NREMT Practice Test Bank -
Multiple Choice Questions And
Correct Detailed Answers (Verified
Answers) |Already Graded
A+||Brand New Version!!
Reason: In compensated shock, the nervous system is mounting a
physiologic response to an underlying illness or injury in order to maintain
perfusion to vital organs such as the brain, heart, and kidneys. The patient
with compensated shock is restless or anxious, has poor peripheral perfusion
(eg, pallor, diaphoresis), tachycardia, and increased respirations (tachypnea).
However, his or her blood pressure is maintained, usually above 90 to 100
mm Hg. In decompensated shock, the body's compensatory mechanisms fail,
blood pressure begins to fall, and perfusion to vital organs decreases. Other
signs of decompensated shock include a decreased level of consciousness,
absent peripheral pulses (radial), and weak central pulses (carotid, femoral).
Following administration of nitroglycerin to a man with crushing chest
pressure, he experiences a significant increase in his heart rate. This is
MOST likely the result of: • A:a cardiac dysrhythmia. • B:a drop in blood
pressure. • C:coronary vasoconstriction. • D:preexisting hypertension. -
ANSWER//The correct answer is B; Reason: Nitroglycerin (NTG) is a
vasodilator drug. It dilates not only the coronary arteries, but also other
arteries in the body. In some patients, NTG may cause a drop in blood
pressure, especially if they are taking other medications that cause
vasodilation (eg, erectile dysfunction drugs [Viagra, Levitra, Cialis]). In
response to a drop in blood pressure, the nervous system attempts to
compensate by increasing the heart rate (tachycardia). Common side effects
of NTG include a headache, a burning sensation under the tongue, or a bitter
taste in the mouth. Always assess the patient's vital signs, before and after
administering nitroglycerin. The process of loading oxygen molecules onto
hemoglobin molecules in the bloodstream is called: • A:respiration. •
B:oxygenation. • C:ventilation. • D:diffusion. - ANSWER//You selected B; This
is correct! Reason: Oxygenation is the process of loading oxygen molecules
onto hemoglobin molecules in the blood. Adequate oxygenation is required for
internal (cellular) respiration to take place. Diffusion is the process in which
gases (oxygen and carbon dioxide) move from an area of higher
concentration to an area of lower concentration. Ventilation is the act of
moving air into and out of the lungs. Negative-pressure ventilation is the act of
normal, unassisted breathing, and occurs when the diaphragm and intercostal
muscles contract, which creates a vacuum and draws air into the lungs.
Positive-pressure ventilation is the act of forcing air into the lungs, such as
when you are providing rescue breathing to an apneic patient or assisting the
ventilations of a patient who is breathing inadequately. Respiration is the
exchange of gases between the body and its environment. Pulmonary
,(external) respiration occurs when gases are exchanged in the lungs and
cellular (internal) respiration occurs when gases are exchanged at the cellular
level. Which of the following patients would MOST likely present with vague or
unusual symptoms of an acute myocardial infarction? • A:75-year-old male
with hypertension • B:55-year-old obese female • C:66-year-old male with
angina • D:72-year-old female with diabetes - ANSWER//You selected D; This
is correct! Reason: Not all patients experiencing acute myocardial infarction
(AMI) present with the classic signs and symptoms one would expect. Middle-
aged men often minimize their symptoms and attribute their chest pain or
discomfort to indigestion. Some patients, however, do not experience any
pain. In particular, elderly women with diabetes may present with vague,
unusual, or atypical symptoms of AMI; their only presenting complaint may be
fatigue or syncope. Do not rule out a cardiac problem just because a patient is
not experiencing chest pain, pressure, or discomfort; this is especially true in
elderly females with diabetes. Which of the following is MOST indicative of a
primary cardiac problem? • A:Tachypnea • B:Sudden fainting • C:Irregular
pulse • D:Tachycardia - ANSWER//You selected C; This is correct! Reason:
An irregular pulse signifies an abnormality within the electrical conduction
system of the heart. Tachycardia, sudden fainting (syncope), and tachypnea
(rapid breathing) can indicate many things other than cardiac problems, such
as shock, heat-related problems, and diabetic complications. You should
always consider the possibility of a cardiac problem in a patient with an
irregular pulse. A 56-year-old man was the unrestrained driver of a small
passenger car that rolled over twice after he rounded a corner too fast. He is
unresponsive; has rapid, shallow respirations; and has a rapid, weak pulse.
