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NREMT Comprehensive Study Resource
and Exam Practice Guide 2025
An oropharyngeal airway is indicated in which type of patient?
A) Semi-conscious patient with intact gag reflex
B) Unconscious patient without an intact gag reflex
C) Conscious patient with snoring respirations
D) Patient with suspected caustic ingestion
Rationale:
An oropharyngeal airway (OPA) is used only in unconscious patients without a gag reflex to
prevent airway obstruction by the tongue. It is contraindicated in patients with gag reflexes or
caustic ingestion because it can trigger vomiting or aspiration.
When selecting the appropriate size OPA for a pediatric patient, the correct method is:
A) Measuring from the corner of the mouth to the tip of the ear
B) Estimating by patient weight
C) Measuring from the tip of the nose to the angle of the jaw
D) Using a length-based resuscitation tape (Broselow tape)
Rationale:
The Broselow tape provides the most accurate and standardized way to size airway adjuncts in
pediatric patients. Weight or nose-to-jaw measurements are less precise.
A 55-year-old diabetic patient presents with confusion, pale cool skin, and a rapid, weak pulse.
Which finding best supports hypoglycemia?
A) Dry, flushed skin
B) Diaphoresis
C) Deep, labored respirations
D) Bounding pulse
Rationale:
Diaphoresis (sweating) is a hallmark sign of hypoglycemia due to sympathetic activation.
Hyperglycemia usually presents with dry, warm skin.
Which two types of nerves are found in the peripheral nervous system?
A) Cranial and spinal
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B) Sensory and motor
C) Afferent and efferent only
D) Autonomic and sympathetic
Rationale:
The peripheral nervous system includes sensory (afferent) and motor (efferent) nerves.
Cranial/spinal refer to origin, and sympathetic is part of the autonomic system.
Which blood vessels deliver oxygenated blood directly to the myocardium?
A) Pulmonary arteries
B) Coronary arteries
C) Carotid arteries
D) Femoral arteries
Rationale:
The coronary arteries branch off the aorta and supply the heart muscle with oxygen-rich blood.
Carotid and cerebral arteries supply the brain, while femoral arteries serve the legs.
Which of the following best describes the sniffing position?
A) Lying flat with head tilted back
B) Sitting upright leaning on arms
C) Sitting upright with head and chin thrust slightly forward
D) Lying on the side with knees bent
Rationale:
The sniffing position aligns the airway for optimal breathing, especially in children. It differs
from the tripod position, where arms are braced forward.
A 66-year-old woman post–aortic aneurysm surgery presents with dyspnea, diminished breath
sounds on the right, and retractions. What is the most likely cause?
A) Pneumothorax
B) Pulmonary embolism
C) Asthma exacerbation
D) Hemothorax
Rationale:
A pulmonary embolism causes sudden dyspnea and hypoxia due to vascular obstruction.
Pneumothorax and hemothorax reduce breath sounds but usually occur with trauma.
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Which description best defines pleuritic chest pain?
A) Constant dull ache in the sternum
B) Sharp pain that worsens with inspiration
C) Pain relieved by sitting forward
D) Burning pain after meals
Rationale:
Pleuritic pain occurs when inflamed pleura rub during respiration, worsening with inspiration.
Burning pain is more typical of GERD.
Which wound would not require an occlusive dressing?
A) Open chest wound
B) Abdominal evisceration
C) Penetrating neck wound
D) Open humeral fracture
Rationale:
Occlusive dressings are used for wounds that risk air entry or fluid loss (chest, neck, abdomen).
Open fractures require sterile, not airtight, dressings.
Providing emergency care without consent can result in what legal charge?
A) Assault
B) Negligence
C) Battery
D) Abandonment
Rationale:
Battery is unlawful physical contact without consent. Assault involves threatening harm, and
negligence concerns failure to act properly.
Which letter is not part of the RICES mnemonic for soft-tissue injury management?
A) Rest
B) Ice
C) Compression
D) Support
Rationale:
RICES stands for Rest, Ice, Compression, Elevation, and Splinting. “Support” is not part of the
mnemonic.
, 100%
The middle muscular layer of the heart wall is called the:
A) Endocardium
B) Epicardium
C) Myocardium
D) Pericardium
Rationale:
The myocardium is the functional contractile layer of the heart. The pericardium is the protective
sac surrounding the heart.
During delivery, what may be necessary to deliver the lower shoulder of the newborn?
A) Apply resistance to the head
B) Rotate the baby counterclockwise
C) Guide the head up slightly
D) Pull gently on the baby’s arm
Rationale:
After the upper shoulder delivers, gentle upward guidance helps release the lower shoulder.
Pulling on the arms risks nerve injury.
Which statement best describes the process of inhalation?
A) Relaxation of the diaphragm decreases thoracic volume
B) Contraction of the diaphragm and intercostals increases thoracic volume, creating
negative pressure
C) Diaphragm rises, forcing air inward
D) Intercostal relaxation pushes air into the lungs
Rationale:
Inhalation is active—diaphragm and intercostals contract to expand the thoracic cavity and draw
air in. Exhalation is passive relaxation.
A trauma patient with bilateral arm fractures and abdominal distension requires a blood pressure
reading. What is the best method?
A) Use a standard adult cuff on the forearm
B) Avoid taking BP to prevent pain
C) Take the blood pressure on the thigh using a large cuff
D) Estimate systolic by palpating the carotid pulse
NREMT Comprehensive Study Resource
and Exam Practice Guide 2025
An oropharyngeal airway is indicated in which type of patient?
