NREMT
Exam Prep
(400+ Practice Questions)
Answers with Rationales
This Document Description:
This document contains a collection of
475 verified multiple-choices questions
and Correct answers with Rationales.
Ideal for exam preparation and concept
reinforcement.
,1. A 78 year old female is found lying on her bathroom floor unconscious. Her
caregiver reports finding her like this upon arrival and is unsure what happened.
You hear gurgling sounds on inspiration. What is the next best step?
a. Suction her airway
b. Begin ventilations with a bag-valve mask
c. Insert an oropharyngeal airway
d. Provide nasal cannula at 2 L/min
Correct Answer:
suction her airway
The gurgling sounds on inspiration suggest her airway needs to be cleared. You want to
make sure you suction and clear her airway before proceeding with treatment.
2. You assess a 23 year-old male who was struck in the right chest wall with an
airbag after a motor vehicle accident. The patient complains of pain on inspiration
and shortness of breath. You gather the following from your physical
assessment: unequal chest wall rise and absent lungs sounds on the right side.
What do you suspect?
a. Flail chest
b. Cardiac tamponade
c. Tension pneumothorax
d. Right chest contusion
Correct Answer:
Tension pneumothorax
Tension pneumothorax is where one of the lungs collapses, and can commonly happen
with traumatic events like a motor vehicle crash. Its hallmark signs and symptoms are
absent lung sounds on affected side and unequal rise and fall of the chest.
3. You arrive on scene to a 4 year-old girl choking on her food. She is
unresponsive and not breathing. What is the next best step in the management of
this patient?
,a. Start chest compressions
b. Provide 5 back slaps
c. Inspect the airway with a finger sweep
d. Perform abdominal thrust
Correct Answer:
Start chest compressions
Since the child is unresponsive and not breathing, this would be the best method to try
and remove the foreign object.
4. A 68 year-old male is experiencing an exacerbation of his COPD. He states he is
having a hard time breathing and it is getting worse. His vital signs are as
follows: BP 140/92, HR 118, RR of 25, SpO2 84% on oxygen by nasal cannula at
3L/min. What is the next best step?
a. Rapid transport and reassess vital signs in 5 minutes
b. Start ventilations with bag-valve mask
c. Provide oxygen by non-rebreather mask
d. Titrate oxygen flow rate on nasal cannula to 6L/min
Correct Answer:
Provide oxygen by non-rebreather mask
The non-rebreather mask is correct as a higher concentration of oxygen can be
administered than via the nasal cannula, especially since the patient has stated his
symptoms are getting worse.
5. A 21 year-old male was shot in the left chest, below the clavicle. Where should
you place the stethoscope to best hear his lung sounds?
a. Anterior chest, below xiphoid process
b. Anterior chest, above suprasternal notch
c. Posterior, above occiput
d. Posterior, below the scapula
,Correct Answer:
Posterior, below the scapula
Below our scapula is a large area of the lungs to auscultate breath sounds.
6. Where does gas exchange of oxygen and carbon dioxide occur?
a. larynx
b. bronchioles
c. alveoli
d. main stem bronchi
Correct Answer:
Alveoli
The alveoli are where the lungs and the blood exchange oxygen and carbon dioxide
during the process of breathing in and breathing out. Oxygen breathed in from the air
passes through the alveoli and into the blood and travels to the tissues throughout the
body.
7. What is the primary role of the epiglottis?
a. bringing oxygen into circulation
b. aids in food digestion
c. assist air flow to the larynx
d. prevent aspiration while eating
Correct Answer:
prevent aspiration while eating
The main job of the epiglottis is to close over the trachea while you're eating to prevent
food entering your airway.
8. What is the PRIMARY role of the mediastinum?
a. Protects vital structures of the chest
b. Protects your diaphragm from collapse
c. Protects your lungs from collapse
,d. Surrounds the heart's four chambers
Correct Answer:
protects vital structures of the chest
The mediastinum protects many vital structures including the heart, large vessels, the
trachea, and critical nerves.
9. You respond to a 8 year old male who states he is having trouble breathing. His
respiratory rate is 44 breaths/min and you notice accessory muscle use on exam.
You can hear an audible wheeze present. What should your initial step be?
a. Start BVM ventilations
b. Attempt a head tilt-chin lift
c. Obtain his oxygen saturation
d. Gather a SAMPLE history
Correct Answer:
Obtain his oxygen saturation
This patient is able to speak so the airway is patent, we don't have any oxygen data so
we need that before we can go ahead with oxygen administration. This will give the final
piece of info to start assessing his current status.
