NREMT PRACTICE TEST BANK - MULTIPLE CHOICE QUESTIONS
AND GRADED A+ ANSWERS
A 44-year-old woman was bitten on the ankle by an unidentified snake
while working in her garden. She is conscious and alert, has stable vital
signs, and denies shortness of breath. Her only complaint is a burning
sensation at the wound site. Your assessment reveals two small puncture
wounds, redness, and swelling. You should:
• A:conclude that envenomation likely did not occur, provide reassurance,
and allow a friend to take her to the hospital.
• B:give supplemental oxygen, splint her leg to decrease movement, and
keep her leg below the level of her heart.
• C:elevate her leg, cover the wound with a dry sterile dressing, and apply
an ice pack to reduce pain and swelling.
• D:administer high-flow oxygen, apply a constricting band proximal to the
bite, and use ice to prevent venom spread.
You selected B; This is correct!
Reason:Given the fact that the snake was not identified, you should assume that
it was poisonous. Furthermore, the presence of puncture wounds, burning,
redness, and swelling are suggestive of envenomation. Therefore, you should
provide emergency care and transport the patient to the hospital. Treatment for a
snake bite involves keeping the patient calm, administering oxygen, splinting
the affected extremity to decrease movement (helps slow the spread of venom),
keeping the extremity below the level of the heart, and transporting the patient
to the hospital. Do NOT apply ice to a snake bite; it may constrict the blood
vessels and force venom further into the bloodstream. The use of a proximal
,constricting band is controversial; if one is used, it should be loose, not tight. En
route to the hospital, monitor the patient's vital signs and mental status, and be
alert for vomiting.
A 34-year-old female complains of persistent fever, fatigue, and night
sweats. During your assessment, you note that she has purple blotches on
her arms and legs. She MOST likely has:
• A:HIV/AIDS.
• B:chickenpox.
• C:tuberculosis.
• D:viral hepatitis.
You selected A; This is correct!
Reason:Signs of human immunodeficiency virus (HIV) infection include
persistent fever, weight loss, fatigue, a cough, and night sweats. The presence of
purple skin blotches (malignant lesions called Kaposi's sarcoma) is consistent
with acquired immune deficiency syndrome (AIDS), also known as late stage
HIV infection. Patients with tuberculosis (TB) also present with fever, fatigue,
weight loss, a cough, and night sweats; however, skin lesions are not common.
Hepatitis is characterized by right upper quadrant abdominal pain, fever, nausea
and vomiting, and a yellow tint to the skin and sclera (jaundice). Chickenpox is
unlikely; the associated rash is characterized by pustules that crust over, not
purple blotches.
The daughter of an elderly patient states that her mother is acting confused
and talking incoherently. This nature of illness is MOST consistent with:
• A:diabetic complications.
• B:altered mental status.
• C:cardiac compromise.
• D:behavioral problems
,You selected B; This is correct!
Reason:The nature of illness is a category in which you place the patient based
on his or her chief complaint. A chief complaint of confusion and incoherent
speech suggests that altered mental status is the nature of illness. An altered
mental status can be caused by a variety of problems, including diabetic and
behavioral problems, and in some cases, cardiac problems.
Which of the following statements regarding heatstroke is correct?
• A:Heatstroke is caused by a hyperactive sweating mechanism.
• B:Not all patients experiencing heatstroke have dry skin.
• C:As core body temperature rises, the patient becomes more agitated.
• D:Heatstroke is more likely to occur when the humidity is low.
You selected B; This is correct!
Reason: Heatstroke occurs when the body is exposed to more heat than it can
eliminate and normal mechanisms for eliminating heat, such as sweating, are
overwhelmed. The core body temperature then rises rapidly to the point where
tissues are destroyed. Heatstroke can develop in patients during prolonged
vigorous physical activity or when they are in a closed, poorly ventilated, hot
and humid space. High humidity impairs a person's ability to eliminate heat via
the sweating mechanism. Many patients with heatstroke have hot, dry, flushed
skin; however, early in the course of heatstroke, the skin may be moist due to
residual perspiration, as with exertional heatstroke. As the core body
temperature rises, the patient's level of consciousness decreases. Untreated
heatstroke will result in death.
