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Quiz Session - Attempts With Random Questions

NREMT EMT Exam Questions

Page 1 of 52

1.

A 64-year-old male patient is in cardiac arrest. The automated external defibrillator (AED) does not advise defibrillation. What is the appropriate next step?

  • Resume CPR, beginning with chest compressions

  • Reanalyze the patient’s rhythm via the AED and defibrillate

  • Re-check for a pulse for an additional 10 seconds

  • Resume CPR, beginning with 2 additional ventilations 

Correct answer: Resume CPR, beginning with chest compressions

CPR should be performed on an unresponsive patient who does not have a palpable pulse. High-quality CPR and rapid defibrillation are important factors of survival. If a shock is not advised, CPR should be resumed. Do not delay chest compressions longer than 10 seconds any time CPR is paused. If a pulse cannot be found within 10 seconds, resume CPR. 

If the patient is apneic, he will require assisted ventilation. However, chest compressions are completed prior to ventilation in CPR.

2.

Which of the following are the correct steps for suctioning a patient's airway using a powered, portable suction unit?

Select the four answer options which are correct.

  • Before suctioning, clamp the tubing and ensure the unit generates a vacuum of at least 300 mmHg

  • Turn the patient's head (if no C-spine injury is suspected) to the side, open the mouth, and insert the catheter to the predetermined depth

  • Apply suction in a circular motion while withdrawing the catheter

  • Measure the catheter from the corner of the mouth to the earlobe or angle of the jaw

  • Measure the catheter from the corner of the mouth to the back of the throat

The steps to suction a patient's airway using a powered, portable suction unit are:

  1. Assemble the unit and turn on the power.
  2. Clamp the tubing and ensure the unit generates a vacuum of more than 300 mmHg.
  3. Measure the catheter from the corner of the mouth to the earlobe or angle of the jaw.
  4. Turn the patient's head (if no C-spine injury is suspected) to the side, open the mouth, and insert the catheter to the predetermined depth.
  5. Apply suction in a circular motion while withdrawing the catheter.
  6. Avoid suctioning longer than 10 seconds. Some textbooks may reflect 15 seconds, but the current recommended practice is to limit suctioning in patients of all ages to 10 seconds.

3.

What is the most likely cause of dark-colored stool? 

  • Gastrointestinal hemorrhage

  • Appendicitis

  • Gallstones

  • Pancreatitis

Correct answer: Gastrointestinal hemorrhage

Gastrointestinal hemorrhage may occur anywhere along the GI tract due to a variety of causes, such as ulcers, esophagitis (gastroesophageal reflux disease), esophageal varices, Mallory-Weiss tears, diverticulitis, gastroenteritis (infection), or hemorrhoids.

Melena—dark, tarry stools—commonly occur due to bleeding in the upper gastrointestinal tract.

Gallstones commonly cause right upper quadrant or midabdominal pain that may radiate to the right upper back, shoulder, or flank.

Appendicitis causes localized right lower quadrant pain, nausea, vomiting, anorexia, fever, chills, and rebound tenderness.

Pancreatitis causes upper left and right quadrant pain that radiates to the back and worsens after eating, as well as nausea, vomiting, abdominal distension, and tenderness.

Gastrointestinal bleeding is not a common symptom of appendicitis, gallstones, or pancreatitis.

4.

What is the name of the cartilaginous ridge where the trachea divides into the right and left main-stem bronchi?

  • Carina

  • Cricoid cartilage

  • Pharynx

  • Epiglottis

Correct answer: Carina

The trachea divides into the two main bronchi at the anatomical point known as the carina. This ring of cartilage appears just superior to the bifurcation of the bronchi into the right and left lungs.

Cricoid cartilage is a firm ridge forming the lower part of the larynx. It is the only complete ring of cartilage around the trachea and is a landmark for cricothyrotomy, the surgical rescue technique of choice for a failed airway in adults.

The pharynx is the area between the mouth and the epiglottis, in which the trachea and esophagus separate.

