NREMT Practice Test Bank - Multiple Choice
A 3-year-old boy is found to be in cardiopulmonary arrest. As You selected B; This is correct!
you begin one-rescuer CPR, your partner prepares the AED.
The appropriate compression to ventilation ratio for this child Reason:A universal compression to ventilation ratio of 30:2 is used for all one-rescuer
is: CPR (adult, child, and infant), with the exception of the newborn. A compression to
• A:3:1 ventilation ratio of 3:1 is used for newborns (one- and two-rescuer). Two-rescuer infant
• B:30:2 and child CPR is performed at a compression to ventilation ratio of 15:2. In this scenario,
• C:5:1 you are performing one-rescuer CPR as your partner prepares the AED; therefore, you
• D:15:2 should give 30 compressions and 2 breaths. However, when you and your partner
resume CPR, give 15 compressions and 2 breaths.
A 3-year-old child has a sudden onset of respiratory distress. You selected B; This is correct!
The mother denies any recent illnesses or fever. You should
suspect: Reason:You should suspect a foreign body airway obstruction in any child who presents
• A:lower respiratory infection. with an acute onset of respiratory distress in the absence of fever. Croup, epiglottitis,
• B:foreign body airway obstruction. and lower airway infections (ie, bronchiolitis, bronchitis) commonly present with a fever.
• C:croup. If the child is experiencing a mild airway obstruction, in which he or she is moving
• D:epiglottitis. adequate air, has a normal level of consciousness, and pink skin, do not attempt to
relieve the airway obstruction; doing so may result in a severe airway obstruction. Offer
oxygen and transport the child to the hospital without delay. If signs of a severe airway
obstruction are present (ie, ineffective cough, decreased level of consciousness,
cyanosis), you should perform abdominal thrusts until the object is expelled or the child
becomes unresponsive. If the child becomes unresponsive, perform chest
compressions.
, NREMT Practice Test Bank - Multiple Choice
A 3-year-old female presents with respiratory distress. She is You selected C; This is correct!
conscious, crying, and clinging to her mother. She has mild
intercostal retractions and an oxygen saturation of 93%. The Reason:Do not assume that a child will simply allow you to administer oxygen to him or
MOST effective way of delivering oxygen to her involves: her as you would to an adult. The child in this scenario, who is in respiratory distress and
• A:ventilations with a flow-restricted, oxygen-powered is mildly hypoxemic (SpO2 of 93%), should receive supplemental oxygen; however, it
device. should be given in a nonthreatening manner. Agitating a sick or injured child causes an
• B:gently restraining her and assisting her ventilations. increase in oxygen consumption and demand, which may cause the child's condition to
• C:asking the mom to hold an oxygen mask near her face. deteriorate. In this scenario, ask the child's mother to hold an oxygen mask near the
• D:a nonrebreathing mask with the flow rate at 6 to 8 L/min. child's face (blow-by oxygen). Closely monitor her condition and be prepared to assist
her ventilations with a bag-mask device if she deteriorates. An oxygen flow rate of 6 to 8
L/min is too low for a nonrebreathing mask; a flow-rate of 12 to 15 L/min should be used.
Do NOT use a flow-restricted, oxygen-powered ventilation device (FROPVD) on any
child; doing so may cause severe gastric distention and lung injury. Allow the child to
assume a position of comfort and transport.
A 4-year-old boy ingested an unknown quantity of drain You selected C; This is correct!
cleaner. He is alert, has a patent airway, and has adequate
breathing. You should: Reason:Once you determine that a poisoning has occurred, and have identified the
• A:administer 1 g/kg of activated charcoal. poison, you should contact the poison control center at once: (800) 222-1222. Give the
• B:give 15 mL of ipecac and contact medical control. patient high-flow oxygen or assist his or her ventilations if necessary. Induction of
• C:contact poison control and give him oxygen. vomiting with syrup of ipecac is no longer recommended because of the risk of
• D:give oxygen and perform a head-to-toe exam. aspiration. Activated charcoal is contraindicated in patients who have ingested a
corrosive substance (eg, drain cleaner) or a petroleum product (eg, gasoline, motor oil).
A head-to-toe exam is not practical in this situation, at least initially. Follow the directions
given to you by the poison control center, transport the child without delay, and monitor
his condition en route.