His left arm is completely amputated just below the elbow. As you and your
partner are treating the patient, other responders are trying to find the
amputated arm. Which of the following statements regarding this scenario is
correct? • A:Your priority should be to recover the man's arm because a
vascular surgeon may be able to successfully reattach it. • B:Quickly move the
patient to the ambulance, continue treatment, and wait for the other
responders to recover his arm. • C:You should transport the patient
immediately, even if the other responders recover his arm before you depart
the scene. • D:If the patient's arm has not been recovered by the time you are
ready to transport, you should transport without d - ANSWER//You selected D;
This is correct! Reason: Life takes priority over limb. The patient is in shock,
which may be complicated by a head injury; therefore, he requires rapid
transport to a trauma center. Although efforts should be made to recover an
amputated body part, this must not delay transport of a critically injured
patient. If the arm has not been recovered by the time you are ready to
transport, you must transport without delay. If his arm is located after you
depart the scene, it can be transported separately. If his arm is recovered
before you depart the scene, however, you should take it with you; surgeons
may be able to successfully reattach it. Care for the amputated part in
accordance with your local protocols. When assessing a patient who
complains of chest pain, which of the following questions would you ask to
assess the "R" in OPQRST? • A:Is there anything that makes the pain worse?
• B:Is the pain in one place or does it move around? • C:Did the pain begin
suddenly or gradually? • D:What were you doing when the pain began? -
ANSWER//You selected B; This is correct! Reason: The "R" in OPQRST
,stands for radiation or referred pain. An appropriate way to determine whether
the pain radiates or not is to ask the patient if the pain remains in one place or
if it moves around. When determining if the patient has referred pain, ask him
or her if he or she hurts somewhere other than his or her chest. If you use the
term "radiating pain," chances are the patient will not understand what you are
asking. You are assessing a young male who was stabbed in the right lower
chest. He is semiconscious and has labored breathing, collapsed jugular
veins, and absent breath sounds on the right side of his chest. This patient
MOST likely has a: • A:liver laceration. • B:hemothorax. • C:pneumothorax. •
D:ruptured spleen. - ANSWER//You selected B; This is correct! Reason: You
should suspect a hemothorax if a patient with chest trauma presents with
shock, especially if the injury was caused by penetrating trauma. Hemothorax
Hypoglycemia and acute ischemic stroke can present similarly because: •
A:both oxygen and glucose are needed for brain function. • B:the majority of
stroke patients have a history of diabetes. • C:the most common cause of a
stroke is hypoglycemia. • D:they are both caused by low levels of glucose in
the blood. - ANSWER//• A:both oxygen and glucose are needed for brain
function. Reason: Although stroke and hypoglycemia are two distinctly
different conditions, their signs and symptoms are often similar. This is
because the brain requires both oxygen and glucose to function normally. An
acute ischemic stroke is caused by a lack of oxygen to a part of the brain due
to a blocked cerebral artery, whereas hypoglycemia (low blood glucose level)
deprives the entire brain of glucose. In either case, the patient presents with
signs of impaired brain function (ie, slurred speech, weakness, altered mental
status). Both conditions may lead to permanent brain damage or death if not
treated promptly. When dealing with an emotionally disturbed patient, you
should be MOST concerned with: • A:gathering all of the patient's medications.
• B:safely transporting to the hospital. • C:whether the patient could harm you.