The epiglottis is a thin, leaf-like structure that folds over the glottis to prevent food and liquid from entering the trachea.

5.

A 22-year old single mother fractured her ankle while playing with her children. Her leg is clearly deformed, and she reports a pain level of 9/10. Her children, ages 2 and 5, are frightened but cooperative. The patient agrees to transport if her children can accompany her, as no family members or neighbors are available to care for them. Which of the following is the best option?

  • Transport the children using appropriate restraint systems in an accompanying police vehicle

  • Secure the mother on the stretcher, place the toddler in a car seat, and secure the seat and the older child to the ambulance bench

  • Secure the mother and toddler on the stretcher with the older child in a captain’s chair

  • Secure the mother on the stretcher and call a taxi to transport the children

Correct answer: Transport the children using appropriate restraint systems in an accompanying police vehicle

While family-centered care is desirable, it must be done without placing the patient, family, child, or provider at increased risk. When possible, arrange for alternative care and/or transportation so that attention can be focused on the patient. Appropriate child restraints should be used when possible, although ambulances are often ill-equipped to secure pediatric passengers. If the child is not the patient, consider utilizing accompanying law enforcement or another emergency vehicle.

If separating the child and parent is problematic, follow proper procedures and protocols and secure both patients with appropriate restraint systems and positions.

There is no way to secure a car seat safely to an ambulance bench.

Stretchers are designed for securing one patient only. A taxicab is unlikely to have an appropriate restraint system for infants or toddlers, and transporting unaccompanied children is inappropriate.

It is never acceptable to secure a child in a parent’s arms for ambulance transport.

6.

Which of the following is not considered a normal role or responsibility of an emergency medical technician (EMT)?

  • Delegating the authority to provide medical care in the field

  • Ensuring and protecting patient privacy

  • Maintaining continuity of care

  • Performing patient assessments

Correct answer: Delegating the authority to provide medical care in the field

An EMT has training in basic life support, such as automated external defibrillation, the use of definitive airway adjuncts, and the assistance of patients with certain medications. Their general roles and responsibilities include the following:

  • ensuring all vehicles and equipment are ready for emergencies
  • ensuring personal safety and that of partners, patients, and bystanders
  • operating emergency vehicles
  • performing scene evaluation
  • requesting additional resources
  • gaining patient access
  • performing patient assessments
  • providing emergency medical care and emotional support when needed
  • maintaining continuity of care
  • resolving emergency incidents
  • upholding medical and legal standards
  • ensuring and protecting patient privacy
  • providing administrative support
  • continually improving professional development
  • cultivating and sustaining community relations
  • giving back to the profession

A medical director is a physician who authorizes or delegates authority to EMTs to provide medical care in the field.

7.

Which of the following medical terms are associated with speech?

Select the three answer options which are correct.

  • Aphasia

  • Agnosia

  • Dysarthria

  • Aphagia

Aphasia is the loss of the ability to understand or express speech. Agnosia is an inability to speak effectively when asked to name or describe an object. Dysarthria is difficulty speaking caused by brain damage or brain changes from pathological conditions.

Aphagia is an inability to swallow.

8.

Two patients were involved in a motor vehicle collision. The driver is assessed and determined to be dead upon arrival. The passenger is wandering around the crash site and appears confused. Which of the following is the most appropriate treatment?

  • Start spinal motion restriction with a cervical collar.

  • Apply a cervical collar and immobilize the patient on a short backboard.

  • There is no need to immobilize the patient as he is able to walk.

  • Have the patient lie on a long spine board and apply a cervical collar.

Correct answer: Start spinal motion restriction with a cervical collar.

MOI alone is not a reason to perform spinal motion restriction, but if a patient exhibits any of the following, it should be employed:

  • Neurological deficits
  • Altered mental status
  • Spinal pain or tenderness
  • Distracting injures
  • Intoxication
  • Other illnesses or injuries that may mask a spinal injury or otherwise cause you to believe they may be unreliable

This patient is confused, so spinal motion restriction should be started.

