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Quiz Session - Attempts With Random Questions

NREMT EMR Exam Questions

Page 6 of 25

101.

Your partner has measured a nasal airway to place in a semi-conscious 70-year-old male with four respirations per minute. According to his wife, he accidentally took his painkiller prescription twice, then started having difficulty breathing 20 minutes later. You notice your partner is struggling to place the nasal airway.

What should your partner do?

  • Remove the device and try the other nostril

  • Keep trying to force the device

  • Switch to an oropharyngeal airway

  • Remove the device and hold the airway open manually

Correct answer: Remove the device and try the other nostril

If resistance is met, the airway should be removed, and the other nostril should be tried. Some patients have one nostril that is larger than the other, so the larger nostril should be tried first. If resistance is met in the larger nostril, the smaller one should be tried next.

Never force a nasal airway into a patient's nose, as this can cause trauma to the nose and airway. Some patients have a deviated septum, which will cause resistance. 

A semi-conscious patient will have a gag reflex, so an oral airway is contraindicated.

Only remove the airway and maintain an open airway manually if both nostrils have been tried without success.

102.

At a local YMCA, a 65-year-old male is complaining of chest pain. The patient says the pain developed while playing tennis, and he has a history of angina. The patient's friend returns from the locker room with the patient's nitroglycerin as you are assessing his vital signs. You are a trained EMR and have permission from your county medical director to assist the patient with his nitroglycerin.

How quickly will the patient's angina pain be relieved?

  • 5 minutes

  • 8 minutes

  • 10 minutes

  • 15 minutes

Correct answer: 5 minutes

Angina pain is usually relieved within 5 minutes after nitroglycerin has been administered. If the medication is a newer prescription, it will work quickly. If the prescription is older or expired, it can take longer to work or may not relieve the pain at all. Always remember the six rights of medication administration before helping a patient with their medication: right patient, right medication, right route, right dose, right time, and right documentation.

If the pain has not diminished after 5 minutes, help the patient take a second dose. The medication could be expired, or the patient may have a heart attack instead of angina.

103.

While off-duty, you see an older man clutch his chest and collapse against his walking partner. You rush over and see the man is unresponsive and without pulses or breathing. The patient's friend says he has been complaining of heartburn all morning. You need to perform CPR and call 911 to activate the EMS system.

What is the first step to take?

  • Call 911, then begin chest compressions

  • Begin chest compressions and call 911 after five cycles of CPR

  • Begin ventilation and call 911 after five cycles of CPR

  • Begin chest compressions and call 911 after one cycle of CPR

Correct answer: Call 911, then begin chest compressions

Since most cardiac arrests in adults are caused by a cardiac event, you want to activate EMS immediately. After 911 has been called, begin chest compressions. If there is a bystander, like in this scenario, you could ask the bystander to call 911 while you begin compressions. Or, you can put your phone on speaker and call 911 while starting chest compressions.

If the patient was an infant or child, you would perform five cycles of CPR before activating EMS, starting with chest compressions. Children and infants typically go into cardiac arrest due to respiratory arrest, so five cycles of CPR are needed first to attempt to correct the respiratory arrest.

Do not ever start CPR with ventilation. 

104.

Which of the following is not a sign of a severe airway obstruction?

  • A forceful cough

  • A silent cough

  • Poor air exchange

  • Increased difficulty breathing

Correct answer: A forceful cough

A forceful cough occurs in patients with a partial airway obstruction. They are still receiving air around the partial obstruction, allowing them to cough forcefully.

A silent cough, poor air exchange, and increased difficulty breathing indicate a severe (complete) airway obstruction. Without fresh oxygen entering the lungs, the body quickly consumes the oxygen from the last breath. The patient cannot breathe in or out, and they will be unable to speak but can produce a silent cough. 

Patients with a complete airway obstruction need immediate help; otherwise, they will become unconscious within three to four minutes.

105.

What is the best response to a patient who is having a seizure?