10. You are called to the home of a 4 year old female patient. The patient has a
persistent "barking cough" and has stridor on exam. The mother tells you that
this has gotten worse over the last few nights, until tonight she had a "hard time"
breathing. What do you suspect?
a. Asthma Exacerbation
b. Bronchiolitis
c. Epiglottitis
d. Croup
Correct Answer:
Croup
,Remember the keys for croup, barking cough, stridor, gradual onset, typically seen in
young children. Epiglottitis can occur at any age and has drooling, painful swallowing,
stridor and a more rapid onset, no barking cough.
11. From the list below name three action steps you can take to help patients with
croup or epiglottitis. (Pick 3)
a. Keep oxygen saturation above 94%
b. Keep the patient calm
c. Begin CPR if the patient has a pulse less than 100
d. Begin bag valve mask ventilations with rapid transport
e. Use blow-by oxygen
f. Immediately begin non-rebreather mask at 15LPM
Correct Answer:
a. keep oxygen saturation above 94%
b. keep patient calm
e. use blow-by oxygen
12. You are about to place an airway adjunct into your patient. Which situation
would you NOT place a nasopharyngeal airway?
a. A semiconscious child who just had a seizure
b. A patient with ecchymosis behind one ear
c. An unconscious patient with an intact gag reflex
d. An semiconscious adult who cannot maintain their own airway
Correct Answer:
a patient with ecchymosis behind one ear
Bruising behind one ear is known as the "Battle sign" and an indication of a basilar skull
fracture, which is a severe head injury. Use of a nasopharyngeal airway with severe
head injuries is contraindicated.
13. You are transporting a 53 year-old male who complains of shortness of breath,
dizziness, numbness in his hands, and a dry mouth. His vital signs are: blood
,pressure 118/80 mmHg, HR 120, RR of 32, SpO2 99%, and ETCO2 of 26 mmHg.
What do you suspect?
a. Hypokalemia
b. Hypoventilation syndrome
c. Pneumothorax
d. Hyperventilation syndrome
Correct Answer:
Hyperventilation syndrome
This patient is hyperventilating as demonstrated by his increased respiratory rate and
low end-tidal reading levels. A high respiratory rate increases the amount of carbon
dioxide exhaled, accounting for the low end-tidal reading. His heart rate is also a little
elevated, possibly due to anxiety.
14. A 10 year-old boy complains of sore throat and pain when swallowing. He
presents in the tripod position and has a fever of 101 degrees F. His parents state
he went to bed fine and woke up suddenly with symptoms. You suspect:
a. Croup
b. Epiglottitis
c. Bacterial Tracheitis
d. Bronchiolitis
Correct Answer:
Epiglottitis
The patient presents with the hallmark symptoms of epiglottitis, sudden sore throat and
pain when swallowing. It is also common for children to wake up the next day suddenly
with these symptoms. He is also demonstrating signs of respiratory distress as he
presents in the tripod position.
15. You arrive on scene to a patient with a history of COPD having an
exacerbation. He requires rapid transport to the emergency department. What is
the best position for the patient to be transported on the stretcher?
a. Trendelenburg position
,b. Supine position
c. Prone position
d. Fowler's position
Correct Answer:
Fowler's position
This position is where the head of the stretcher is elevated 45-60 degrees, so the
patient is sitting upright. This position is typically the most comfortable for patients with
difficulty breathing.
16. You and your partner arrive on scene to a 7 year-old male who has tripped and
fell into a pool, hitting his head. You find he has no respirations and no pulse.
What is the next best step in the management of this patient?
a. Provide manual stabilization of cervical spine and gather additional rescuers to
perform 2-rescuer CPR at a 15:2 ratio.
b. Apply cervical collar and deliver 2-rescuer CPR at 30:2 ratio.
c. Insert nasopharyngeal airway and begin bag-valve mask ventilations at 12-20
breaths/min
d. Apply cervical collar, insert nasopharyngeal airway, and gather additional
rescuers to perform 2-rescuer CPR at 15:2 ratio.
Correct Answer:
Provide manual stabilization of cervical spine and gather additional rescuers to
perform 2-rescuer CPR at a 15:2 ratio.
AHA guidelines suggest 2-rescuer CPR for a child is performed at a 15:2 ratio and that
manual stabilization of C-spine is preferred when performing CPR.
17. When a person inhales, the diaphragm moves...
a. Up
b. Down
c. Anterior
d. Posterior
,Correct Answer:
Down
The diaphragm moves down on inspiration to allow room for the lungs to expand.