The use of long spine boards varies from EMS system to system, and state to state. Follow local protocols for use. You should place a cervical collar before the long spine board, and do not have the patient lay down on it, but use the standing takedown technique instead.

Short backboards are not used for patients who are out of vehicles and walking.

9.

A 20-year-old female complains of rapid-onset abdominal pain with nausea and vomiting. The management of a patient experiencing acute abdominal pain should include which of the following?

  • Administration of supplemental oxygen if needed and left-sided placement of the patient

  • Auscultation of the bowel sounds throughout the epigastric area

  • Administration of small sips of water to prevent dehydration and combat nausea and vomiting

  • Supine placement to minimize nausea and vomiting during transport

Correct answer: Administration of supplemental oxygen if needed and left-sided placement of the patient

An acute abdomen is the sudden onset of abdominal pain that is commonly caused by severe, progressive conditions that require medical attention. An acute abdomen can occur due to a multitude of symptoms and lead to abdominal distension, nausea, vomiting, systemic infection, and gastrointestinal bleeding. Since internal bleeding is a risk factor, supplemental oxygen and treatment for shock are appropriate for patients with sudden-onset abdominal pain. Low-flow oxygen may decrease nausea and anxiety; if dyspnea occurs, high concentrations of oxygen should be used. Follow local protocols. 

It is not typical for EMTs to auscultate bowel sounds. If you are trained to do so, note that bowel sounds are difficult to hear in a prehospital setting, even in a quiet area. As bowel sounds are difficult to interpret, they are of limited use in a prehospital setting.

A patient should have no fluid or food intake with an acute abdomen, as ingestion may further exacerbate symptoms and could delay surgical interventions if indicated.

A patient experiencing nausea and vomiting should be placed on their left side in order to prevent aspiration of vomitus and maintain a patent airway.

10.

Which of the following may be indicated for an adult patient with pulmonary edema? 

Select the two answer options which are correct.

  • Nitroglycerin

  • CPAP

  • Albuterol 

  • Aspirin 

  • Epi

Nitroglycerin is highly beneficial when used for patients with pulmonary edema, as it leads to a reduction in arteriolar pressure that decreases hydrostatic pressure in the capillary bed. This reduces fluid being forced from the capillaries into the lungs. Follow local protocols and contact medical control for orders for nitroglycerin administration. CPAP treats pulmonary edema by increasing pressure in the alveoli, forcing fluid back into the interstitial space and out of the lungs. Always request ALS intercept when treating a patient with acute pulmonary edema. 

Albuterol is a bronchodilator used frequently to reverse bronchospasm, but it has little effect on pulmonary edema. Aspirin is used in acute coronary syndromes to reduce thrombosis and slow the progression of myocardial infarction. It is not useful for managing pulmonary edema. 

11.

A pregnant patient at 34 weeks gestation is experiencing a seizure. What is the most appropriate next step after ensuring the scene is safe and the airway is managed?

  • Request ALS response to the scene or begin rapid transport to the hospital.

  • Administer oral glucose to treat potential hypoglycemia.

  • Prepare to perform immediate cesarean delivery in the field.

  • Immediately induce labor to deliver the baby and alleviate the mother's condition.

Correct answer: Request ALS response to the scene or begin rapid transport to the hospital.

This patient is exhibiting signs of eclampsia, a condition that requires immediate IV medication. Request a paramedic unit to respond to the scene or begin emergent transport to the hospital if ALS is unavailable.

While hypoglycemia can cause seizures, administering oral glucose to a seizing or postictal patient can lead to aspiration.

Cesarean deliveries are beyond the scope of practice for EMTs and require surgical facilities.

Inducing labor in the field is outside the scope of practice of an EMT and does not directly address the immediate life-threatening condition of a seizure.

12.