  • Protect the patient from self-injury

  • Protect the patient from swallowing their tongue

  • Maintain an open airway

  • Administer high-flow oxygen

Correct answer: Protect the patient from self-injury

The best treatment for a patient who is having a seizure is to protect them from self-injury. Focus on protecting the head from hitting the ground or sharp objects and then keeping their limbs from hitting nearby objects. You can place the tip of your shoe or put a pillow or towel under their head. Move objects and provide adequate space around the patient.

The patient could bite their tongue, but they cannot physically swallow their tongue.

When a patient is having a seizure, do not try to open their airway or apply oxygen. Wait until the seizure is over.

106.

What sequence should EMRs remember when faced with a water rescue?

  • Reach, throw, row, go

  •  Go, reach, throw, row

  • Reach, throw, go, row

  • Row, go, reach, throw

Correct answer: Reach, throw, row, go

For a water rescue, the four steps are reach, throw, row, go. First, reach toward the patient with a readily available object, such as a pole, oar, branch, or paddle. If you cannot reach the patient, throw something that will float or the patient can grab. If the patient is too far away, row to them if a small boat is available. As a last resort, you may have to go into the water to help the patient.

The other answers are not in the proper order.

107.

A pregnant patient is bleeding heavily after childbirth. In addition to placing sanitary pads at the vaginal opening, what else is recommended to help stop the bleeding?

  •  Encourage the newborn to nurse at the mother's breast

  • Pack the vaginal opening with sterile gauze

  • Wait until the bleeding is controlled to transport the patient to the hospital

  • Administer high-flow oxygen and place the patient in an upright position

Correct answer: Encourage the newborn to nurse at the mother's breast

If a pregnant patient is bleeding heavily after childbirth, in addition to placing sanitary pads at the vaginal opening, encouraging the newborn to nurse at the mother's breast is recommended to help stop the bleeding. When a newborn nurses, it causes the uterus to contract and can often help stop the bleeding. Massaging the uterus is also recommended.

Do not pack the vagina with gauze, especially if the placenta has not been delivered yet.

The patient is not stable if they are bleeding heavily, and they need to be transported immediately to the hospital. Do not wait on the scene for the bleeding to stop.

It is recommended to administer high-flow oxygen for anyone who may be going into shock, but do not sit the patient upright. Blood needs to flow toward the heart, not away from it. Also, administering oxygen and sitting the patient upright do not help stop the bleeding.

108.

You are called to a river for a possible drowning. When you arrive, you see a kayaker with their head above water, struggling to stay afloat. Their kayak is nowhere in sight.

Which rescue step is indicated at this time?

  • Try to reach them with the closest available object

  • Go into the water to bring the patient to shore

  • Row to them on an inflatable boat

  • Throw a rope

Correct answer: Try to reach them with the closest available object

For any water rescue, remember the steps of reach, throw, row, go. First, try to reach the patient with the closest available object, such as a branch, oar, paddle, or pole.

If you first try to reach them with an object and are unsuccessful, throw them a rope or a flotation device. Rowing on an inflatable boat is advised after trying to reach them with an object or throwing them a flotation device or rope. As a last resort, go into the water if you are trained in water rescue techniques and are a strong swimmer.

109.

You are providing care for a patient with multiple gunshot wounds. You have controlled external bleeding, and the patient is alert and oriented. He reports feeling very thirsty, and you note rapid respirations, pale, clammy skin, and a rapid pulse. 

All the following actions are appropriate except:

  • Allow him to take a small drink of water

  • Place a blanket on the patient 

  • Apply oxygen

  • Ensure rapid transport to a trauma center

Correct answer: Allow him to take a small drink of water

This patient is exhibiting signs of shock. Apply oxygen, keep the patient warm, and ensure rapid transport to a trauma center occurs. Do not give patients in shock anything to eat or drink, as it may cause vomiting. If the patient requires surgery, an empty stomach is important.

110.

An SCBA must be worn by rescuers when they are entering a contaminated, unsafe environment. What is an SCBA?

