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Quiz Session - Attempts With Random Questions

NREMT EMR Exam Questions

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1.

Several conditions result from atherosclerosis. Which of the following is not a condition that results from atherosclerosis?

  • Tension pneumothorax

  • Cardiac arrest

  • Angina pectoris

  • Myocardial infarction

Correct answer: Tension pneumothorax

A tension pneumothorax is not caused by atherosclerosis but by blunt or penetrating trauma to the chest. A tension pneumothorax occurs when air accumulates between the chest wall and the lung, increasing the pressure in the chest. With increased pressure, the amount of blood returning to the heart decreases.

Cardiac arrest, angina pectoris, and myocardial infarction can occur as a result of atherosclerosis. When a patient has atherosclerosis, layers of fat coat the inner walls of the arteries, causing a blockage and decreasing blood flow to the heart.

2.

You are an EMR who is called for a possible drowning in a lake. When you enter the water, you find the patient face down. You safely roll them over and assess their circulation, airway, and breathing. The patient has no pulse and is not breathing.

What is your next step?

  • Stabilize the head and neck and remove the patient from the water

  • Stabilize the head and neck and begin rescue breathing in the water

  • Stabilize the head and neck and begin chest compressions in the water

  • Stabilize the head and neck and wait for your partner to assist you in the water

Correct answer: Stabilize the head and neck and remove the patient from the water

When a patient is in the water and has experienced cardiac arrest, stabilize the head and neck and remove the patient from the water. The patient needs CPR, which can only be effective once the patient is removed from the water and placed on a hard surface. Always suspect a spinal injury if a patient is unconscious in the water.

Since the patient is in cardiac arrest, they need to be removed from the water, and CPR needs to be performed. If the patient had a pulse, rescue breaths would be performed in the water.

Chest compressions are needed, but they cannot be administered in the water. The patient needs to be placed on a hard surface.

The patient needs to be removed from the water immediately. You do not have time to wait for your partner to assist you.

3.

Your EMS unit is dispatched to a home two blocks from your station for a choking infant. Upon your arrival, a young woman runs out of the house holding a conscious infant who is in obvious respiratory distress and unable to breathe. The woman explains she is babysitting, and she saw the infant's brother put something in the infant's mouth. Before she could see what it was, the baby started choking. You assess the infant's airway and determine there is no air exchange.

How should you begin treating this patient?

  • Perform five back slaps followed by five chest thrusts, continuing until the object is dislodged or the infant becomes unconscious

  • Perform five chest compressions followed by five back slaps, continuing until the object is dislodged or the infant becomes unconscious

  • Perform five chest thrusts followed by five back slaps, continuing until the object is dislodged or the infant becomes unconscious

  • Perform five back slaps followed by five abdominal thrusts, continuing until the object is dislodged or the infant becomes unconscious

Correct answer: Perform five back slaps followed by five chest thrusts, continuing until the object is dislodged or the infant becomes unconscious

With the infant facedown on your forearm and their head lower than their trunk, deliver five back slaps forcefully between the infant's shoulder blades. Turn the infant over, faceup, with their head lower than their trunk. Using two fingers, deliver five chest thrusts in the middle of the sternum. Continue these steps until the foreign object is expelled or the patient becomes unconscious.

Only do chest compressions if the patient is or becomes unconscious.

When a conscious infant has a complete airway obstruction, start with back slaps, not chest thrusts.

Abdominal thrusts are not indicated for an infant. Their internal organs are still developing and susceptible to injury.

4.

You are dispatched to an 18-year-old male who has been "huffing" and is complaining of difficulty breathing and chest pain.

What does the term "huffing" mean?

  • Intentionally inhaling volatile chemicals

  • Hyperventilating into a paper bag

  • Smoking marijuana from a bong

  • Smoking crack cocaine from a crack pipe

Correct answer: Intentionally inhaling volatile chemicals

The term "huffing" refers to a person intentionally inhaling volatile chemicals from a plastic bag. The volatile chemicals can be bought in hardware stores or gas stations, such as gasoline, paint thinners, spray paint, lacquers, and cleaning compounds. When the chemical is "huffed," the user can experience chest pain, difficulty breathing, unconsciousness, seizures, and cardiac arrest. 