On a hot afternoon, a 64-year-old obese male with no discernible medical history complains of weakness and muscle cramps. He has a rapid heartbeat. 

Which of the following is most likely?

  • Heat exhaustion

  • Heat stroke 

  • Heat cramps 

  • Acute coronary syndrome

Correct answer: Heat exhaustion

Dizziness, weakness, syncope, altered mental status, nausea, vomiting, headaches, and muscle cramping are common in heat exhaustion. If the onset is in a hot, humid, or poorly ventilated area, the suspicion for heat-related issues should be increased. Heat exhaustion progresses into heat stroke when there is a loss of consciousness and the body's temperature reaches critical levels.

An acute abdomen is the sudden onset of abdominal pain associated with a severe, progressive problem, which is not present in this scenario. 

Acute coronary syndrome may create weakness and tachycardia with chest pain/discomfort and dyspnea. Muscle cramps are not a common sign of acute coronary syndrome. 

13.

Which of the following is a classic symptom of acute coronary syndrome (ACS)?

  • Chest pain or discomfort described as pressure or heaviness

  • Low back pain with radiation to the legs

  • Dull pain that does not radiate

  • Abdominal pain

Correct answer: Chest pain or discomfort described as pressure or heaviness

ACS is a group of symptoms caused by myocardial ischemia; the most notable symptom is chest pain that is described as pressure or heaviness. Not all patients have chest pain during ACS or acute myocardial infarction (AMI). Additional signs and symptoms of ACS/AMI may include the following: 

  • weakness
  • dyspnea
  • nausea or vomiting
  • lower jaw, arm, back, abdominal, or neck pain
  • sweating without an obvious cause 
  • pink frothy sputum (indicating possible pulmonary edema)
  • an irregular cardiac rhythm
  • syncope 
  • sudden death

Any patient complaining of nontraumatic chest pain should be assumed to have an AMI until it is ruled out by a physician.

14.

Which of the following is not commonly seen in new-onset type 1 diabetes mellitus?

  • Polypharmacy

  • Polydipsia

  • Polyuria

  • Polyphagia

Correct answer: Polypharmacy

Type 1 diabetes mellitus is an autoimmune disorder in which antibodies are created against pancreatic beta cells. Insulin is subsequently inadequate or absent in these patients. Common signs and symptoms for new-onset type 1 diabetes mellitus include polyuria (increased urination), polydipsia (increased fluid intake due to thirst), polyphagia (increased food intake due to hunger), fatigue, and weight loss. External insulin use (injectable insulin) is required for survival for patients who have autoimmune diabetes mellitus.

Polypharmacy is the use of multiple medications by a patient. Polypharmacy is not necessarily associated with new-onset type 1 diabetes mellitus.

15.

A 23-year-old female is breathing at a rate of 45 breaths per minute and is visibly upset. She has no known medical conditions and takes no medications. She reports numbness and tingling in her hands. From which of the following is the patient most likely suffering?

  • Hyperventilation

  • Diabetic ketoacidosis

  • Pneumonia

  • Aspirin overdose

Correct answer: Hyperventilation

Hyperventilation is over-breathing (above a normal respiration rate), reducing arterial carbon dioxide. Hyperventilation may occur due to an elevated level of carbon dioxide, such as in diabetic ketoacidosis, an overdose of aspirin, or a severe infection. 

Hyperventilation may also occur with anxiety, dizziness, numbness/tingling, and painful spasms in the hands and feet due to excess loss of carbon dioxide; this condition is known as hyperventilation syndrome or respiratory alkalosis. Instructing a responsive patient to slow their breathing, giving supplemental oxygen, and providing transport are appropriate when hyperventilation is occurring.

Diabetic ketoacidosis is a possible cause of hyperventilation; however, an altered mental status, body aches, abdominal pain, and nausea/vomiting may also occur.

Signs and symptoms of pneumonia vary, depending on the patient and the severity of the illness; typically, dyspnea and fever occur. A productive cough, chest discomfort, headache, nausea/vomiting, musculoskeletal pain, weight loss, and confusion are possible.