  • Self-contained breathing apparatus

  • Self-contained breathing appliance

  • Self-contaminated breathing apparatus

  • Safe-containment breathing apparatus

Correct answer: Self-contained breathing apparatus

In contaminated, unsafe environments, rescuers are required to wear a self-contained breathing apparatus (SCBA). Examples of unsafe environments include smoky areas like a house fire, confined spaces such as underground mines or caves, and areas where toxic gas has been released. EMRs are not usually trained to use SCBAs unless they work for a fire department or related agency. The SCBA consists of a mask, regulator, and air supply.

111.

What is the respiratory rate in a conscious, healthy newborn?

  • Over 40 breaths per minute

  • Over 50 breaths per minute

  • Over 30 breaths per minute

  • Over 20 breaths per minute

Correct answer: Over 40 breaths per minute

Newborns typically breathe 40-60 times per minute. Physiologically, newborns have smaller lungs and weaker respiratory muscles, and they mostly breathe through their noses.  On average, newborns and infants younger than 6 months take 40 breaths per minute.

Since the range is 40-60 breaths per minute, a respiratory rate of over 50 breaths per minute would exclude 40 breaths per minute, which is a healthy rate.

A respiratory rate of 20 or 30 breaths per minute for a newborn would indicate respiratory distress. The patient would require ventilation.

112.

An ambulance was called following a domestic disturbance, and CPR is in progress on an unknown-aged male. When you arrive, an officer is doing compressions on the patient and says they withheld ventilation since they did not have a mask. You go to the patient's head to start ventilation.

How do you place the mask from a bag-mask device on the patient's face?

  • Start by putting the angled or grooved end of the mask over the bridge of the nose, then bring the mask down to the groove between the lower lip and chin

  • Start by putting the mask down to the groove between the lower lip and chin, then place the angled or grooved end of the mask over the bridge of the nose

  • Start by putting the angled or grooved end of the mask underneath the nose, then bring the mask down to the groove between the lower lip and chin

  • Start by putting the angled or grooved end of the mask over the bridge of the nose, then bring the mask down to the bottom of the chin

Correct answer: Start by putting the angled or grooved end of the mask over the bridge of the nose, then bring the mask down to the groove between the lower lip and chin

To place the mask on the patient, start by putting the angled or grooved end of the mask over the bridge of the nose. Next, bring the mask down to the groove between the lower lip and chin. Seal the mask using the proper technique, holding it in position. It is ready to provide ventilation.

Do not place the mask underneath the nose. The nose needs to be covered so the ventilated air does not escape from the nose.

Mask placement at the bottom of the chin will be too large to provide adequate ventilation.

113.

You are going to assess a 73-year-old female who is sitting in a chair. She called 911 for chest pain. In which of the following positions would it be best to speak to the patient? 

  • Position yourself at eye level in front of the patient

  • Stand over the patient, maintaining eye contact

  • Stand next to the patient

  • Position yourself at eye level at the patient's side

Correct answer: Position yourself at eye level in front of the patient

When talking to a patient who is seated, position yourself at eye level with the patient. This non-threatening position will help make the patient feel comfortable. As an EMR, your body language is as important as what you have to say. You do not want the patient to feel intimidated.

Standing over the patient can be threatening and can make the patient feel uncomfortable.

Positioning yourself next to the patient can appear indifferent, as you cannot maintain eye contact. You want to position yourself at eye level in front of the patient.

114.

You are performing CPR on a 64-year-old man by yourself with a ratio of 30:2 compressions to breaths. A second rescuer arrives to help. Which of the following is correct?

  • Keep 30:2 compressions to breaths 

  • Switch to 15:2 compressions to breaths 

  • Switch roles every 10 cycles of CPR 

  • Have the second person leave to find an AED

Correct answer: Keep 30:2 compressions to breaths

The compression-to-breath ratio for a single rescuer or multiple rescuers is 30:2. Switch roles every 5 cycles of CPR, or about every 2 minutes. This helps ensure fatigue will not affect the effectiveness of chest compressions. If an AED is not nearby, it would be better to have the second rescuer assist with CPR instead of going to search for one. 

