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Quiz Session - Attempts With Random Questions

NREMT AEMT Exam Questions

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1.

You respond to a 911 call for a male who has overdosed on heroin. Upon arrival, you find him unresponsive, pulseless, and apneic. What action should you take first?

  • Begin chest compressions

  • Place the AED and power it on

  • Begin bag-mask ventilations

  • Administer Narcan (nalaxone) IN

Correct answer: Begin chest compressions

The most important factor in cardiac arrest is effective chest compressions. An AED should be placed, but chest compressions should begin while it is being placed. Narcan will help reverse the opioid effects, but the patient has progressed into cardiac arrest and Narcan will not be a priority before chest compressions. Deliver two breaths with a bag mask device after 30 compressions. 

2.

Which of the following treatments will increase preload?

  • Administration of an IV fluid bolus

  • Administration of nitroglycerin 

  • Administration of aspirin

  • Administration of oxygen 

Correct answer: Administration of a fluid bolus

Preload is the amount of blood returning to the heart. A fluid bolus will help to increase preload, which helps to raise blood pressure. IV fluid boluses can be helpful when treating hypotension. Nitroglycerin reduces afterload, which reduces blood pressure. Aspirin and oxygen have no impact on blood pressure or preload. 

3.

Scene

You are on scene, and the ambulance is having trouble getting close due to the crowd and will need several minutes to reach your location. Which of the following would be the most appropriate action in this scenario?

  • Move the patient to a sheltered area near your location

  • Walk with the patient through the open grandstand area to meet the ambulance

  • Stay with the patient until the ambulance can get closer

  • Walk with the patient to the first aid booth, so he can be released from care

Correct answer: Move the patient to a sheltered area near your location

The AEMT should avoid objects that project up from the ground to prevent injury from subsequent lighting strikes. The patient is alert and does not require immediate life-saving interventions, so moving this patient to the sheltered area until the ambulance arrives is the appropriate choice. You should not release this patient until you can perform a secondary assessment. He may have injuries not immediately apparent that should be evaluated further.

4.

Which of the following is called persistent nausea and vomiting during pregnancy?

  • Hyperemesis gravidarum

  • Lightening

  • Morning sickness

  • Preeclampsia

Correct answer: Hyperemesis gravidarum

Hyperemesis gravidarum is a condition of persistent nausea and vomiting during pregnancy.

Lightening is movement of the fetus down into the pelvis prior to birth. Morning sickness is nausea and vomiting that occurs during pregnancy. And, despite its name, morning sickness can strike at any time of the day or night. Many pregnant women have morning sickness, especially during the first trimester. Preeclampsia is a condition during pregnancy characterized by hypertension, protein in the urine, and edema. It is a precursor to eclampsia.

5.

A 27-year-old female is in late shock secondary to blunt thoracic trauma. Her respirations are shallow at a rate of 8 breaths/min. Which of the following would you expect to see?

  • Carbon dioxide retention and acidosis

  • Oxygen deficiency and alkalosis

  • Oxygen deficiency and increased pH

  • Carbon dioxide retention and alkalosis

Correct answer: Carbon dioxide retention and acidosis

Decreased respiration leads to retention of carbon dioxide, increased carbonic acid, and acidosis. Hypoventilation due to airway obstruction, cardiac arrest, opioid overdose, pulmonary edema, or chest or head injury can quickly devolve into a life-threatening acidosis. Signs of life-threatening respiratory distress in adults include altered mental status, severe cyanosis, absent or abnormal breath sounds, 2-3 word dyspnea, coughing, tachycardia, pallor, diaphoresis, and tripod-posturing.

Assisted ventilations in an adult with a pulse should be administered every 5-6 seconds and every 3-5 seconds for a child or infant.

6.

What is the best position to place a conscious patient with suspected acute myocardial infarction?  

