NREMT Trauma Mastery EXAM 2025 WITH100 Critical
Practice Questions with Detailed Rationale
1. During a soccer game, a 20-year-old man collided shoulder-to-shoulder with
another player. He has pain and a noticeable anterior bulge to the left
shoulder. Which of the following is the MOST effective method of immobilizing
this injury?
A:A sling to support the left arm and swathes to secure the arm to the body
B:A sling to support the left arm and swathes to maintain downward traction
C:An air-inflatable splint with the left arm immobilized in the flexed position
D:A long board splint with the left arm immobilized in the extended position: A;
This is correct!
Reason:
Injuries to the shoulder are most effectively immobilized with the use of a sling
and swathe. The sling will provide support and relieve pain to the shoulder, and
the swathe will secure the arm to the body. The purpose of the swathe is not to
facilitate traction. Patients with dislocated or fractured shoulders will not allow you
to extend their arm, so any attempt to immobilize the injury in such a fashion will not
be possible and could worsen the injury.
2. Damaged small blood vessels beneath the skin following blunt trauma
causes:
A:mottling.
B:ecchymosis.
C:hematoma.
D:cyanosis.: B;
Reason:
When small blood vessels beneath the skin are damaged, blood seeps into the soft
tissues. This manifests as a bruise, also referred to as ecchymosis. A hematoma
,develops when larger blood vessels are ruptured and the internal bleeding forms
a "lump." Cyanosis is a blue or purple discoloration of the skin and signifies a low
content of oxygen in the blood. Mottling occurs when the skin takes on a blotched,
purple appearance and is a sign of shock (hypoperfusion).
3. During transport of a patient with a head injury, which of the following will
provide you with the MOST information regarding the patient's condition?
A:Heart rate
B:Mental status
C:Pupil size
D:Blood pressure: B;
Reason:
The patient's mental status provides you with the most information regarding overall
perfusion status, especially when monitoring a patient with a head injury. Frequent
neurologic assessments, which includes assessing the patient's pupils, are critical in
determining if the patient's condition is improving or deteriorating. Vital signs should
be monitored according to the patient's condition, at least every 5 minutes if he or
she is unstable and at least every 15 minutes if he or she is stable.
4. You are called to a local nightclub for an injured patient. Law enforcement
personnel have secured the scene. Upon arrival, you see a young man who is
lying on the ground screaming in pain; bright red blood is spurting from an
apparent stab wound to his groin area. You should:
,A:control the bleeding.
B:prevent hypothermia.
C:ensure an open airway.
D:apply 100% oxygen.: A; This is correct!
Reason:
This patient's airway is obviously patent; he is screaming in pain. Blood spurting from
the groin area indicates arterial bleeding from the femoral artery. If this bleeding is
not controlled immediately, the patient will die. Oxygen and other shock treatment
(ie, keeping him warm) should be initiated after this life-threatening bleeding is
controlled. If you take the time to set up and administer oxygen prior to managing
the bleeding, the patient will die. Base your treatment priorities on what will kill the
patient first.
5. When assessing and treating a patient with a gunshot wound, you should
routinely:
A:evaluate the pulses proximal to the wound.
B:apply ice directly to the wound.
C:determine why the patient was shot.
D:look for the presence of an exit wound.: D;
Reason:
When assessing a patient who sustained a gunshot wound, you should routinely
look for an exit wound, which may be difficult to find. Exit wounds can be a source
of continued bleeding, both externally and internally. They may or may not follow the
same path as the entrance wound. This is why it is important to conduct a thorough
examination of the patient. Ice can be applied to the wound, but only after the wound
has been covered by a sterile dressing. Determining why the patient was shot is the
responsibility of law enforcement, not the EMT. If the wound is close to an extremity,
pulse, motor, and sensory function should be assessed distal to the wound.