Huffing does not refer to hyperventilating in a paper bag, smoking marijuana from a bong, or smoking crack cocaine from a crack pipe,

5.

During two-rescuer CPR on an adult patient, what is the ratio of compressions to ventilations?

  • 30:2

  • 15:2

  • 30:1

  • 5:1

Correct answer: 30:2

In two-rescuer CPR on an adult patient, one rescuer will provide 30 compressions. After 30 compressions are completed, the second rescuer will provide 2 ventilations.

The ratio 15:2 is used for infants and children when two rescuers are providing CPR.

One ventilation will not deliver enough oxygen to the patient.

6.

A 63-year-old male was coaching a baseball game and collapsed. En route, dispatch advises that CPR is in progress. Upon your arrival, you notice a bystander is performing chest compressions, but they are not compressing the chest as deeply as they should.

How deeply should compressions be administered on this patient?

  • At least 2 inches

  • At least 1 inch

  • At least 1.5 inches

  • At least 3 inches

Correct answer: At least 2 inches

When performing CPR on an adult patient, the compression depth must be at least 2 inches for CPR to be effective. Adults are larger than children and infants, with larger organs and thoracic cavities. A depth of at least 2 inches is necessary to circulate the blood and oxygen throughout the patient's body. Allow the chest to recoil in between compressions to allow maximum blood filling in the patient's heart.

If compressions are under 2 inches, CPR is not as effective, and the patient's chance of survival is diminished.

A compression depth of at least 3 inches is too deep and can cause further harm to the patient. 

7.

When using a spring-loaded center punch to break a window, where do you place the punch?

  • In the lowest corner of the window

  • In the highest corner of the window

  • In the center of the window

  • In the top-middle portion of the window

Correct answer: In the lowest corner of the window

A spring-loaded center punch should be placed in the lowest corner of the window to keep the glass from shattering. When it is used in the lowest corner of the window, the glass should break but stay intact until it is removed by gloved hands.

When the punch is used in any other location, the glass will break and fall onto any patients who may be in the vehicle. It is recommended to use the punch to break windows that are away from any patients, if possible.

8.

Which of the following is not a sign of effective CPR on an adult patient?

  • A radial pulse is felt during chest compressions.

  • The patient's skin color improves.

  • The patient's chest rises during ventilation.

  • Compressions and ventilations are delivered at the appropriate rate and depth.

Correct answer: A radial pulse is felt during chest compressions.

Knowing the signs of effective CPR allows the rescuer to assess their efforts while resuscitating the patient. If CPR is not being performed correctly, efforts will be wasted, and the patient's chance of survival decreases. One sign that does not indicate effective CPR is a radial pulse that is felt during chest compression. Do not check the radial pulse during compressions; instead, check the carotid pulse of an adult patient.

Other signs of effective CPR are as follows: 

  • an improvement in the patient's skin color (from blue to pink)
  • the chest visibly rising during ventilation
  • compressions and ventilations occurring at the appropriate rate and depth

If these signs are not present,  reevaluate the patient's airway, the rescuer's hand position, and the rate and depth of compression.

9.

You are helping treat a patient with a CHF exacerbation. She is alert and oriented. In what position should you place this patient? 

  • Sitting upright 

  • Supine 

  • Recovery position 

  • Semi-Fowler position 

Correct answer: Sitting upright 

Patients with congestive heart failure (CHF) exacerbation often have pulmonary edema and difficulty breathing. Placing the patient upright in a sitting position is required to help them breathe. 

Laying them supine or in the recovery position may worsen the symptoms. A semi-Fowler position (laying flat with head elevated at a 45-degree angle) would still make it difficult to breathe, and it would be best to place her upright. 

10.

A 21-year-old female patient cut her finger while slicing tomatoes. When you arrive, the patient is holding her hand under the kitchen faucet. When you look at her finger, you notice the patient sliced down the side of her finger, and a piece of skin is torn away from the finger and is hanging like a flap.

What is this type of injury called?

  • An avulsion

  • An amputation

  • An abrasion

  • A puncture

Correct answer: An avulsion

An avulsion is a type of injury characterized by the tearing away of body tissue. The avulsion may be completely severed from the body or attached by a flap of skin. Avulsions can involve small or large amounts of tissue. If an entire body part is torn away, the wound is called a traumatic amputation.

