NREMT STUDY GUIDE 2025 PRACTICE EXAM
QUESTIONS WITH VERIFIED ANSWERS
Where does gas exchange of oxygen and carbon dioxide occur?
a. larynx
b. bronchioles
c. alveoli
d. main stem bronchi
Alveoli
The alveoli are where the lungs and the blood exchange oxygen and carbon dioxide during the
process of breathing in and breathing out. Oxygen breathed in from the air passes through the
alveoli and into the blood and travels to the tissues throughout the body.
What is the primary role of the epiglottis?
a. bringing oxygen into circulation
b. aids in food digestion
c. assist air flow to the larynx
d. prevent aspiration while eating
prevent aspiration while eating
The main job of the epiglottis is to close over the trachea while you're eating to prevent food
entering your airway.
What is the PRIMARY role of the mediastinum?
a. Protects vital structures of the chest
b. Protects your diaphragm from collapse
c. Protects your lungs from collapse
d. Surrounds the heart's four chambers
protects vital structures of the chest
The mediastinum protects many vital structures including the heart, large vessels, the trachea,
and critical nerves.
You respond to a 8 year old male who states he is having trouble breathing. His respiratory
rate is 44 breaths/min and you notice accessory muscle use on exam. You can hear an
audible wheeze present. What should your initial step be?
a. Start BVM ventilations
,b. Attempt a head tilt-chin lift
c. Obtain his oxygen saturation
d. Gather a SAMPLE history
Obtain his oxygen saturation
This patient is able to speak so the airway is patent, we don't have any oxygen data so we need
that before we can go ahead with oxygen administration. This will give the final piece of info to
start assessing his current status.
You are called to the home of a 4 year old female patient. The patient has a persistent
"barking cough" and has stridor on exam. The mother tells you that this has gotten worse
over the last few nights, until tonight she had a "hard time" breathing. What do you
suspect?
a. Asthma Exacerbation
b. Bronchiolitis
c. Epiglottitis
d. Croup
Croup
Remember the keys for croup, barking cough, stridor, gradual onset, typically seen in young
children. Epiglottitis can occur at any age and has drooling, painful swallowing, stridor and a
more rapid onset, no barking cough.
From the list below name three action steps you can take to help patients with croup or
epiglottitis. (Pick 3)
a. Keep oxygen saturation above 94%
b. Keep the patient calm
c. Begin CPR if the patient has a pulse less than 100
d. Begin bag valve mask ventilations with rapid transport
e. Use blow-by oxygen
f. Immediately begin non-rebreather mask at 15LPM
a. keep oxygen saturation above 94%
b. keep patient calm
e. use blow-by oxygen
You are about to place an airway adjunct into your patient. Which situation would you
NOT place a nasopharyngeal airway?
,a. A semiconscious child who just had a seizure
b. A patient with ecchymosis behind one ear
c. An unconscious patient with an intact gag reflex
d. An semiconscious adult who cannot maintain their own airway
a patient with ecchymosis behind one ear
Bruising behind one ear is known as the "Battle sign" and an indication of a basilar skull
fracture, which is a severe head injury. Use of a nasopharyngeal airway with severe head injuries
is contraindicated.
You are transporting a 53 year-old male who complains of shortness of breath, dizziness,
numbness in his hands, and a dry mouth. His vital signs are: blood pressure 118/80 mmHg,
HR 120, RR of 32, SpO2 99%, and ETCO2 of 26 mmHg. What do you suspect?
a. Hypokalemia
b. Hypoventilation syndrome
c. Pneumothorax
d. Hyperventilation syndrome
Hyperventilation syndrome
This patient is hyperventilating as demonstrated by his increased respiratory rate and low end-
tidal reading levels. A high respiratory rate increases the amount of carbon dioxide exhaled,
accounting for the low end-tidal reading. His heart rate is also a little elevated, possibly due to
anxiety.
