NREMT- Cardiology Exam with Questions and
Answers 2025-2026 Latest Update
• In addition to chest pain or discomfort, a patient experiencing an acute
coronary syndrome would MOST likely present with: A: severe projectile vomiting
and flushed skin. B: irregular breathing and low blood pressure. C: ashen skin
color, diaphoresis, and anxiety.
D: profound cyanosis, dry skin, and a headache.: C; Chest pain, pressure, or
discomfort is the most common symptom of acute coronary syndrome, or ACS (eg,
unstable angina, acute myocardial infarction); it occurs in approximately 80% of
cases. Patients with ACS are usually anxious and may have a feeling of impending
doom. Nausea and vomiting are common complaints; however, projectile vomiting,
which is typically associated with increased intracranial pressure, is uncommon.
The skin is often ashen gray and clammy (diaphoretic) because of poor cardiac
output and decreased perfusion. Less commonly, the patient's skin is cyanotic.
Respirations are usually unlabored unless the patient has congestive heart failure,i
n which case respirations are rapid and labored; irregular breathing, however, is
not common. Blood pressure may fall as a result of decreased cardiac output;
however, most patients will have a normal or elevated blood pressure. If the patient
complains of a headache, it is usually a side effect of the nitroglycerin they took
before your arrival; ACS itself usually does not cause a headache.
• Which of the following patients would MOST likely present with vague oru
nusual symptoms of an acute myocardial infarction? A: 55-year-old obese female
B: 66-year-old male with angina
C: 72-year-old female with diabetes
D: 75-year-old male with hypertension: C; Not all patients experiencing acute
myocardial infarction (AMI) present with the classic signs and symptoms one would
expect. Middle-aged men often minimize their symptoms and attribute their chest
pain or discomfort to indigestion. Some patients, however, do not experience any
pain. In particular, elderly women with diabetes may present with vague, unusual, or
atypical symptoms of AMI; their only presenting complaint may be fatigue or
syncope. Do not rule out a cardiac problem just because a patient is not
experiencing chest pain, pressure, or discomfort; this is especially true in elderly
females with diabetes.
• During your assessment of a 70-year-old man with crushing chest pain, you
note that his blood pressure is 80/50 mm Hg.Your MOST important action should
be to: A: assess his oxygen saturation.B : keep the patient warm.
C: give high-flow oxygen.
D: transport without delay.: D; Patients with chest pain, pressure, or discomfort
with a systolic BP less than 100 mm Hg should be transported to the hospital
without delay. Hypotension in a patient with chest pain indicates cardiogenic
shock due to severe cardiac damage and requires treatment that can only be given
at the hospital. Any delay in transport delays definitive care and increases the
,patient's chance of death. High-flow oxygen, thermal management, and
assessment of oxygen saturation are clearly important; however, your primary
focus should be to get the patient to the hospital as soon as possible.
• A 65-year-old man has generalized weakness and chest pressure. He has a
bottle of prescribed nitroglycerin, but states that he has not taken any of his
medication. As your partner prepares to administer oxygen, you should: A:
administer up to 325 mg of aspirin if the patient is not allergic to it. B: perform a
secondary assessment and obtain baseline vital signs.C : apply the AED and
prepare the patient for immediate transport.
D: assist the patient with his nitroglycerin with medical control approval.: A; Aspirin
has clearly been shown to reduce mortality and morbitiy associated with acute
coronary syndrome (ACS) and should be given as early as possible; the dose is 160
to 325 mg. Even though this patient has chest pain and prescribed nitroglycerin, you
must first complete a secondary assessment and obtain baseline vital signs. Medical
control will need this information—specifically the patient's blood pressure—in
order to determine whether you should assist the patient with his nitroglycerin. The
AED is not indicated for this patient because he is not in cardiac arrest.
• While transporting an elderly woman who was complaining of nausea,
vomiting, and weakness, she suddenly becomes unresponsive. You should: A:
analyze her heart rhythm with the AED.
B: quickly look at her chest for obvious
movement.C : feel for a carotid pulse for at
least 5 seconds.
D: open her airway and ensure that it is clear.: B; If a patient is found unre- sponsive
or becomes unresponsive in your presence, your first action should be to assess for
breathing; this should be done by quickly (no more than 10 seconds) looking at the
chest for obvious movement. If the patient is not breathing or only has agonal
gasps, you should check for a pulse for at least 5 seconds but no more than 10
seconds. If the patient has a pulse but is not breathing, open the airway and provide
rescue breathing. If the patient does not have a pulse, begin CPR (starting with chest
compressions), and apply the AED as soon as possible. If you are transporting a
patient who becomes unresponsive, pulseless, and apneic, you
should begin CPR and instruct your partner to stop the ambulance and prepare the
AED.