, NREMT Practice Test Bank - Multiple Choice
A 4-year-old girl fell from a third-story window and landed on The correct answer is B;
her head. She is semiconscious with slow, irregular breathing
and is bleeding from her mouth and nose. You should: Reason:In any semi- or unconscious patient with a head injury, you should manually
• A:suction her oropharynx, open her airway with the jaw- stabilize the head and open the airway with the jaw-thrust maneuver. If there are any
thrust maneuver, insert an oropharyngeal airway, and assist secretions in the mouth, suction the oropharynx. If possible, insert a simple airway
her ventilations. adjunct. The patient in this scenario is semiconscious and likely has an intact gag reflex;
• B:open her airway with the jaw-thrust maneuver while therefore, you should not attempt to insert an oropharyngeal airway. Conversely, you
manually stabilizing her head, suction her oropharynx, and should not insert a nasopharyngeal airway in patients with a head injury, especially if
assist her ventilations. there is fluid or blood draining from the nose (a sign of a skull fracture). After ensuring a
• C:open her airway by carefully tilting her head back, suction patent airway, you should turn your attention to the patient's breathing. Slow, irregular
her oropharynx, and administer high-flow oxygen via breathing will not provide adequate minute volume and should be treated with
nonrebreathing mask. ventilatory assistance.
• D:manually stabilize her head, open her airway with the jaw-
thrust maneuver, insert a nasopharyngeal airway, and suction
her oropharynx.
The 5-minute Apgar assessment of a newborn reveals a heart The correct answer is D;
rate of 130 beats/min, cyanosis to the hands and feet, and
rapid respirations. The infant cries when you flick the soles of Reason: The Apgar score, which is obtained at 1 and 5 minutes after birth (and every 5
its feet and resists attempts to straighten its legs. These minutes thereafter), assigns numbers (0, 1, or 2) to the following five areas: Appearance,
findings equate to an Apgar score of: Pulse, Grimace, Activity, and Respirations. A score of 1 is assigned for appearance if the
• A:8 newborn's body is pink, but its hands and feet remain blue. If its heart rate is greater than
• B:10 100 beats/min, it receives a score of 2 for the pulse. If it cries and tries to move its foot
• C:7 away when soles of its feet are flicked, it is assigned a score of 2 for grimace/irritability. If
• D:9 it resists attempts to straighten its hips and knees, a score of 2 is assigned for
activity/muscle tone. If its respirations are rapid, a score of 2 is assigned. Based on these
parameters, the newborn in this scenario would receive an Apgar score of 9. Refer to
your EMT textbook for a complete review of the Apgar score.
, NREMT Practice Test Bank - Multiple Choice
A 5-year-old boy was struck by a car when he ran out into the The correct answer is D;
street. When you arrive at the scene and approach the child,
you see him lying supine approximately 15 feet from the car. Reason:Children are smaller than adults; therefore, when they are injured by the same
Based on the child's age and mechanism of injury, which of mechanism of injury as an adult, the location of their injuries may differ from those of an
the following should you suspect to be his PRIMARY injury? adult. For example, when an adult is struck by a vehicle, the primary injury typically
• A:Head injury occurs at or below the knees, depending on the height of the bumper at the time of
• B:Upper thorax injury impact. Because the child is shorter, initial impact typically occurs at or near the pelvis.
• C:Lower leg injury Secondary injury occurs when child's chest collides with the vehicle's grille. Tertiary injury
• D:Pelvic injury occurs when the child strikes the side of his or her head on the pavement after being
propelled away from the vehicle. In some cases, the child is pulled underneath the
vehicle and is dragged.
A 6-year-old boy complains of pain to the right lower You selected D; This is correct!
quadrant of his abdomen. Assessment of this child's abdomen
should include: Reason: When assessing the abdomen of any patient, you should determine the location
• A:palpating the right lower quadrant first. of the pain and palpate that area last. Begin by palpating the abdomen furthest away
• B:auscultating bowel sounds for 2 minutes. from the area of pain; in this case, the left upper quadrant is furthest away from the right
• C:avoiding palpation of the abdomen. lower quadrant. Palpating the painful area first will interfere with the rest of your
• D:palpating the left upper quadrant first. assessment because the patient will be in significant pain and will likely not remain still
during the remainder of the assessment. This is especially true in children. Auscultation of
bowel sounds is generally not performed in the prehospital setting; little, if any,
information will be gained from doing so.
