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Quiz Session - Attempts With Random Questions

NREMT EMR Exam Questions

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21.

An adult patient has ingested a poisonous substance that is not an acid, a base, or a petroleum-based product. What is the normal dose of activated charcoal in this case?

  • 25 to 50 grams

  • 12.5 to 25 grams

  • 15 to 35 grams

  • 20 to 40 grams

Correct answer: 25 to 50 grams

When activated charcoal is given to an adult patient who has ingested a poisonous substance that is not an acid, a base, or a petroleum-based product, the normal dose is 25 to 50 grams. Activated charcoal is a finely ground powder that is mixed with water and given by mouth. The charcoal binds to the poison and prevents it from being absorbed into the digestive tract. Activated charcoal is only administered if local protocols and training allow. 

The dose for a pediatric patient is 12.5 to 25 grams, which is half of an adult dose.

22.

If you have not been trained to remove a poisonous substance from a patient's skin, who should you call for assistance?

  • A hazardous materials team

  • A chemical control team

  • A poison control team

  • A chemical materials team

Correct answer: A hazardous materials team

If a patient has a poisonous substance on their skin and you have not been trained to remove it, call a hazardous materials (HAZMAT) team. A HAZMAT team has special training to remove poisonous substances safely from patients' skin without putting the first responders in danger. 

Chemical control and materials teams are fictitious names.

A poison control team offers assistance to callers at a poison control center.

23.

You are called to a residential living facility for an unresponsive 88-year-old female. Upon arrival, you find the patient pulseless and not breathing on her couch, with no signs of trauma. You and your partner move the patient to the floor to start CPR. Your partner starts compressions while you perform a head tilt-chin lift maneuver. The patient has intact dentures in place.

Which of the following should be done before ventilating the patient?

  • Leave the dentures in place

  • Remove the dentures

  • Perform a finger sweep

  • Suction the patient's mouth

Correct answer: Leave the dentures in place

When dentures are intact and not loose in the mouth, leave them in place. Firmly attached dentures make a better seal between the patient's mouth and the breathing device, offering better ventilation.

Only remove dentures when they are loose or dislodged to prevent them from obstructing the airway while providing ventilation. If dentures are removed, place them in a safe spot so they will not get lost or damaged.

Performing a finger sweep or suctioning the patient's mouth is not indicated. If you perform ventilation and receive resistance, a finger sweep or suctioning would be necessary. 

24.

You are an off-duty EMR enjoying a day at the beach. While swimming, you notice a surfer who has fallen off her board and is lying facedown in the water. After turning her onto her back using the proper technique, you assess that she has a pulse but is not breathing after you open the airway. You determine the patient needs rescue breaths, and you are in waist-deep water.

What is your next step?

  • Begin rescue breaths in the water

  • Drag the patient onto shore and begin rescue breathing

  • Drag the patient onto shore and call 911 before starting rescue breathing

  • Begin rescue breathing once you have placed the patient on a hard surface

Correct answer: Begin rescue breaths in the water

If a patient in the water has a pulse and is not breathing after the airway is opened, begin rescue breaths in the water. The quicker you start rescue breathing, the quicker the patient will be receiving oxygen, which increases the chance of survival. After 4 to 6 minutes without oxygen, brain damage begins. Rescue breathing can be performed in the water at any depth, but ventilation will be easier if you can stand on the bottom of the body of water.

Dragging the patient onto shore would delay the patient receiving oxygen, so rescue breathing in the water is preferred.

If you dragged the patient to shore and called 911 first, it would delay rescue breaths even longer.

Before starting CPR, the patient would need to be on a hard surface. However, rescue breathing should be started in the water to increase the patient's chance of survival.

25.

How many emotional phases occur in response to a situational crisis?

  • Four

  • Two

  • Three

  • Five

Correct answer: Four

There are four emotional phases in a situational crisis. Not every person will experience every emotional phase, but they will certainly experience one or more of them. Understanding the different phases will allow you to help people who are experiencing a behavioral crisis.

The first phase is high anxiety or emotional shock. The second phase is denial, the third is anger, and the fourth is remorse or grief.

26.

Approximately how much blood loss occurs during normal childbirth?

