NREMT Practice Test Bank - Multiple
Choice
Hypoglycemia and acute ischemic stroke can present similarly because:
• A:both oxygen and glucose are needed for brain function.
• B:the majority of stroke patients have a history of diabetes.
• C:the most common cause of a stroke is hypoglycemia.
• D:they are both caused by low levels of glucose in the blood. - • A:both oxygen and glucose
are needed for brain function.
Reason: Although stroke and hypoglycemia are two distinctly different conditions, their
signs and symptoms are often similar. This is because the brain requires both oxygen and
glucose to function normally. An acute ischemic stroke is caused by a lack of oxygen to a
part of the brain due to a blocked cerebral artery, whereas hypoglycemia (low blood
glucose level) deprives the entire brain of glucose. In either case, the patient presents with
signs of impaired brain function (ie, slurred speech, weakness, altered mental status). Both
conditions may lead to permanent brain damage or death if not treated promptly.
When dealing with an emotionally disturbed patient, you should be MOST concerned with:
• A:gathering all of the patient's medications.
• B:safely transporting to the hospital.
• C:whether the patient could harm you.
• D:obtaining a complete medical history. - You selected C; This is correct!
Reason: When managing any patient with an emotional or psychiatric crisis, your primary
concern is your own safety. Safely transporting the patient to the hospital is your ultimate
goal. If possible, you should attempt to obtain a medical history and should take any of the
patient's prescribed medications to the hospital. However, this should not supercede your
own safety or interfere with safely transporting the patient.
You are at the scene where a man panicked while swimming in a small lake. Your initial
attempt to rescue him should include:
• A:rowing a small raft to the victim.
• B:reaching for the victim with a long stick.
• C:throwing a rope to the victim.
• D:swimming to the victim to rescue him. - You selected B; This is correct!
Reason: General rules to follow when attempting to rescue a patient from the water include
"reach, throw, row, and then go." In this case, you should attempt to reach the victim by
having him grab hold of a large stick or similar object. If this is unsuccessful, throw the
victim a rope or flotation device (if available). If these are not available, row to the patient
,in a small raft (if available). Going into the water to retrieve the victim is a last resort. The
rescuer must be a strong swimmer because patients who are in danger of drowning are in a
state of blind panic and will make every attempt to keep themselves afloat, even if it means
forcing the rescuer underwater.
How should you classify a patient's nature of illness if he or she has a low blood glucose
level, bizarre behavior, and shallow breathing?
• A:Behavioral emergency
• B:Altered mental status
• C:Respiratory emergency
• D:Cardiac compromise - The correct answer is B;
Reason: The nature of illness (NOI) is the medical equivalent to mechanism of injury (MOI).
Altered mental status should be the suspected NOI in any patient with any fluctuation in
level of consciousness, which can range from bizarre behavior to complete
unresponsiveness. Causes of an altered mental status include hypo- or hyperglycemia, head
trauma, stroke, behavioral crises, drug overdose, and shock, among others.
A young female is unresponsive after overdosing on an unknown type of drug. Her
respirations are slow and shallow and her pulse is slow and weak. Which of the following
drugs is the LEAST likely cause of her condition?
• A:Seconal
• B:Heroin
• C:Cocaine
• D:Valium - The correct answer is C;
Reason: Of the drugs listed, cocaine would be the least likely cause of the patient's
condition. Cocaine is a central nervous system (CNS) stimulant; you would expect her to be
hypertensive, tachycardic, tachypneic, and perhaps even violent. Heroin, Valium, and
Seconal are all CNS depressants and could explain her condition. Heroin is an illegal
narcotic (opiate), Valium is a benzodiazepine sedative-hypnotic drug, and Seconal is a
barbiturate. Narcotics, benzodiazepines, and barbiturates are all CNS depressants. When
taken in excess, they cause a decreased level of consciousness, respiratory depression,
bradycardia, and hypotension.
Activated charcoal is contraindicated for a patient who is:
• A:conscious and alert and has ingested a large amount of Motrin.
• B:emotionally upset and has ingested two bottles of aspirin.
• C:agitated and claims to have ingested a bottle of Tylenol.
• D:awake and alert and has swallowed a commercial drain cleaner. - You selected D; This
is correct!
Reason:Activated charcoal adsorbs (sticks to) many ingested substances, preventing them
from being absorbed into the body by the stomach or intestines. In some cases, you may
give activated charcoal to patients who have ingested certain substances, if approved by
medical control or local protocol. Activated charcoal is contraindicated for patients who
,have ingested an acid or alkali (ie, drain cleaner) or a petroleum product (ie, gasoline), who
have a decreased level of consciousness and cannot protect their own airway, or who are
unable to swallow.
