NR EXAM zm
Exam Solution zm
NREMT Bank Multiple Choice 2026 A+ GRADE ASSURE zm zm zm zm zm zm zm
D COMPLETE SOLUTIONS AND VERIFIED ANSWERS (22
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679)
QUESTION 1 zm
Hypoglycemia and acute ischemic stroke can present similarly because: • A:both oxyge
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n and glucose are needed for brain function. • B:the majority of stroke patients have
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a history of diabetes. • C:the most common cause of a stroke is hypoglycemia. • D:they
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are both caused by low levels of glucose in the blood.
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ANSWER
• A:both oxygen and glucose are needed for brain function. Reason: Although stroke and hypoglycem
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ia are two distinctly different conditions, their signs and symptoms are often similar. This is because
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the brain requires both oxygen and glucose to function normally. An acute ischemic stroke is cause
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d by a lack of oxygen to a part of the brain due to a blocked cerebral artery, whereas hypoglycemia
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m(low blood glucose level) deprives the entire brain of glucose. In either case, the patient presents w
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ith signs of impaired brain function (ie, slurred speech, weakness, altered mental status). Both condi
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tions may lead to permanent brain damage or death if not treated promptly.
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QUESTION 2 zm
When dealing with an emotionally disturbed patient, you should be MOST concerned
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with: • A:gathering all of the patient's medications. • B:safely transporting to the hospi
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tal. • C:whether the patient could harm you. • D:obtaining a complete medical history.
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ANSWER
You selected C; This is correct! Reason: When managing any patient with an emotional or psychiatri
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c crisis, your primary concern is your own safety. Safely transporting the patient to the hospital is y
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our ultimate goal. If possible, you should attempt to obtain a medical history and should take any of
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the patient's prescribed medications to the hospital. However, this should not supercede your own
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safety or interfere with safely transporting the patient.
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QUESTION 3 zm
,You are at the scene where a man panicked while swimming in a small lake. Your init
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ial attempt to rescue him should include: • A:rowing a small raft to the victim. • B:rea
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ching for the victim with a long stick. • C:throwing a rope to the victim. • D:swimming
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mto the victim to rescue him.
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ANSWER
You selected B; This is correct! Reason: General rules to follow when attempting to rescue a patient
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mfrom the water include "reach, throw, row, and then go." In this case, you should attempt to reach
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the victim by having him grab hold of a large stick or similar object. If this is unsuccessful, throw th
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e victim a rope or flotation device (if available). If these are not available, row to the patient in a s
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mall raft (if available). Going into the water to retrieve the victim is a last resort. The rescuer must
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be a strong swimmer because patients who are in danger of drowning are in a state of blind panic
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and will make every attempt to keep themselves afloat, even if it means forcing the rescuer underw
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ater.
QUESTION 4 zm
How should you classify a patient's nature of illness if he or she has a low blood gluc
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ose level, bizarre behavior, and shallow breathing? • A:Behavioral emergency • B:Alter
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ed mental status • C:Respiratory emergency • D:Cardiac compromise
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ANSWER
The correct answer is B; Reason: The nature of illness (NOI) is the medical equivalent to mechanism
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of injury (MOI). Altered mental status should be the suspected NOI in any patient with any fluctuat
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ion in level of consciousness, which can range from bizarre behavior to complete unresponsiveness.
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Causes of an altered mental status include hypo-
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or hyperglycemia, head trauma, stroke, behavioral crises, drug overdose, and shock, among others.
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QUESTION 5 zm
A young female is unresponsive after overdosing on an unknown type of drug. Her res
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pirations are slow and shallow and her pulse is slow and weak. Which of the followin
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g drugs is the LEAST likely cause of her condition? • A:Seconal • B:Heroin • C:Cocaine
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• D:Valium
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ANSWER
The correct answer is C; Reason: Of the drugs listed, cocaine would be the least likely cause of the
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patient's condition. Cocaine is a central nervous system (CNS) stimulant; you would expect her to be
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hypertensive, tachycardic, tachypneic, and perhaps even violent. Heroin, Valium, and Seconal are all
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CNS depressants and could explain her condition. Heroin is an illegal narcotic (opiate), Valium is a b
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enzodiazepine sedative- zm
hypnotic drug, and Seconal is a barbiturate. Narcotics, benzodiazepines, and barbiturates are all CNS
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mdepressants. When taken in excess, they cause a decreased level of consciousness, respiratory depre
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ssion, bradycardia, and hypotension.
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QUESTION 6 zm
,Activated charcoal is contraindicated for a patient who is: • A:conscious and alert and
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has ingested a large amount of Motrin. • B:emotionally upset and has ingested two bo
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ttles of aspirin. • C:agitated and claims to have ingested a bottle of Tylenol. • D:awake
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mand alert and has swallowed a commercial drain cleaner.
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ANSWER
You selected D; This is correct! Reason:Activated charcoal adsorbs (sticks to) many ingested substan
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ces, preventing them from being absorbed into the body by the stomach or intestines. In some cases
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, you may give activated charcoal to patients who have ingested certain substances, if approved by
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medical control or local protocol. Activated charcoal is contraindicated for patients who have ingeste
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d an acid or alkali (ie, drain cleaner) or a petroleum product (ie, gasoline), who have a decreased le
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vel of consciousness and cannot protect their own airway, or who are unable to swallow.