  • Approximately 1 to 2 cups

  • Approximately 1/2 to 1 cup

  • Approximately 2 to 3 cups

  • Approximately 3 to 4 cups

Correct answer: Approximately 1 to 2 cups

During normal childbirth, approximately 1 to 2 cups of blood is lost. In addition to this blood loss, the patient may also have a small amount of blood in the bloody show, when the mucus plug is released.

Anything greater than 2 cups of blood loss suggests hemorrhaging. If the patient is bleeding heavily, place sanitary pads at the vaginal opening, treat the patient for shock, and arrange rapid transport by ambulance to the closest medical facility.

27.

You are assessing a patient's breathing rate using the START triage method. What breathing rate would earn the patient a Priority 1 red tag?

  • A breathing rate of greater than 30 breaths per minute

  • A breathing rate of greater than 20 breaths per minute

  • A breathing rate of greater than 28 breaths per minute

  • A breathing rate of greater than 40 breaths per minute

Correct answer: A breathing rate of greater than 30 breaths per minute

When assessing a patient's breathing rate using the START triage method, a breathing rate above 30 breaths per minute would earn the patient a Priority 1 (red) tag. Patients who are breathing at a rate of greater than 30 breaths per minute are displaying one of the primary signs of shock and need immediate care.

If a patient presents with a breathing rate of 20 to 28 breaths per minute, they are still within the normal range and will be assessed for their circulation and mental status before receiving a triage tag.

When a patient has a breathing rate of over 40 breaths per minute, they will definitely be assigned a red triage tag. However, a breathing rate above 30 breaths per minute is the guideline in the START triage method.

28.

When does a scene size-up begin? 

  • With dispatch 

  • Upon first arrival at the scene 

  • During the primary survey

  • Upon all responders' arrival at the scene 

Correct answer: With dispatch 

As soon as the dispatcher tells you of the incident, begin to plan for what you may encounter upon arrival. This is the first part of a scene size-up. 

A scene size-up may occur in all the choices listed but begins with the dispatch. 

29.

You are at the scene of a vehicle accident with major front-end damage. How do you reduce the risk of the vehicle's battery causing an electrical short circuit?

  • Turn off the vehicle's ignition

  • Turn off the vehicle's radio

  • Disconnect the positive battery cable

  • Disconnect the negative battery cable

Correct answer: Turn off the vehicle's ignition

To reduce the risk of an electrical short circuit, turn off the vehicle's ignition to cut the power. Turning off the ignition also protects the patient, rescuers, and bystanders by keeping the car still.

Turning off the vehicle's radio only cuts power to the radio, not to the electrical system.

Do not disconnect either of the battery cables unless you have been properly trained and have the right tools. Battery acid leakage could harm anyone trying to disconnect the battery. The quickest and safest thing to do is turn off the vehicle's ignition.

30.

You are performing CPR on an older female who collapsed at a grocery store. You are an off-duty EMR who witnessed the collapse, and you have asked a bystander to call 911. Another bystander offers to help, and you instruct them to find a store manager and obtain an AED if available. Within minutes, an AED is available, and the store manager says he is CPR-trained and wants to help. You ask him to take over compressions while you open the AED.

Where should you place the AED pads?

  • One to the right of the breastbone just below the collarbone and the other on the left lower chest with the top of the pad 2 to 3 inches below the armpit

  • One to the left of the breastbone just below the collarbone and the other on the left lower chest with the top of the pad 2 to 3 inches below the armpit

  • One to the right of the breastbone just below the collarbone and the other on the right lower chest with the top of the pad 2 to 3 inches below the armpit

  • One to the right of the breastbone just below the collarbone and the other on the patient's left back

Correct answer: One to the right of the breastbone just below the collarbone and the other on the left lower chest with the top of the pad 2 to 3 inches below the armpit

Every AED manufacturer is different. Make sure to follow their directions for use regarding AED pad placement. In each case, the pads will have a diagram that shows the correct placement. One pad will be applied to the right of the breastbone just below the collarbone, and the other will be on the left lower chest with the top of the pad 2 to 3 inches below the armpit. Having the pads in these locations allows the electrical current to reach both sides of the heart, which increases the chance of the heart being shocked back into a regular rhythm.

Both AED pads go on the patient's chest. Infants may have AED pads placed on their front and back, but one will be in the middle of their chest, and the other will be in the middle of their back. The patient will be "sandwiched" between the pads.