6. Following blunt trauma to the chest, a 33-year-old male has shallow, painful
breathing. On assessment, you note that an area to the left side of his chest
collapses during inhalation and bulges during exhalation. These are signs of
a/an:
, A:isolated rib fracture.
B:flail chest.
C:pulmonary contusion.
D:pneumothorax.: B;
Reason:
If two or more ribs are fractured in two or more places or if the sternu m is fractured
along with several ribs, a segment of chest wall may be detached from the rest of the
thoracic cage. This injury is called a flail chest. In a flail chest, the detached portion of
the chest wall moves opposite of normal. It moves in during inhalation and out during
exhalation (paradoxical motion). Isolated (single) rib fractures are not associated
with paradoxical motion because they are usually only fractured in one place. In a
pneumothorax, the patient's respirations are often labored; in severe cases, an entire
side of the chest may not move at all (asymmetrical chest movement). A pulmonary
contusion (bruising of the lung tissue) does not cause paradoxical chest motion
unless associated with a flail chest.
7. Following a head injury, a young female is semiconscious and is bleeding
from the nose and left ear. You should:
A:control the bleeding from her nose by pinching her nostrils closed.
B:place a pressure dressing over her ear to prevent blood loss.
C:cover her ear and nose with a loose gauze pad to collect the blood.
D:insert a nasal airway to keep her tongue from blocking the airway.: C;
Reason:
Blood draining from the ears or nose following a head injury may contain cere-
brospinal fluid (CSF) and indicates a skull fracture. In these cases, do NOT attempt
to stop the flow of blood. Applying excessive pressure may force the blood leaking
from the ears or nose to collect within the cranium, which could increase the pressure
on the brain and cause permanent damage. Loosely cover the ears or nose with a
sterile gauze pad to collect the blood and help keep contaminants out (patients with
a skull fracture and CSF leakage are at risk for meningitis). The nasopharyngeal
(nasal) airway is contraindicated in patients with a possible skull fracture, especially
if blood is draining from the nose. The airway adjunct may inadvertently enter the
cranial vault through the fracture.
Practice Questions with Detailed Rationale
1. During a soccer game, a 20-year-old man collided shoulder-to-shoulder with
another player. He has pain and a noticeable anterior bulge to the left
shoulder. Which of the following is the MOST effective method of immobilizing
this injury?
A:A sling to support the left arm and swathes to secure the arm to the body
B:A sling to support the left arm and swathes to maintain downward traction
C:An air-inflatable splint with the left arm immobilized in the flexed position
D:A long board splint with the left arm immobilized in the extended position: A;
This is correct!
Reason:
Injuries to the shoulder are most effectively immobilized with the use of a sling
and swathe. The sling will provide support and relieve pain to the shoulder, and
the swathe will secure the arm to the body. The purpose of the swathe is not to
facilitate traction. Patients with dislocated or fractured shoulders will not allow you
to extend their arm, so any attempt to immobilize the injury in such a fashion will not
be possible and could worsen the injury.
2. Damaged small blood vessels beneath the skin following blunt trauma
causes:
A:mottling.
B:ecchymosis.
C:hematoma.
D:cyanosis.: B;
Reason:
When small blood vessels beneath the skin are damaged, blood seeps into the soft
tissues. This manifests as a bruise, also referred to as ecchymosis. A hematoma
,develops when larger blood vessels are ruptured and the internal bleeding forms
a "lump." Cyanosis is a blue or purple discoloration of the skin and signifies a low
content of oxygen in the blood. Mottling occurs when the skin takes on a blotched,
purple appearance and is a sign of shock (hypoperfusion).
3. During transport of a patient with a head injury, which of the following will
provide you with the MOST information regarding the patient's condition?
A:Heart rate
B:Mental status
C:Pupil size
D:Blood pressure: B;
Reason:
The patient's mental status provides you with the most information regarding overall
perfusion status, especially when monitoring a patient with a head injury. Frequent
neurologic assessments, which includes assessing the patient's pupils, are critical in
determining if the patient's condition is improving or deteriorating. Vital signs should
be monitored according to the patient's condition, at least every 5 minutes if he or
she is unstable and at least every 15 minutes if he or she is stable.
