NREMT Practice Test Bank - Multiple
Choice
A 16-year-old, 125-pound male ingested a bottle of aspirin approximately 20
minutes ago. Medical control orders you to administer activated charcoal in a
dose of 1 g/kg. How much activated charcoal should you administer?
• A:54 g
• B:60 g
• C:51 g
• D:57 g - ANS - You selected D; This is correct!
Reason: First, you must determine the patient's weight in kilograms (kg). Either of
the following formulae can be used to convert pounds to kilograms: Formula 1:
weight (in pounds) ÷ 2.2 = weight in kg. Formula 2: weight (in pounds) ÷ 2 - 10% =
weight in kg. On the basis of the above formulae, a 125-pound patient weighs 57
kg. Using formula 1, the equation is as follows: 125 (weight in pounds) ÷ 2.2 =
56.81 (57 [rounded to the nearest tenth]). Using formula 2, the equation is as
follows: 125 (weight in pounds) ÷ 2 = 62.5 (63 [rounded to the nearest tenth] - 6.3
(10% of 63) = 56.7 (57 [rounded to the nearest tenth]). Since the drug order is for 1
g/kg, you should administer 57 g of activated charcoal to your 125-pound patient.
\A 19-year-old female has a closed, swollen deformity to her left forearm. You are
unable to palpate a radial pulse and the skin distal to the injury is cold and pale.
Several attempts to contact medical control have failed and you are
approximately 45 miles away from the closest hospital. You should:
• A:apply an air splint to her forearm, keep her arm below the level of her heart,
place an icepack over the injury, and transport.
• B:begin transport at once, gently manipulate her arm en route until distal
circulation is restored, and apply an air splint.
• C:splint her entire arm with rigid board splints, elevate the limb above the level
of her heart, and transport immediately.
• D:make one attempt to restore distal circulation by applying gentle manual
traction in line with the long axis of the limb. - ANS - The correct answer is D;
Reason:
Cold, pale skin and an absent distal pulse indicates that blood flow distal to the
injury is compromised. You should notify medical control, who will likely direct
you to attempt to restore distal circulation. However, if you are unable to contact
,medical control and your transport time will be lengthy, you should make ONE
attempt to restore distal circulation by applying gentle manual traction in line with
the long axis of the limb. Be careful, as excessive manipulation can worsen the
vascular problem. If you are unsuccessful after one attempt, splint the limb in the
most comfortable position for the patient and transport at once. If distal
circulation is restored, splint the limb in whatever position allows the strongest
distal pulse. You should elevate the limb above the level of the heart to help
minimize swelling. An icepack may also help reduce pain and swelling.
\A 19-year-old male was assaulted and has trauma to multiple body systems.
After performing your primary assessment and treating any immediate
life-threatening injuries, you should:
• A:obtain a full set of baseline vital signs.
• B:transport at once and intercept with ALS.
• C:perform a rapid head-to-toe assessment.
• D:fully immobilize his spine and transport. - ANS - You selected D; The correct
answer is C;
Reason:
After treating all life-threatening conditions found in the primary assessment, you
should perform a rapid head-to-toe assessment (rapid body scan) to look for and
treat other life threats. In many cases, patients with trauma to multiple body
systems have other life-threatening injuries that are not readily apparent during
the primary assessment. You should obtain baseline vital signs as soon as
possible; however, this should not delay or interrupt your primary or rapid
head-to-toe assessments. After performing the primary and rapid head-to-toe
assessments, fully immobilize the patient's spine and transport to an appropriate
hospital. Consider an advanced life support (ALS) intercept, as long as it does
not cause a significant delay in transport.
\A 21-year-old male was bitten on the left forearm by a dog. He is conscious and
alert and denies any other injuries. An animal control officer is at the scene and
has contained the dog. Your assessment of the patient's arm reveals a large
avulsion with a peeled back flap of skin. Distal circulation is adequate and the
patient is able to feel and move his fingers. In addition to bleeding control, you
should:
• A:perform a rapid head-to-toe assessment.
• B:irrigate the wound for at least 15 minutes.
• C:replace the avulsed flap to its original position.
