NREMT COGNITIVE EXAM
QUESTIONS AND ANSWERS
1.In trauma a low pulse pressure suggests?:
ANS Significant blood loss
2.Blood pressure has a direct effect on?:
ANS The perfusion of the body tissues
3.Cells that die during a stroke are called?:
ANS Infarcted cells
4.You are called to a home where a 91 year old man has had a syncopal
episode and is vomiting. The caregiver who called 911 stated that the
patient's bowel movements have been bright red since yesterday. The
patient has not complained of any pain, but is nauseated. What is most
likely wrong with this man and which choice includes appropriate treatment
steps?
Choices:
A. He has an upper GI bleed and should be transported sitting up with high
flow O2 administered via a non rebreather mask at 15 LPM.
B. He has had a TIA and should be given high flow oxygen via NRB
and transported on his effected side to the nearest hospital.
1/
147
,C. He has pancreatitis and should be given high flow O2 via NRB at 15
LPM. Rapid transport in a left lateral recumbent position while keeping him
warm will help avoid shock.
D. He has a lower GI bleed and should be given O2 via nasal cannula at
4LPM and transported in a position of comfort while treating for shock
ANS: D. He has a lower GI bleed and should be given O2 via nasal
cannula at 4LPM and transported in a position of comfort while treating
for shock
Rationale: The bright red blood in the bowel movements is indicative
of a lower GI bleed. Answer 1,2, and 3 all utilize an NRB to deliver
high flow O2. Given that the patient is vomiting and nauseated, it
would be advisable to use a nasal
cannula, rather than an NRB, to help avoid potential airway compromise
the patient continues to vomit.
5.If a patient was feeling nauseated this would likely be a re-
sponse. If a person was tachycardic it would likely be a
response.:
ANS Parasympathetic/Sympathetic
6.You are assessing an 84 year old man. Upon auscultation of the lungs
you discover crackles or rale sounds. He is complaining of chest pain
and congestion. These signs and symptoms can indicate?
2/
147
,Choices:
A. An embolism
B. Collapse of the vena cava
C. Left ventricular failure
D. Right ventricular failure
ANS: C. Left ventricle failure
Rationale: These are signs and symptoms of a possible failure of the left
ventricle. The pump portion of the heart is unable to pump efficiently an
fluid begins to back up into the lungs.
7.A child between 3-5 would have normal vitals if they were?
Choices:
A. 35 breaths a minute, pulse of 88, and Systolic BP of 100
B. 24 breaths a minute, pulse of 76, and Systolic BP of 98
C. 20 breaths a minute, pulse of 100, and Systolic BP of 110
D. 20 breaths a minute, pulse of 120, and Systolic BP of 120:
ANS 20 breaths a minute, pulse of 100, and Systolic BP of 110
Rationale: A child between 3 and 5 (preschool-age) should have
3/
147
, respirations be- tween 20-30, a pulse of 80-120, and a systolic BP of 80 -
110.
(Toddler 12 to 36 months)
8.The pediatric assessment triangle is composed of three elements:
Choices:
A. Muscle Tone, Respiratory depth and rate, Perfusion
B. Circulation, Appearance, Work of Breathing
C. Level of Consciousness, Quality of Respirations, General Appearance
D. Blood pressure, Pulse rate, Respiratory Rate
ANS: B. Circulation, Appearance, Work of Breathing
Rationale: PAT is Work of Breathing, Skin Circulation, Appearance. The
pediatric assessment triangle is used to form a rapid general
impression of a child without
making physical contact. Look at the child's appearance and muscle
tone. Look at the work of breathing for signs of respiratory distress.
Tachypnea or retractions of sternum and or intercostal muscles is a sign
of respiratory difficulty. Look at the skin as a quick reference for
circulation. Pallor can be a sign of poor circulation.
9.The patient is a 6 year old girl whose mother says has been sick for a
few days and then started having breathing problems this morning.