4. You are called to a local nightclub for an injured patient. Law enforcement
personnel have secured the scene. Upon arrival, you see a young man who is
lying on the ground screaming in pain; bright red blood is spurting from an
apparent stab wound to his groin area. You should:
,A:control the bleeding.
B:prevent hypothermia.
C:ensure an open airway.
D:apply 100% oxygen.: A; This is correct!
Reason:
This patient's airway is obviously patent; he is screaming in pain. Blood spurting from
the groin area indicates arterial bleeding from the femoral artery. If this bleeding is
not controlled immediately, the patient will die. Oxygen and other shock treatment
(ie, keeping him warm) should be initiated after this life-threatening bleeding is
controlled. If you take the time to set up and administer oxygen prior to managing
the bleeding, the patient will die. Base your treatment priorities on what will kill the
patient first.
5. When assessing and treating a patient with a gunshot wound, you should
routinely:
A:evaluate the pulses proximal to the wound.
B:apply ice directly to the wound.
C:determine why the patient was shot.
D:look for the presence of an exit wound.: D;
Reason:
When assessing a patient who sustained a gunshot wound, you should routinely
look for an exit wound, which may be difficult to find. Exit wounds can be a source
of continued bleeding, both externally and internally. They may or may not follow the
same path as the entrance wound. This is why it is important to conduct a thorough
examination of the patient. Ice can be applied to the wound, but only after the wound
has been covered by a sterile dressing. Determining why the patient was shot is the
responsibility of law enforcement, not the EMT. If the wound is close to an extremity,
pulse, motor, and sensory function should be assessed distal to the wound.
6. Following blunt trauma to the chest, a 33-year-old male has shallow, painful
breathing. On assessment, you note that an area to the left side of his chest
collapses during inhalation and bulges during exhalation. These are signs of
a/an:
, A:isolated rib fracture.
B:flail chest.
C:pulmonary contusion.
D:pneumothorax.: B;
Reason:
If two or more ribs are fractured in two or more places or if the sternu m is fractured
along with several ribs, a segment of chest wall may be detached from the rest of the
thoracic cage. This injury is called a flail chest. In a flail chest, the detached portion of
the chest wall moves opposite of normal. It moves in during inhalation and out during
exhalation (paradoxical motion). Isolated (single) rib fractures are not associated
with paradoxical motion because they are usually only fractured in one place. In a
pneumothorax, the patient's respirations are often labored; in severe cases, an entire
side of the chest may not move at all (asymmetrical chest movement). A pulmonary
contusion (bruising of the lung tissue) does not cause paradoxical chest motion
unless associated with a flail chest.
7. Following a head injury, a young female is semiconscious and is bleeding
from the nose and left ear. You should:
A:control the bleeding from her nose by pinching her nostrils closed.
B:place a pressure dressing over her ear to prevent blood loss.
C:cover her ear and nose with a loose gauze pad to collect the blood.
D:insert a nasal airway to keep her tongue from blocking the airway.: C;
Reason:
Blood draining from the ears or nose following a head injury may contain cere-
brospinal fluid (CSF) and indicates a skull fracture. In these cases, do NOT attempt
to stop the flow of blood. Applying excessive pressure may force the blood leaking
from the ears or nose to collect within the cranium, which could increase the pressure
on the brain and cause permanent damage. Loosely cover the ears or nose with a
sterile gauze pad to collect the blood and help keep contaminants out (patients with
a skull fracture and CSF leakage are at risk for meningitis). The nasopharyngeal
(nasal) airway is contraindicated in patients with a possible skull fracture, especially
if blood is draining from the nose. The airway adjunct may inadvertently enter the
cranial vault through the fracture.
