NREMT EXAM 2026 EXAM TEST PAPER UPDATED
QUESTIONS AND ANSWERS 100% CORRECT
Exam
cardiogenic shock - answer-the type of shock caused by inadequate function of the
heart. This develops when the heart cannot maintain sufficient output to meet the
demands of the body
-caused by any disease or event which prevents heart pumping
-can occur directly after AMI up to 24 hours
Obstructive shock - answerThe type of shock that results when conditions that cause
mechanical obstruction of the cardiac muscle also impact pump function
ex. cardiac tamponade, tension pneumothorax
Beck's triad - answerSigns of a cardiac tamponade. JVD, narrowing BP pressures,
muffled heart sounds
Distributive shock - answerThe type of shock when there is widespread dilation of the
small arterioles, venules, or both. Blood pools in the expanded vascular beds and tissue
perfusion decreases
Types of distributive shock - answerSeptic shock caused by severe infections;
neurogenic shock caused by damage to the spinal cord (bradycardia, low BP, warm
skin); anaphylactic shock caused by allergic reaction; psychogenic shock
Hypovolemic shock - answerThe type of shock that results from an inadequate amount
of fluid or volume in the system
-15% of blood volume
How do you treat for shock? - answerKeep the patient warm, control bleeding, put the
patient in a position of comfort, and administer high-flow oxygen
brain damage without oxygen - answer-without enough oxygen, cardiac arrest or brain
damage occurs within about 4 minutes
-permanent brain damage within 6 minutes
-death likely within 10 minutes
FBAO - answer-signs of blockage include inability to cough or speak or inability to
ventilate patient
-bending patient forward at the waist, support chest with one hand, use heel of hand to
give 5 back blows between shoulder blades
,-then 5 abdominal thrusts
-alternate between the two until object is dislodged
-if patient loses consciousness, give CPR starting with chest compressions
-given even if patient has a pulse, so don't check
-before giving breaths, look inside mouth for any visible objects
FBAO in children - answer-using thigh for support, lay facing down along forearm;
ensure head is lower than the body
-give 5 firm back blows between blades
-5 chest thrusts; place 2 to 3 fingers in the middle of the chest just below the nipples.
push down 1.5 inches.
-alternate, unless lose consciousness, then CPR
mouse to mouth/mouth to nose - answer-mouth to mouth performed when patient does
not have adequate breathing and artificial ventilation not available
-open airway
-place barrier device
-pinch nose and form seal around patient's mouth
-check for FBAO if you do not see chest rise and fall
-give 1 breath every 5 to 6 seconds for adults and 1 every 3 for peds
Steps of CPR - answerDetermine unresponsiveness. Check for breathing for up to 10
seconds. Check carotid pulse for up to 10 seconds. Begin CPR until AED is available.
Give 30 compressions at 100 beats/min and then 2 breaths over the course of 1
second. Once an advanced airway is inserted, ventilate at a rate of 8-10 breaths/min
and do not stop compressions.
This is exactly the same for children, except two-rescuer CPR is 15:2. If patient
experiences a return of spontaneous circulation, ventilate at a rate of 10-12 breaths/min.
compression to breath ratios - answerunder 8 years old:
-2 provider: 15:2
-1 provider: 30:2
-one third of chest diameter
older:
-30:2 always
-2 inches
AED procedure - answer-if cardiac arrest was not seen by EMS, give 5 cycles of 30:2
before defibrillating
-if cardiac arrest was seen, one EMT begins compressions and the other applies AED
-if only one EMT available, apply AED immediately
-check for pulse 2 minutes after defib
-if no shockable rhythm, wait 2 minutes and re-analyze
,When to place left lateral - answerIf patient has adequate breathing and is uninjured. To
maintain a patent airway in an unresponsive patient.
What to do if you fail to ventilate - answerIf the breath doesn't go in successfully,
reposition the patient and try again. If there is still nothing, assume there is a foreign
body obstruction and begin CPR on an unresponsive apneic patient. Continue to
attempt ventilations and open the mouth and look in every time.
Pneumothorax signs - answer-dyspnea, pleuritic chest pain that worsens during
inspiration and expiration, absent or decreased breath sounds
-rupture of visceral lining
Pulmonary embolism signs - answer-dyspnea, acute chest pain, hemoptysis, cyanosis,
tachypnea, hypoxia, tachycardia?**
GCS Eye Opening - answerSpontaneous = 4
To voice = 3
To pain = 2
None = 1
GCS Verbal Response - answerOriented = 5
Confused = 4
Inappropriate words = 3
Incomprehensible words = 2
None = 1
GCS Motor Response - answerObeys commands = 6
Localizes pain = 5
Withdraws (pain) = 4
Flexion (pain) = 3
Extension (pain) = 2
None = 1
Rule of nines (adults) - answerHead = 9%
Front = 18%
Back = 18%
Each arm = 9%
Groin = 1%
Each leg = 18%
Rule of nines (child) - answerHead = 18%
Front = 18%
Back = 18%
Each arm = 9%
Each leg = 14%
, Cushing's triad - answerSign there might be an increase in intracranial pressure.