• D:obtaining a complete medical history. - ANSWER//You selected C; This is
correct! Reason: When managing any patient with an emotional or psychiatric
crisis, your primary concern is your own safety. Safely transporting the patient
to the hospital is your ultimate goal. If possible, you should attempt to obtain a
medical history and should take any of the patient's prescribed medications to
the hospital. However, this should not supercede your own safety or interfere
with safely transporting the patient. You are at the scene where a man
panicked while swimming in a small lake. Your initial attempt to rescue him
should include: • A:rowing a small raft to the victim. • B:reaching for the victim
with a long stick. • C:throwing a rope to the victim. • D:swimming to the victim
to rescue him. - ANSWER//You selected B; This is correct! Reason: General
rules to follow when attempting to rescue a patient from the water include
"reach, throw, row, and then go." In this case, you should attempt to reach the
victim by having him grab hold of a large stick or similar object. If this is
unsuccessful, throw the victim a rope or flotation device (if available). If these
are not available, row to the patient in a small raft (if available). Going into the
water to retrieve the victim is a last resort. The rescuer must be a strong
swimmer because patients who are in danger of drowning are in a state of
blind panic and will make every attempt to keep themselves afloat, even if it
means forcing the rescuer underwater. How should you classify a patient's
nature of illness if he or she has a low blood glucose level, bizarre behavior,
, and shallow breathing? • A:Behavioral emergency • B:Altered mental status •
C:Respiratory emergency • D:Cardiac compromise - ANSWER//The correct
answer is B; Reason: The nature of illness (NOI) is the medical equivalent to
mechanism of injury (MOI). Altered mental status should be the suspected
NOI in any patient with any fluctuation in level of consciousness, which can
range from bizarre behavior to complete unresponsiveness. Causes of an
altered mental status include hypo- or hyperglycemia, head trauma, stroke,
behavioral crises, drug overdose, and shock, among others. A young female
is unresponsive after overdosing on an unknown type of drug. Her
respirations are slow and shallow and her pulse is slow and weak. Which of
the following drugs is the LEAST likely cause of her condition? • A:Seconal •
B:Heroin • C:Cocaine • D:Valium - ANSWER//The correct answer is C;
Reason: Of the drugs listed, cocaine would be the least likely cause of the
patient's condition. Cocaine is a central nervous system (CNS) stimulant; you
would expect her to be hypertensive, tachycardic, tachypneic, and perhaps
even violent. Heroin, Valium, and Seconal are all CNS depressants and could
explain her condition. Heroin is an illegal narcotic (opiate), Valium is a
benzodiazepine sedative-hypnotic drug, and Seconal is a barbiturate.
Narcotics, benzodiazepines, and barbiturates are all CNS depressants. When
taken in excess, they cause a decreased level of consciousness, respiratory
depression, bradycardia, and hypotension. Activated charcoal is
contraindicated for a patient who is: • A:conscious and alert and has ingested
a large amount of Motrin. • B:emotionally upset and has ingested two bottles
of aspirin. • C:agitated and claims to have ingested a bottle of Tylenol. •
D:awake and alert and has swallowed a commercial drain cleaner. -
ANSWER//You selected D; This is correct! Reason:Activated charcoal
adsorbs (sticks to) many ingested substances, preventing them from being
absorbed into the body by the stomach or intestines. In some cases, you may
give activated charcoal to patients who have ingested certain substances, if
approved by medical control or local protocol. Activated charcoal is
contraindicated for patients who have ingested an acid or alkali (ie, drain
cleaner) or a petroleum product (ie, gasoline), who have a decreased level of
consciousness and cannot protect their own airway, or who are unable to
swallow. The MOST obvious way to reduce heat loss from radiation and
convection is to: • A:move away from a cold object. • B:increase metabolism
by shivering. • C:wear a thick wind-proof jacket. • D:move to a warmer
environment. - ANSWER//you selected D; This is correct! Reason:In a cold
environment, the body has two ways of staying warm: generating heat
(thermogenesis) and reducing heat loss. Radiation is the transfer of heat by
radiant energy. The body can lose heat by radiation, such as when a person
stands in a cold room. Convection occurs when heat is transferred to
circulating air, as when cool air moves across the body's surface. A person
standing in windy cold weather, wearing lightweight clothing, is losing heat to
the environment mostly by convection. The quickest and most obvious way to
decrease heat loss from radiation and convection is to move out of the cold
environment and seek shelter from wind. Shivering increases the body's
metabolism and is a mechanism for generating heat, not reducing heat loss.
Layers of clothing trap air and provide excellent insulation; thus, layered
clothing decreases heat loss better than a single, thick jacket. Conduction is
the direct transfer of heat from a part of the body to a colder object by direct
Multiple Choice Questions And
Correct Detailed Answers (Verified
Answers) |Already Graded
A+||Brand New Version!!
