NREMT EXAM COMPREHENSIVE
REVIEW QUESTIONS AND ANSWERS
1. A 68-year-old male presents with sudden onset of severe dyspnea and pink, frothy sputum.
He has a history of hypertension and two previous myocardial infarctions. Crackles are heard
bilaterally. Which of the following is the most appropriate physiological explanation for his
condition?
A. Increased pulmonary capillary hydrostatic pressure
B. Right-sided heart failure causing systemic edema
C. Decreased permeability of the alveolar-capillary membrane
D. Right ventricular hypertrophy leading to decreased cardiac output
Answer: A
Conceptual Explanation: The patient is exhibiting signs of acute pulmonary edema (left-
sided heart failure). In this condition, the left ventricle fails to pump efficiently, leading to a
backup of blood into the lungs. This increases the hydrostatic pressure in the pulmonary
capillaries, forcing fluid into the alveoli.
,2. You are treating a 22-year-old female who was ejected from a vehicle. She is unresponsive
with a respiratory rate of 8 and shallow. You note bruising behind her ears and clear fluid
leaking from her nose. What is the most immediate priority?
A. Begin positive pressure ventilation with high-flow oxygen
B. Apply a cervical collar and long backboard immediately
C. Perform a detailed head-to-toe secondary assessment
D. Suction the nose to prevent aspiration of cerebrospinal fluid
Answer: A
Conceptual Explanation: While spinal precautions and head injuries are critical, the
immediate priority in the primary assessment is the ‘Airway/Breathing’ phase. A
respiratory rate of 8 and shallow indicates inadequate minute volume, requiring immediate
assisted ventilation.
3. During a mass casualty incident, you encounter a patient who is awake, has a respiratory
rate of 24, a radial pulse of 110, and follows simple commands but has a large jagged
laceration on the thigh with controlled bleeding. According to the START triage system, how
should this patient be tagged?
A. Green (Minor)
B. Yellow (Delayed)
C. Red (Immediate)
D. Black (Deceased)
, Answer: B
Conceptual Explanation: Under START triage, a patient who can follow commands, has
respirations under 30, and a radial pulse is not ‘Immediate.’ Since they have a significant
injury requiring treatment but are currently stable, they are tagged Yellow.
4. Which of the following findings is most suggestive of a tension pneumothorax rather than a
simple pneumothorax?
A. Diminished breath sounds on the affected side
B. Sudden onset of sharp, pleuritic chest pain
C. Hyperresonance upon percussion of the chest wall
D. Jugular venous distention (JVD) and obstructive shock signs
Answer: D
Conceptual Explanation: Tension pneumothorax involves a shift in intrathoracic pressure
that compresses the vena cava and the heart, leading to JVD and signs of obstructive shock
(hypotension). Simple pneumothorax does not typically cause these systemic
hemodynamic changes.
5. An 8-year-old child presents with a high fever, muffled voice, and is sitting in a ‘tripod’
position while drooling. What is the most likely diagnosis and appropriate action?
A. Croup; administer humidified oxygen and encourage coughing
B. Asthma; assist the patient with their rescue inhaler
REVIEW QUESTIONS AND ANSWERS
1. A 68-year-old male presents with sudden onset of severe dyspnea and pink, frothy sputum.
He has a history of hypertension and two previous myocardial infarctions. Crackles are heard
bilaterally. Which of the following is the most appropriate physiological explanation for his
condition?
A. Increased pulmonary capillary hydrostatic pressure
B. Right-sided heart failure causing systemic edema
C. Decreased permeability of the alveolar-capillary membrane
D. Right ventricular hypertrophy leading to decreased cardiac output
Answer: A
Conceptual Explanation: The patient is exhibiting signs of acute pulmonary edema (left-
sided heart failure). In this condition, the left ventricle fails to pump efficiently, leading to a
backup of blood into the lungs. This increases the hydrostatic pressure in the pulmonary
capillaries, forcing fluid into the alveoli.
,2. You are treating a 22-year-old female who was ejected from a vehicle. She is unresponsive
with a respiratory rate of 8 and shallow. You note bruising behind her ears and clear fluid
leaking from her nose. What is the most immediate priority?
A. Begin positive pressure ventilation with high-flow oxygen
B. Apply a cervical collar and long backboard immediately
C. Perform a detailed head-to-toe secondary assessment
D. Suction the nose to prevent aspiration of cerebrospinal fluid
Answer: A
Conceptual Explanation: While spinal precautions and head injuries are critical, the
immediate priority in the primary assessment is the ‘Airway/Breathing’ phase. A
respiratory rate of 8 and shallow indicates inadequate minute volume, requiring immediate
assisted ventilation.
3. During a mass casualty incident, you encounter a patient who is awake, has a respiratory
rate of 24, a radial pulse of 110, and follows simple commands but has a large jagged
laceration on the thigh with controlled bleeding. According to the START triage system, how
should this patient be tagged?
A. Green (Minor)
B. Yellow (Delayed)
C. Red (Immediate)
D. Black (Deceased)
, Answer: B
Conceptual Explanation: Under START triage, a patient who can follow commands, has
respirations under 30, and a radial pulse is not ‘Immediate.’ Since they have a significant
injury requiring treatment but are currently stable, they are tagged Yellow.
4. Which of the following findings is most suggestive of a tension pneumothorax rather than a
simple pneumothorax?
A. Diminished breath sounds on the affected side
B. Sudden onset of sharp, pleuritic chest pain
C. Hyperresonance upon percussion of the chest wall
D. Jugular venous distention (JVD) and obstructive shock signs
Answer: D
Conceptual Explanation: Tension pneumothorax involves a shift in intrathoracic pressure
that compresses the vena cava and the heart, leading to JVD and signs of obstructive shock
(hypotension). Simple pneumothorax does not typically cause these systemic
hemodynamic changes.
5. An 8-year-old child presents with a high fever, muffled voice, and is sitting in a ‘tripod’
position while drooling. What is the most likely diagnosis and appropriate action?
A. Croup; administer humidified oxygen and encourage coughing
B. Asthma; assist the patient with their rescue inhaler