31.

You are preparing to place AED pads on a patient. You notice a transdermal medication patch on the patient's chest where the AED pad needs to be placed. What should be done next?

  • Remove the patch and clean the skin before placing the AED pad

  • Leave the patch in place and put the AED pad over the patch

  • Leave the patch in place and put the AED pad in a different location

  • Do not use the AED on this patient

Correct answer: Remove the patch and clean the skin before placing the AED pad

If a patient has a transdermal medication patch on their chest where the AED pad needs to be placed, remove the patch and clean the skin of residual medication before placing the AED pad. Do not put an AED pad directly over a transdermal medication patch because it can inflict thermal burns on the patient after a shock is delivered.

The AED pad cannot be placed in a different location. They must be placed in a specific location to be effective.

32.

What percentage of the blood is plasma?

  • 55%

  • 45%

  • 80%

  • 60%

Correct answer: 55%

Plasma makes up more than half (55%) of the blood's overall content. When separated from the rest of the blood, plasma is a light yellow liquid. Plasma carries water, salts, and enzymes.

The main role of plasma is to take nutrients, hormones, and proteins to parts of the body via the circulatory system. Cells also expel waste products into the plasma for removal from the body.

Blood cells make up the other 45% of blood.

33.

While working as an EMR firefighter, you respond to a motor vehicle accident with an unknown number of patients or injuries. Upon your arrival, a law enforcement officer points to one female patient with multiple injuries who was ejected from the vehicle. The patient is lying approximately 50 feet from the vehicle. As you approach the patient, you see her moving slightly while moaning in pain. You notice an open femur fracture and heavy bleeding from her right femur, deformity to her right humerus, and an open head wound to the side of her head with moderate bleeding. The patient has an open airway, and another firefighter is holding cervical precautions. 

Which injury should you treat first?

  •  Control bleeding from the right femur

  •  Control bleeding from the head wound

  • Splint the right femur using a traction splint

  • Splint the right humerus using a rigid splint

Correct answer: Control bleeding from the right femur

Controlling life-threatening hemorrhage is one of the main concerns for a trauma patient, along with airway and breathing. The patient has an open airway, and another firefighter is managing cervical precautions, so you should control the bleeding before splinting any injuries. Femur fractures can lose up to three pints of blood, so controlling the bleeding from the femur is the top priority.

Since the head wound is bleeding moderately, it would be the next priority to treat after bleeding is controlled on the femur.

Due to this patient's trauma, you may not have time to splint the extremities using traction and rigid splints. You can help immobilize the femur and humerus after placing the patient on a backboard and using straps to secure her, but the extent of her injuries will require rapid transport to a trauma center.

34.

What is another term for a miscarriage?

  • A spontaneous abortion

  • A spontaneous delivery

  • An incomplete abortion

  • An ectopic pregnancy

Correct answer: A spontaneous abortion

Another term for a miscarriage is spontaneous abortion. A miscarriage is the delivery of an underdeveloped or incomplete fetus. If a patient experiences a miscarriage, the fetus and any other tissues that pass from the vagina should be transported with the patient. When a patient experiences a miscarriage, they are at risk of hemorrhaging and shock. The patient should be closely observed during transport.

A spontaneous delivery, an incomplete abortion, and an ectopic pregnancy are not miscarriages. 

35.

The rotors of a helicopter can generate a blast of air equivalent to 60 to 80 mph. Which term is used for this blast of air?

  • A wash

  • A whirlwind

  • A gust

  • A cyclone

Correct answer: A wash

A wash is a blast of air that is generated by the rotors of a helicopter. It is important to know the technical terms related to helicopters since the pilot may need to communicate with you directly. The wash is equivalent to 60 to 80 mph and can blow loose objects around the landing zone. All loose objects must be secured before the helicopter lands.

The blast of air is not called a whirlwind, a gust, or a cyclone.

36.

You are working as an EMR and receive a call for a gunshot victim. Law enforcement officers are at the scene and declare it safe to enter. Upon your arrival, you find a 19-year-old male who has been shot in his bicep with heavy arterial bleeding. While your partner is preparing to apply a tourniquet, you manually apply pressure to the brachial artery to control the bleeding. 