• A 50-year-old man presents with crushing chest pain of sudden onset. He is
diaphoretic, apprehensive, and tachypneic. You should: A: obtain baseline vital
signs.
B: perform a complete physical exam.C : apply
supplemental oxygen. ts with chest cated for any n
as possible; lvement as
D: ask him if he takes nitroglycerin.: C; All of the interventions and
,assessments listed in this question should be performed on a patient who
presen pain, pressure, or discomfort. However, supplemental oxygen is indi
patient with a potential cardiac problem and should be given
as soo this is especially true when the patient has potential respiratory invo well
(ie, dyspnea, tachypnea). Administer oxygen in a concentration sufficient to
maintain an oxygen saturation of 94% or greater. Aspirin (up to 325 mg) should
also be administered as soon as possible, unless the patient is allergic to it. After
applying oxygen and administering aspirin, you should perform a physical exam
and obtain baseline vital signs. You would inquire about any prescription
medications the patient is taking (eg, NTG) during the SAMPLE history.
• You are treating a 60-year-old man in cardiac arrest. After delivering a shock with
the AED and performing CPR for 2 minutes, you achieve return of spontaneous
circulation. Your next action should be to: us circulation hould be remains ely,
administer
A: provide rapid
transport to the hospital. B: remove
the AED and apply 100% oxygen.
C: assess his airway and
ventilatory
status.
D: reanalyze his rhythm for confirmation.: C; If return of
spontaneo (ROSC) occurs (eg, a palpable pulse is restored), your
first action s to reassess the patient's airway and ventilatory
status. If the patient apneic, continue rescue breathing. If the
patient is breathing adequat
high-flow oxygen. After reassessing airway and breathing, and treating accordingly,
you should prepare for immediate transport. Because of the high risk that cardiac
arrest can recur following resuscitation, you should not remove the AED pads;
simply turn the AED off instead. Analysis of the patient's cardiac rhythm is not
indicated because he now has a pulse.
• Which of the following is an abnormal finding when using the Cincinnati stroke
scale to assess a patient who presents with signs of a stroke?
A: Both arms drift slowly and equally down to the patient's side.B :
The patient's face is symmetrical when he or she smiles.
C: One of the pupils is dilated and does not react to light.
losed and
. If one arm bnormal her teeth. qually). If
, D: One arm drifts down compared with the other side.: D; The
Cincinnati Stroke Scale is used to assess patients suspected of experiencing a
stroke. It consists of three tests: speech, facial droop, and arm drift. Abnormality in
any one of these areas indicates a high probability of stroke. To test arm drift, ask
the patient to hold both arms in front of his or her body, palms facing upward, with
eyes c without moving. Over the next 10 seconds, observe the patient's arms drifts
down toward the ground, you know that side is weak; this is an a finding. To test for
facial droop, have the patient smile, showing his or The face should be symmetrical
(both sides of the face should move e only one side of the face moves well, you
know that something is wrong with the part of the brain that controls the facial
muscles. You should assess the pupils of a patient with a suspected stroke;
however, this is not a component of the Cincinnati Stroke Scale.
• Which of the following is the MOST appropriate response when a patient
with chest pain asks you if he or she is having a heart attack? A: Yes, so I
recommend going to the hospital.
B: I believe you are, but only a physician can tell for sure.
C: Probably not, but we should transport you to be safe.
D: I don't know, but we will take good care of you.: D; Patients experiencing chest
pain often have a good idea about what is happening, so do not lie or offer false
reassurance. Conversely, do not tell the patient they are having a heart attack; this
can only be diagnosed by a physician, not an EMT in the field. If asked, "Am I
having a heart attack?" an appropriate response would be, "I don't know for sure,b
ut in case you are, we are going to take good care of you."
• A middle-aged woman took three of her prescribed nitroglycerin tablets
after she began experiencing chest pain. She complains of a bad headache and is
still experiencing chest pain. You should assume that: A: her blood pressure is
elevated.
itter tastea t many
cts, the NTG
B: her chest
pain is not cardiac-related. C: her nitroglycerin
is no longer potent.
D: she has ongoing cardiac ischemia.: D; A headache and/or a b under the tongue
are common side effects of nitroglycerin (NTG) th patients experience. If the
patient does not experience these side effe may have lost its potency. However, if a
patient with chest pain takes NTG and experiences these side effects, but still has
chest pain, you should assume that his or her pain is the result of cardiac
ischemia, a relative deprivation of oxygen to the heart. NTG is a vasodilator drug; if
Answers 2025-2026 Latest Update
• In addition to chest pain or discomfort, a patient experiencing an acute
coronary syndrome would MOST likely present with: A: severe projectile vomiting
and flushed skin. B: irregular breathing and low blood pressure. C: ashen skin
color, diaphoresis, and anxiety.