Reason: In compensated shock, the nervous system is mounting a
physiologic response to an underlying illness or injury in order to maintain
perfusion to vital organs such as the brain, heart, and kidneys. The patient
with compensated shock is restless or anxious, has poor peripheral perfusion
(eg, pallor, diaphoresis), tachycardia, and increased respirations (tachypnea).
However, his or her blood pressure is maintained, usually above 90 to 100
mm Hg. In decompensated shock, the body's compensatory mechanisms fail,
blood pressure begins to fall, and perfusion to vital organs decreases. Other
signs of decompensated shock include a decreased level of consciousness,
absent peripheral pulses (radial), and weak central pulses (carotid, femoral).
Following administration of nitroglycerin to a man with crushing chest
pressure, he experiences a significant increase in his heart rate. This is
MOST likely the result of: • A:a cardiac dysrhythmia. • B:a drop in blood
pressure. • C:coronary vasoconstriction. • D:preexisting hypertension. -
ANSWER//The correct answer is B; Reason: Nitroglycerin (NTG) is a
vasodilator drug. It dilates not only the coronary arteries, but also other
arteries in the body. In some patients, NTG may cause a drop in blood
pressure, especially if they are taking other medications that cause
vasodilation (eg, erectile dysfunction drugs [Viagra, Levitra, Cialis]). In
response to a drop in blood pressure, the nervous system attempts to
compensate by increasing the heart rate (tachycardia). Common side effects
of NTG include a headache, a burning sensation under the tongue, or a bitter
taste in the mouth. Always assess the patient's vital signs, before and after
administering nitroglycerin. The process of loading oxygen molecules onto
hemoglobin molecules in the bloodstream is called: • A:respiration. •
B:oxygenation. • C:ventilation. • D:diffusion. - ANSWER//You selected B; This
is correct! Reason: Oxygenation is the process of loading oxygen molecules
onto hemoglobin molecules in the blood. Adequate oxygenation is required for
internal (cellular) respiration to take place. Diffusion is the process in which
gases (oxygen and carbon dioxide) move from an area of higher
concentration to an area of lower concentration. Ventilation is the act of
moving air into and out of the lungs. Negative-pressure ventilation is the act of
normal, unassisted breathing, and occurs when the diaphragm and intercostal
muscles contract, which creates a vacuum and draws air into the lungs.
Positive-pressure ventilation is the act of forcing air into the lungs, such as
when you are providing rescue breathing to an apneic patient or assisting the
ventilations of a patient who is breathing inadequately. Respiration is the
exchange of gases between the body and its environment. Pulmonary
,(external) respiration occurs when gases are exchanged in the lungs and
cellular (internal) respiration occurs when gases are exchanged at the cellular
level. Which of the following patients would MOST likely present with vague or
unusual symptoms of an acute myocardial infarction? • A:75-year-old male
with hypertension • B:55-year-old obese female • C:66-year-old male with
angina • D:72-year-old female with diabetes - ANSWER//You selected D; This
is correct! Reason: Not all patients experiencing acute myocardial infarction
(AMI) present with the classic signs and symptoms one would expect. Middle-
aged men often minimize their symptoms and attribute their chest pain or
discomfort to indigestion. Some patients, however, do not experience any
pain. In particular, elderly women with diabetes may present with vague,
unusual, or atypical symptoms of AMI; their only presenting complaint may be
fatigue or syncope. Do not rule out a cardiac problem just because a patient is
not experiencing chest pain, pressure, or discomfort; this is especially true in
elderly females with diabetes. Which of the following is MOST indicative of a
primary cardiac problem? • A:Tachypnea • B:Sudden fainting • C:Irregular
pulse • D:Tachycardia - ANSWER//You selected C; This is correct! Reason:
An irregular pulse signifies an abnormality within the electrical conduction
system of the heart. Tachycardia, sudden fainting (syncope), and tachypnea
(rapid breathing) can indicate many things other than cardiac problems, such
as shock, heat-related problems, and diabetic complications. You should
always consider the possibility of a cardiac problem in a patient with an
irregular pulse. A 56-year-old man was the unrestrained driver of a small
passenger car that rolled over twice after he rounded a corner too fast. He is
unresponsive; has rapid, shallow respirations; and has a rapid, weak pulse.