There is no indication the patient has overdosed on aspirin.

16.

A 21-year-old intoxicated male requires ventilatory assistance. He has a clenched jaw and is somewhat combative. Which of the following airway adjuncts would be appropriate to assist in opening his airway?

  • A nasopharyngeal airway

  • An oropharyngeal airway

  • A laryngeal mask airway

  • A King LTD airway

Correct answer: A nasopharyngeal airway

Nasopharyngeal airways are used for patients with an altered level of consciousness who have an intact gag reflex or who will not tolerate an oropharyngeal airway. Contraindications to a nasopharyngeal airway include a severe head injury with blood draining from the nose and a history of a fractured nasal bone.

Oropharyngeal airways keep the tongue from blocking the upper airway and make suctioning easier if necessary. Indications for an oropharyngeal airway include an unresponsive patient without a gag reflex or a patient being ventilated with a bag-valve mask. Contraindications to an oropharyngeal airway include a conscious patient or a patient who has an intact gag reflex.

A laryngeal mask airway and a King LTD airway are supraglottic airways that can secure the airway and provide artificial ventilation to unresponsive, apneic patients.

17.

Which of the following is a common side effect of nitroglycerin?

  • Headaches

  • Drowsiness

  • Nausea

  • Hypertension

Correct answer: Headaches

Common side effects of nitroglycerin include hypotension, headaches, and changes in heart rate (tachycardia or bradycardia).

18.

Which of the following is not typically a sign or symptom of cardiac compromise?

  • Shivering

  • Sweating

  • Dyspnea

  • Nausea/vomiting

Correct answer: Shivering

Shivering is an involuntary shaking of muscles when a person is cold to produce heat and maintain thermostasis.

Chest pain/discomfort that is typically described as pressure or heaviness, nausea/vomiting, dyspnea, and sweating are common signs and symptoms of cardiac compromise.

19.

Which of the following signs is not an indicator that a patient may be experiencing inadequate breathing?

  • Warm, dry skin with normal capillary refill

  • Cyanosis around the lips and nail beds

  • Tachypnea in the presence of shortness of breath

  • Adventitious breath sounds

Correct answer: Warm, dry skin with normal capillary refill

Inadequate breathing leads to inadequate oxygen perfusion, which may cause bradypnea or tachypnea in the presence of shortness of breath (dyspnea); irregular breathing rhythm; diminished, absent or noisy auscultated breath sounds; unequal or inadequate (shallow) chest expansion/depth; use of accessory muscles; cyanosis; cool or moist skin; or skin pulling in around the ribs (retractions).

Adventitious breath sounds are abnormal sounds such as crackles or rales, wheezes or rhonchi, pleural rubs, or stridor.

20.

A 73-year-old male is prone in his front yard. He is unresponsive, with a good pulse and adequate respirations. No witnesses to the event are present, and no family members are available to give an adequate history. 

Which of the following is the most appropriate next step?

  • Maintain inline cervical stabilization, apply a cervical collar, and log-roll the patient with assistance onto a long backboard

  • Roll the patient into a supine position and perform a sternal rub to assess the level of responsiveness

  • Roll the patient into a supine position and apply ammonia inhalants

  • Assess the patient's blood sugar prior to assessing for injuries

Correct answer: Maintain inline cervical stabilization, apply a cervical collar, and log-roll the patient with assistance onto a long backboard

Spinal motion restriction and quick loading into the ambulance are indicated for patients with potential spinal injuries. Spinal motion restriction should be completed immediately after the assessment and treatment of life-threatening conditions (ABCs). If it is not clear whether spinal motion restriction is necessary, err on the side of caution and provide motion restriction. Spinal injuries can worsen if the patient is not assessed and treated for potential spinal injuries prior to movement, even during a log-roll.

Assessing the patient's blood sugar should be completed after spinal motion restriction and placing the patient in position to manage the airway. 

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