• D:apply oxygen via a nonrebreathing mask. - ANS - The correct answer is C;
Reason:
,An avulsion is an injury that separates various layers of soft tissue, usually
between the subcutaneous layer and fascia, so that they become completely
detached or hang as a flap. The patient's injury is isolated and not
life-threatening; therefore, a rapid head-to-toe assessment is not indicated.
Unless your protocols specify otherwise, oxygen is usually not necessary for
patients with isolated, non-life-threatening soft tissue injuries. If the avulsed
tissue is hanging from a small piece of skin, circulation through the flap may be
at risk. If you can, replace the avulsed flap to its original position, as long as it is
not visibly contaminated with dirt and/or other foreign materials, and then cover
the wound with a dry sterile dressing. Unless the wound is grossly contaminated
with dirt or debris, irrigation is usually deferred until the patient is evaluated by a
physician. Furthermore, flushing an open wound may force dirt or other debris
into the wound, increasing the risk of infection.
\A 21-year-old man partially amputated his right arm when the chainsaw he was
using to trim trees slipped. You can feel a weak radial pulse and his arm is cool to
the touch. Dark red blood is flowing heavily from the wound. You should:
• A:control the bleeding, manipulate the arm to improve circulation, and apply a
splint.
• B:apply bulky compression dressings to the wound and splint the extremity.
• C:carefully pack sterile dressings into the wound and fully splint the extremity.
• D:apply a tourniquet proximal to the injury and tighten it until the bleeding
stops. - ANS - The correct answer is B;
Reason:
When caring for a partially amputated extremity, control bleeding with bulky
compression (pressure) dressings and splint the extremity to prevent further
injury. If direct pressure does not immediately control the bleeding, however, a
proximal tourniquet should be applied without delay. Never pack dressings into a
wound; this may cause further damage and increases the risk of infection.
Although your patient's radial pulse is weak, it is present and indicates blood flow
distal to the injury. Do not manipulate his arm; doing so may lacerate or
compress an artery and compromise distal circulation.
\A 22-year-old female fell on her knee and is in severe pain. Her knee is flexed and
severely deformed. Her leg is cold to the touch and you are unable to palpate a
distal pulse. You should:
• A:carefully straighten her leg until you restore a distal pulse and then apply
padded board splints.
• B:apply gentle longitudinal traction as you straighten her leg and then apply a
traction splint.
, • C:manually stabilize her injury and contact medical control for further
stabilization instructions.
• D:place a pillow behind her knee and stabilize the injury by applying padded
board splints. - ANS - The correct answer is C;
Reason:
A dislocated knee occurs when the proximal end of the tibia completely displaces
from its juncture with the distal femur. In some cases, the popliteal artery behind
the knee may be compressed, resulting in compromised distal blood flow. Signs
of this include absent distal pulses and a pale extremity that is cool or cold.
Manually stabilize the knee and assess for distal pulses. If distal pulses are
absent, contact medical control immediately for further stabilization instructions.
Medical control may instruct you to make ONE attempt to realign the knee to
reduce compression of the popliteal artery and restore distal circulation. If you
are unable to restore distal circulation or medical control advises you not to
manipulate the injury, splint the knee in the position it was found and transport
promptly. Traction splints are contraindicated in any injury to or near the knee
\A 22-year-old female woman was shot by her husband. Law enforcement is at the
scene and has the husband in custody. The patient is conscious, but extremely
restless, and is pale and diaphoretic. As your partner administers high-flow
oxygen, you should:
• A:keep her warm by applying blankets.
• B:take her BP to detect hypotension.
• C:compare her carotid and radial pulses.
• D:look for and control any bleeding. - ANS - You selected D; This is correct!
Reason:
The primary assessment of any patient includes ensuring a patent airway,
assessing breathing adequacy, administering high-flow oxygen or assisting
ventilations, assessing circulation, and controlling all active bleeding. You and
your partner must work as a team; as your partner administers high-flow oxygen,
you should be looking for her gunshot wound(s) and ensuring that all bleeding is
controlled. After the primary assessment and management, begin treating her for
shock (eg, applying a blanket, elevating her lower extremities [if local protocol
permits]) and perform a rapid head-to-toe assessment to search for other injuries
that may not have been obvious during the primary assessment. Assess the
patient's vital signs after all life-threatening injuries or conditions have been
identified and corrected.