The MOST obvious way to reduce heat loss from radiation and convection is to:
• A:move away from a cold object.
• B:increase metabolism by shivering.
• C:wear a thick wind-proof jacket.
• D:move to a warmer environment. - you selected D; This is correct!
Reason:In a cold environment, the body has two ways of staying warm: generating heat
(thermogenesis) and reducing heat loss. Radiation is the transfer of heat by radiant energy.
The body can lose heat by radiation, such as when a person stands in a cold room.
Convection occurs when heat is transferred to circulating air, as when cool air moves
across the body's surface. A person standing in windy cold weather, wearing lightweight
clothing, is losing heat to the environment mostly by convection. The quickest and most
obvious way to decrease heat loss from radiation and convection is to move out of the cold
environment and seek shelter from wind. Shivering increases the body's metabolism and is
a mechanism for generating heat, not reducing heat loss. Layers of clothing trap air and
provide excellent insulation; thus, layered clothing decreases heat loss better than a single,
thick jacket. Conduction is the direct transfer of heat from a part of the body to a colder
object by direct contact, as when a warm hand touches cold metal or ice. The most obvious
way to decrease heat loss by conduction is to remove your hand from the cold object.
A near-drowning is MOST accurately defined as:
• A:complications within 24 hours following submersion in water.
• B:immediate death due to prolonged submersion in water.
• C:survival for at least 24 hours following submersion in water.
• D:death greater than 24 hours following submersion in water. - You selected C; This is
correct!
Reason:Collectively, drowning and near-drowning are referred to as submersion injuries.
Drowning is defined as death after submersion in a liquid medium, usually water. In a
drowning, death is either immediate or occurs within 24 hours following submersion.
Near-drowning is defined as survival, at least temporarily (24 hours), after submersion. It
should be noted, however, that complications such as pneumonia and pulmonary edema
can cause death greater than 24 hours following submersion. For this reason, all patients
with a submersion injury should be transported to the hospital, even if they appear fine at
the scene.
A young woman reports significant weight loss over the last month, persistent fever, and
night sweats. When you assess her, you note the presence of dark purple lesions covering
her trunk and upper extremities. You should suspect:
• A:end-stage cancer.
• B:HIV/AIDS.
• C:tuberculosis.
, • D:rheumatic fever. - You selected B; This is correct!
Reason:Weight loss, fever, and night sweats could indicate tuberculosis or HIV/AIDS;
however, the dark purple lesions on the skin, which are called Kaposi's sarcoma, are
malignant skin tumors and are a classic finding in patients in the later stages of AIDS.
A 48-year-old male became acutely hypoxic, experienced a seizure, and is now postictal.
The MOST effective way to prevent another seizure is to:
• A:dim the lights in the back of the ambulance.
• B:place him in the recovery position.
• C:administer high-flow supplemental oxygen.
• D:give him oral glucose if he can swallow. - You selected C; This is correct!
Reason:You should administer high-flow oxygen to all patients who are actively seizing and
to patients who experienced a seizure and are postictal. This is especially true if the seizure
was caused by hypoxia. Increasing the oxygen content of the blood, which minimizes
hypoxia, may prevent another seizure. The recovery position is appropriate for uninjured
patients with a decreased level of consciousness and adequate breathing; it will help
maintain the airway and facilitate drainage of secretions from the mouth, but will not
prevent another seizure. Oral glucose may prevent another seizure if hypoglycemia was the
cause of the seizure. You should dim the lights in the back of the ambulance to help prevent
any seizure, not just those that are caused by hypoxia.
Which of the following conditions would be the LEAST likely to be present in a patient who
was submerged in water?
• A:Spinal injury
• B:Gastric distention
• C:Hyperglycemia
• D:Laryngospasm - You selected C; This is correct!
Reason: Many factors can contribute to or result from a submersion injury (eg, drowning,
near-drowning). It is not uncommon for a person to experience a spinal injury after diving
head first into shallow water, especially if he or she is under the influence of alcohol. When
a swimmer panics, he or she initially swallows large amounts of water, resulting in gastric
distention. Gastric distention can cause aspiration if the patient regurgitates water during
rescue breathing; protect the airway! During the panic phase, the victim expends a
tremendous amount of energy (and glucose) from flailing around in the water, possibly
resulting in hypoglycemia. Inhaling even a small amount of fresh or salt water can severely
irritate the larynx, which sends the muscles of the larynx and vocal cords into spasm
(laryngospasm), resulting in airway blockage and hypoxia.
A 42-year-old male presents with fever, a severe headache, and a stiff neck. He is conscious,
but confused. His wife tells you that he does not have any medical problems and does not
take any medications. You should be MOST suspicious for:
• A:acute stroke.