A 78 year old female is found lying on her bathroom floor unconscious. Her caregiver
reports finding her like this upon arrival and is unsure what happened. You hear gurgling
sounds on inspiration. What is the next best step?
a. Suction her airway
b. Begin ventilations with a bag-valve mask
c. Insert an oropharyngeal airway
d. Provide nasal cannula at 2 L/min
suction her airway
The gurgling sounds on inspiration suggest her airway needs to be cleared. You want to make
sure you suction and clear her airway before proceeding with treatment.
You assess a 23 year-old male who was struck in the right chest wall with an airbag after a
motor vehicle accident. The patient complains of pain on inspiration and shortness of
, breath. You gather the following from your physical assessment: unequal chest wall rise
and absent lungs sounds on the right side. What do you suspect?
a. Flail chest
b. Cardiac tamponade
c. Tension pneumothorax
d. Right chest contusion
Tension pneumothorax
Tension pneumothorax is where one of the lungs collapses, and can commonly happen with
traumatic events like a motor vehicle crash. Its hallmark signs and symptoms are absent lung
sounds on affected side and unequal rise and fall of the chest.
You arrive on scene to a 4 year-old girl choking on her food. She is unresponsive and not
breathing. What is the next best step in the management of this patient?
a. Start chest compressions
b. Provide 5 back slaps
c. Inspect the airway with a finger sweep
d. Perform abdominal thrust
Start chest compressions
Since the child is unresponsive and not breathing, this would be the best method to try and
remove the foreign object.
A 68 year-old male is experiencing an exacerbation of his COPD. He states he is having a
hard time breathing and it is getting worse. His vital signs are as follows: BP 140/92, HR
118, RR of 25, SpO2 84% on oxygen by nasal cannula at 3L/min. What is the next best
step?
a. Rapid transport and reassess vital signs in 5 minutes
b. Start ventilations with bag-valve mask
c. Provide oxygen by non-rebreather mask
d. Titrate oxygen flow rate on nasal cannula to 6L/min
Provide oxygen by non-rebreather mask
The non-rebreather mask is correct as a higher concentration of oxygen can be administered than
via the nasal cannula, especially since the patient has stated his symptoms are getting worse.
A 21 year-old male was shot in the left chest, below the clavicle. Where should you place
the stethoscope to best hear his lung sounds?
QUESTIONS WITH VERIFIED ANSWERS
Where does gas exchange of oxygen and carbon dioxide occur?
a. larynx
b. bronchioles
c. alveoli
d. main stem bronchi
Alveoli
The alveoli are where the lungs and the blood exchange oxygen and carbon dioxide during the
process of breathing in and breathing out. Oxygen breathed in from the air passes through the
alveoli and into the blood and travels to the tissues throughout the body.
What is the primary role of the epiglottis?
a. bringing oxygen into circulation
b. aids in food digestion
c. assist air flow to the larynx
d. prevent aspiration while eating
prevent aspiration while eating
The main job of the epiglottis is to close over the trachea while you're eating to prevent food
entering your airway.
What is the PRIMARY role of the mediastinum?
a. Protects vital structures of the chest
b. Protects your diaphragm from collapse
c. Protects your lungs from collapse
d. Surrounds the heart's four chambers
protects vital structures of the chest
The mediastinum protects many vital structures including the heart, large vessels, the trachea,
and critical nerves.
You respond to a 8 year old male who states he is having trouble breathing. His respiratory
rate is 44 breaths/min and you notice accessory muscle use on exam. You can hear an
audible wheeze present. What should your initial step be?
a. Start BVM ventilations
,b. Attempt a head tilt-chin lift
c. Obtain his oxygen saturation
d. Gather a SAMPLE history
Obtain his oxygen saturation
This patient is able to speak so the airway is patent, we don't have any oxygen data so we need
that before we can go ahead with oxygen administration. This will give the final piece of info to
start assessing his current status.
You are called to the home of a 4 year old female patient. The patient has a persistent
"barking cough" and has stridor on exam. The mother tells you that this has gotten worse
over the last few nights, until tonight she had a "hard time" breathing. What do you
suspect?
a. Asthma Exacerbation
b. Bronchiolitis
c. Epiglottitis
d. Croup
Croup
Remember the keys for croup, barking cough, stridor, gradual onset, typically seen in young
children. Epiglottitis can occur at any age and has drooling, painful swallowing, stridor and a
more rapid onset, no barking cough.