18. You arrive on scene to a patient in respiratory arrest. Your partner states he
sees signs of cyanosis around the patient's lips and fingertips. Which of the
following best describes cyanosis?
a. Paleness of the skin
b. Red and purple spots on skin
c. Bluish discoloration of the skin
d. Yellow tinge of the skin
Correct Answer:
Bluish discoloration of the skin.
This is known as cyanosis, which is due to poor oxygenation and/or circulation of the
blood. It is commonly first seen around the lips and nail beds of a patient.
19. A 72 year old male presents with sudden onset shortness of breath. He has a
previous history of a heart attack 6 months ago. His vital signs are as follows: BP
100/82, HR 98, RR of 22, and SpO2 86% on room air. On auscultation of lung
sounds you hear rales bilaterally. What is the next best step?
a. Initiate CPR
b. Administer ventilations with bag-valve mask at 12-20 breaths/min
c. Rapid transport in Trendelenburg position
d. Administer supplemental oxygen to increase SpO2 to 94% or higher
Correct Answer:
Administer supplemental oxygen to increase SpO2 to 94% or higher
This patient requires supplemental oxygen as his oxygen saturation level is low. He
does not require ventilations via BVM at this time and transport via Trendelenburg
position would increase his breathing difficulty. CPR is not needed as this patient has a
pulse and is breathing.
, 20. What is the most common cause of an airway blockage?
a. Food obstruction
b. The tongue
c. Vomit
d. Throat swelling
Correct Answer:
The tongue
When a patient becomes unconscious, their throat muscles relax which can cause the
tongue to fall back and block the airway.
21. What is the physical process of moving air into and out of the lungs?
a. Inspiration
b. Oxygenation
c. Ventilation
d. Diffusion
Correct Answer:
Ventilation
The process of ventilation is the physical act of moving air into and out of the lungs.
22. A 38 year-old female presents restless on her couch with shortness of breath
and accessory muscle use. From your assessment you find an open and clear
airway. What is the next best step?
a. Assess skin color and mental status
b. Obtain oxygen saturation
c. Assess respiratory rate, quality, and effort
d. Take her radial pulse
Correct Answer:
Assess respiratory rate, quality, and effort
Exam Prep
(400+ Practice Questions)
Answers with Rationales
This Document Description:
This document contains a collection of
475 verified multiple-choices questions
and Correct answers with Rationales.
Ideal for exam preparation and concept
reinforcement.
,1. A 78 year old female is found lying on her bathroom floor unconscious. Her
caregiver reports finding her like this upon arrival and is unsure what happened.
You hear gurgling sounds on inspiration. What is the next best step?
a. Suction her airway
b. Begin ventilations with a bag-valve mask
c. Insert an oropharyngeal airway
d. Provide nasal cannula at 2 L/min
Correct Answer:
suction her airway
The gurgling sounds on inspiration suggest her airway needs to be cleared. You want to
make sure you suction and clear her airway before proceeding with treatment.
2. You assess a 23 year-old male who was struck in the right chest wall with an
airbag after a motor vehicle accident. The patient complains of pain on inspiration
and shortness of breath. You gather the following from your physical
assessment: unequal chest wall rise and absent lungs sounds on the right side.
What do you suspect?
a. Flail chest
b. Cardiac tamponade
c. Tension pneumothorax
d. Right chest contusion
Correct Answer:
Tension pneumothorax
Tension pneumothorax is where one of the lungs collapses, and can commonly happen
with traumatic events like a motor vehicle crash. Its hallmark signs and symptoms are
absent lung sounds on affected side and unequal rise and fall of the chest.
3. You arrive on scene to a 4 year-old girl choking on her food. She is
unresponsive and not breathing. What is the next best step in the management of
this patient?
,a. Start chest compressions
b. Provide 5 back slaps
c. Inspect the airway with a finger sweep
d. Perform abdominal thrust
Correct Answer:
Start chest compressions
Since the child is unresponsive and not breathing, this would be the best method to try
and remove the foreign object.
4. A 68 year-old male is experiencing an exacerbation of his COPD. He states he is
having a hard time breathing and it is getting worse. His vital signs are as
follows: BP 140/92, HR 118, RR of 25, SpO2 84% on oxygen by nasal cannula at
3L/min. What is the next best step?
a. Rapid transport and reassess vital signs in 5 minutes
b. Start ventilations with bag-valve mask
c. Provide oxygen by non-rebreather mask
d. Titrate oxygen flow rate on nasal cannula to 6L/min
Correct Answer:
Provide oxygen by non-rebreather mask
The non-rebreather mask is correct as a higher concentration of oxygen can be
administered than via the nasal cannula, especially since the patient has stated his
symptoms are getting worse.
