NREMT EXAM PREPARATION GUIDE: 200 PRACTICE QUESTIONS WITH
CORRECT ANSWERS AND DETAILED RATIONALES COVERING ALL
TESTED TOPICS FOR THE LATEST 2026/2027 VERSION
1. A 72-year-old male complains of severe chest pain and shortness of
breath. He is diaphoretic and nauseous. His blood pressure is 88/60
mmHg and his heart rate is 110 bpm. What is the most appropriate
initial treatment?
A) Aspirin 324 mg chewed
B) Nitroglycerin 0.4 mg sublingual
C) Morphine sulfate 2 mg IV
D) Normal saline 250 mL bolus
Correct Answer: D) Normal saline 250 mL bolus
Rationale: The patient is in cardiogenic shock, indicated by hypotension
and tachycardia. Nitroglycerin and morphine can further drop blood
pressure and should be used cautiously or withheld. Aspirin is
important but fluid resuscitation to improve perfusion is a priority in the
presence of hypotension.
2. A patient is found unresponsive with a blood glucose of 32 mg/dL.
Which medication should be administered first if the patient has no IV
access?
A) Oral glucose tablets
B) Glucagon 1 mg IM
C) Dextrose 50% IV push
D) Milk and crackers
Correct Answer: B) Glucagon 1 mg IM
,Rationale: Glucagon is administered IM or SubQ when IV access is
unavailable and the patient is unconscious. Oral glucose requires the
patient to be awake and protect their airway. Dextrose is an IV
medication.
3. Which of the following is a contraindication for the use of a
nasopharyngeal airway?
A) Suspected skull fracture
B) Gag reflex present
C) Severe head injury
D) Conscious patient
Correct Answer: A) Suspected skull fracture
Rationale: A nasopharyngeal airway is contraindicated in patients with
suspected skull fractures or basal skull fractures because of the risk of
intracranial placement through a fractured cribriform plate.
4. A 45-year-old female is experiencing a generalized tonic-clonic
seizure that has lasted 7 minutes. Which medication is most
appropriate to administer?
A) Naloxone 2 mg IN
B) Albuterol 2.5 mg nebulized
C) Diazepam 5 mg IV
D) Epinephrine 1:1000 0.3 mg IM
Correct Answer: C) Diazepam 5 mg IV
Rationale: Prolonged seizures (status epilepticus) require rapid
termination with benzodiazepines such as diazepam, lorazepam, or
midazolam to prevent brain damage.
5. What is the correct compression-to-ventilation ratio for two-rescuer
adult CPR with an advanced airway in place?
,A) 30:2
B) 15:2
C) Continuous compressions at 100-120/min with ventilations at 10/min
D) Continuous compressions at 80/min with ventilations at 20/min
Correct Answer: C) Continuous compressions at 100-120/min with
ventilations at 10/min
Rationale: Once an advanced airway is placed, rescuers provide
continuous chest compressions at 100-120 per minute and deliver one
breath every 6 seconds (10 breaths per minute) without pausing
compressions.
6. A patient presents with jugular venous distension, tracheal
deviation to the left, and absent breath sounds on the right side after
a stab wound to the chest. What is the most likely diagnosis?
A) Cardiac tamponade
B) Tension pneumothorax
C) Simple pneumothorax
D) Hemothorax
Correct Answer: B) Tension pneumothorax
Rationale: Tension pneumothorax presents with tracheal deviation away
from the affected side, JVD, and absent breath sounds. This is a life-
threatening emergency requiring needle decompression.
7. Which of the following burn classifications is characterized by
damage through the epidermis and dermis, appearing waxy, white, or
charred, and typically being painless?
A) Superficial (first-degree)
B) Superficial partial-thickness (second-degree)
C) Deep partial-thickness (second-degree)
D) Full-thickness (third-degree)
, Correct Answer: D) Full-thickness (third-degree)
Rationale: Full-thickness burns destroy the epidermis and dermis, often
appearing leathery, waxy, white, or charred. Nerve endings are
destroyed, making them painless.
8. A 56-year-old male complains of acute onset severe headache,
nausea, and photophobia. His blood pressure is 210/120 mmHg. What
condition is most likely?
A) Migraine headache
B) Sinusitis
C) Hypertensive emergency
D) Subarachnoid hemorrhage
Correct Answer: C) Hypertensive emergency
Rationale: A severe headache with a diastolic blood pressure above 120
mmHg indicates a hypertensive emergency with end-organ damage.
While subarachnoid hemorrhage is possible, the extreme hypertension
points to a hypertensive crisis as the primary issue.
9. Which of the following is the most reliable indicator of adequate
artificial ventilation in an adult patient?
A) Gastric distention
B) Pulse oximetry reading of 94%
C) Visible chest rise and fall
D) Improved skin color
Correct Answer: C) Visible chest rise and fall
Rationale: The most reliable clinical indicator of effective ventilation is
visible, bilateral chest rise and fall. Pulse oximetry and skin color are
delayed indicators.