From the list below name three action steps you can take to help patients with croup or
epiglottitis. (Pick 3)
a. Keep oxygen saturation above 94%
b. Keep the patient calm
c. Begin CPR if the patient has a pulse less than 100
d. Begin bag valve mask ventilations with rapid transport
e. Use blow-by oxygen
f. Immediately begin non-rebreather mask at 15LPM
a. keep oxygen saturation above 94%
b. keep patient calm
e. use blow-by oxygen
You are about to place an airway adjunct into your patient. Which situation would you
NOT place a nasopharyngeal airway?
,a. A semiconscious child who just had a seizure
b. A patient with ecchymosis behind one ear
c. An unconscious patient with an intact gag reflex
d. An semiconscious adult who cannot maintain their own airway
a patient with ecchymosis behind one ear
Bruising behind one ear is known as the "Battle sign" and an indication of a basilar skull
fracture, which is a severe head injury. Use of a nasopharyngeal airway with severe head injuries
is contraindicated.
You are transporting a 53 year-old male who complains of shortness of breath, dizziness,
numbness in his hands, and a dry mouth. His vital signs are: blood pressure 118/80 mmHg,
HR 120, RR of 32, SpO2 99%, and ETCO2 of 26 mmHg. What do you suspect?
a. Hypokalemia
b. Hypoventilation syndrome
c. Pneumothorax
d. Hyperventilation syndrome
Hyperventilation syndrome
This patient is hyperventilating as demonstrated by his increased respiratory rate and low end-
tidal reading levels. A high respiratory rate increases the amount of carbon dioxide exhaled,
accounting for the low end-tidal reading. His heart rate is also a little elevated, possibly due to
anxiety.
A 78 year old female is found lying on her bathroom floor unconscious. Her caregiver
reports finding her like this upon arrival and is unsure what happened. You hear gurgling
sounds on inspiration. What is the next best step?
a. Suction her airway
b. Begin ventilations with a bag-valve mask
c. Insert an oropharyngeal airway
d. Provide nasal cannula at 2 L/min
suction her airway
The gurgling sounds on inspiration suggest her airway needs to be cleared. You want to make
sure you suction and clear her airway before proceeding with treatment.
You assess a 23 year-old male who was struck in the right chest wall with an airbag after a
motor vehicle accident. The patient complains of pain on inspiration and shortness of
, breath. You gather the following from your physical assessment: unequal chest wall rise
and absent lungs sounds on the right side. What do you suspect?
a. Flail chest
b. Cardiac tamponade
c. Tension pneumothorax
d. Right chest contusion
Tension pneumothorax
Tension pneumothorax is where one of the lungs collapses, and can commonly happen with
traumatic events like a motor vehicle crash. Its hallmark signs and symptoms are absent lung
sounds on affected side and unequal rise and fall of the chest.
You arrive on scene to a 4 year-old girl choking on her food. She is unresponsive and not
breathing. What is the next best step in the management of this patient?
a. Start chest compressions
b. Provide 5 back slaps
c. Inspect the airway with a finger sweep
d. Perform abdominal thrust
Start chest compressions
Since the child is unresponsive and not breathing, this would be the best method to try and
remove the foreign object.
A 68 year-old male is experiencing an exacerbation of his COPD. He states he is having a
hard time breathing and it is getting worse. His vital signs are as follows: BP 140/92, HR
118, RR of 25, SpO2 84% on oxygen by nasal cannula at 3L/min. What is the next best
step?
a. Rapid transport and reassess vital signs in 5 minutes
b. Start ventilations with bag-valve mask
c. Provide oxygen by non-rebreather mask
d. Titrate oxygen flow rate on nasal cannula to 6L/min
Provide oxygen by non-rebreather mask
The non-rebreather mask is correct as a higher concentration of oxygen can be administered than
via the nasal cannula, especially since the patient has stated his symptoms are getting worse.
A 21 year-old male was shot in the left chest, below the clavicle. Where should you place
the stethoscope to best hear his lung sounds?