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QUESTION 7 zm
A near-
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drowning is MOST accurately defined as: • A:complications within 24 hours following
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submersion in water. • B:immediate death due to prolonged submersion in water. • C:
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survival for at least 24 hours following submersion in water. • D:death greater than 2
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4 hours following submersion in water.
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ANSWER
You selected C; This is correct! Reason:Collectively, drowning and near-
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drowning are referred to as submersion injuries. Drowning is defined as death after submersion in a
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liquid medium, usually water. In a drowning, death is either immediate or occurs within 24 hours f
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ollowing submersion. Near- zm zm
drowning is defined as survival, at least temporarily (24 hours), after submersion. It should be note
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d, however, that complications such as pneumonia and pulmonary edema can cause death greater th
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an 24 hours following submersion. For this reason, all patients with a submersion injury should be t
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ransported to the hospital, even if they appear fine at the scene.
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QUESTION 8 zm
A young woman reports significant weight loss over the last month, persistent fever, a
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nd night sweats. When you assess her, you note the presence of dark purple lesions c
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overing her trunk and upper extremities. You should suspect: • A:end-
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stage cancer. • B:HIV/AIDS. • C:tuberculosis. • D:rheumatic fever.
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ANSWER
You selected B; This is correct! Reason:Weight loss, fever, and night sweats could indicate tuberculos
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is or HIV/AIDS; however, the dark purple lesions on the skin, which are called Kaposi's sarcoma, ar
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e malignant skin tumors and are a classic finding in patients in the later stages of AIDS.
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QUESTION 9 zm
, A 42-year-
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old male presents with fever, a severe headache, and a stiff neck. He is conscious, but
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confused. His wife tells you that he does not have any medical problems and does not
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mtake any medications. You should be MOST suspicious for: • A:acute stroke. • B:influe
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nza. • C:meningitis. • D:tuberculosis. (
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ANSWER
You selected C; This is correct! Reason:Meningitis is an inflammation of the protective coverings of t
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he brain and spinal cord (meninges). Common signs and symptoms of meningitis include fever, head
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ache, neck stiffness (nuchal rigidity), and vomiting. An altered mental status is common in severe ca
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ses. Meningococcal meningitis, caused by a bacterium, is the most contagious and potentially fatal ty
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pe of meningitis. The patient's signs and symptoms are not consistent with acute stroke, tuberculosi
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s (TB), or influenza (the flu). Although fever is common with both TB and the flu, neither causes ne
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ck stiffness. Acute stroke may be associated with a headache, especially a hemorrhagic stroke; howe
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ver, stroke patients typically do not have a fever.
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QUESTION 10 zm
All of the following are signs of gastrointestinal bleeding, EXCEPT: • A:melena. • B:he
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matemesis. • C:tachycardia. • D:hemoptysis. zm zm zm zm
ANSWER
You selected D; This is correct! Reason:Signs and symptoms of gastrointestinal (GI) bleeding include
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abdominal pain; vomiting blood (hematemesis); the passage of dark, tarry stools (melena); and brigh
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t red rectal bleeding (hematochezia). If blood loss is significant, the patient may have signs of shock
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m(eg, tachycardia, diaphoresis, tachypnea, hypotension). Hemoptysis (coughing up blood) is a sign of
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a pulmonary injury, not GI bleeding.
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QUESTION 11 zm
A 50-year-
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old woman who is conscious and alert complains of a severe migraine headache. Whe
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n caring for her, you should generally avoid: • A:transporting her in a supine position.
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• B:shining a light into her pupils. • C:dimming the lights in the ambulance. • D:applyi
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ng ice packs to her forehead.
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ANSWER
You selected B; This is correct! Reason:Patients with migraine or cluster headaches typically have ph
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otophobia (light sensitivity). Any type of bright light, especially if shone directly into the eyes, will c
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ause the patient with a headache unnecessary severe pain. Dimming the lights in the ambulance and
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mmaking the patient as comfortable as possible are the treatments of choice for a patient with a hea
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dache. Some patients benefit from ice packs applied to the forehead; just be sure to wrap the ice pa
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ck with roller gauze. Oxygen also should be administered as needed. Typically, the patient will prefe
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r to lie supine or on the side
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QUESTION 12 zm
Exam Solution zm
NREMT Bank Multiple Choice 2026 A+ GRADE ASSURE zm zm zm zm zm zm zm
D COMPLETE SOLUTIONS AND VERIFIED ANSWERS (22
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679)
QUESTION 1 zm
Hypoglycemia and acute ischemic stroke can present similarly because: • A:both oxyge
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n and glucose are needed for brain function. • B:the majority of stroke patients have
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a history of diabetes. • C:the most common cause of a stroke is hypoglycemia. • D:they
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are both caused by low levels of glucose in the blood.