5. A 21 year-old male was shot in the left chest, below the clavicle. Where should
you place the stethoscope to best hear his lung sounds?
a. Anterior chest, below xiphoid process
b. Anterior chest, above suprasternal notch
c. Posterior, above occiput
d. Posterior, below the scapula
,Correct Answer:
Posterior, below the scapula
Below our scapula is a large area of the lungs to auscultate breath sounds.
6. Where does gas exchange of oxygen and carbon dioxide occur?
a. larynx
b. bronchioles
c. alveoli
d. main stem bronchi
Correct Answer:
Alveoli
The alveoli are where the lungs and the blood exchange oxygen and carbon dioxide
during the process of breathing in and breathing out. Oxygen breathed in from the air
passes through the alveoli and into the blood and travels to the tissues throughout the
body.
7. What is the primary role of the epiglottis?
a. bringing oxygen into circulation
b. aids in food digestion
c. assist air flow to the larynx
d. prevent aspiration while eating
Correct Answer:
prevent aspiration while eating
The main job of the epiglottis is to close over the trachea while you're eating to prevent
food entering your airway.
8. What is the PRIMARY role of the mediastinum?
a. Protects vital structures of the chest
b. Protects your diaphragm from collapse
c. Protects your lungs from collapse
,d. Surrounds the heart's four chambers
Correct Answer:
protects vital structures of the chest
The mediastinum protects many vital structures including the heart, large vessels, the
trachea, and critical nerves.
9. You respond to a 8 year old male who states he is having trouble breathing. His
respiratory rate is 44 breaths/min and you notice accessory muscle use on exam.
You can hear an audible wheeze present. What should your initial step be?
a. Start BVM ventilations
b. Attempt a head tilt-chin lift
c. Obtain his oxygen saturation
d. Gather a SAMPLE history
Correct Answer:
Obtain his oxygen saturation
This patient is able to speak so the airway is patent, we don't have any oxygen data so
we need that before we can go ahead with oxygen administration. This will give the final
piece of info to start assessing his current status.
10. You are called to the home of a 4 year old female patient. The patient has a
persistent "barking cough" and has stridor on exam. The mother tells you that
this has gotten worse over the last few nights, until tonight she had a "hard time"
breathing. What do you suspect?
a. Asthma Exacerbation
b. Bronchiolitis
c. Epiglottitis
d. Croup
Correct Answer:
Croup
,Remember the keys for croup, barking cough, stridor, gradual onset, typically seen in
young children. Epiglottitis can occur at any age and has drooling, painful swallowing,
stridor and a more rapid onset, no barking cough.
11. From the list below name three action steps you can take to help patients with
croup or epiglottitis. (Pick 3)
a. Keep oxygen saturation above 94%
b. Keep the patient calm
c. Begin CPR if the patient has a pulse less than 100
d. Begin bag valve mask ventilations with rapid transport
e. Use blow-by oxygen
f. Immediately begin non-rebreather mask at 15LPM
Correct Answer:
a. keep oxygen saturation above 94%
b. keep patient calm
e. use blow-by oxygen
12. You are about to place an airway adjunct into your patient. Which situation
would you NOT place a nasopharyngeal airway?
a. A semiconscious child who just had a seizure
b. A patient with ecchymosis behind one ear
c. An unconscious patient with an intact gag reflex
d. An semiconscious adult who cannot maintain their own airway
Correct Answer:
a patient with ecchymosis behind one ear
Bruising behind one ear is known as the "Battle sign" and an indication of a basilar skull
fracture, which is a severe head injury. Use of a nasopharyngeal airway with severe
head injuries is contraindicated.
13. You are transporting a 53 year-old male who complains of shortness of breath,
dizziness, numbness in his hands, and a dry mouth. His vital signs are: blood
,pressure 118/80 mmHg, HR 120, RR of 32, SpO2 99%, and ETCO2 of 26 mmHg.
What do you suspect?
a. Hypokalemia
b. Hypoventilation syndrome
c. Pneumothorax
d. Hyperventilation syndrome
Correct Answer:
Hyperventilation syndrome
This patient is hyperventilating as demonstrated by his increased respiratory rate and
low end-tidal reading levels. A high respiratory rate increases the amount of carbon
dioxide exhaled, accounting for the low end-tidal reading. His heart rate is also a little
elevated, possibly due to anxiety.