His left arm is completely amputated just below the elbow. As you and your
partner are treating the patient, other responders are trying to find the
amputated arm. Which of the following statements regarding this scenario is
correct? • A:Your priority should be to recover the man's arm because a
vascular surgeon may be able to successfully reattach it. • B:Quickly move the
patient to the ambulance, continue treatment, and wait for the other
responders to recover his arm. • C:You should transport the patient
immediately, even if the other responders recover his arm before you depart
the scene. • D:If the patient's arm has not been recovered by the time you are
ready to transport, you should transport without d - ANSWER//You selected D;
This is correct! Reason: Life takes priority over limb. The patient is in shock,
which may be complicated by a head injury; therefore, he requires rapid
transport to a trauma center. Although efforts should be made to recover an
amputated body part, this must not delay transport of a critically injured
patient. If the arm has not been recovered by the time you are ready to
transport, you must transport without delay. If his arm is located after you
depart the scene, it can be transported separately. If his arm is recovered
before you depart the scene, however, you should take it with you; surgeons
may be able to successfully reattach it. Care for the amputated part in
accordance with your local protocols. When assessing a patient who
complains of chest pain, which of the following questions would you ask to
assess the "R" in OPQRST? • A:Is there anything that makes the pain worse?
• B:Is the pain in one place or does it move around? • C:Did the pain begin
suddenly or gradually? • D:What were you doing when the pain began? -
ANSWER//You selected B; This is correct! Reason: The "R" in OPQRST
,stands for radiation or referred pain. An appropriate way to determine whether
the pain radiates or not is to ask the patient if the pain remains in one place or
if it moves around. When determining if the patient has referred pain, ask him
or her if he or she hurts somewhere other than his or her chest. If you use the
term "radiating pain," chances are the patient will not understand what you are
asking. You are assessing a young male who was stabbed in the right lower
chest. He is semiconscious and has labored breathing, collapsed jugular
veins, and absent breath sounds on the right side of his chest. This patient
MOST likely has a: • A:liver laceration. • B:hemothorax. • C:pneumothorax. •
D:ruptured spleen. - ANSWER//You selected B; This is correct! Reason: You
should suspect a hemothorax if a patient with chest trauma presents with
shock, especially if the injury was caused by penetrating trauma. Hemothorax
Hypoglycemia and acute ischemic stroke can present similarly because: •
A:both oxygen and glucose are needed for brain function. • B:the majority of
stroke patients have a history of diabetes. • C:the most common cause of a
stroke is hypoglycemia. • D:they are both caused by low levels of glucose in
the blood. - ANSWER//• A:both oxygen and glucose are needed for brain
function. Reason: Although stroke and hypoglycemia are two distinctly
different conditions, their signs and symptoms are often similar. This is
because the brain requires both oxygen and glucose to function normally. An
acute ischemic stroke is caused by a lack of oxygen to a part of the brain due
to a blocked cerebral artery, whereas hypoglycemia (low blood glucose level)
deprives the entire brain of glucose. In either case, the patient presents with
signs of impaired brain function (ie, slurred speech, weakness, altered mental
status). Both conditions may lead to permanent brain damage or death if not
treated promptly. When dealing with an emotionally disturbed patient, you
should be MOST concerned with: • A:gathering all of the patient's medications.
• B:safely transporting to the hospital. • C:whether the patient could harm you.