A) Semi-conscious patient with intact gag reflex
B) Unconscious patient without an intact gag reflex
C) Conscious patient with snoring respirations
D) Patient with suspected caustic ingestion
Rationale:
An oropharyngeal airway (OPA) is used only in unconscious patients without a gag reflex to
prevent airway obstruction by the tongue. It is contraindicated in patients with gag reflexes or
caustic ingestion because it can trigger vomiting or aspiration.
When selecting the appropriate size OPA for a pediatric patient, the correct method is:
A) Measuring from the corner of the mouth to the tip of the ear
B) Estimating by patient weight
C) Measuring from the tip of the nose to the angle of the jaw
D) Using a length-based resuscitation tape (Broselow tape)
Rationale:
The Broselow tape provides the most accurate and standardized way to size airway adjuncts in
pediatric patients. Weight or nose-to-jaw measurements are less precise.
A 55-year-old diabetic patient presents with confusion, pale cool skin, and a rapid, weak pulse.
Which finding best supports hypoglycemia?
A) Dry, flushed skin
B) Diaphoresis
C) Deep, labored respirations
D) Bounding pulse
Rationale:
Diaphoresis (sweating) is a hallmark sign of hypoglycemia due to sympathetic activation.
Hyperglycemia usually presents with dry, warm skin.
Which two types of nerves are found in the peripheral nervous system?
A) Cranial and spinal
,100%
B) Sensory and motor
C) Afferent and efferent only
D) Autonomic and sympathetic
Rationale:
The peripheral nervous system includes sensory (afferent) and motor (efferent) nerves.
Cranial/spinal refer to origin, and sympathetic is part of the autonomic system.
Which blood vessels deliver oxygenated blood directly to the myocardium?
A) Pulmonary arteries
B) Coronary arteries
C) Carotid arteries
D) Femoral arteries
Rationale:
The coronary arteries branch off the aorta and supply the heart muscle with oxygen-rich blood.
Carotid and cerebral arteries supply the brain, while femoral arteries serve the legs.
Which of the following best describes the sniffing position?
A) Lying flat with head tilted back
B) Sitting upright leaning on arms
C) Sitting upright with head and chin thrust slightly forward
D) Lying on the side with knees bent
Rationale:
The sniffing position aligns the airway for optimal breathing, especially in children. It differs
from the tripod position, where arms are braced forward.
A 66-year-old woman post–aortic aneurysm surgery presents with dyspnea, diminished breath
sounds on the right, and retractions. What is the most likely cause?
A) Pneumothorax
B) Pulmonary embolism
C) Asthma exacerbation
D) Hemothorax
Rationale:
A pulmonary embolism causes sudden dyspnea and hypoxia due to vascular obstruction.
Pneumothorax and hemothorax reduce breath sounds but usually occur with trauma.
,100%
Which description best defines pleuritic chest pain?
A) Constant dull ache in the sternum
B) Sharp pain that worsens with inspiration
C) Pain relieved by sitting forward
D) Burning pain after meals
Rationale:
Pleuritic pain occurs when inflamed pleura rub during respiration, worsening with inspiration.
Burning pain is more typical of GERD.
Which wound would not require an occlusive dressing?
A) Open chest wound
B) Abdominal evisceration
C) Penetrating neck wound
D) Open humeral fracture
Rationale:
Occlusive dressings are used for wounds that risk air entry or fluid loss (chest, neck, abdomen).
Open fractures require sterile, not airtight, dressings.
Providing emergency care without consent can result in what legal charge?
A) Assault
B) Negligence
C) Battery
D) Abandonment
Rationale:
Battery is unlawful physical contact without consent. Assault involves threatening harm, and
negligence concerns failure to act properly.
Which letter is not part of the RICES mnemonic for soft-tissue injury management?
A) Rest
B) Ice
C) Compression
D) Support
Rationale:
RICES stands for Rest, Ice, Compression, Elevation, and Splinting. “Support” is not part of the
mnemonic.
, 100%
The middle muscular layer of the heart wall is called the:
A) Endocardium
B) Epicardium
C) Myocardium
D) Pericardium
Rationale:
The myocardium is the functional contractile layer of the heart. The pericardium is the protective
sac surrounding the heart.
During delivery, what may be necessary to deliver the lower shoulder of the newborn?
A) Apply resistance to the head
B) Rotate the baby counterclockwise
C) Guide the head up slightly
D) Pull gently on the baby’s arm
Rationale:
After the upper shoulder delivers, gentle upward guidance helps release the lower shoulder.
Pulling on the arms risks nerve injury.
Which statement best describes the process of inhalation?
A) Relaxation of the diaphragm decreases thoracic volume
B) Contraction of the diaphragm and intercostals increases thoracic volume, creating
negative pressure
C) Diaphragm rises, forcing air inward
D) Intercostal relaxation pushes air into the lungs
Rationale:
Inhalation is active—diaphragm and intercostals contract to expand the thoracic cavity and draw
air in. Exhalation is passive relaxation.
A trauma patient with bilateral arm fractures and abdominal distension requires a blood pressure
reading. What is the best method?
A) Use a standard adult cuff on the forearm
B) Avoid taking BP to prevent pain
C) Take the blood pressure on the thigh using a large cuff
D) Estimate systolic by palpating the carotid pulse