D: profound cyanosis, dry skin, and a headache.: C; Chest pain, pressure, or
discomfort is the most common symptom of acute coronary syndrome, or ACS (eg,
unstable angina, acute myocardial infarction); it occurs in approximately 80% of
cases. Patients with ACS are usually anxious and may have a feeling of impending
doom. Nausea and vomiting are common complaints; however, projectile vomiting,
which is typically associated with increased intracranial pressure, is uncommon.
The skin is often ashen gray and clammy (diaphoretic) because of poor cardiac
output and decreased perfusion. Less commonly, the patient's skin is cyanotic.
Respirations are usually unlabored unless the patient has congestive heart failure,i
n which case respirations are rapid and labored; irregular breathing, however, is
not common. Blood pressure may fall as a result of decreased cardiac output;
however, most patients will have a normal or elevated blood pressure. If the patient
complains of a headache, it is usually a side effect of the nitroglycerin they took
before your arrival; ACS itself usually does not cause a headache.
• Which of the following patients would MOST likely present with vague oru
nusual symptoms of an acute myocardial infarction? A: 55-year-old obese female
B: 66-year-old male with angina
C: 72-year-old female with diabetes
D: 75-year-old male with hypertension: C; Not all patients experiencing acute
myocardial infarction (AMI) present with the classic signs and symptoms one would
expect. Middle-aged men often minimize their symptoms and attribute their chest
pain or discomfort to indigestion. Some patients, however, do not experience any
pain. In particular, elderly women with diabetes may present with vague, unusual, or
atypical symptoms of AMI; their only presenting complaint may be fatigue or
syncope. Do not rule out a cardiac problem just because a patient is not
experiencing chest pain, pressure, or discomfort; this is especially true in elderly
females with diabetes.
• During your assessment of a 70-year-old man with crushing chest pain, you
note that his blood pressure is 80/50 mm Hg.Your MOST important action should
be to: A: assess his oxygen saturation.B : keep the patient warm.
C: give high-flow oxygen.
D: transport without delay.: D; Patients with chest pain, pressure, or discomfort
with a systolic BP less than 100 mm Hg should be transported to the hospital
without delay. Hypotension in a patient with chest pain indicates cardiogenic
shock due to severe cardiac damage and requires treatment that can only be given
at the hospital. Any delay in transport delays definitive care and increases the
,patient's chance of death. High-flow oxygen, thermal management, and
assessment of oxygen saturation are clearly important; however, your primary
focus should be to get the patient to the hospital as soon as possible.
• A 65-year-old man has generalized weakness and chest pressure. He has a
bottle of prescribed nitroglycerin, but states that he has not taken any of his
medication. As your partner prepares to administer oxygen, you should: A:
administer up to 325 mg of aspirin if the patient is not allergic to it. B: perform a
secondary assessment and obtain baseline vital signs.C : apply the AED and
prepare the patient for immediate transport.
D: assist the patient with his nitroglycerin with medical control approval.: A; Aspirin
has clearly been shown to reduce mortality and morbitiy associated with acute
coronary syndrome (ACS) and should be given as early as possible; the dose is 160
to 325 mg. Even though this patient has chest pain and prescribed nitroglycerin, you
must first complete a secondary assessment and obtain baseline vital signs. Medical
control will need this information—specifically the patient's blood pressure—in
order to determine whether you should assist the patient with his nitroglycerin. The
AED is not indicated for this patient because he is not in cardiac arrest.
• While transporting an elderly woman who was complaining of nausea,
vomiting, and weakness, she suddenly becomes unresponsive. You should: A:
analyze her heart rhythm with the AED.
B: quickly look at her chest for obvious
movement.C : feel for a carotid pulse for at
least 5 seconds.
D: open her airway and ensure that it is clear.: B; If a patient is found unre- sponsive
or becomes unresponsive in your presence, your first action should be to assess for
breathing; this should be done by quickly (no more than 10 seconds) looking at the
chest for obvious movement. If the patient is not breathing or only has agonal
gasps, you should check for a pulse for at least 5 seconds but no more than 10
seconds. If the patient has a pulse but is not breathing, open the airway and provide
rescue breathing. If the patient does not have a pulse, begin CPR (starting with chest
compressions), and apply the AED as soon as possible. If you are transporting a
patient who becomes unresponsive, pulseless, and apneic, you
should begin CPR and instruct your partner to stop the ambulance and prepare the
AED.