• D:obtaining a complete medical history. - ANSWER//You selected C; This is
correct! Reason: When managing any patient with an emotional or psychiatric
crisis, your primary concern is your own safety. Safely transporting the patient
to the hospital is your ultimate goal. If possible, you should attempt to obtain a
medical history and should take any of the patient's prescribed medications to
the hospital. However, this should not supercede your own safety or interfere
with safely transporting the patient. You are at the scene where a man
panicked while swimming in a small lake. Your initial attempt to rescue him
should include: • A:rowing a small raft to the victim. • B:reaching for the victim
with a long stick. • C:throwing a rope to the victim. • D:swimming to the victim
to rescue him. - ANSWER//You selected B; This is correct! Reason: General
rules to follow when attempting to rescue a patient from the water include
"reach, throw, row, and then go." In this case, you should attempt to reach the
victim by having him grab hold of a large stick or similar object. If this is
unsuccessful, throw the victim a rope or flotation device (if available). If these
are not available, row to the patient in a small raft (if available). Going into the
water to retrieve the victim is a last resort. The rescuer must be a strong
swimmer because patients who are in danger of drowning are in a state of
blind panic and will make every attempt to keep themselves afloat, even if it
means forcing the rescuer underwater. How should you classify a patient's
nature of illness if he or she has a low blood glucose level, bizarre behavior,
, and shallow breathing? • A:Behavioral emergency • B:Altered mental status •
C:Respiratory emergency • D:Cardiac compromise - ANSWER//The correct
answer is B; Reason: The nature of illness (NOI) is the medical equivalent to
mechanism of injury (MOI). Altered mental status should be the suspected
NOI in any patient with any fluctuation in level of consciousness, which can
range from bizarre behavior to complete unresponsiveness. Causes of an
altered mental status include hypo- or hyperglycemia, head trauma, stroke,
behavioral crises, drug overdose, and shock, among others. A young female
is unresponsive after overdosing on an unknown type of drug. Her
respirations are slow and shallow and her pulse is slow and weak. Which of
the following drugs is the LEAST likely cause of her condition? • A:Seconal •
B:Heroin • C:Cocaine • D:Valium - ANSWER//The correct answer is C;
Reason: Of the drugs listed, cocaine would be the least likely cause of the
patient's condition. Cocaine is a central nervous system (CNS) stimulant; you
would expect her to be hypertensive, tachycardic, tachypneic, and perhaps
even violent. Heroin, Valium, and Seconal are all CNS depressants and could
explain her condition. Heroin is an illegal narcotic (opiate), Valium is a
benzodiazepine sedative-hypnotic drug, and Seconal is a barbiturate.
Narcotics, benzodiazepines, and barbiturates are all CNS depressants. When
taken in excess, they cause a decreased level of consciousness, respiratory
depression, bradycardia, and hypotension. Activated charcoal is
contraindicated for a patient who is: • A:conscious and alert and has ingested
a large amount of Motrin. • B:emotionally upset and has ingested two bottles
of aspirin. • C:agitated and claims to have ingested a bottle of Tylenol. •
D:awake and alert and has swallowed a commercial drain cleaner. -
ANSWER//You selected D; This is correct! Reason:Activated charcoal
adsorbs (sticks to) many ingested substances, preventing them from being
absorbed into the body by the stomach or intestines. In some cases, you may
give activated charcoal to patients who have ingested certain substances, if
approved by medical control or local protocol. Activated charcoal is
contraindicated for patients who have ingested an acid or alkali (ie, drain
cleaner) or a petroleum product (ie, gasoline), who have a decreased level of
consciousness and cannot protect their own airway, or who are unable to
swallow. The MOST obvious way to reduce heat loss from radiation and
convection is to: • A:move away from a cold object. • B:increase metabolism
by shivering. • C:wear a thick wind-proof jacket. • D:move to a warmer
environment. - ANSWER//you selected D; This is correct! Reason:In a cold
environment, the body has two ways of staying warm: generating heat
(thermogenesis) and reducing heat loss. Radiation is the transfer of heat by
radiant energy. The body can lose heat by radiation, such as when a person
stands in a cold room. Convection occurs when heat is transferred to
circulating air, as when cool air moves across the body's surface. A person
standing in windy cold weather, wearing lightweight clothing, is losing heat to
the environment mostly by convection. The quickest and most obvious way to
decrease heat loss from radiation and convection is to move out of the cold
environment and seek shelter from wind. Shivering increases the body's
metabolism and is a mechanism for generating heat, not reducing heat loss.
Layers of clothing trap air and provide excellent insulation; thus, layered
clothing decreases heat loss better than a single, thick jacket. Conduction is
the direct transfer of heat from a part of the body to a colder object by direct