Which three words do EMRs use to remember the sequence of applying pressure to the brachial artery?

  • Slap, slide, squeeze

  • Push, slide, squeeze

  • Slap, slide, press

  • Slap, push, squeeze

Correct answer: Slap, slide, squeeze

EMRs learn the words slap, slide, squeeze to remember the sequence of applying pressure to the brachial artery:

First, gently "slap" the inside of the bicep with your fingers halfway between the shoulder and the elbow to push the bicep out of the way. Then, "slide" your fingers up to push the bicep away. Squeeze (press) your hand down on the humerus. As you press down, you should be able to feel the pulse.

37.

Which agency regulates the types of reflective vests that EMS professionals wear for better visibility on emergency scenes?

  • The American National Standards Institute (ANSI)

  • The Occupational Health and Safety Administration (OSHA)

  • The National Highway Traffic Safety Administration (NHTSA)

  • The National Incident Management System (NIMS)

Correct answer: The American National Standards Institute (ANSI)

ANSI regulation is designed to decrease the likelihood of EMS and other first-responder fatalities or injuries caused by motor vehicles, construction vehicles, and equipment while working on federally funded highways.

OSHA ensures safe and healthful working conditions for workers by setting and enforcing standards. They do not regulate which types of safety equipment EMS professionals wear. 

NHTSA is responsible for assessing, planning, developing, and promoting emergency medical services and 911 systems.

NIMS works with all levels of government, non-governmental organizations, and private sectors to prepare for, prevent, respond to, recover from, and mitigate the effects of incidents.

38.

You are an off-duty EMR and receive a knock on your door at midnight. Your neighbor is on the doorstep, holding her 2-year-old daughter. When you open the door, the mother looks frightened and says her daughter is very sick. You bring your neighbor and her daughter into your house to assess the child. The patient has noisy, whooping inhalations and a seal-like barking cough. The mother states the coughing started suddenly, and the child has had a cold for the past three days. 

You call 911 and ask for a unit to respond to your location. The dispatcher explains the response may be delayed.

How should you treat a patient with croup until an EMS unit arrives?

  • Turn on a hot shower, shut the bathroom door so the room can steam, then have the mother and child go into the bathroom

  • Turn on a cold shower and have the mother and child go into the bathroom

  • Wait with the mother and child outside in the cool air

  • Give the child Tylenol and a glass of cool water

Correct answer: Turn on a hot shower, shut the bathroom door so the room can steam, then have the mother and child go into the bathroom

Croup is an upper airway infection that causes swelling and narrowing of the airway. Patients with suspected croup respond best to warm, moist air. The warm air relaxes the vocal cords and lessens the croupy sound, which effectively treats the patient while reassuring the parent.

Cool air is not recommended for patients with croup, as it will further constrict the airway. Most patients who develop croup do so after having a common cold and being in a cool environment. 

Giving the patient Tylenol and a glass of cool water is not advised. Patients with croup have a narrowing of the airway, and giving anything by mouth is contraindicated.

39.

When do you obtain the first set of vital signs from a patient?

  • During the secondary assessment

  • During the primary assessment

  • During the reassessment

  • During history taking

Correct answer: During the secondary assessment

The first set of vital signs is taken during the secondary assessment. Vital signs can be taken before the complete physical examination is completed or after the exam is done. If you have a partner, they can also take vital signs while you are performing the secondary assessment.

During the primary assessment, you will be developing your first impression of the patient and stabilizing any life-threatening conditions. 

During the reassessment, you will retake the patient’s vital signs and reassess the patient’s condition.

During history taking, you will assess the patient’s signs and symptoms and ask questions about the patient’s past medical history, allergies, medications, and last oral intake.

40.

What is the heart rate of a healthy, conscious newborn?

  • Greater than 100 beats per minute

  • Greater than 70 beats per minute

  • Greater than 80 beats per minute

  • Greater than 90 beats per minute

Correct answer: Greater than 100 beats per minute

The heart rate of a conscious, healthy newborn will be greater than 100 beats per minute. Newborns' heart rates are faster than those of children and adults because their metabolism is faster. As the infant grows, their heart rate will gradually decrease. By their teenage years, their heart rate will likely be equal to that of an adult.

Any heart rate below 100 beats per minute is considered slow for a newborn and may need medical intervention.

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