• A 50-year-old man presents with crushing chest pain of sudden onset. He is
diaphoretic, apprehensive, and tachypneic. You should: A: obtain baseline vital
signs.
B: perform a complete physical exam.C : apply
supplemental oxygen. ts with chest cated for any n
as possible; lvement as
D: ask him if he takes nitroglycerin.: C; All of the interventions and
,assessments listed in this question should be performed on a patient who
presen pain, pressure, or discomfort. However, supplemental oxygen is indi
patient with a potential cardiac problem and should be given
as soo this is especially true when the patient has potential respiratory invo well
(ie, dyspnea, tachypnea). Administer oxygen in a concentration sufficient to
maintain an oxygen saturation of 94% or greater. Aspirin (up to 325 mg) should
also be administered as soon as possible, unless the patient is allergic to it. After
applying oxygen and administering aspirin, you should perform a physical exam
and obtain baseline vital signs. You would inquire about any prescription
medications the patient is taking (eg, NTG) during the SAMPLE history.
• You are treating a 60-year-old man in cardiac arrest. After delivering a shock with
the AED and performing CPR for 2 minutes, you achieve return of spontaneous
circulation. Your next action should be to: us circulation hould be remains ely,
administer
A: provide rapid
transport to the hospital. B: remove
the AED and apply 100% oxygen.
C: assess his airway and
ventilatory
status.
D: reanalyze his rhythm for confirmation.: C; If return of
spontaneo (ROSC) occurs (eg, a palpable pulse is restored), your
first action s to reassess the patient's airway and ventilatory
status. If the patient apneic, continue rescue breathing. If the
patient is breathing adequat
high-flow oxygen. After reassessing airway and breathing, and treating accordingly,
you should prepare for immediate transport. Because of the high risk that cardiac
arrest can recur following resuscitation, you should not remove the AED pads;
simply turn the AED off instead. Analysis of the patient's cardiac rhythm is not
indicated because he now has a pulse.
• Which of the following is an abnormal finding when using the Cincinnati stroke
scale to assess a patient who presents with signs of a stroke?
A: Both arms drift slowly and equally down to the patient's side.B :
The patient's face is symmetrical when he or she smiles.
C: One of the pupils is dilated and does not react to light.
losed and
. If one arm bnormal her teeth. qually). If
, D: One arm drifts down compared with the other side.: D; The
Cincinnati Stroke Scale is used to assess patients suspected of experiencing a
stroke. It consists of three tests: speech, facial droop, and arm drift. Abnormality in
any one of these areas indicates a high probability of stroke. To test arm drift, ask
the patient to hold both arms in front of his or her body, palms facing upward, with
eyes c without moving. Over the next 10 seconds, observe the patient's arms drifts
down toward the ground, you know that side is weak; this is an a finding. To test for
facial droop, have the patient smile, showing his or The face should be symmetrical
(both sides of the face should move e only one side of the face moves well, you
know that something is wrong with the part of the brain that controls the facial
muscles. You should assess the pupils of a patient with a suspected stroke;
however, this is not a component of the Cincinnati Stroke Scale.
• Which of the following is the MOST appropriate response when a patient
with chest pain asks you if he or she is having a heart attack? A: Yes, so I
recommend going to the hospital.
B: I believe you are, but only a physician can tell for sure.
C: Probably not, but we should transport you to be safe.
D: I don't know, but we will take good care of you.: D; Patients experiencing chest
pain often have a good idea about what is happening, so do not lie or offer false
reassurance. Conversely, do not tell the patient they are having a heart attack; this
can only be diagnosed by a physician, not an EMT in the field. If asked, "Am I
having a heart attack?" an appropriate response would be, "I don't know for sure,b
ut in case you are, we are going to take good care of you."
• A middle-aged woman took three of her prescribed nitroglycerin tablets
after she began experiencing chest pain. She complains of a bad headache and is
still experiencing chest pain. You should assume that: A: her blood pressure is
elevated.
itter tastea t many
cts, the NTG
B: her chest
pain is not cardiac-related. C: her nitroglycerin
is no longer potent.
D: she has ongoing cardiac ischemia.: D; A headache and/or a b under the tongue
are common side effects of nitroglycerin (NTG) th patients experience. If the
patient does not experience these side effe may have lost its potency. However, if a
patient with chest pain takes NTG and experiences these side effects, but still has
chest pain, you should assume that his or her pain is the result of cardiac
ischemia, a relative deprivation of oxygen to the heart. NTG is a vasodilator drug; if