14. A 10 year-old boy complains of sore throat and pain when swallowing. He
presents in the tripod position and has a fever of 101 degrees F. His parents state
he went to bed fine and woke up suddenly with symptoms. You suspect:
a. Croup
b. Epiglottitis
c. Bacterial Tracheitis
d. Bronchiolitis
Correct Answer:
Epiglottitis
The patient presents with the hallmark symptoms of epiglottitis, sudden sore throat and
pain when swallowing. It is also common for children to wake up the next day suddenly
with these symptoms. He is also demonstrating signs of respiratory distress as he
presents in the tripod position.
15. You arrive on scene to a patient with a history of COPD having an
exacerbation. He requires rapid transport to the emergency department. What is
the best position for the patient to be transported on the stretcher?
a. Trendelenburg position
,b. Supine position
c. Prone position
d. Fowler's position
Correct Answer:
Fowler's position
This position is where the head of the stretcher is elevated 45-60 degrees, so the
patient is sitting upright. This position is typically the most comfortable for patients with
difficulty breathing.
16. You and your partner arrive on scene to a 7 year-old male who has tripped and
fell into a pool, hitting his head. You find he has no respirations and no pulse.
What is the next best step in the management of this patient?
a. Provide manual stabilization of cervical spine and gather additional rescuers to
perform 2-rescuer CPR at a 15:2 ratio.
b. Apply cervical collar and deliver 2-rescuer CPR at 30:2 ratio.
c. Insert nasopharyngeal airway and begin bag-valve mask ventilations at 12-20
breaths/min
d. Apply cervical collar, insert nasopharyngeal airway, and gather additional
rescuers to perform 2-rescuer CPR at 15:2 ratio.
Correct Answer:
Provide manual stabilization of cervical spine and gather additional rescuers to
perform 2-rescuer CPR at a 15:2 ratio.
AHA guidelines suggest 2-rescuer CPR for a child is performed at a 15:2 ratio and that
manual stabilization of C-spine is preferred when performing CPR.
17. When a person inhales, the diaphragm moves...
a. Up
b. Down
c. Anterior
d. Posterior
,Correct Answer:
Down
The diaphragm moves down on inspiration to allow room for the lungs to expand.
18. You arrive on scene to a patient in respiratory arrest. Your partner states he
sees signs of cyanosis around the patient's lips and fingertips. Which of the
following best describes cyanosis?
a. Paleness of the skin
b. Red and purple spots on skin
c. Bluish discoloration of the skin
d. Yellow tinge of the skin
Correct Answer:
Bluish discoloration of the skin.
This is known as cyanosis, which is due to poor oxygenation and/or circulation of the
blood. It is commonly first seen around the lips and nail beds of a patient.
19. A 72 year old male presents with sudden onset shortness of breath. He has a
previous history of a heart attack 6 months ago. His vital signs are as follows: BP
100/82, HR 98, RR of 22, and SpO2 86% on room air. On auscultation of lung
sounds you hear rales bilaterally. What is the next best step?
a. Initiate CPR
b. Administer ventilations with bag-valve mask at 12-20 breaths/min
c. Rapid transport in Trendelenburg position
d. Administer supplemental oxygen to increase SpO2 to 94% or higher
Correct Answer:
Administer supplemental oxygen to increase SpO2 to 94% or higher
This patient requires supplemental oxygen as his oxygen saturation level is low. He
does not require ventilations via BVM at this time and transport via Trendelenburg
position would increase his breathing difficulty. CPR is not needed as this patient has a
pulse and is breathing.
, 20. What is the most common cause of an airway blockage?
a. Food obstruction
b. The tongue
c. Vomit
d. Throat swelling
Correct Answer:
The tongue
When a patient becomes unconscious, their throat muscles relax which can cause the
tongue to fall back and block the airway.
21. What is the physical process of moving air into and out of the lungs?
a. Inspiration
b. Oxygenation
c. Ventilation
d. Diffusion
Correct Answer:
Ventilation
The process of ventilation is the physical act of moving air into and out of the lungs.
22. A 38 year-old female presents restless on her couch with shortness of breath
and accessory muscle use. From your assessment you find an open and clear
airway. What is the next best step?
a. Assess skin color and mental status
b. Obtain oxygen saturation
c. Assess respiratory rate, quality, and effort
d. Take her radial pulse
Correct Answer:
Assess respiratory rate, quality, and effort
