NREMT Exam Questions with Complete and Correct Answers

NREMT Exam Questions with Complete and Correct Answers Crenation Shrinking of a cell due to osmosis. Hemolysis Breaking of a cell. Atrophy (of a cell) Also involves the shrinking of a cell, but is not due to an osmotic force, and is usually due to tissue breakdown. Hypertrophy (of a cell) Enlarging or thickening of a cell. Class 1 research Most reliable and valid, it is the highest and best for citation, research and policy development is derived from prospective, controlled, randomized, double-blind studies. Class 2 research Biased, non-randomized, or retrospective studies with weaker evidence. Class 3 research Case studies, medical opinions, or consensus documents. Clinical research Focuses on improving pt outcomes. Evidence-based research Aims to improve medical practices. Descriptive statistics Describes a phenomenon. Inferential statistics Can use information learned in the groups to make predictions about the general public. Pandemic disease Meets two criteria, number 1 is it affects many people across a large region, and number 2, is the disease is infectious in nature. Trigeminal nerve 5th cranial nerve, it is responsible for chewing and facial sensation. Oculomotor nerve 3rd cranial nerve, controls eye movement. Olfactory nerve 1st cranial nerve, controls sense of smell. Where do you cric someone? Inferior to the thyroid cartilage, and superior to the cricoid cartilage is the cricothyroid ligament (or membrane). EMS systems do not rely on mobile phones only for long distance communication why? It can be overwhelmed, esp in a MCI. What is the drug name most health care workers use? Generic. You have a neonate who is bradycardic at 48bpm, what should you do first? Begin compressions. What is the antidote for a tylenol OD? Mucomyst. A pt who is in cardiac arrest and is intubated should get how many breaths per minute? 10, one breath every 6 seconds. A pt has pinpoint pupils caused by a morphine OD, why does morphine cause that? Causes parasympathetic simulation which constricts the eyes. What shouldn't you do with transdermal patches? Never rub it into the skin. While trying to intubate the paramedic sees a foreign object just distal to the vocal cords, what should they do? Attempt to remove it with the magill forceps. What is the antidote for magnesium toxicity? Calcium gluconate. What change in the elderly will have the greatest impact on paramedics? Decrease in creatinine clearance (kidney function). What will paramedics see on the monitor for a pt with WPW? Slurring of the QRS complex known as the delta wave. Which heart valve is usually the first to go? The bicuspid valve. Why are high-velocity bullets more dangerous than medium velocity? They cause cavitation which can create more damage. What is something you can do to identify crush syndrome? Do an EKG, and look for hyperkalemia (widening QRS and peaked T waves). What is kernig sign? It is suspected with meningitis, and it is when the pt is having difficulty extending the lower leg in the flexed position. Gastritis Sudden onset shortly after eating, abd pain, irritates the stomach, tender abd. What pulmonary issue can affect the lungs unilaterally? Pulmonary embolism Tilt test 20/10/20 rule, a decrease in systolic bp of 20, an increase in pulse of 20, and an increase in diastolic bp of 10. Used to determines pt level of hydration. Testicular Torsion Testicular torsion is an emergency because blood supply to the testes has been reduced due to twisting of the spermatic cord, vessels, and testicles. It commonly occurs in prepubescent boys whose scrotal sac is growing to accommodate the soon-to-enlarge testes. Chronic hypertension usually results in what kind of stroke? Hemorrhagic Providing no contraindications exist, what should be the first attempt of intubation? Visual laryngoscopy A patient with a destructive pulmonary disease resulting in alveolar damage will likely have a detrimental change in which one of the lung volumes listed below? Residual volume, has a hard time expelling all the air, leading in higher CO2 levels What form of noninvasive pressure support ventilation allows the spontaneously breathing patient to exhale against a lower pressure than she is being aided with upon inspiration? BiPap Leading cause of death in sickle cell anemia? Infection (pneumonia) Fluid bolus for children? 