NREMT COGNITIVE EXAM (AFTER YOU PASS YOUR CLASS AND FORGET EVERYTHING) QUESTIONS AND ANSWERS

NREMT COGNITIVE EXAM (AFTER YOU
PASS YOUR CLASS AND FORGET
EVERYTHING) QUESTIONS AND
ANSWERS



Initraumaiailowipulseipressureisuggests?i-ians-Significantibloodiloss

Bloodipressureihasiaidirectieffection?i-ians-Theiperfusioniofitheibodysitissues

Cellsithatidieiduringiaistrokeiareicalled?i-ians-Infarctedicells

Youiareicalleditoiaihomeiwhereiai91iyearioldimanihasihadiaisyncopaliepisodeiandiisiv
omiting.iTheicaregiveriwhoicalledi911istatedithatitheipatient'sibowelimovementsihavei
beenibrightiredisinceiyesterday.iTheipatientihasinoticomplainediofianyipain,ibutiisinau
seated.iWhatiisimostilikelyiwrongiwithithisimaniandiwhichichoiceiincludesiappropriateit
reatmentisteps?

Choices:
A.iHeihasianiupperiGIibleediandishouldibeitransportedisittingiupiwithihighiflowiO2iadm
inisterediviaiainonirebreatherimaskiati15iLPM.

B.iHeihasihadiaiTIAiandishouldibeigivenihighiflowioxygeniviaiNRBianditransportedioni
hisieffectedisideitoitheinearestihospital.

C.iHeihasipancreatitisiandishouldibeigivenihighiflowiO2iviaiNRBiati15iLPM.iRapiditran
sportiiniaileftilateralirecumbentipositioniwhileikeepingihimiwarmiwillihelpiavoidishock.

D.iHeihasiailoweriGIibleediandishouldibeigiveniO2iviainasalicannulaiati4LPMianditran
sportediiniaipositionioficomfortiwhileiti-ians-
D.iHeihasiailoweriGIibleediandishouldibeigiveniO2iviainasalicannulaiati4LPMianditran
sportediiniaipositionioficomfortiwhileitreatingiforishock

Rationale:iTheibrightiredibloodiinitheibowelimovementsiisiindicativeiofiailoweriGIibleed
.iAnsweri1,2,iandi3ialliutilizeianiNRBitoideliverihighiflowiO2.iGivenithatitheipatientiisiv

,omitingiandinauseated,iitiwouldibeiadvisableitoiuseiainasalicannula,iratherithanianiNR
B,itoihelpiavoidipotentialiairwayicompromiseiifitheipatienticontinuesitoivomit.

Ifiaipatientiwasifeelinginauseatedithisiwouldilikelyibeia_______________response.iIfia
ipersoniwasitachycardiciitiwouldilikelyibeia___________________iresponse.i-ians-
Parasympathetic/Sympathetic

Youiareiassessingiani84iyearioldiman.iUponiauscultationiofitheilungsiyouidiscovericra
cklesioriraleisounds.iHeiisicomplainingiofichestipainiandicongestion.iTheseisignsiandi
symptomsicaniindicate?

Choices:
A.iAniembolism

B.iCollapseiofitheivenaicava

C.iLeftiventricularifailure

D.iRightiventricularifailurei-ians-C.iLeftiventricleifailure

Rationale:iTheseiareisignsiandisymptomsiofiaipossibleifailureiofitheileftiventricle.iThei
pumpiportioniofitheiheartiisiunableitoipumpiefficientlyiandifluidibeginsitoibackiupiintoit
heilungs.

Aichildibetweeni3-5iwouldihaveinormalivitalsiifitheyiwere?

Choices:
A.i35ibreathsiaiminute,ipulseiofi88,iandiSystoliciBPiofi100

B.i24ibreathsiaiminute,ipulseiofi76,iandiSystoliciBPiofi98

C.i20ibreathsiaiminute,ipulseiofi100,iandiSystoliciBPiofi110

D.i20ibreathsiaiminute,ipulseiofi120,iandiSystoliciBPiofi120i-ians-
20ibreathsiaiminute,ipulseiofi100,iandiSystoliciBPiofi110

Rationale:iAichildibetweeni3iandi5i(preschool-
age)ishouldihaveirespirationsibetweeni20-30,iaipulseiofi80-
120,iandiaisystoliciBPiofi80i-i110.
(Toddleri12itoi36imonths)

Theipediatriciassessmentitriangleiisicomposediofithreeielements:

Choices:
A.iMuscleiTone,iRespiratoryidepthiandirate,iPerfusion

,B.iCirculation,iAppearance,iWorkiofiBreathing

C.iLeveliofiConsciousness,iQualityiofiRespirations,iGeneraliAppearance

D.iBloodipressure,iPulseirate,iRespiratoryiRatei-ians-
B.iCirculation,iAppearance,iWorkiofiBreathing

Rationale:iPATiisiWorkiofiBreathing,iSkiniCirculation,iAppearance.iTheipediatriciasses
smentitriangleiisiuseditoiformiairapidigeneraliimpressioniofiaichildiwithoutimakingiphys
icalicontact.iLookiatitheichild'siappearanceiandimuscleitone.iLookiatitheiworkiofibreath
ingiforisignsiofirespiratoryidistress.iTachypneaioriretractionsiofisternumiandioriintercos
talimusclesiisiaisigniofirespiratoryidifficulty.iLookiatitheiskiniasiaiquickireferenceiforicir
culation.iPalloricanibeiaisigniofipooricirculation.