  • A position of comfort

  • Semi-fowlers

  • Supine

  • Left lateral recumbent 

Correct answer: A position of comfort

Patients experiencing an Acute Myocardial Infarction (AMI) need physical and emotional rest. They should be placed in a position of comfort. This helps reduce the anxiety and catecholemine release that often accompanies a heart attack. Semi-fowlers is placing a patient on their back with the head elevated 45 degrees. This is not always the most comfortable position for a patient having an AMI. Supine is lying flat on the back, and may not be comfortable for the patient having an AMI. Left lateral recumbent is the recovery position, and should be used for unresponsive but breathing patients without suspicion of cervical spine injury. 

7.

What is the most important reason for applying an AED as quickly as possible?

  • To improve the chances of converting ventricular fibrillation

  • To improve the chances of converting asystole

  • To determine that the patient is in cardiac arrest

  • To determine if the patient has a pulse.

Correct answer: To improve the chances of converting ventricular fibrillation

One of the links in the chain of survival is early defibrillation. Ventricular fibrillation is often present in sudden cardiac arrest in adults, and the earlier this rhythm is converted to a normal rhythm, the higher the chances of survival. Asystole is the absence of electrical activity in the heart which cannot be converted by an AED. An AED cannot determine the presence of a pulse or cardiac arrest, the EMS provider must verify pulselessness before applying the AED. 

8.

Which of the following is the natural, intrinsic pacemaker of the heart?

  • Sinoatrial node 

  • Atrioventricular node

  • Atrioventruclar bundle 

  • Perkinje fibers

Correct answer: Sinoatrial node 

The Sinoatrial node (SA node) is the the heart's natural pacemaker and has an intrinsic rate of 60 to 100 beats per minute. If the SA node fails, the Atrioventricular (AV) node, the artiventrocular bundle, or perkinje fibers in the ventricles can assume the pacemaker role of the heart. 

9.

Damage to cellular tissue as a result of excessive oxygen levels in the blood is called which of the following?

  • Oxygen toxicity

  • Decompression sickness

  • Nitrogen narcosis

  • Subcutaneous emphysema

Correct answer: Oxygen toxicity

Administration of oxygen to patients is a common practice, though many patients do not benefit from it. Oxygen toxicity refers to damage to cellular tissue resulting from excessive oxygen levels in the blood.

Increased oxygen levels contribute to production of free radicals, resulting in tissue damage and cellular death in some patients. Use caution with administration of oxygen therapy, understanding that hypoxemia is much worse than oxygen toxicity, so when in doubt, if you are unable to measure oxygen saturation reliably and the patient has the potential for hypoxia, provide supplemental oxygen. Follow local protocols.

Decompression sickness is caused by ascending too fast in SCUBA diving. It is also called "the bends." 

Nitrogen narcosis is a change in consciousness, neuromuscular function, and behavior brought on by breathing compressed inert gasses. It has also been called depth intoxication, “narks,” and rapture of the deep.

Subcutaneous emphysema occurs when air becomes trapped under the skin. It is often the result of a pneumothorax or trauma to the airway. 

10.

You respond to a 911 call for an adult male unresponsive. Your patient is a 50-year-old male found outside in his driveway with air temperatures below freezing. It is unknown how long he has been down. A rapid exam reveals no signs of trauma, he is unresponsive, pulseless, and apneic. His pupils are fixed and dilated. What is the most appropriate action? 

  • Quickly move him to the ambulance and begin CPR 

  • Begin CPR and place an AED 

  • Contact medical control for permission to withhold resuscitation attempts

  • Quickly move him to the ambulance and begin active rewarming

Correct answer: Quickly move him to the ambulance and begin CPR 

Fixed and dilated pupils, and unknown down time are not indications to withhold CPR in a patient with hypothermia. Quickly moving this patient to the ambulance and beginning CPR is the most appropriate action. While resuscitation is underway, attempt to obtain his core body temperature. Active rewarming may be started while CPR is occurring if protocols allow. Place an AED as soon as possible and defibrillate as indicated. 

11.

Your patient presents with a chronic cough, wheezing, and cyanosis. What disease or condition do you expect your patient is suffering?