Hypertension, bradycardia, and abnormal breathing.
Appendicitis pain - answer-pain to the RLQ
-rebounding pain
-fever
peritonitis - answer-inflammation of peritoneum
-abdominal pain, lack of appetite, markle test
markle heel drop - answermarkle test; used to assess a patient with abdominal pain,
patient drops down onto heels, pain will be felt in region of pain source
cholecystitis pain - answerRUQ pain, referred to the right shoulder
gastrointestinal bleeding - answer-hematemesis
-hematochezia (blood in stool)
-melena (dark, tarry stool)
esophageal varices - answer-weakening of blood vessels in esophagus
-alcoholism
-vomiting large amounts of bright red blood
Aortic aneurysm pain - answerLower back and lower quadrants pain; tearing
Mallory Weiss syndrome - answerWhen the junction between the esophagus and the
stomach tears. Alcoholism and eating disorders can cause this
Three P's of diabetes - answerPolyuria, polyphagia, and polydipsia. When the patient
has hyperglycemia, glucose is excreted by the kidney and the process requires a large
amount of water.
DKA - answerWithout glucose in the cells, the body will break down fat. When fat is
used as an immediate energy source, chemicals called ketones and fatty acids are
formed as waste products and are hard for the body to excrete
signs: Kussmaul respirations, vomiting, abdominal pain, tachycardia
Kussmaul respirations - answerHelp the body blow off excess acids (CO2) which are
deep, rapid breaths
Signs of hyperglycemia - answergradual onset, warm and dry skin, fruity breath,
Kussmaul respirations (rapid and deep), restlessness, slurred speech, gradual response
to treatment, diabetic coma
Diabetic coma - answerOr hyperglycemic crisis. A state of unconsciousness resulting
from ketoacidosis, hyperglycemia, and dehydration
QUESTIONS AND ANSWERS 100% CORRECT
Exam
cardiogenic shock - answer-the type of shock caused by inadequate function of the
heart. This develops when the heart cannot maintain sufficient output to meet the
demands of the body
-caused by any disease or event which prevents heart pumping
-can occur directly after AMI up to 24 hours
Obstructive shock - answerThe type of shock that results when conditions that cause
mechanical obstruction of the cardiac muscle also impact pump function
ex. cardiac tamponade, tension pneumothorax
Beck's triad - answerSigns of a cardiac tamponade. JVD, narrowing BP pressures,
muffled heart sounds
Distributive shock - answerThe type of shock when there is widespread dilation of the
small arterioles, venules, or both. Blood pools in the expanded vascular beds and tissue
perfusion decreases
Types of distributive shock - answerSeptic shock caused by severe infections;
neurogenic shock caused by damage to the spinal cord (bradycardia, low BP, warm
skin); anaphylactic shock caused by allergic reaction; psychogenic shock
Hypovolemic shock - answerThe type of shock that results from an inadequate amount
of fluid or volume in the system
-15% of blood volume
How do you treat for shock? - answerKeep the patient warm, control bleeding, put the
patient in a position of comfort, and administer high-flow oxygen
brain damage without oxygen - answer-without enough oxygen, cardiac arrest or brain
damage occurs within about 4 minutes
-permanent brain damage within 6 minutes
-death likely within 10 minutes
FBAO - answer-signs of blockage include inability to cough or speak or inability to
ventilate patient
-bending patient forward at the waist, support chest with one hand, use heel of hand to
give 5 back blows between shoulder blades
,-then 5 abdominal thrusts
-alternate between the two until object is dislodged
-if patient loses consciousness, give CPR starting with chest compressions
-given even if patient has a pulse, so don't check
-before giving breaths, look inside mouth for any visible objects
FBAO in children - answer-using thigh for support, lay facing down along forearm;
ensure head is lower than the body
-give 5 firm back blows between blades
-5 chest thrusts; place 2 to 3 fingers in the middle of the chest just below the nipples.
push down 1.5 inches.
