NREMT HIGH-LEVEL
COMPREHENSIVE EXAM PREP
(2026/2027) QUESTIONS AND ANSWERS
1. A 67-year-old male presents with sudden onset of tearing chest pain radiating to the back,
a blood pressure of 160/90 in the right arm, and 130/70 in the left arm. What is the most
likely condition?
A. Aortic Dissection
B. Myocardial Infarction
C. Pulmonary Embolism
D. Tension Pneumothorax
Answer: A
Conceptual Explanation: Aortic dissection typically presents with tearing pain and a
significant blood pressure differential between the arms.
2. Which of the following is a late sign of compensated shock in a pediatric patient?
A. Tachycardia
B. Delayed capillary refill
,C. Hypotension
D. Altered mental status
Answer: C
Conceptual Explanation: Pediatric patients compensate well until they crash;
hypotension is a late and ominous sign of decompensated shock.
3. A patient is found with pinpoint pupils, bradycardia, and excessive salivation. Which
toxidrome is most likely?
A. Cholinergic
B. Anticholinergic
C. Sympathomimetic
D. Opioid
Answer: A
Conceptual Explanation: Cholinergic poisoning (like organophosphates) causes
SLUDGEM symptoms, including salivation and miosis.
4. During neonatal resuscitation, at what heart rate should chest compressions be initiated?
A. Below 100 bpm
B. Below 80 bpm
C. Below 60 bpm
, D. Below 40 bpm
Answer: C
Conceptual Explanation: Neonatal guidelines require compressions if the heart rate
remains below 60 bpm despite adequate ventilation.
5. Which phase of a seizure is characterized by muscle contraction and relaxation?
A. Tonic phase
B. Aura phase
C. Postictal phase
D. Clonic phase
Answer: D
Conceptual Explanation: The clonic phase involves the rhythmic contraction and
relaxation of muscles.
6. In the Incident Command System (ICS), who is responsible for providing facilities, services,
and materials?
A. Operations Section
B. Planning Section
C. Logistics Section
D. Finance Section
COMPREHENSIVE EXAM PREP
(2026/2027) QUESTIONS AND ANSWERS
1. A 67-year-old male presents with sudden onset of tearing chest pain radiating to the back,
a blood pressure of 160/90 in the right arm, and 130/70 in the left arm. What is the most
likely condition?
A. Aortic Dissection
B. Myocardial Infarction
C. Pulmonary Embolism
D. Tension Pneumothorax
Answer: A
Conceptual Explanation: Aortic dissection typically presents with tearing pain and a
significant blood pressure differential between the arms.
2. Which of the following is a late sign of compensated shock in a pediatric patient?
A. Tachycardia
B. Delayed capillary refill
,C. Hypotension
D. Altered mental status
Answer: C
Conceptual Explanation: Pediatric patients compensate well until they crash;
hypotension is a late and ominous sign of decompensated shock.
3. A patient is found with pinpoint pupils, bradycardia, and excessive salivation. Which
toxidrome is most likely?
A. Cholinergic
B. Anticholinergic
C. Sympathomimetic
D. Opioid
Answer: A
Conceptual Explanation: Cholinergic poisoning (like organophosphates) causes
SLUDGEM symptoms, including salivation and miosis.
4. During neonatal resuscitation, at what heart rate should chest compressions be initiated?
A. Below 100 bpm
B. Below 80 bpm
C. Below 60 bpm
, D. Below 40 bpm
Answer: C
Conceptual Explanation: Neonatal guidelines require compressions if the heart rate
remains below 60 bpm despite adequate ventilation.
5. Which phase of a seizure is characterized by muscle contraction and relaxation?
A. Tonic phase
B. Aura phase
C. Postictal phase
D. Clonic phase
Answer: D
Conceptual Explanation: The clonic phase involves the rhythmic contraction and
relaxation of muscles.
6. In the Incident Command System (ICS), who is responsible for providing facilities, services,
and materials?
A. Operations Section
B. Planning Section
C. Logistics Section
D. Finance Section
