NREMT Exam Questions with Correct
Answers
cardiogenic shock
-the type of shock caused by inadequate function of the heart. This develops when the heart
cannot maintain sufficient output to meet the demands of the body
-caused by any disease or event which prevents heart pumping
-can occur directly after AMI up to 24 hours
Obstructive shock
The type of shock that results when conditions that cause mechanical obstruction of the
cardiac muscle also impact pump function
ex. cardiac tamponade, tension pneumothorax
Beck's triad
Signs of a cardiac tamponade. JVD, narrowing BP pressures, muffled heart sounds
Distributive shock
The type of shock when there is widespread dilation of the small arterioles, venules, or both.
Blood pools in the expanded vascular beds and tissue perfusion decreases
Types of distributive shock
Septic shock caused by severe infections; neurogenic shock caused by damage to the spinal
cord (bradycardia, low BP, warm skin); anaphylactic shock caused by allergic reaction;
psychogenic shock
Hypovolemic shock
,The type of shock that results from an inadequate amount of fluid or volume in the system
-15% of blood volume
How do you treat for shock?
Keep the patient warm, control bleeding, put the patient in a position of comfort, and
administer high-flow oxygen
brain damage without oxygen
-without enough oxygen, cardiac arrest or brain damage occurs within about 4 minutes
-permanent brain damage within 6 minutes
-death likely within 10 minutes
FBAO
-signs of blockage include inability to cough or speak or inability to ventilate patient
-bending patient forward at the waist, support chest with one hand, use heel of hand to give 5
back blows between shoulder blades
-then 5 abdominal thrusts
-alternate between the two until object is dislodged
-if patient loses consciousness, give CPR starting with chest compressions
-given even if patient has a pulse, so don't check
-before giving breaths, look inside mouth for any visible objects
FBAO in children
-using thigh for support, lay facing down along forearm; ensure head is lower than the body
-give 5 firm back blows between blades
-5 chest thrusts; place 2 to 3 fingers in the middle of the chest just below the nipples. push
,down 1.5 inches.
-alternate, unless lose consciousness, then CPR
mouse to mouth/mouth to nose
-mouth to mouth performed when patient does not have adequate breathing and artificial
ventilation not available
-open airway
-place barrier device
-pinch nose and form seal around patient's mouth
-check for FBAO if you do not see chest rise and fall
-give 1 breath every 5 to 6 seconds for adults and 1 every 3 for peds
Steps of CPR
Determine unresponsiveness. Check for breathing for up to 10 seconds. Check carotid pulse
for up to 10 seconds. Begin CPR until AED is available. Give 30 compressions at 100
beats/min and then 2 breaths over the course of 1 second. Once an advanced airway is
inserted, ventilate at a rate of 8-10 breaths/min and do not stop compressions.
This is exactly the same for children, except two-rescuer CPR is 15:2. If patient experiences a
return of spontaneous circulation, ventilate at a rate of 10-12 breaths/min.
compression to breath ratios
under 8 years old:
-2 provider: 15:2
-1 provider: 30:2
-one third of chest diameter
, older:
-30:2 always
-2 inches
AED procedure
-if cardiac arrest was not seen by EMS, give 5 cycles of 30:2 before defibrillating
-if cardiac arrest was seen, one EMT begins compressions and the other applies AED
-if only one EMT available, apply AED immediately
-check for pulse 2 minutes after defib
-if no shockable rhythm, wait 2 minutes and re-analyze
When to place left lateral
If patient has adequate breathing and is uninjured. To maintain a patent airway in an
unresponsive patient.
What to do if you fail to ventilate
If the breath doesn't go in successfully, reposition the patient and try again. If there is still
nothing, assume there is a foreign body obstruction and begin CPR on an unresponsive
apneic patient. Continue to attempt ventilations and open the mouth and look in every time.
