NREMT Paramedic Prep - 200 Questions
A patient is experiencing a possible neurological emergency from a blunt force closed head injury. He is found to
have abnormal pupillary reactions to light and has lost the ability to move his eyes from side to side to follow your
finger movements. He is also unable to identify the number of fingers you are holding up. He reports he is able to see
the fingers but is not able to focus enough to identify how many fingers are present.
Which of the following cranial nerves should you suspect may be involved in his injury?
A.
Cranial nerves I, V, and VI
B.
Cranial nerves V and VII
C.
Cranial nerves IX and X
D.
Cranial nerves II, III, and IV - Correct Answer D.
A patient suffering from an ST-elevation myocardial infarction or a presumably new-onset left bundle branch block
may benefit from the use of fibrinolytic therapy if the agent is given promptly. How long does a patient have to receive
the first fibrinolytic agent to salvage ischemic heart tissue?
A.
Within 12 hours of symptoms onset
B.
Within the first 90 minutes from symptom onset
C.
Within 24 hours of symptoms onset
D.
Within the first hour ("golden hour") from symptom onset - Correct Answer A.
According to the American Heart Association, healthcare providers should not attempt to alter glucose concentration
within a specific range because of the increased risk of hypoglycemia. What is the suggested range?
A.
60-90 mg/dL
B.
80-110 mg/dL
C.
186-202 mg/dL
D.
110-160 mg/dL - Correct Answer B.
After assisting a full-term pregnant patient in the delivery of her newborn, the newborn remains bradycardic with a
heart rate of 50 beats per minute and exhibits cyanosis around his mouth, nose, fingers, and toes. He is not
responding well and appears lethargic following the five-minute APGAR assessment.
What would be the best initial intervention at this point to increase his heart rate?
,A. Deliver adequate artificial ventilation after ensuring a definitive airway
B. Administer epinephrine 1:10,000 at 0.1 mg/mL intravenously
C. Administer a vasopressor agent intravenously per medical command recommendations
D. "Fast and hard" chest compressions at more than 120 compressions per minute - Correct Answer A.
After assisting a pregnant patient to deliver her full-term newborn at home, you quickly dry the infant and open his
airway to help begin spontaneous respiration. However, after a few seconds, you realize the newborn has copious
secretions in his airway preventing effective spontaneous respiration.
Which of the following should you do to safely and effectively clear the infant's airway?
A. Use a portable suction machine with a rigid suction catheter to suction his posterior airway
B. Use a bulb syringe to suction his nose first and his mouth second
C. With assistance, use two bulb syringes to suction his mouth and nose simultaneously
D. Use a bulb syringe to suction his mouth first and then his nose second - Correct Answer D.
After attempting to slow the bleeding associated with natural childbirth by non-invasive means, your patient continues
to bleed significantly. Per medical direction, after ensuring a second fetus is not present, which of the following would
be the most appropriate intervention for the new mother?
A.
Rapidly administer a 2-3 liter glucose-containing IV solution such as D5W using a pressure infusion
B.
Place ice packs on the abdomen and at the opening of the birth canal to promote clotting
C.
Mix 10 units of oxytocin to 1 liter of lactated Ringer's solution and run at 20-30 gtts/min
D.
Apply firm, direct pressure to the area above the pubic bone while inserting a sterile ABD pad into the opening of the
birth canal - Correct Answer C.
After intubating your apneic patient, what tube placement confirmation means should be assessed first?
A.
Auscultate each lung field for the presence of breath sounds
B.
Attach capnography to determine the presence of ventilatory waveform
C.
Attach an end-tidal carbon dioxide detector
D.
Auscultate over the epigastric region for the presence or absence of breath sounds - Correct Answer D
An adult asthma patient is experiencing laryngospasm and ineffective respirations, making orotracheal intubation
impossible. So, you quickly decide to perform nasotracheal intubation. Which of the following tubes would be most
appropriate for the procedure for an average height and weight adult?
A.
Cuffed 6.0-6.5 mm endotracheal tube
B.
,Uncuffed 7-8 mm endotracheal tube
C.
Uncuffed 6.0-6.5 mm endotracheal tube
D.
Cuffed 7-8 mm endotracheal tube - Correct Answer A
An adult patient who experiences the loss of his/her gag reflex following a closed-head and suspected spinal injury
may have suffered an injury to which of the following cranial nerves?
A.
Cranial nerve X (vagus)
B.
Cranial nerve III (oculomotor)
C.
Cranial nerve XII (hypoglossal)
D.
Cranial nerve IX (glossopharyngeal) - Correct Answer A.
An adult trauma patient suffered a fall from greater than 15 feet. When predicting the injuries associated with this type
injury, the paramedic should evaluate the distance fallen, the position of the body on impact, and which of the
following?