Choice
A 16-year-old, 125-pound male ingested a bottle of aspirin approximately 20
minutes ago. Medical control orders you to administer activated charcoal in a
dose of 1 g/kg. How much activated charcoal should you administer?
• A:54 g
• B:60 g
• C:51 g
• D:57 g - ANS - You selected D; This is correct!
Reason: First, you must determine the patient's weight in kilograms (kg). Either of
the following formulae can be used to convert pounds to kilograms: Formula 1:
weight (in pounds) ÷ 2.2 = weight in kg. Formula 2: weight (in pounds) ÷ 2 - 10% =
weight in kg. On the basis of the above formulae, a 125-pound patient weighs 57
kg. Using formula 1, the equation is as follows: 125 (weight in pounds) ÷ 2.2 =
56.81 (57 [rounded to the nearest tenth]). Using formula 2, the equation is as
follows: 125 (weight in pounds) ÷ 2 = 62.5 (63 [rounded to the nearest tenth] - 6.3
(10% of 63) = 56.7 (57 [rounded to the nearest tenth]). Since the drug order is for 1
g/kg, you should administer 57 g of activated charcoal to your 125-pound patient.
\A 19-year-old female has a closed, swollen deformity to her left forearm. You are
unable to palpate a radial pulse and the skin distal to the injury is cold and pale.
Several attempts to contact medical control have failed and you are
approximately 45 miles away from the closest hospital. You should:
• A:apply an air splint to her forearm, keep her arm below the level of her heart,
place an icepack over the injury, and transport.
• B:begin transport at once, gently manipulate her arm en route until distal
circulation is restored, and apply an air splint.
• C:splint her entire arm with rigid board splints, elevate the limb above the level
of her heart, and transport immediately.
• D:make one attempt to restore distal circulation by applying gentle manual
traction in line with the long axis of the limb. - ANS - The correct answer is D;
Reason:
Cold, pale skin and an absent distal pulse indicates that blood flow distal to the
injury is compromised. You should notify medical control, who will likely direct
you to attempt to restore distal circulation. However, if you are unable to contact
,medical control and your transport time will be lengthy, you should make ONE
attempt to restore distal circulation by applying gentle manual traction in line with
the long axis of the limb. Be careful, as excessive manipulation can worsen the
vascular problem. If you are unsuccessful after one attempt, splint the limb in the
most comfortable position for the patient and transport at once. If distal
circulation is restored, splint the limb in whatever position allows the strongest
distal pulse. You should elevate the limb above the level of the heart to help
minimize swelling. An icepack may also help reduce pain and swelling.
\A 19-year-old male was assaulted and has trauma to multiple body systems.
After performing your primary assessment and treating any immediate
life-threatening injuries, you should:
• A:obtain a full set of baseline vital signs.
• B:transport at once and intercept with ALS.
• C:perform a rapid head-to-toe assessment.
• D:fully immobilize his spine and transport. - ANS - You selected D; The correct
answer is C;
Reason:
After treating all life-threatening conditions found in the primary assessment, you
should perform a rapid head-to-toe assessment (rapid body scan) to look for and
treat other life threats. In many cases, patients with trauma to multiple body
systems have other life-threatening injuries that are not readily apparent during
the primary assessment. You should obtain baseline vital signs as soon as
possible; however, this should not delay or interrupt your primary or rapid
head-to-toe assessments. After performing the primary and rapid head-to-toe
assessments, fully immobilize the patient's spine and transport to an appropriate
hospital. Consider an advanced life support (ALS) intercept, as long as it does
not cause a significant delay in transport.
\A 21-year-old male was bitten on the left forearm by a dog. He is conscious and
alert and denies any other injuries. An animal control officer is at the scene and
has contained the dog. Your assessment of the patient's arm reveals a large
avulsion with a peeled back flap of skin. Distal circulation is adequate and the
patient is able to feel and move his fingers. In addition to bleeding control, you
should:
• A:perform a rapid head-to-toe assessment.
• B:irrigate the wound for at least 15 minutes.
• C:replace the avulsed flap to its original position.