Pneumothorax signs
-dyspnea, pleuritic chest pain that worsens during inspiration and expiration, absent or
decreased breath sounds
-rupture of visceral lining
Pulmonary embolism signs
-dyspnea, acute chest pain, hemoptysis, cyanosis, tachypnea, hypoxia, tachycardia?**
Answers
cardiogenic shock
-the type of shock caused by inadequate function of the heart. This develops when the heart
cannot maintain sufficient output to meet the demands of the body
-caused by any disease or event which prevents heart pumping
-can occur directly after AMI up to 24 hours
Obstructive shock
The type of shock that results when conditions that cause mechanical obstruction of the
cardiac muscle also impact pump function
ex. cardiac tamponade, tension pneumothorax
Beck's triad
Signs of a cardiac tamponade. JVD, narrowing BP pressures, muffled heart sounds
Distributive shock
The type of shock when there is widespread dilation of the small arterioles, venules, or both.
Blood pools in the expanded vascular beds and tissue perfusion decreases
Types of distributive shock
Septic shock caused by severe infections; neurogenic shock caused by damage to the spinal
cord (bradycardia, low BP, warm skin); anaphylactic shock caused by allergic reaction;
psychogenic shock
Hypovolemic shock
,The type of shock that results from an inadequate amount of fluid or volume in the system
-15% of blood volume
How do you treat for shock?
Keep the patient warm, control bleeding, put the patient in a position of comfort, and
administer high-flow oxygen
brain damage without oxygen
-without enough oxygen, cardiac arrest or brain damage occurs within about 4 minutes
-permanent brain damage within 6 minutes
-death likely within 10 minutes
FBAO
-signs of blockage include inability to cough or speak or inability to ventilate patient
-bending patient forward at the waist, support chest with one hand, use heel of hand to give 5
back blows between shoulder blades
-then 5 abdominal thrusts
-alternate between the two until object is dislodged
-if patient loses consciousness, give CPR starting with chest compressions
-given even if patient has a pulse, so don't check
-before giving breaths, look inside mouth for any visible objects
FBAO in children
-using thigh for support, lay facing down along forearm; ensure head is lower than the body
-give 5 firm back blows between blades
-5 chest thrusts; place 2 to 3 fingers in the middle of the chest just below the nipples. push
,down 1.5 inches.
-alternate, unless lose consciousness, then CPR
mouse to mouth/mouth to nose
-mouth to mouth performed when patient does not have adequate breathing and artificial
ventilation not available
-open airway
-place barrier device
-pinch nose and form seal around patient's mouth
-check for FBAO if you do not see chest rise and fall
-give 1 breath every 5 to 6 seconds for adults and 1 every 3 for peds
Steps of CPR
Determine unresponsiveness. Check for breathing for up to 10 seconds. Check carotid pulse
for up to 10 seconds. Begin CPR until AED is available. Give 30 compressions at 100
beats/min and then 2 breaths over the course of 1 second. Once an advanced airway is
inserted, ventilate at a rate of 8-10 breaths/min and do not stop compressions.
This is exactly the same for children, except two-rescuer CPR is 15:2. If patient experiences a
return of spontaneous circulation, ventilate at a rate of 10-12 breaths/min.
compression to breath ratios
under 8 years old:
-2 provider: 15:2
-1 provider: 30:2
-one third of chest diameter
, older:
-30:2 always
-2 inches
AED procedure
-if cardiac arrest was not seen by EMS, give 5 cycles of 30:2 before defibrillating
-if cardiac arrest was seen, one EMT begins compressions and the other applies AED
-if only one EMT available, apply AED immediately
-check for pulse 2 minutes after defib
-if no shockable rhythm, wait 2 minutes and re-analyze
When to place left lateral
If patient has adequate breathing and is uninjured. To maintain a patent airway in an
unresponsive patient.
What to do if you fail to ventilate
If the breath doesn't go in successfully, reposition the patient and try again. If there is still
nothing, assume there is a foreign body obstruction and begin CPR on an unresponsive
apneic patient. Continue to attempt ventilations and open the mouth and look in every time.
Pneumothorax signs
-dyspnea, pleuritic chest pain that worsens during inspiration and expiration, absent or
decreased breath sounds
-rupture of visceral lining
Pulmonary embolism signs
-dyspnea, acute chest pain, hemoptysis, cyanosis, tachypnea, hypoxia, tachycardia?**