Law enforcement requests your assistance to evaluate a young female who
they believe has overdosed. The patient is conscious, is displaying bizarre
behavior, and is very restless. Her BP is 170/90 mm Hg and her heart rate
is 130 beats/min. You see needle tracks on both of her arms. She is MOST
, likely under the influence of a:
• A:benzodiazepine.
• B:sedative-hypnotic.
• C:powerful narcotic.
• D:methamphetamine.
You selected D; This is correct!
Reason:The needle tracks on the patient's arms indicate narcotic abuse, most
likely heroin; however, her signs and symptoms are not consistent with those
caused by a narcotic or any other central nervous system (CNS) depressant (eg,
benzodiazepine [a sedative-hypnotic]). Signs of CNS depression include a
decreased level of consciousness, hypoventilation, bradycardia, and
hypotension. Her signs and symptoms are consistent with a sympathomimetic
(upper) overdose. Sympathomimetic drugs mimic the effects of the sympathetic
(fight or flight) nervous system; therefore, restlessness or hyperactivity,
hypertension, tachycardia, and pupillary dilation are common findings in
patients who overdose. Amphetamine and methamphetamine (eg, ice, speed,
crack) are examples of sympathomimetics.
Which of the following signs and symptoms are MOST characteristic of
hyperglycemic ketoacidosis?
• A:Warm, dry skin and a slow onset
• B:Warm, dry skin and a rapid onset
• C:Cool, clammy skin and a rapid onset
• D:Cool, clammy skin and a slow onset
You selected A; This is correct!
Reason:Hyperglycemic ketoacidosis (diabetic coma) is characterized by a
dangerously high blood glucose level (hyperglycemia); slow onset; warm, dry
skin (from dehydration); and Kussmaul's respirations, which are deep and rapid
AND GRADED A+ ANSWERS
A 44-year-old woman was bitten on the ankle by an unidentified snake
while working in her garden. She is conscious and alert, has stable vital
signs, and denies shortness of breath. Her only complaint is a burning
sensation at the wound site. Your assessment reveals two small puncture
wounds, redness, and swelling. You should:
• A:conclude that envenomation likely did not occur, provide reassurance,
and allow a friend to take her to the hospital.
• B:give supplemental oxygen, splint her leg to decrease movement, and
keep her leg below the level of her heart.
• C:elevate her leg, cover the wound with a dry sterile dressing, and apply
an ice pack to reduce pain and swelling.
• D:administer high-flow oxygen, apply a constricting band proximal to the
bite, and use ice to prevent venom spread.
You selected B; This is correct!
Reason:Given the fact that the snake was not identified, you should assume that
it was poisonous. Furthermore, the presence of puncture wounds, burning,
redness, and swelling are suggestive of envenomation. Therefore, you should
provide emergency care and transport the patient to the hospital. Treatment for a
snake bite involves keeping the patient calm, administering oxygen, splinting
the affected extremity to decrease movement (helps slow the spread of venom),
keeping the extremity below the level of the heart, and transporting the patient
to the hospital. Do NOT apply ice to a snake bite; it may constrict the blood
vessels and force venom further into the bloodstream. The use of a proximal
,constricting band is controversial; if one is used, it should be loose, not tight. En
route to the hospital, monitor the patient's vital signs and mental status, and be
alert for vomiting.
A 34-year-old female complains of persistent fever, fatigue, and night
sweats. During your assessment, you note that she has purple blotches on
her arms and legs. She MOST likely has:
• A:HIV/AIDS.
• B:chickenpox.
• C:tuberculosis.
• D:viral hepatitis.
You selected A; This is correct!