An abrasion is when the skin is rubbed against a rough surface (e.g., when a person falls and skins their knee).

A puncture wound is caused by a sharp object that penetrates the skin, such as a stab or gunshot wound.

11.

A patient had chemicals splashed in their eyes. For how long should you flush their eyes?

  • For at least 20 minutes

  • For at least 2 minutes

  • For at least 5 minutes

  • For at least 10 minutes

Correct answer: For at least 20 minutes

Chemicals can cause extreme pain and severe eye injuries, including blindness, so you should flush the eyes for a considerable time. Gently flush the eyes while holding them open so the water reaches the entire surface. It is recommended to flush from the inner corner of the eye to the outward edge to avoid contaminating the other eye, but when both eyes are affected, this is difficult to do. Thus, it is recommended to put the patient's face under a shower, faucet, or garden hose so the water flows across the patient's face and eyes.

Any time less than 20 minutes is not recommended. The patient needs copious amounts of water to flush their eyes, and you should flush for at least 20 minutes while on scene. During transport, continue flushing the patient's eyes.

12.

Which type of CPR is preferable to administer?

  • Two-rescuer CPR

  • One-rescuer CPR

  • Three-rescuer CPR

  • Four-rescuer CPR

Correct answer: Two-rescuer CPR

Two-rescuer CPR is preferred because it is less exhausting for the rescuers. One-rescuer CPR can be physically exhausting in a short amount of time. Two-rescuer CPR allows a switch of positions every two minutes.

One-rescuer CPR can still be beneficial to an unresponsive patient, but the rescuer may not be able to maintain CPR for as long as two rescuers can.

Three- or four-rescuer CPR is not taught in CPR classes, only one- and two-rescuer CPR is taught. However, if there are more than two rescuers who are trained in CPR, they can switch positions with the first two rescuers. 

13.

What do emergency lights and sirens allow an EMR to do?

  • Allows the EMR to request the right of way

  • Allows the EMR to ignore traffic laws

  • Allows the EMR to have the right of way

  • Allows the EMR to drive as fast as they want

Correct answer: Allows the EMR to request the right of way

Emergency lights and sirens only allow the EMR to request the right of way, but it does not guarantee other drivers will yield or pull over. An EMR must know the state laws for operating a vehicle with emergency lights and sirens.

Traffic laws cannot be ignored when using emergency lights and sirens. You may be able to run a red light after stopping and clearing the intersection, but traffic laws still apply to those driving emergency vehicles.

Emergency lights and sirens do not allow the EMR to have the right of way but to request the right of way.

EMRs cannot drive as fast as they want just because they are operating emergency lights and sirens. Traffic laws still need to be followed.

14.

What specially constructed bag contains a rope that can be thrown to a distressed person in the water?

  • A rescue throw bag

  • A lifesaving throw bag

  • A first-responders bag

  • A rope rescue bag

Correct answer: A rescue throw bag

Personnel who use a rescue throw bag need to be trained and practice before using it for a distressed person in the water. The bag consists of a rope that is loosely packed into the bag so the rope can unwind from the top of the bag when the bag is thrown to a person.

The bag is not called a lifesaving throw bag, a first-responders bag, or a rope rescue bag.

15.

Which type of fire extinguisher is recommended for an EMR's life support kit?

  • A 5 lb ABC dry chemical fire extinguisher

  • A 5 lb water fire extinguisher

  • A 5 lb carbon dioxide (CO2) fire extinguisher

  • A 5 lb AB foam fire extinguisher

Correct answer: A 5 lb ABC dry chemical fire extinguisher

An EMR's life support kit should contain a 5 lb ABC dry chemical fire extinguisher. This versatile type can extinguish Classes A, B, and C fires. Class A extinguishers will put out fires involving ordinary combustibles such as wood and paper. Class B extinguishers are used on flammable liquids like grease, gasoline, and oil. Class C extinguishers are suitable for use only on electrically energized fires. Class D extinguishers are designed for use on flammable metals.

A water fire extinguisher can only fight Class A fires. EMRs need to carry a more versatile fire extinguisher.