-alternate, unless lose consciousness, then CPR
mouse to mouth/mouth to nose - answer-mouth to mouth performed when patient does
not have adequate breathing and artificial ventilation not available
-open airway
-place barrier device
-pinch nose and form seal around patient's mouth
-check for FBAO if you do not see chest rise and fall
-give 1 breath every 5 to 6 seconds for adults and 1 every 3 for peds
Steps of CPR - answerDetermine unresponsiveness. Check for breathing for up to 10
seconds. Check carotid pulse for up to 10 seconds. Begin CPR until AED is available.
Give 30 compressions at 100 beats/min and then 2 breaths over the course of 1
second. Once an advanced airway is inserted, ventilate at a rate of 8-10 breaths/min
and do not stop compressions.
This is exactly the same for children, except two-rescuer CPR is 15:2. If patient
experiences a return of spontaneous circulation, ventilate at a rate of 10-12 breaths/min.
compression to breath ratios - answerunder 8 years old:
-2 provider: 15:2
-1 provider: 30:2
-one third of chest diameter
older:
-30:2 always
-2 inches
AED procedure - answer-if cardiac arrest was not seen by EMS, give 5 cycles of 30:2
before defibrillating
-if cardiac arrest was seen, one EMT begins compressions and the other applies AED
-if only one EMT available, apply AED immediately
-check for pulse 2 minutes after defib
-if no shockable rhythm, wait 2 minutes and re-analyze
,When to place left lateral - answerIf patient has adequate breathing and is uninjured. To
maintain a patent airway in an unresponsive patient.
What to do if you fail to ventilate - answerIf the breath doesn't go in successfully,
reposition the patient and try again. If there is still nothing, assume there is a foreign
body obstruction and begin CPR on an unresponsive apneic patient. Continue to
attempt ventilations and open the mouth and look in every time.
Pneumothorax signs - answer-dyspnea, pleuritic chest pain that worsens during
inspiration and expiration, absent or decreased breath sounds
-rupture of visceral lining
Pulmonary embolism signs - answer-dyspnea, acute chest pain, hemoptysis, cyanosis,
tachypnea, hypoxia, tachycardia?**
GCS Eye Opening - answerSpontaneous = 4
To voice = 3
To pain = 2
None = 1
GCS Verbal Response - answerOriented = 5
Confused = 4
Inappropriate words = 3
Incomprehensible words = 2
None = 1
GCS Motor Response - answerObeys commands = 6
Localizes pain = 5
Withdraws (pain) = 4
Flexion (pain) = 3
Extension (pain) = 2
None = 1
Rule of nines (adults) - answerHead = 9%
Front = 18%
Back = 18%
Each arm = 9%
Groin = 1%
Each leg = 18%
Rule of nines (child) - answerHead = 18%
Front = 18%
Back = 18%
Each arm = 9%
Each leg = 14%
, Cushing's triad - answerSign there might be an increase in intracranial pressure.
Hypertension, bradycardia, and abnormal breathing.
Appendicitis pain - answer-pain to the RLQ
-rebounding pain
-fever
peritonitis - answer-inflammation of peritoneum
-abdominal pain, lack of appetite, markle test
markle heel drop - answermarkle test; used to assess a patient with abdominal pain,
patient drops down onto heels, pain will be felt in region of pain source
cholecystitis pain - answerRUQ pain, referred to the right shoulder
gastrointestinal bleeding - answer-hematemesis
-hematochezia (blood in stool)
-melena (dark, tarry stool)
esophageal varices - answer-weakening of blood vessels in esophagus
-alcoholism
-vomiting large amounts of bright red blood
Aortic aneurysm pain - answerLower back and lower quadrants pain; tearing
Mallory Weiss syndrome - answerWhen the junction between the esophagus and the
stomach tears. Alcoholism and eating disorders can cause this
Three P's of diabetes - answerPolyuria, polyphagia, and polydipsia. When the patient
has hyperglycemia, glucose is excreted by the kidney and the process requires a large
amount of water.
DKA - answerWithout glucose in the cells, the body will break down fat. When fat is
used as an immediate energy source, chemicals called ketones and fatty acids are
formed as waste products and are hard for the body to excrete
signs: Kussmaul respirations, vomiting, abdominal pain, tachycardia
Kussmaul respirations - answerHelp the body blow off excess acids (CO2) which are
deep, rapid breaths
Signs of hyperglycemia - answergradual onset, warm and dry skin, fruity breath,
Kussmaul respirations (rapid and deep), restlessness, slurred speech, gradual response
to treatment, diabetic coma
Diabetic coma - answerOr hyperglycemic crisis. A state of unconsciousness resulting
from ketoacidosis, hyperglycemia, and dehydration