A 3-year-old boy is found to be in cardiopulmonary arrest. As You selected B; This is correct!
you begin one-rescuer CPR, your partner prepares the AED.
The appropriate compression to ventilation ratio for this child Reason:A universal compression to ventilation ratio of 30:2 is used for all one-rescuer
is: CPR (adult, child, and infant), with the exception of the newborn. A compression to
• A:3:1 ventilation ratio of 3:1 is used for newborns (one- and two-rescuer). Two-rescuer infant
• B:30:2 and child CPR is performed at a compression to ventilation ratio of 15:2. In this scenario,
• C:5:1 you are performing one-rescuer CPR as your partner prepares the AED; therefore, you
• D:15:2 should give 30 compressions and 2 breaths. However, when you and your partner
resume CPR, give 15 compressions and 2 breaths.
A 3-year-old child has a sudden onset of respiratory distress. You selected B; This is correct!
The mother denies any recent illnesses or fever. You should
suspect: Reason:You should suspect a foreign body airway obstruction in any child who presents
• A:lower respiratory infection. with an acute onset of respiratory distress in the absence of fever. Croup, epiglottitis,
• B:foreign body airway obstruction. and lower airway infections (ie, bronchiolitis, bronchitis) commonly present with a fever.
• C:croup. If the child is experiencing a mild airway obstruction, in which he or she is moving
• D:epiglottitis. adequate air, has a normal level of consciousness, and pink skin, do not attempt to
relieve the airway obstruction; doing so may result in a severe airway obstruction. Offer
oxygen and transport the child to the hospital without delay. If signs of a severe airway
obstruction are present (ie, ineffective cough, decreased level of consciousness,
cyanosis), you should perform abdominal thrusts until the object is expelled or the child
becomes unresponsive. If the child becomes unresponsive, perform chest
compressions.
, NREMT Practice Test Bank - Multiple Choice
A 3-year-old female presents with respiratory distress. She is You selected C; This is correct!
conscious, crying, and clinging to her mother. She has mild
intercostal retractions and an oxygen saturation of 93%. The Reason:Do not assume that a child will simply allow you to administer oxygen to him or
MOST effective way of delivering oxygen to her involves: her as you would to an adult. The child in this scenario, who is in respiratory distress and
• A:ventilations with a flow-restricted, oxygen-powered is mildly hypoxemic (SpO2 of 93%), should receive supplemental oxygen; however, it
device. should be given in a nonthreatening manner. Agitating a sick or injured child causes an
• B:gently restraining her and assisting her ventilations. increase in oxygen consumption and demand, which may cause the child's condition to
• C:asking the mom to hold an oxygen mask near her face. deteriorate. In this scenario, ask the child's mother to hold an oxygen mask near the
• D:a nonrebreathing mask with the flow rate at 6 to 8 L/min. child's face (blow-by oxygen). Closely monitor her condition and be prepared to assist
her ventilations with a bag-mask device if she deteriorates. An oxygen flow rate of 6 to 8
L/min is too low for a nonrebreathing mask; a flow-rate of 12 to 15 L/min should be used.
Do NOT use a flow-restricted, oxygen-powered ventilation device (FROPVD) on any
child; doing so may cause severe gastric distention and lung injury. Allow the child to
assume a position of comfort and transport.
A 4-year-old boy ingested an unknown quantity of drain You selected C; This is correct!
cleaner. He is alert, has a patent airway, and has adequate
breathing. You should: Reason:Once you determine that a poisoning has occurred, and have identified the
• A:administer 1 g/kg of activated charcoal. poison, you should contact the poison control center at once: (800) 222-1222. Give the
• B:give 15 mL of ipecac and contact medical control. patient high-flow oxygen or assist his or her ventilations if necessary. Induction of
• C:contact poison control and give him oxygen. vomiting with syrup of ipecac is no longer recommended because of the risk of
• D:give oxygen and perform a head-to-toe exam. aspiration. Activated charcoal is contraindicated in patients who have ingested a
corrosive substance (eg, drain cleaner) or a petroleum product (eg, gasoline, motor oil).
A head-to-toe exam is not practical in this situation, at least initially. Follow the directions
given to you by the poison control center, transport the child without delay, and monitor
his condition en route.