Carbon dioxide (CO2) fire extinguishers fight Classes B and C fires, not Class A.

Foam fire extinguishers are only used on Classes A and B fires.

16.

Physiologically, how is a pulse generated?

  • As the heart contracts, it sends a pressure wave through the artery.

  • As the heart circulates, it sends a pressure wave through the artery.

  • As the heart contracts, it sends a pressure wave through the vein.

  • As the heart dilates, it sends a pressure wave through the vein.

Correct answer: As the heart contracts, it sends a pressure wave through the artery.

The arterial pulse is generated as the heart contracts, sending a pressure wave through the artery. Arterial pulse is the rhythmic contraction and expansion of an artery due to a surge of blood, which is generated by each heartbeat pushing a wave of blood into circulation.

The heart itself does not circulate. Blood, nutrients, and oxygen circulate throughout the body as part of the circulatory system.

The pulse felt in a patient is an arterial pulse. A pulse is not felt through a vein. 

17.

What carries oxygenated blood from the lungs to the heart?

  • Pulmonary veins and venules

  • Pulmonary arteries and venules

  • Pulmonary veins and arteries

  • Pulmonary capillaries and venules

Correct answer: Pulmonary veins and venules

The pulmonary venules surround the alveolus of the lungs and carry oxygen-rich blood. The pulmonary venules connect the capillaries to the pulmonary vein, directing the oxygen-rich blood from the capillaries to the pulmonary vein toward the heart.

The pulmonary artery carries deoxygenated blood away from the right ventricle to the lungs.

Arteries carry oxygenated blood away from the heart, while pulmonary veins carry blood to the heart.

Pulmonary capillaries are the junction points between the pulmonary arteries and the pulmonary veins.

18.

What is an example of an airway adjunct?

  • An oral airway

  • A bag-mask device

  • A non-rebreather mask

  • A nasal cannula

Correct answer: An oral airway

Airway adjuncts are used to maintain an open airway in a patient who cannot manage their airway. Two examples are an oral airway and a nasal airway. An oral airway is only used for unresponsive patients without a gag reflex. A nasal airway can be used for conscious or unconscious adults with or without a gag reflex. Nasal airways can be used for children by a trained healthcare provider, but EMRs do not typically have this skill in their scope of practice.

Bag-mask devices, non-rebreather masks, and nasal cannulas are pieces of oxygen delivery equipment that provide supplemental oxygen or ventilation.

19.

You are assessing an unconscious male who fell from a three-story building while working on his roof. He struck his head on the concrete and has severe head trauma. He has grunting respirations and a gag reflex but cannot manage his airway alone. Firefighters have already performed the jaw-thrust maneuver and implemented spinal precautions.

What is the next step in managing this patient's airway?

  • Call medical control to see if they advise placing a nasal airway

  • Measure an appropriately sized nasal airway and place it in the patient's nostril

  • Place a nasal cannula on the patient at six liters per minute

  • Measure an appropriately sized oral airway and place it in the patient's mouth

Correct answer: Call medical control to see if they advise placing a nasal airway

If a patient has sustained severe head trauma, the insertion of a nasal airway could further damage their brain. Call medical control to see what they advise in this situation. If they do not want you to insert a nasal airway, manage the airway using a bag-mask device or a non-rebreather mask, depending on the patient's respiratory rate.

If the patient did not have severe head trauma, you would measure an appropriately sized nasal airway and place it in the patient's nostril.

 A patient with severe head trauma needs high concentrations of oxygen. A nasal cannula is not helpful in this scenario.

The patient has a gag reflex, so an oral airway is contraindicated.

20.

When a person is physically dependent on alcohol and they are suddenly deprived of it, they can develop severe withdrawal symptoms called delirium tremens. 

How soon after a person stops drinking alcohol does delirium tremens first appear?

  • Three to four days

  • One to two days

  • Three to four hours

  •  One week

Correct answer: Three to four days

Delirium tremens usually appears three to four days after a person stops drinking alcohol. It can be fatal if the person is not medically treated and observed and causes shaking, confusion, restlessness, seizures, chest pain, fevers, gastrointestinal distress, and hallucinations.

Delirium tremens can last for 10 days.

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