20ml/kg, avg 5 year old weighs between 30-40 lbs, so that would be 16kg & they'd get 320ml. Anaphylaxsis is what kind of shock? Distributive. What condition has a higher mortality rate in geriatric pt's than any other? Renal disease/kidney failure. What kind of sound will a pneumothorax make upon percussion? Hyper-resonant (like a drum). What kind of sound will a hemothorax make upon percussion? Hypo-resonant (a dull sound). A pt takes a med that is enteric coated, why does this med have that coating? It delays breakdown of the medication until it gets to the duodenum (intestine) so that way it doesn't irritate the stomach. What is tardive dyskinesia? Uncontrollable repetitive movements (lip smacking, chewing, movements of the mouth) brought on by long term use of anti-psychotic medications. A pulmonary contusion presents with what S&S? Rales upon inspiration (only unilaterally), diminished breath sounds, pain upon palpation in that area. What is the most common cause of cerebral palsy? The most common cause is abnormal cerebral development or cerebral dysgenisis. What is a low velocity weapon? Hand held items, knife, fist, sword, etc. What is a medium/high velocity weapon? Those that discharge projectile that pierces the body (bullet, arrow, etc). Which fracture is most likely to cause compartment syndrome? Femur fracture. What is the antidote for a benzo OD? Romazicon (flumazenil) Parenteral medication routes? IV, IM, subcu, intranasal. Enteral medication routes? All involve the GI tract. Oral, rectal, sublingual. The CAGE assessment is what? A well-known tool to help EMS providers identify if a pt has a substance abuse issue. C- "Have you ever been concerned about your drinking?", A- "Have you ever annoyed by criticism of your drinking?", G- "Have you ever felt guilty about your drinking?", E- "Have you ever felt the need for an eye opener?". Alpha receptors cause what? Vasoconstriction and pale skin. Beta receptors cause what? Increase in HR. A penetration injury through the thoracic disrupting what structural lining, will cause the lung to collapse? Parietal pleura (adheres to the chest wall), will cause air to fill that space and eventually collapse the lung. When were ambulances first used in the US? 1800's. What are the two most common electrolyte imbalances associated with dehydration? Hypokalemia, and hypernatremia. Hypernatremia has S&S of what? Weak, dizzy, lethargic, dehydrated, poor skin tugor, decreased urinary output, AMS. What are common risks associated with pt's receiving bronchoscopys? Pneumothorax An acute stress reaction is described as what? When a person experiences the S&S of stress directly after the incident, (angry, anxious, crying, nervous, etc). A brown-sequard injury (incomplete cord transection) Usually occurs in a stabbing, or traumatic event. Pt will only experiences loss of PMS on one side of the body, (right or left), or will experiences loss of sensation in one, but loss of motor in the other, meaning that the PMS is not equal on both sides. If they were equal, it would be a complete cord injury. What doesn't cause SLUDGEM affects? Cyandies. Organophosphates, nerve agents, and carbamates all cause the SLUDGEM affects. An MCI is defined as? When the # of pt's overwhelms the system. When approaching a school bus while you are driving priority, what's the safest approach? Come to a complete stop. Do not endanger children. When using the START system for triage, what is the first parameter for sorting pt's out? Identify the pt's who can walk. What is the antidote for anthrax? Ciprofloxacin What is the antidote for cyanide poisoning? Amyl Nitrate What is the minimum space for a LZ during the day? 60x60 What do the colors on placards represent? Yellow, reactivity. Red, flammable. Blue, health hazard. What are the hazard class levels on placards? 1-explosives, 2-gases, 3-flammable liquid/combustible liquid, 4-flammable solid, spontaneous combustible, and dangerous when wet, 5-oxidizer/organic peroxide, 6-poison/poison inhalation hazard, 7-radioactive, 8-corrosive, 9-misc What does RPM stand for in the START system? Respiration's, pulse, mental. What is the best way to assess your interventions from the pt? Look at the pt's mood. What assessment finding should the paramedic expect to find in an elderly pt that has COPD? A barrel chest with increased A:P diameter. What defines a 2nd degree AV block- Mobitz type 2? Multiple P waves for each QRS, sometimes consistently. What is not seen in croup symptoms? Tachypnea.A What is an urgent move? A pt with AMS (unresponsive). What is an emergency move? They are reserved for pt's who are in harms way (fire, explosion). Kaposi sarcoma is what? A cancer associated with HIV/AIDS. An intramuscular medication is injected at what angle? 90 degree. A subcutaneous medication is injected at what angle? 45 degree into the fatty tissue. What is the most life threatening risk that is associated with lower abd pain in women? First, ectopic pregnancy. Second, PID- can lead to sepsis. What is an anaphylactoid reaction? An allergic reaction that happens after the first exposure to something. It's considered abnormal, and happens when a pt starts a new med or tries a new food. What are seratonin reuptake inhibitors? Prozac, Zoloft, and Paxil - used to treat a multitude of psychiatric disorders. What's the first thing an EMS responder should do when dealing with a car in an MVC? Make sure the ignition is turned off, and make sure the car is parked with the E brake on. How far can rotor wing aircraft go? They are typically deployed for distances less than 100 miles. For transports greater than 100 miles, what should you do? Fixed wing transport should be considered first. Tension headaches present with what S&S? Bilateral in nature. Cluster headaches present with what S&S? Causes severe pain, unilateral, may be a part of a cluster of several headaches over a period of