• B:influenza.
Choice
Hypoglycemia and acute ischemic stroke can present similarly because:
• A:both oxygen and glucose are needed for brain function.
• B:the majority of stroke patients have a history of diabetes.
• C:the most common cause of a stroke is hypoglycemia.
• D:they are both caused by low levels of glucose in the blood. - • A:both oxygen and glucose
are needed for brain function.
Reason: Although stroke and hypoglycemia are two distinctly different conditions, their
signs and symptoms are often similar. This is because the brain requires both oxygen and
glucose to function normally. An acute ischemic stroke is caused by a lack of oxygen to a
part of the brain due to a blocked cerebral artery, whereas hypoglycemia (low blood
glucose level) deprives the entire brain of glucose. In either case, the patient presents with
signs of impaired brain function (ie, slurred speech, weakness, altered mental status). Both
conditions may lead to permanent brain damage or death if not treated promptly.
When dealing with an emotionally disturbed patient, you should be MOST concerned with:
• A:gathering all of the patient's medications.
• B:safely transporting to the hospital.
• C:whether the patient could harm you.
• D:obtaining a complete medical history. - You selected C; This is correct!
Reason: When managing any patient with an emotional or psychiatric crisis, your primary
concern is your own safety. Safely transporting the patient to the hospital is your ultimate
goal. If possible, you should attempt to obtain a medical history and should take any of the
patient's prescribed medications to the hospital. However, this should not supercede your
own safety or interfere with safely transporting the patient.
You are at the scene where a man panicked while swimming in a small lake. Your initial
attempt to rescue him should include:
• A:rowing a small raft to the victim.
• B:reaching for the victim with a long stick.
• C:throwing a rope to the victim.
• D:swimming to the victim to rescue him. - You selected B; This is correct!
Reason: General rules to follow when attempting to rescue a patient from the water include
"reach, throw, row, and then go." In this case, you should attempt to reach the victim by
having him grab hold of a large stick or similar object. If this is unsuccessful, throw the
victim a rope or flotation device (if available). If these are not available, row to the patient
,in a small raft (if available). Going into the water to retrieve the victim is a last resort. The
rescuer must be a strong swimmer because patients who are in danger of drowning are in a
state of blind panic and will make every attempt to keep themselves afloat, even if it means
forcing the rescuer underwater.
How should you classify a patient's nature of illness if he or she has a low blood glucose
level, bizarre behavior, and shallow breathing?
• A:Behavioral emergency
• B:Altered mental status
• C:Respiratory emergency
• D:Cardiac compromise - The correct answer is B;
Reason: The nature of illness (NOI) is the medical equivalent to mechanism of injury (MOI).
Altered mental status should be the suspected NOI in any patient with any fluctuation in
level of consciousness, which can range from bizarre behavior to complete
unresponsiveness. Causes of an altered mental status include hypo- or hyperglycemia, head
trauma, stroke, behavioral crises, drug overdose, and shock, among others.
A young female is unresponsive after overdosing on an unknown type of drug. Her
respirations are slow and shallow and her pulse is slow and weak. Which of the following
drugs is the LEAST likely cause of her condition?
• A:Seconal
• B:Heroin
• C:Cocaine
• D:Valium - The correct answer is C;
Reason: Of the drugs listed, cocaine would be the least likely cause of the patient's
condition. Cocaine is a central nervous system (CNS) stimulant; you would expect her to be
hypertensive, tachycardic, tachypneic, and perhaps even violent. Heroin, Valium, and
Seconal are all CNS depressants and could explain her condition. Heroin is an illegal
narcotic (opiate), Valium is a benzodiazepine sedative-hypnotic drug, and Seconal is a
barbiturate. Narcotics, benzodiazepines, and barbiturates are all CNS depressants. When
taken in excess, they cause a decreased level of consciousness, respiratory depression,
bradycardia, and hypotension.
Activated charcoal is contraindicated for a patient who is:
• A:conscious and alert and has ingested a large amount of Motrin.
• B:emotionally upset and has ingested two bottles of aspirin.
• C:agitated and claims to have ingested a bottle of Tylenol.
• D:awake and alert and has swallowed a commercial drain cleaner. - You selected D; This
is correct!
Reason:Activated charcoal adsorbs (sticks to) many ingested substances, preventing them
from being absorbed into the body by the stomach or intestines. In some cases, you may
give activated charcoal to patients who have ingested certain substances, if approved by
medical control or local protocol. Activated charcoal is contraindicated for patients who
,have ingested an acid or alkali (ie, drain cleaner) or a petroleum product (ie, gasoline), who
have a decreased level of consciousness and cannot protect their own airway, or who are
unable to swallow.