  • Bronchitis 

  • Asthma 

  • Anaphylaxis 

  • Heart failure 

Correct answer: Bronchitis

Bronchitis is characterized by a chronic productive cough with a copious amount of sputum produced due to the chronic inflammation of the bronchial tubes. Bronchitis will also present with wheezing lung sounds and cyanosis as air exchange is hindered due to restricted air movement.

Asthma is a reactive airway condition that environmental factors like pollen and pollutants can exacerbate. Patients with asthma present with wheezing and, at times, coughing. What makes this different than bronchitis is that coughing associated with asthma is not chronic.

Anaphylaxis occurs when the body has an inappropriate inflammatory response to an allergen. This response results in flushed skin, hives, edema, and wheezing. Anaphylaxis is an acute condition and not associated with a chronic cough.

Heart failure is a condition where the heart cannot adequately pump blood, resulting in edema in the extremities and the lungs (pulmonary edema). Pulmonary edema results in "crackles" being heard in the lungs, not wheezing. Coughing is not a sign or symptom that heart failure patients often report.

12.

Which of the following is an indication of adequate artificial ventilation?

  • Pulse rate returns to normal.

  • Minimal or no chest rise and fall.

  • Breath sounds cannot be heard during auscultation.

  • Skin color is cyanotic.

Correct answer: Pulse rate returns to normal range

When evaluating the effectiveness of artificial ventilations, look for visible and equal chest rise and fall, breath sounds that can be heard during auscultation, ventilations being delivered at an appropriate rate (for age), pulse rate that returns to the normal range, skin color that improves, and oxygen saturation levels that improve.

13.

Which of the following is not a pediatric lower airway emergency?

  • Epiglottitis 

  • Bronchiolitis

  • Asthma 

  • Pneumonia

Correct answer: Epiglottitis 

Epiglottitis is inflammation of the epiglottis, which is considered the upper airway. Asthma, bronchiolitis, and pneumonia are all pediatric lower airway emergencies. 

14.

Which of the following is the main reason to use a CPR feedback device during a resuscitation?

  • To help ensure an adequate rate and depth of chest compressions

  • To help keep track of total code time

  • To determine if there is a pulse 

  • To determine times for ventilations

Correct answer: To help ensure an adequate rate and depth of chest compressions

CPR feedback devices help rescuers ensure they are proving chest compressions at the adequate depth and rate. They do not indicate timing for ventilations, nor do they indicate the presence of a pulse. 

15.

What is the treatment for a newborn whose heart rate is less than 100 bpm?

  • Provide positive pressure ventilation with a blend of air and oxygen for 30 seconds, and reassess

  • Provide positive pressure ventilation with 100% oxygen for 2 minutes, and reassess

  • Provide positive pressure ventilation with 100% oxygen for 10 seconds, and reassess

  • Provide positive pressure ventilation with 100% oxygen for 15 seconds, and reassess

Correct answer: Provide positive pressure ventilation with a blend of air and oxygen for 30 seconds, and reassess

In the case of a newborn who is not breathing or whose heart rate is less than 100 bpm, immediate positive pressure ventilation with a blend of air and oxygen is recommended. After 30 seconds of effective ventilation, if the heart rate reaches at least 100 beats per minute and the infant is breathing adequately, the ventilation can be stopped to assess the newborn's condition further. If the newborn's heart rate remains less than 60 bpm, continue ventilation and begin chest compressions.

16.

The physiologic process of heat production is called which of the following?

  • Thermogenesis

  • Thermoregulation

  • Thermolysis

  • Convection

Correct answer: Thermogenesis

Thermogenesis is the physiologic process of heat production.

Thermoregulation is the balance between heat production and heat loss. Thermolysis is the process of heat loss. Convection is one method of thermolysis.

17.

You and your partner are manually ventilating an asthma patient on the verge of respiratory arrest. As you ventilate this patient, what should you consider regarding the ventilation rate?