115.

What is the function of the right atrium?

  • To receive blood from the veins

  • To receive highly oxygenated blood from the lungs

  • To pump deoxygenated blood to the lungs

  • To pump highly oxygenated blood throughout the body

Correct answer: To receive blood from the veins

The right atrium receives blood from the veins. The blood the right atrium receives is deoxygenated. Then, the right atrium empties the blood into the right ventricle.

The left atrium receives highly oxygenated blood from the lungs. 

 The right ventricle pumps deoxygenated blood to the lungs, where the gas exchange can occur and oxygenated blood can be pumped to the left atrium.

The left ventricle takes this highly oxygenated blood and pumps it throughout the body. 

116.

Which term is used when a pregnant patient reports they have lost their mucus plug?

  • Bloody show

  • Broken waters

  • Crowning

  • Contractions

Correct answer: Bloody show

During the first stage of labor, the pregnant patient's body is preparing for birth. This stage is characterized by several steps, one of which is the loss of the mucus plug (i.e., the bloody show). The mucus that covers the cervix is often mixed with blood. 

Broken waters are when the amniotic sac ruptures. Usually, a patient's waters will break during the first stage of labor, but this may not happen until the birth is further along.

Crowning refers to the newborn's head appearing at the vaginal opening.

Contractions are the labor pains that move from the top of the uterus to the bottom when a pregnant patient is in labor.

117.

What is the strongest bone in the body?

  • Femur

  • Pelvis

  • Clavicle 

  • Spine 

Correct answer: Femur

The femur (thighbone) is the largest and strongest bone in the body. The femur is highly vascular, and fractures to this bone can result in significant blood loss in the thigh. Up to 40% of femur fractures may require a blood transfusion, as this injury can result in a loss of up to three pints of blood. This is a significant problem, especially for elderly patients who have a smaller cardiac reserve, which is the difference between the rate at which the heart pumps blood and its maximum capacity for pumping blood at any time.

The spine is not just one bone but is comprised of 33 vertebrae. The clavicle is the most frequently fractured bone in the body.

118.

What structure does the airway divide into below the trachea?

  • The bronchi

  • The bronchioles

  • The lungs

  • The alveoli

Correct answer: The bronchi

Below the trachea, the airway divides into the bronchi, which are two large tubes that are supported by cartilage. The bronchi act as a passageway for air from the mouth and trachea, down to the alveoli, and back out of the body. 

The bronchi keep branching into smaller airways called bronchioles in the lungs. The bronchioles deliver air to the alveoli, allowing the exchange of oxygen and carbon dioxide.

The bronchioles terminate in tiny air sacs called alveoli, which exchange oxygen and carbon dioxide in the lungs. The tissues receive oxygen, and carbon dioxide is eliminated from the body.

119.

An 88-year-old female patient with difficulty breathing is coughing up greenish-yellow sputum and has a slight fever.

Which common infectious disease often affects older adults?

  • Pneumonia

  • Emphysema

  • Congestive heart failure

  • Asthma

Correct answer: Pneumonia

Pneumonia is a common infectious disease that older adults are susceptible to because of their weakened immune systems. Pneumonia frequently kills older adults and is considered a true medical emergency. Minor symptoms can quickly become a major illness. Any older patient with congestion and a possible fever should be seen by a physician. 

Emphysema, congestive heart failure, and asthma affect many older adults, but they are not infectious diseases.

120.

What is the definition of triage in an emergency medical setting?

  • Casualty sorting

  • Casualty treating

  • Casualty transport

  • Casualty numbers

Correct answer: Casualty sorting

The sorting of patients into groups according to their need for medical treatment is called triage, which is a French term. The purpose of casualty sorting is to determine the order in which patients should be treated based on the severity of their injuries. The goal is to provide the most good for the greatest number of people.

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