The MOST obvious way to reduce heat loss from radiation and convection is to:
• A:move away from a cold object.
• B:increase metabolism by shivering.
• C:wear a thick wind-proof jacket.
• D:move to a warmer environment. - you selected D; This is correct!
Reason:In a cold environment, the body has two ways of staying warm: generating heat
(thermogenesis) and reducing heat loss. Radiation is the transfer of heat by radiant energy.
The body can lose heat by radiation, such as when a person stands in a cold room.
Convection occurs when heat is transferred to circulating air, as when cool air moves
across the body's surface. A person standing in windy cold weather, wearing lightweight
clothing, is losing heat to the environment mostly by convection. The quickest and most
obvious way to decrease heat loss from radiation and convection is to move out of the cold
environment and seek shelter from wind. Shivering increases the body's metabolism and is
a mechanism for generating heat, not reducing heat loss. Layers of clothing trap air and
provide excellent insulation; thus, layered clothing decreases heat loss better than a single,
thick jacket. Conduction is the direct transfer of heat from a part of the body to a colder
object by direct contact, as when a warm hand touches cold metal or ice. The most obvious
way to decrease heat loss by conduction is to remove your hand from the cold object.
A near-drowning is MOST accurately defined as:
• A:complications within 24 hours following submersion in water.
• B:immediate death due to prolonged submersion in water.
• C:survival for at least 24 hours following submersion in water.
• D:death greater than 24 hours following submersion in water. - You selected C; This is
correct!
Reason:Collectively, drowning and near-drowning are referred to as submersion injuries.
Drowning is defined as death after submersion in a liquid medium, usually water. In a
drowning, death is either immediate or occurs within 24 hours following submersion.
Near-drowning is defined as survival, at least temporarily (24 hours), after submersion. It
should be noted, however, that complications such as pneumonia and pulmonary edema
can cause death greater than 24 hours following submersion. For this reason, all patients
with a submersion injury should be transported to the hospital, even if they appear fine at
the scene.
A young woman reports significant weight loss over the last month, persistent fever, and
night sweats. When you assess her, you note the presence of dark purple lesions covering
her trunk and upper extremities. You should suspect:
• A:end-stage cancer.
• B:HIV/AIDS.
• C:tuberculosis.
, • D:rheumatic fever. - You selected B; This is correct!
Reason:Weight loss, fever, and night sweats could indicate tuberculosis or HIV/AIDS;
however, the dark purple lesions on the skin, which are called Kaposi's sarcoma, are
malignant skin tumors and are a classic finding in patients in the later stages of AIDS.
A 48-year-old male became acutely hypoxic, experienced a seizure, and is now postictal.
The MOST effective way to prevent another seizure is to:
• A:dim the lights in the back of the ambulance.
• B:place him in the recovery position.
• C:administer high-flow supplemental oxygen.
• D:give him oral glucose if he can swallow. - You selected C; This is correct!
Reason:You should administer high-flow oxygen to all patients who are actively seizing and
to patients who experienced a seizure and are postictal. This is especially true if the seizure
was caused by hypoxia. Increasing the oxygen content of the blood, which minimizes
hypoxia, may prevent another seizure. The recovery position is appropriate for uninjured
patients with a decreased level of consciousness and adequate breathing; it will help
maintain the airway and facilitate drainage of secretions from the mouth, but will not
prevent another seizure. Oral glucose may prevent another seizure if hypoglycemia was the
cause of the seizure. You should dim the lights in the back of the ambulance to help prevent
any seizure, not just those that are caused by hypoxia.
Which of the following conditions would be the LEAST likely to be present in a patient who
was submerged in water?
• A:Spinal injury
• B:Gastric distention
• C:Hyperglycemia
• D:Laryngospasm - You selected C; This is correct!
Reason: Many factors can contribute to or result from a submersion injury (eg, drowning,
near-drowning). It is not uncommon for a person to experience a spinal injury after diving
head first into shallow water, especially if he or she is under the influence of alcohol. When
a swimmer panics, he or she initially swallows large amounts of water, resulting in gastric
distention. Gastric distention can cause aspiration if the patient regurgitates water during
rescue breathing; protect the airway! During the panic phase, the victim expends a
tremendous amount of energy (and glucose) from flailing around in the water, possibly
resulting in hypoglycemia. Inhaling even a small amount of fresh or salt water can severely
irritate the larynx, which sends the muscles of the larynx and vocal cords into spasm
(laryngospasm), resulting in airway blockage and hypoxia.
A 42-year-old male presents with fever, a severe headache, and a stiff neck. He is conscious,
but confused. His wife tells you that he does not have any medical problems and does not
take any medications. You should be MOST suspicious for:
• A:acute stroke.
• B:influenza.