  • Ventilate slower than usual to avoid auto-PEEP

  • Hyperventilate the patient 

  • Ventilate at the usual rate 

  • Manual ventilation is not recommended for this patient

Correct answer: Ventilate slower than usual to avoid auto-PEEP

Auto-PEEP occurs in patients that are being mechanically or manually ventilated. Auto-PEEP is also referred to as breath stacking and occurs when the patient receives another breath before completely exhaling the last one. Breath stacking is dangerous and can cause significant pressure in the lungs, resulting in a pneumothorax and tension pneumothorax. Auto-PEEP can also cause a considerable decrease in venous return to the heart if the intrathoracic pressure in the chest exceeds the pressure of the blood returning to the heart. These principles are fundamental in patients with reactive airway diseases like asthma and COPD (Chronic Obstructive Pulmonary Disease). Both of these diseases make exhalation difficult for the patient. It may seem counterintuitive, but ventilating these patients at a slower rate is more beneficial.

Hyperventilating the patient is incorrect. There are very few times in EMS (Emergency Medical Services) that hyperventilation benefits the patient. Patients with reactive airway disease require slower ventilations. Slower ventilations allow the patient to complete exhalation before receiving another breath. Slower ventilations reduce the chances of pneumothorax and decrease venous return to the heart.

Ventilating a patient with reactive airway disease at the normal rate is likely to cause Auto-PEEP. Auto-PEEP occurs when a breath is administered to a patient when they have not wholly exhaled their last breath. This concept is fundamental in patients with reactive airway disease who have difficulty with exhalations.

Patients with significant respiratory fatigue, bordering on respiratory failure, must receive manual or mechanical ventilation. When ventilating reactive airway disease patients, you must ventilate slower than you usually would. Doing so allows the patient to exhale entirely before receiving another breath and will reduce the risk of Auto-PEEP.

18.

Post-Scene

Which of the following treatments should have been provided at the scene for the firefighter in this scenario?

Select the 3 answer options that are correct.

  • Administer chewable aspirin

  • Small IV fluid bolus

  • Administer oxygen 

  • 1000 mL IV fluid bolus

  • Administration of epinephrine IV

  • Administer sublingual nitroglycerin

In this scenario, the firefighter has signs and symptoms consistent with acute coronary syndrome (ACS). Treatments should include aspirin, IV insertion, and oxygen.

A small fluid bolus may be beneficial because he may be dehydrated. However, fluid boluses in patients with STEMI should be used cautiously, as they can overload the circulatory system and worsen the condition. During transport, monitor his vital signs closely.

There is no indication of administering epinephrine to this patient. AEMTs may only administer epinphrine IV to a patient in cardiac arrest (if local protocols allow). AEMTs can assist with nitroglycerin administration, but this patient is not prescribed nitroglycerin.

19.

Hypoglycemia in a neonate patient would be a blood glucose level below which value?

  • 20 mg/dL

  • 60 mg/dL

  • 30 mg/dL

  • 100 mg/dL

Correct answer: 20 mg/dL

In the first one to two hours after delivery, a healthy neonate may have a blood glucose level of 30 mg/dL, increasing to 45 mg/dL 12 hours after birth. Hypoglycemia in a newborn is a blood glucose level below 20 mg/dL. 

20.

Medical treatment of patients occurs in which control zone at a HAZMAT incident? 

  • The cold zone 

  • The warm zone 

  • The hot zone 

  • The treatment sector 

Correct answer: The cold zone 

At a HAZMAT incident, control zones are established to limit access and help reduce exposures. The hot zone is the area immediately surrounding the released material, and only specially trained responders with proper PPE are permitted. The warm zone serves as a transition between the hot and cold zone, and is where decontamination should occur. The cold zone is the area that is safe, and does not require PPE. The command post is established in the cold zone, and patients or responders will be decontamined before entering the cold zone. Any medical treatment will occur in the cold zone, after decontamination. The treatment sector is not a control zone for a HAZMAT incident, but it is established in a mass casualty incident. 

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