, NREMT Practice Test Bank - Multiple Choice
A 4-year-old girl fell from a third-story window and landed on The correct answer is B;
her head. She is semiconscious with slow, irregular breathing
and is bleeding from her mouth and nose. You should: Reason:In any semi- or unconscious patient with a head injury, you should manually
• A:suction her oropharynx, open her airway with the jaw- stabilize the head and open the airway with the jaw-thrust maneuver. If there are any
thrust maneuver, insert an oropharyngeal airway, and assist secretions in the mouth, suction the oropharynx. If possible, insert a simple airway
her ventilations. adjunct. The patient in this scenario is semiconscious and likely has an intact gag reflex;
• B:open her airway with the jaw-thrust maneuver while therefore, you should not attempt to insert an oropharyngeal airway. Conversely, you
manually stabilizing her head, suction her oropharynx, and should not insert a nasopharyngeal airway in patients with a head injury, especially if
assist her ventilations. there is fluid or blood draining from the nose (a sign of a skull fracture). After ensuring a
• C:open her airway by carefully tilting her head back, suction patent airway, you should turn your attention to the patient's breathing. Slow, irregular
her oropharynx, and administer high-flow oxygen via breathing will not provide adequate minute volume and should be treated with
nonrebreathing mask. ventilatory assistance.
• D:manually stabilize her head, open her airway with the jaw-
thrust maneuver, insert a nasopharyngeal airway, and suction
her oropharynx.
The 5-minute Apgar assessment of a newborn reveals a heart The correct answer is D;
rate of 130 beats/min, cyanosis to the hands and feet, and
rapid respirations. The infant cries when you flick the soles of Reason: The Apgar score, which is obtained at 1 and 5 minutes after birth (and every 5
its feet and resists attempts to straighten its legs. These minutes thereafter), assigns numbers (0, 1, or 2) to the following five areas: Appearance,
findings equate to an Apgar score of: Pulse, Grimace, Activity, and Respirations. A score of 1 is assigned for appearance if the
• A:8 newborn's body is pink, but its hands and feet remain blue. If its heart rate is greater than
• B:10 100 beats/min, it receives a score of 2 for the pulse. If it cries and tries to move its foot
• C:7 away when soles of its feet are flicked, it is assigned a score of 2 for grimace/irritability. If
• D:9 it resists attempts to straighten its hips and knees, a score of 2 is assigned for
activity/muscle tone. If its respirations are rapid, a score of 2 is assigned. Based on these
parameters, the newborn in this scenario would receive an Apgar score of 9. Refer to
your EMT textbook for a complete review of the Apgar score.
, NREMT Practice Test Bank - Multiple Choice
A 5-year-old boy was struck by a car when he ran out into the The correct answer is D;
street. When you arrive at the scene and approach the child,
you see him lying supine approximately 15 feet from the car. Reason:Children are smaller than adults; therefore, when they are injured by the same
Based on the child's age and mechanism of injury, which of mechanism of injury as an adult, the location of their injuries may differ from those of an
the following should you suspect to be his PRIMARY injury? adult. For example, when an adult is struck by a vehicle, the primary injury typically
• A:Head injury occurs at or below the knees, depending on the height of the bumper at the time of
• B:Upper thorax injury impact. Because the child is shorter, initial impact typically occurs at or near the pelvis.
• C:Lower leg injury Secondary injury occurs when child's chest collides with the vehicle's grille. Tertiary injury
• D:Pelvic injury occurs when the child strikes the side of his or her head on the pavement after being
propelled away from the vehicle. In some cases, the child is pulled underneath the
vehicle and is dragged.
A 6-year-old boy complains of pain to the right lower You selected D; This is correct!
quadrant of his abdomen. Assessment of this child's abdomen
should include: Reason: When assessing the abdomen of any patient, you should determine the location
• A:palpating the right lower quadrant first. of the pain and palpate that area last. Begin by palpating the abdomen furthest away
• B:auscultating bowel sounds for 2 minutes. from the area of pain; in this case, the left upper quadrant is furthest away from the right
• C:avoiding palpation of the abdomen. lower quadrant. Palpating the painful area first will interfere with the rest of your
• D:palpating the left upper quadrant first. assessment because the patient will be in significant pain and will likely not remain still
during the remainder of the assessment. This is especially true in children. Auscultation of
bowel sounds is generally not performed in the prehospital setting; little, if any,
information will be gained from doing so.