A. The type of landing surface involved
B. The ambient temperature at the time of the fall
C. The patient's neurological status
D. The body parts that were struck with the most force - Correct Answer A.
An unresponsive adult trauma patient exhibits pale, cold, and clammy skin that appears ashen/cyanotic. He is
breathing less than eight times a minute, has a heart rate of 32 beats a minute, and shows an irregular
bradyarrhythmia on the monitor in lead II. He is experiencing frank hypotension that is barely palpable.
Which of the following stages of shock is most likely causing his presentation?
A.
Irreversible shock
B.
Uncompensated shock
C.
Reversible shock
D.
Compensated shock - Correct Answer A
Due to automaticity, a cardiac cell can initiate electrical impulses. The more superior its location, the more intrinsic
beats it is able to produce per minute. Which of the following is known as the chief pacemaker of the heart?
A.
Sinoatrial node
B.
Purkinje fibers
C.
Bundle of His
, D.
Atrioventricular node - Correct Answer A.
During a detailed physical exam of your dyspneic 73-year-old female patient, you palpate small pockets of air in the
subcutaneous tissue of the skin in the upper right region of her chest, just below her clavicle. Which of the following
medical conditions is most likely to cause this abnormal finding?
A.
Bacterial pneumonia
B.
Spontaneous pneumothorax
C.
Dry pleurisy
D.
Chronic obstructive pulmonary disease - Correct Answer B.
During which wave, complex, interval, or segment of an electrocardiogram tracing does the absolute refractory period
take place in a normally functioning heart?
A.
S-T segment
B.
P-R interval
C.
P wave
D.
Q-T interval - Correct Answer D.
EMS communication over open airways is normally conducted through two-way radios of varying frequencies and
controlled by the FCC. Of the frequency bands listed below, which one is strictly assigned to two-way communication
or one-way paging, operating in the simplex mode?
A.
Very High Frequency (VHF), low and high bands between 32-170 MHz
B.
Ultra High Frequency (UHF) bands between 450-470 MHz
C.
Ultra High Frequency (UHF) bands up to 400 MHz
D.
Very High Frequency, low band (VHF) between 20-30 MHz - Correct Answer A.
Epinephrine is effective in helping reverse the adverse effects of anaphylaxis. It is the drug of choice because it
causes bronchodilation and vasoconstriction to improve respiratory effort and improve blood pressure.
What other effect does epinephrine have on the patient's body during an anaphylactic reaction?
A. It reduces the release of chemical mediators from the mast cells
B. It is effective in reducing the inflammatory response of the reaction
C. Increases the heart rate to improve peripheral perfusion
D. It causes peripheral vasoconstriction to reduce the itching associated with the reaction - Correct Answer A.
A patient is experiencing a possible neurological emergency from a blunt force closed head injury. He is found to
have abnormal pupillary reactions to light and has lost the ability to move his eyes from side to side to follow your
finger movements. He is also unable to identify the number of fingers you are holding up. He reports he is able to see
the fingers but is not able to focus enough to identify how many fingers are present.
Which of the following cranial nerves should you suspect may be involved in his injury?
A.
Cranial nerves I, V, and VI
B.
Cranial nerves V and VII
C.
Cranial nerves IX and X
D.
Cranial nerves II, III, and IV - Correct Answer D.
A patient suffering from an ST-elevation myocardial infarction or a presumably new-onset left bundle branch block
may benefit from the use of fibrinolytic therapy if the agent is given promptly. How long does a patient have to receive
the first fibrinolytic agent to salvage ischemic heart tissue?
A.
Within 12 hours of symptoms onset
B.
Within the first 90 minutes from symptom onset
C.
Within 24 hours of symptoms onset
D.
Within the first hour ("golden hour") from symptom onset - Correct Answer A.
According to the American Heart Association, healthcare providers should not attempt to alter glucose concentration
within a specific range because of the increased risk of hypoglycemia. What is the suggested range?
A.
60-90 mg/dL
B.
80-110 mg/dL
C.
186-202 mg/dL
D.
110-160 mg/dL - Correct Answer B.
After assisting a full-term pregnant patient in the delivery of her newborn, the newborn remains bradycardic with a
heart rate of 50 beats per minute and exhibits cyanosis around his mouth, nose, fingers, and toes. He is not
responding well and appears lethargic following the five-minute APGAR assessment.
What would be the best initial intervention at this point to increase his heart rate?
,A. Deliver adequate artificial ventilation after ensuring a definitive airway
B. Administer epinephrine 1:10,000 at 0.1 mg/mL intravenously
C. Administer a vasopressor agent intravenously per medical command recommendations
D. "Fast and hard" chest compressions at more than 120 compressions per minute - Correct Answer A.
After assisting a pregnant patient to deliver her full-term newborn at home, you quickly dry the infant and open his
airway to help begin spontaneous respiration. However, after a few seconds, you realize the newborn has copious
secretions in his airway preventing effective spontaneous respiration.
Which of the following should you do to safely and effectively clear the infant's airway?