• D:apply oxygen via a nonrebreathing mask. - ANS - The correct answer is C;
Reason:
,An avulsion is an injury that separates various layers of soft tissue, usually
between the subcutaneous layer and fascia, so that they become completely
detached or hang as a flap. The patient's injury is isolated and not
life-threatening; therefore, a rapid head-to-toe assessment is not indicated.
Unless your protocols specify otherwise, oxygen is usually not necessary for
patients with isolated, non-life-threatening soft tissue injuries. If the avulsed
tissue is hanging from a small piece of skin, circulation through the flap may be
at risk. If you can, replace the avulsed flap to its original position, as long as it is
not visibly contaminated with dirt and/or other foreign materials, and then cover
the wound with a dry sterile dressing. Unless the wound is grossly contaminated
with dirt or debris, irrigation is usually deferred until the patient is evaluated by a
physician. Furthermore, flushing an open wound may force dirt or other debris
into the wound, increasing the risk of infection.
\A 21-year-old man partially amputated his right arm when the chainsaw he was
using to trim trees slipped. You can feel a weak radial pulse and his arm is cool to
the touch. Dark red blood is flowing heavily from the wound. You should:
• A:control the bleeding, manipulate the arm to improve circulation, and apply a
splint.
• B:apply bulky compression dressings to the wound and splint the extremity.
• C:carefully pack sterile dressings into the wound and fully splint the extremity.
• D:apply a tourniquet proximal to the injury and tighten it until the bleeding
stops. - ANS - The correct answer is B;
Reason:
When caring for a partially amputated extremity, control bleeding with bulky
compression (pressure) dressings and splint the extremity to prevent further
injury. If direct pressure does not immediately control the bleeding, however, a
proximal tourniquet should be applied without delay. Never pack dressings into a
wound; this may cause further damage and increases the risk of infection.
Although your patient's radial pulse is weak, it is present and indicates blood flow
distal to the injury. Do not manipulate his arm; doing so may lacerate or
compress an artery and compromise distal circulation.
\A 22-year-old female fell on her knee and is in severe pain. Her knee is flexed and
severely deformed. Her leg is cold to the touch and you are unable to palpate a
distal pulse. You should:
• A:carefully straighten her leg until you restore a distal pulse and then apply
padded board splints.
• B:apply gentle longitudinal traction as you straighten her leg and then apply a
traction splint.
, • C:manually stabilize her injury and contact medical control for further
stabilization instructions.
• D:place a pillow behind her knee and stabilize the injury by applying padded
board splints. - ANS - The correct answer is C;
Reason:
A dislocated knee occurs when the proximal end of the tibia completely displaces
from its juncture with the distal femur. In some cases, the popliteal artery behind
the knee may be compressed, resulting in compromised distal blood flow. Signs
of this include absent distal pulses and a pale extremity that is cool or cold.
Manually stabilize the knee and assess for distal pulses. If distal pulses are
absent, contact medical control immediately for further stabilization instructions.
Medical control may instruct you to make ONE attempt to realign the knee to
reduce compression of the popliteal artery and restore distal circulation. If you
are unable to restore distal circulation or medical control advises you not to
manipulate the injury, splint the knee in the position it was found and transport
promptly. Traction splints are contraindicated in any injury to or near the knee
\A 22-year-old female woman was shot by her husband. Law enforcement is at the
scene and has the husband in custody. The patient is conscious, but extremely
restless, and is pale and diaphoretic. As your partner administers high-flow
oxygen, you should:
• A:keep her warm by applying blankets.
• B:take her BP to detect hypotension.
• C:compare her carotid and radial pulses.
• D:look for and control any bleeding. - ANS - You selected D; This is correct!
Reason:
The primary assessment of any patient includes ensuring a patent airway,
assessing breathing adequacy, administering high-flow oxygen or assisting
ventilations, assessing circulation, and controlling all active bleeding. You and
your partner must work as a team; as your partner administers high-flow oxygen,
you should be looking for her gunshot wound(s) and ensuring that all bleeding is
controlled. After the primary assessment and management, begin treating her for
shock (eg, applying a blanket, elevating her lower extremities [if local protocol
permits]) and perform a rapid head-to-toe assessment to search for other injuries
that may not have been obvious during the primary assessment. Assess the
patient's vital signs after all life-threatening injuries or conditions have been
identified and corrected.
