End-tidal CO₂ (capnography)
Rationale: Waveform capnography confirms endotracheal tube placement and adequacy of ventilation.
5. A 60-year-old female is unresponsive with a respiratory rate of 6 breaths/min. What is the most
appropriate initial action?
A) Place in recovery position
B) Assist ventilations with a BVM and 100% oxygen
C) Administer naloxone
D) Check blood glucose
Answer B: Assist ventilations with a BVM and 100% oxygen
Rationale: Inadequate respiratory rate requires immediate ventilatory support. Address airway/breathing
before further assessment.
6. A patient with a suspected overdose of opioids has pinpoint pupils, bradypnea, and lethargy.
What is the treatment?
A) Activated charcoal
B) Naloxone (Narcan)
C) Flumazenil
D) Dextrose 50%
,Answer B: Naloxone (Narcan)
Rationale: Naloxone is a competitive opioid antagonist that reverses respiratory depression and
sedation.
7. A 22-year-old male has a knife impaled in his right lower quadrant. What is the appropriate
management?
A) Remove the knife and apply pressure
B) Stabilize the knife in place with bulky dressings
C) Pack the wound around the knife
D) Apply a tourniquet
Answer B: Stabilize the knife in place with bulky dressings
Rationale: Never remove an impaled object; stabilize it to prevent further injury.
8. A 3-year-old child is choking and unable to cough. What is the next step?
A) Back slaps and chest thrusts
B) Abdominal thrusts (Heimlich maneuver) – for children >1 year, use abdominal thrusts; for infants, use
back slaps/chest thrusts. For a 3-year-old, abdominal thrusts are appropriate.
C) Blind finger sweep
D) Oxygen via non-rebreather
Answer B: Abdominal thrusts (Heimlich maneuver)
Rationale: For a conscious child >1 year, perform abdominal thrusts until the object is expelled.
9. A patient with severe anaphylaxis has stridor and hypotension. Which medication should be
given first?
A) Diphenhydramine
B) Albuterol
C) Epinephrine IM
D) Methylprednisolone
, Answer C: Epinephrine IM
Rationale: Epinephrine is first-line for anaphylaxis; it reverses bronchospasm, hypotension, and stridor.
10. Which of the following is a sign of a tension pneumothorax?
A) Absent breath sounds on the affected side
B) Tracheal deviation away from the affected side
C) Subcutaneous emphysema
D) Hypotension
Answer B: Tracheal deviation away from the affected side
Rationale: Tracheal deviation is a late sign of tension pneumothorax. Other signs include absent breath
sounds, hypotension, and distended neck veins.
11. A patient is in ventricular fibrillation. What is the immediate treatment?
A) CPR for 2 minutes
B) Defibrillation (as soon as possible)
C) Epinephrine IV
D) Amiodarone
Answer B: Defibrillation (as soon as possible)
Rationale: Defibrillation is the treatment of choice for VF/pulseless VT; early shock improves survival.
12. A 65-year-old male with a history of COPD is in respiratory distress. He is speaking in short
phrases. What is the most appropriate oxygen delivery device?
A) Nasal cannula at 2 L/min
B) Venturi mask (to deliver precise FiO₂)
C) Non-rebreather mask at 15 L/min
D) Simple face mask at 10 L/min
Answer B: Venturi mask (to deliver precise FiO₂)