A. Use a portable suction machine with a rigid suction catheter to suction his posterior airway
B. Use a bulb syringe to suction his nose first and his mouth second
C. With assistance, use two bulb syringes to suction his mouth and nose simultaneously
D. Use a bulb syringe to suction his mouth first and then his nose second - Correct Answer D.
After attempting to slow the bleeding associated with natural childbirth by non-invasive means, your patient continues
to bleed significantly. Per medical direction, after ensuring a second fetus is not present, which of the following would
be the most appropriate intervention for the new mother?
A.
Rapidly administer a 2-3 liter glucose-containing IV solution such as D5W using a pressure infusion
B.
Place ice packs on the abdomen and at the opening of the birth canal to promote clotting
C.
Mix 10 units of oxytocin to 1 liter of lactated Ringer's solution and run at 20-30 gtts/min
D.
Apply firm, direct pressure to the area above the pubic bone while inserting a sterile ABD pad into the opening of the
birth canal - Correct Answer C.
After intubating your apneic patient, what tube placement confirmation means should be assessed first?
A.
Auscultate each lung field for the presence of breath sounds
B.
Attach capnography to determine the presence of ventilatory waveform
C.
Attach an end-tidal carbon dioxide detector
D.
Auscultate over the epigastric region for the presence or absence of breath sounds - Correct Answer D
An adult asthma patient is experiencing laryngospasm and ineffective respirations, making orotracheal intubation
impossible. So, you quickly decide to perform nasotracheal intubation. Which of the following tubes would be most
appropriate for the procedure for an average height and weight adult?
A.
Cuffed 6.0-6.5 mm endotracheal tube
B.
,Uncuffed 7-8 mm endotracheal tube
C.
Uncuffed 6.0-6.5 mm endotracheal tube
D.
Cuffed 7-8 mm endotracheal tube - Correct Answer A
An adult patient who experiences the loss of his/her gag reflex following a closed-head and suspected spinal injury
may have suffered an injury to which of the following cranial nerves?
A.
Cranial nerve X (vagus)
B.
Cranial nerve III (oculomotor)
C.
Cranial nerve XII (hypoglossal)
D.
Cranial nerve IX (glossopharyngeal) - Correct Answer A.
An adult trauma patient suffered a fall from greater than 15 feet. When predicting the injuries associated with this type
injury, the paramedic should evaluate the distance fallen, the position of the body on impact, and which of the
following?
A. The type of landing surface involved
B. The ambient temperature at the time of the fall
C. The patient's neurological status
D. The body parts that were struck with the most force - Correct Answer A.
An unresponsive adult trauma patient exhibits pale, cold, and clammy skin that appears ashen/cyanotic. He is
breathing less than eight times a minute, has a heart rate of 32 beats a minute, and shows an irregular
bradyarrhythmia on the monitor in lead II. He is experiencing frank hypotension that is barely palpable.
Which of the following stages of shock is most likely causing his presentation?
A.
Irreversible shock
B.
Uncompensated shock
C.
Reversible shock
D.
Compensated shock - Correct Answer A
Due to automaticity, a cardiac cell can initiate electrical impulses. The more superior its location, the more intrinsic
beats it is able to produce per minute. Which of the following is known as the chief pacemaker of the heart?
A.
Sinoatrial node
B.
Purkinje fibers
C.
Bundle of His
, D.
Atrioventricular node - Correct Answer A.
During a detailed physical exam of your dyspneic 73-year-old female patient, you palpate small pockets of air in the
subcutaneous tissue of the skin in the upper right region of her chest, just below her clavicle. Which of the following
medical conditions is most likely to cause this abnormal finding?
A.
Bacterial pneumonia
B.
Spontaneous pneumothorax
C.
Dry pleurisy
D.
Chronic obstructive pulmonary disease - Correct Answer B.
During which wave, complex, interval, or segment of an electrocardiogram tracing does the absolute refractory period
take place in a normally functioning heart?
A.
S-T segment
B.
P-R interval
C.
P wave
D.
Q-T interval - Correct Answer D.
EMS communication over open airways is normally conducted through two-way radios of varying frequencies and
controlled by the FCC. Of the frequency bands listed below, which one is strictly assigned to two-way communication
or one-way paging, operating in the simplex mode?
A.
Very High Frequency (VHF), low and high bands between 32-170 MHz
B.
Ultra High Frequency (UHF) bands between 450-470 MHz
C.
Ultra High Frequency (UHF) bands up to 400 MHz
D.
Very High Frequency, low band (VHF) between 20-30 MHz - Correct Answer A.
Epinephrine is effective in helping reverse the adverse effects of anaphylaxis. It is the drug of choice because it
causes bronchodilation and vasoconstriction to improve respiratory effort and improve blood pressure.
What other effect does epinephrine have on the patient's body during an anaphylactic reaction?
A. It reduces the release of chemical mediators from the mast cells
B. It is effective in reducing the inflammatory response of the reaction
C. Increases the heart rate to improve peripheral perfusion
D. It causes peripheral vasoconstriction to reduce the itching associated with the reaction - Correct Answer A.