4/
147
QUESTIONS AND ANSWERS
1.In trauma a low pulse pressure suggests?:
ANS Significant blood loss
2.Blood pressure has a direct effect on?:
ANS The perfusion of the body tissues
3.Cells that die during a stroke are called?:
ANS Infarcted cells
4.You are called to a home where a 91 year old man has had a syncopal
episode and is vomiting. The caregiver who called 911 stated that the
patient's bowel movements have been bright red since yesterday. The
patient has not complained of any pain, but is nauseated. What is most
likely wrong with this man and which choice includes appropriate treatment
steps?
Choices:
A. He has an upper GI bleed and should be transported sitting up with high
flow O2 administered via a non rebreather mask at 15 LPM.
B. He has had a TIA and should be given high flow oxygen via NRB
and transported on his effected side to the nearest hospital.
1/
147
,C. He has pancreatitis and should be given high flow O2 via NRB at 15
LPM. Rapid transport in a left lateral recumbent position while keeping him
warm will help avoid shock.
D. He has a lower GI bleed and should be given O2 via nasal cannula at
4LPM and transported in a position of comfort while treating for shock
ANS: D. He has a lower GI bleed and should be given O2 via nasal
cannula at 4LPM and transported in a position of comfort while treating
for shock
Rationale: The bright red blood in the bowel movements is indicative
of a lower GI bleed. Answer 1,2, and 3 all utilize an NRB to deliver
high flow O2. Given that the patient is vomiting and nauseated, it
would be advisable to use a nasal
cannula, rather than an NRB, to help avoid potential airway compromise
the patient continues to vomit.
5.If a patient was feeling nauseated this would likely be a re-
sponse. If a person was tachycardic it would likely be a
response.:
ANS Parasympathetic/Sympathetic
6.You are assessing an 84 year old man. Upon auscultation of the lungs
you discover crackles or rale sounds. He is complaining of chest pain
and congestion. These signs and symptoms can indicate?
2/
147
,Choices:
A. An embolism
B. Collapse of the vena cava
C. Left ventricular failure
D. Right ventricular failure
ANS: C. Left ventricle failure
Rationale: These are signs and symptoms of a possible failure of the left
ventricle. The pump portion of the heart is unable to pump efficiently an
fluid begins to back up into the lungs.
7.A child between 3-5 would have normal vitals if they were?
Choices:
A. 35 breaths a minute, pulse of 88, and Systolic BP of 100
B. 24 breaths a minute, pulse of 76, and Systolic BP of 98
C. 20 breaths a minute, pulse of 100, and Systolic BP of 110
D. 20 breaths a minute, pulse of 120, and Systolic BP of 120:
ANS 20 breaths a minute, pulse of 100, and Systolic BP of 110
Rationale: A child between 3 and 5 (preschool-age) should have
3/
147
, respirations be- tween 20-30, a pulse of 80-120, and a systolic BP of 80 -
110.
(Toddler 12 to 36 months)
8.The pediatric assessment triangle is composed of three elements:
Choices:
A. Muscle Tone, Respiratory depth and rate, Perfusion
B. Circulation, Appearance, Work of Breathing
C. Level of Consciousness, Quality of Respirations, General Appearance
D. Blood pressure, Pulse rate, Respiratory Rate
ANS: B. Circulation, Appearance, Work of Breathing
Rationale: PAT is Work of Breathing, Skin Circulation, Appearance. The
pediatric assessment triangle is used to form a rapid general
impression of a child without
making physical contact. Look at the child's appearance and muscle
tone. Look at the work of breathing for signs of respiratory distress.
Tachypnea or retractions of sternum and or intercostal muscles is a sign
of respiratory difficulty. Look at the skin as a quick reference for
circulation. Pallor can be a sign of poor circulation.
9.The patient is a 6 year old girl whose mother says has been sick for a
few days and then started having breathing problems this morning.
4/
147