Reason:Signs of human immunodeficiency virus (HIV) infection include
persistent fever, weight loss, fatigue, a cough, and night sweats. The presence of
purple skin blotches (malignant lesions called Kaposi's sarcoma) is consistent
with acquired immune deficiency syndrome (AIDS), also known as late stage
HIV infection. Patients with tuberculosis (TB) also present with fever, fatigue,
weight loss, a cough, and night sweats; however, skin lesions are not common.
Hepatitis is characterized by right upper quadrant abdominal pain, fever, nausea
and vomiting, and a yellow tint to the skin and sclera (jaundice). Chickenpox is
unlikely; the associated rash is characterized by pustules that crust over, not
purple blotches.
The daughter of an elderly patient states that her mother is acting confused
and talking incoherently. This nature of illness is MOST consistent with:
• A:diabetic complications.
• B:altered mental status.
• C:cardiac compromise.
• D:behavioral problems
,You selected B; This is correct!
Reason:The nature of illness is a category in which you place the patient based
on his or her chief complaint. A chief complaint of confusion and incoherent
speech suggests that altered mental status is the nature of illness. An altered
mental status can be caused by a variety of problems, including diabetic and
behavioral problems, and in some cases, cardiac problems.
Which of the following statements regarding heatstroke is correct?
• A:Heatstroke is caused by a hyperactive sweating mechanism.
• B:Not all patients experiencing heatstroke have dry skin.
• C:As core body temperature rises, the patient becomes more agitated.
• D:Heatstroke is more likely to occur when the humidity is low.
You selected B; This is correct!
Reason: Heatstroke occurs when the body is exposed to more heat than it can
eliminate and normal mechanisms for eliminating heat, such as sweating, are
overwhelmed. The core body temperature then rises rapidly to the point where
tissues are destroyed. Heatstroke can develop in patients during prolonged
vigorous physical activity or when they are in a closed, poorly ventilated, hot
and humid space. High humidity impairs a person's ability to eliminate heat via
the sweating mechanism. Many patients with heatstroke have hot, dry, flushed
skin; however, early in the course of heatstroke, the skin may be moist due to
residual perspiration, as with exertional heatstroke. As the core body
temperature rises, the patient's level of consciousness decreases. Untreated
heatstroke will result in death.
Law enforcement requests your assistance to evaluate a young female who
they believe has overdosed. The patient is conscious, is displaying bizarre
behavior, and is very restless. Her BP is 170/90 mm Hg and her heart rate
is 130 beats/min. You see needle tracks on both of her arms. She is MOST
, likely under the influence of a:
• A:benzodiazepine.
• B:sedative-hypnotic.
• C:powerful narcotic.
• D:methamphetamine.
You selected D; This is correct!
Reason:The needle tracks on the patient's arms indicate narcotic abuse, most
likely heroin; however, her signs and symptoms are not consistent with those
caused by a narcotic or any other central nervous system (CNS) depressant (eg,
benzodiazepine [a sedative-hypnotic]). Signs of CNS depression include a
decreased level of consciousness, hypoventilation, bradycardia, and
hypotension. Her signs and symptoms are consistent with a sympathomimetic
(upper) overdose. Sympathomimetic drugs mimic the effects of the sympathetic
(fight or flight) nervous system; therefore, restlessness or hyperactivity,
hypertension, tachycardia, and pupillary dilation are common findings in
patients who overdose. Amphetamine and methamphetamine (eg, ice, speed,
crack) are examples of sympathomimetics.
Which of the following signs and symptoms are MOST characteristic of
hyperglycemic ketoacidosis?
• A:Warm, dry skin and a slow onset
• B:Warm, dry skin and a rapid onset
• C:Cool, clammy skin and a rapid onset
• D:Cool, clammy skin and a slow onset
You selected A; This is correct!
Reason:Hyperglycemic ketoacidosis (diabetic coma) is characterized by a
dangerously high blood glucose level (hyperglycemia); slow onset; warm, dry
skin (from dehydration); and Kussmaul's respirations, which are deep and rapid