CORRECT ANSWERS AND DETAILED RATIONALES COVERING ALL
TESTED TOPICS FOR THE LATEST 2026/2027 VERSION
1. A 72-year-old male complains of severe chest pain and shortness of
breath. He is diaphoretic and nauseous. His blood pressure is 88/60
mmHg and his heart rate is 110 bpm. What is the most appropriate
initial treatment?
A) Aspirin 324 mg chewed
B) Nitroglycerin 0.4 mg sublingual
C) Morphine sulfate 2 mg IV
D) Normal saline 250 mL bolus
Correct Answer: D) Normal saline 250 mL bolus
Rationale: The patient is in cardiogenic shock, indicated by hypotension
and tachycardia. Nitroglycerin and morphine can further drop blood
pressure and should be used cautiously or withheld. Aspirin is
important but fluid resuscitation to improve perfusion is a priority in the
presence of hypotension.
2. A patient is found unresponsive with a blood glucose of 32 mg/dL.
Which medication should be administered first if the patient has no IV
access?
A) Oral glucose tablets
B) Glucagon 1 mg IM
C) Dextrose 50% IV push
D) Milk and crackers
Correct Answer: B) Glucagon 1 mg IM
,Rationale: Glucagon is administered IM or SubQ when IV access is
unavailable and the patient is unconscious. Oral glucose requires the
patient to be awake and protect their airway. Dextrose is an IV
medication.
3. Which of the following is a contraindication for the use of a
nasopharyngeal airway?
A) Suspected skull fracture
B) Gag reflex present
C) Severe head injury
D) Conscious patient
Correct Answer: A) Suspected skull fracture
Rationale: A nasopharyngeal airway is contraindicated in patients with
suspected skull fractures or basal skull fractures because of the risk of
intracranial placement through a fractured cribriform plate.
4. A 45-year-old female is experiencing a generalized tonic-clonic
seizure that has lasted 7 minutes. Which medication is most
appropriate to administer?
A) Naloxone 2 mg IN
B) Albuterol 2.5 mg nebulized
C) Diazepam 5 mg IV
D) Epinephrine 1:1000 0.3 mg IM
Correct Answer: C) Diazepam 5 mg IV
Rationale: Prolonged seizures (status epilepticus) require rapid
termination with benzodiazepines such as diazepam, lorazepam, or
midazolam to prevent brain damage.
5. What is the correct compression-to-ventilation ratio for two-rescuer
adult CPR with an advanced airway in place?
,A) 30:2
B) 15:2
C) Continuous compressions at 100-120/min with ventilations at 10/min
D) Continuous compressions at 80/min with ventilations at 20/min
Correct Answer: C) Continuous compressions at 100-120/min with
ventilations at 10/min
Rationale: Once an advanced airway is placed, rescuers provide
continuous chest compressions at 100-120 per minute and deliver one
breath every 6 seconds (10 breaths per minute) without pausing
compressions.
6. A patient presents with jugular venous distension, tracheal
deviation to the left, and absent breath sounds on the right side after
a stab wound to the chest. What is the most likely diagnosis?
A) Cardiac tamponade
B) Tension pneumothorax
C) Simple pneumothorax
D) Hemothorax
Correct Answer: B) Tension pneumothorax
Rationale: Tension pneumothorax presents with tracheal deviation away
from the affected side, JVD, and absent breath sounds. This is a life-
threatening emergency requiring needle decompression.
7. Which of the following burn classifications is characterized by
damage through the epidermis and dermis, appearing waxy, white, or
charred, and typically being painless?
A) Superficial (first-degree)
B) Superficial partial-thickness (second-degree)
C) Deep partial-thickness (second-degree)
D) Full-thickness (third-degree)
, Correct Answer: D) Full-thickness (third-degree)
Rationale: Full-thickness burns destroy the epidermis and dermis, often
appearing leathery, waxy, white, or charred. Nerve endings are
destroyed, making them painless.
8. A 56-year-old male complains of acute onset severe headache,
nausea, and photophobia. His blood pressure is 210/120 mmHg. What
condition is most likely?
A) Migraine headache
B) Sinusitis
C) Hypertensive emergency
D) Subarachnoid hemorrhage
Correct Answer: C) Hypertensive emergency
Rationale: A severe headache with a diastolic blood pressure above 120
mmHg indicates a hypertensive emergency with end-organ damage.
While subarachnoid hemorrhage is possible, the extreme hypertension
points to a hypertensive crisis as the primary issue.
9. Which of the following is the most reliable indicator of adequate
artificial ventilation in an adult patient?
A) Gastric distention
B) Pulse oximetry reading of 94%
C) Visible chest rise and fall
D) Improved skin color
Correct Answer: C) Visible chest rise and fall
Rationale: The most reliable clinical indicator of effective ventilation is
visible, bilateral chest rise and fall. Pulse oximetry and skin color are
delayed indicators.