Theipatientiisiai6iyearioldigirliwhoseimotherisaysihasibeenisickiforiaifewidaysiandithe
nistartedihavingibreathingiproblemsithisimorning.iUponiassessment,iyouinoticeitheichil
diisiflaringiherinostrilsiandihasiaihoarseivoiceiwhenitalking.iWhatiisisheimostilikelyisuff
eringifromiandiwhatishouldiyouido?
Choices:
A.iSheicouldihaveicroupiandineedsitoibeitransportediwithiainasalicannulaiati4ilpm

B.iSheicouldihaveitonsillitisiandiwillirequireitransportitoitheihospitaliiniaipositionioficom
fort

C.iSheicouldihaveiSARSiandishouldibeitransportediwearingiaiHEPAimask

D.iSheicouldihaveiepiglottitisiandineedsitoibeitransportediwithihighiflowiO2ionianiNRB
i-ians-
D.iSheicouldihaveiepiglottitisiandineedsitoibeitransportediwithihighiflowiO2ionianiNRB

Rationale:iEpiglottitisiisiknownitoistrikeichildreniinithisiageigroup.iCroupiisiusuallyiiniyo
ungerichildren.iTransportingiwithiairwayisupportiisitheibestianswer.

Whatiisipulseipressure?i-ians-
Theidifferenceibetweenitheisystoliciandidiastolicimeasurementsiofitheibloodipressure

Ai57iyearioldiwomaniisicomplainingiofichestipain.iHeribloodipressureiisi109/88iandihe
rirespirationsiareiati22iperiminute.iWhaticonditionidoesitheipatient'sibloodipressureiind
icate?

A.iParadoxicaliPressure
B.iLowipulseipressure
C.Systolicitranscardiacieschemia
D.iMartinersiRulei-ians-B.iLowipulseipressure
Rationale:iAipulseipressureiisiconsiderediabnormallyilowiifiitiisilessithani25%iofitheisy
stolicivalue.iInithisiquestioniitiisiabouti20%iofitheisystolicivalue.iTheipulseipressureiisit

, heidifferenceibetweenitheisystoliciandidiastolicimeasurementsiofitheibloodipressure.i1
09isystolici-
i88idiastolici=i21immHg.iInitraumaiailowipulseipressureisuggestsisignificantibloodiloss
.iIfitheipulseipressureiisiextremelyilow,ii.e.i25immHgioriless,itheicauseimayibeilowistro
keivolume,iasiiniCongestiveiHeartiFailureiand/
orishock.iAilowipulseipressureicanialsoibeicausedibyiaorticivalveistenosisiandicardiaci
tamponade.

Whichiofitheifollowingichoicesiisiainormalisystolicibloodipressureiiniaichild?

Choices:
A.Greaterithani120immiHg

B.iGreaterithani70immiHg

C.iLessithani80immiHg

D.i70immiHgi-ians-B.iGreaterithani70immiHg
Rationale:i80-110immiHgiisiconsiderediainormalirangeiforiaichild.

AiTransientiIschemiciAttacki(TIA)iwilliusuallyistopiafter:
Choices:

A.i30-60iminutes

B.i1-2idays

C.i10-15iminutes

D.iProperiinterventioni-ians-C.i10itoi15iminutes
Rationale:iTransientiIschemiciAttacki(TIA)iisiaiblockageiofivesselsiinitheibrainithatiusu
allyisubsidesiafteriaiperiodiofi10itoi15iminutes.iHowever,iifitheipatient'sisymptomsipers
istilongerithani15iminutes,icontinueitoitreatitheipatientiasiifitheyiareihavingiaiCVAi(Cer
ebrovasculariAccident).iIfiresolutionitakesiplaceiwithinithei10-
15iminutes,ithenichancesiareitheyihaveihadiaiTIA.iTheifinalidiagnosisiofiTIAiisimadeiif
itheisymptomsiresolveiwithini24ihoursiandiisideterminedibyiaiphysician.

Ifitheipulseipressureiisiextremelyilow,ii.e.i25immHgioriless,itheicauseimayibe...i-ians-
Lowistrokeivolume,iasiiniCongestiveiHeartiFailureiand/
orishock.iAilowipulseipressureicanialsoibeicausedibyiaorticivalveistenosisiandicardiaci
tamponade.

Youiareicalleditoitheisceneiofiaimanidown.iDispatchireportsitheimaniisipulselessiandib
ystandersiareidoingiCPR.iAccordingitoitheiNREMTiCardiaciArrestiManagement/
AEDiskillisheet,iwhichiofitheifollowingisequencesiisiappropriate?