days. More likely to occur in males. What is a big factor in contributing to a wound not healing? A pt with type 2 diabetes. It can affect wounds more than being old. How does albuterol help in a pt with a crush injury? Albuterol promotes movement of potassium to the intracellular space, resolving vascular hyperkalemia. If someone has a cognitive impairment, what does it affect? Language skills, memory abilities, and perceptual skills. If someone has a cerebral impairment, what does that affect? The ability to ambulate, motor skills. In the AVR lead, what should it look like? Inverted everything (P, QRS, T). How to exactly determine a NG is in the right place? Aspirate the liquid and verify the PH level. When using a traction splint, where should the fracture be located to indicate using one? At the femoral diaphysis. Midshaft fracture. Diaphysis refers to the middle of the bone. What is autonomic dysreflexia? Sudden onset of excessively high BP. Usually seen in pt's with a spinal cord injury that involve the throacic nerves (T6 or above). S&S of autonomic dysreflexia? Sweating, blurred vision, hypertension, and anxiety. Bradycardia is also common. A pt with DKA is likely to a have a hx of what? Type 1 diabetes. AHA says the best way to provide ventilation's to someone is how? Mouth to mask. Pt's age 6-12 months can do what? Can grasp things with their hands, sit upright on their own & identify objects. What is percussion of the lungs used for? To determine whether the pt has a pneumothorax or a hemothorax. If you use the percussion technique, and you hear a dull sound what does that mean? It is interpreted as blood or other fluid. If you use the percussion technique and you hear a hollow sound, what does that mean? It is interpreted as air. Adrenergic agents affect or stimulate what? The CNS system. What is the first segment of the large intestine? The cecum. The cecum in the large intestine is followed by what? The colon, ascending, transverse, and descending. Where should you position yourself when gathering info about the pt? At the pt's eye level. If someone has decreased peripheral perfusion, what will be affected as far as respiratory goes? Internal respirations will be diminished. A white layer of fungus covering a newborn/infants tongue is called what? Referred to as "thrush" or candidiasis. What defines schizophrenia? Delusional, hearing voices, hallucinations, etc. Not something you would see in a bipolar pt. Neurological deficits secondary to an occlusive stroke are caused by what? Ischemia and damage to the brain tissue. If an elderly pt has open-angle glaucoma what should the paramedic be aware of? Many medications have an impact on the disease, and paramedics might not be able to give the pt the meds like they normally would. ARD's pt's will benefit from what? CPAP. What is a frank breech? Occurs when the buttocks are presenting out of the vaginal canal. What is a complete breech? When the legs are folded and complete cross in front of the infant. What is a positive inotropic agent? Dopamine, or dobutamine. What can happen to someone who OD's on antacids? Metabolic alkalosis - tingling, dizziness, seizures, tremors. What gas law describes the bellows action of the chest? Boyle's law, think "Boyle's bubbles". Henry's law describes what? The effects of pressure on keeping gases dissolved in liquids "Henry's hyperbaric". What makes up "stroke volume"? Determined by ventricular preload, myocardial contractility, and afterload. Sodium bicarb is now no longer used when? In cardiac arrest situations. It may be used in cases of suspected hyperkalemia, metabolic acidosis, and tricyclic overdose. Use of nitroglycerin should be withheld in the event of what kind of MI? Inferior. How to test for a change in cardiac output? SV x HR. Which ever answer is furthest from the baseline is the correct one. What is one limitation to be considered when using rotor-wing transport not present in other modes of transportation? Pt weight. What is the major factor that sets apart a TIA from other strokes? It's symptoms last less than 24 hrs. The FDA categories for medication while pregnant are what? A, B, C, D, X, and NR. A is considered safe. B is when the risks to the fetus are remote. C indicates fetal risk, which cannot be ruled out. D means there is evidence of fetal risk. X is complete off limits for pregnancy. NR means "no rating". DNA is stored within the what of the cell? The nucleus. Succinylcholine is contraindicated in what kind of pts? Pt's with suspected hyperkalemia. Burns, crush injuries, or prolonged bed rest, and dialysis pt's because the frequently experience electrolyte imbalances. What is a cumulative effect when giving meds? The total effect of two medications for the clinical treatment of a single condition. If a pt has a LVAD device, and goes into cardiac arrest, what should be done? A manual foot or hand pump may be used to support circulation. Do not start compression's as it could tear the LVAD from the muscle wall. Electrical therapy can be performed, but the pump needs to be disconnected first. Uncuffed ET tubes are used for what ages? Until ages 8-10.