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ANSWER
• A:both oxygen and glucose are needed for brain function. Reason: Although stroke and hypoglycem
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ia are two distinctly different conditions, their signs and symptoms are often similar. This is because
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the brain requires both oxygen and glucose to function normally. An acute ischemic stroke is cause
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d by a lack of oxygen to a part of the brain due to a blocked cerebral artery, whereas hypoglycemia
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m(low blood glucose level) deprives the entire brain of glucose. In either case, the patient presents w
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ith signs of impaired brain function (ie, slurred speech, weakness, altered mental status). Both condi
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tions may lead to permanent brain damage or death if not treated promptly.
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QUESTION 2 zm
When dealing with an emotionally disturbed patient, you should be MOST concerned
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with: • A:gathering all of the patient's medications. • B:safely transporting to the hospi
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tal. • C:whether the patient could harm you. • D:obtaining a complete medical history.
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ANSWER
You selected C; This is correct! Reason: When managing any patient with an emotional or psychiatri
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c crisis, your primary concern is your own safety. Safely transporting the patient to the hospital is y
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our ultimate goal. If possible, you should attempt to obtain a medical history and should take any of
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the patient's prescribed medications to the hospital. However, this should not supercede your own
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safety or interfere with safely transporting the patient.
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QUESTION 3 zm
,You are at the scene where a man panicked while swimming in a small lake. Your init
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ial attempt to rescue him should include: • A:rowing a small raft to the victim. • B:rea
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ching for the victim with a long stick. • C:throwing a rope to the victim. • D:swimming
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mto the victim to rescue him.
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ANSWER
You selected B; This is correct! Reason: General rules to follow when attempting to rescue a patient
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mfrom the water include "reach, throw, row, and then go." In this case, you should attempt to reach
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the victim by having him grab hold of a large stick or similar object. If this is unsuccessful, throw th
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
e victim a rope or flotation device (if available). If these are not available, row to the patient in a s
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
mall raft (if available). Going into the water to retrieve the victim is a last resort. The rescuer must
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
be a strong swimmer because patients who are in danger of drowning are in a state of blind panic
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
and will make every attempt to keep themselves afloat, even if it means forcing the rescuer underw
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ater.
QUESTION 4 zm
How should you classify a patient's nature of illness if he or she has a low blood gluc
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ose level, bizarre behavior, and shallow breathing? • A:Behavioral emergency • B:Alter
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ed mental status • C:Respiratory emergency • D:Cardiac compromise
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ANSWER
The correct answer is B; Reason: The nature of illness (NOI) is the medical equivalent to mechanism
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of injury (MOI). Altered mental status should be the suspected NOI in any patient with any fluctuat
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ion in level of consciousness, which can range from bizarre behavior to complete unresponsiveness.
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Causes of an altered mental status include hypo-
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or hyperglycemia, head trauma, stroke, behavioral crises, drug overdose, and shock, among others.
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QUESTION 5 zm
A young female is unresponsive after overdosing on an unknown type of drug. Her res
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pirations are slow and shallow and her pulse is slow and weak. Which of the followin
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g drugs is the LEAST likely cause of her condition? • A:Seconal • B:Heroin • C:Cocaine
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• D:Valium
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ANSWER
The correct answer is C; Reason: Of the drugs listed, cocaine would be the least likely cause of the
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patient's condition. Cocaine is a central nervous system (CNS) stimulant; you would expect her to be
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hypertensive, tachycardic, tachypneic, and perhaps even violent. Heroin, Valium, and Seconal are all
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CNS depressants and could explain her condition. Heroin is an illegal narcotic (opiate), Valium is a b
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enzodiazepine sedative- zm
hypnotic drug, and Seconal is a barbiturate. Narcotics, benzodiazepines, and barbiturates are all CNS
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mdepressants. When taken in excess, they cause a decreased level of consciousness, respiratory depre
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ssion, bradycardia, and hypotension.
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QUESTION 6 zm
,Activated charcoal is contraindicated for a patient who is: • A:conscious and alert and
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has ingested a large amount of Motrin. • B:emotionally upset and has ingested two bo
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ttles of aspirin. • C:agitated and claims to have ingested a bottle of Tylenol. • D:awake
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mand alert and has swallowed a commercial drain cleaner.
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ANSWER
You selected D; This is correct! Reason:Activated charcoal adsorbs (sticks to) many ingested substan
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ces, preventing them from being absorbed into the body by the stomach or intestines. In some cases
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, you may give activated charcoal to patients who have ingested certain substances, if approved by
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medical control or local protocol. Activated charcoal is contraindicated for patients who have ingeste
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d an acid or alkali (ie, drain cleaner) or a petroleum product (ie, gasoline), who have a decreased le
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vel of consciousness and cannot protect their own airway, or who are unable to swallow.
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QUESTION 7 zm
A near-
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drowning is MOST accurately defined as: • A:complications within 24 hours following
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submersion in water. • B:immediate death due to prolonged submersion in water. • C:
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survival for at least 24 hours following submersion in water. • D:death greater than 2
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4 hours following submersion in water.
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ANSWER
You selected C; This is correct! Reason:Collectively, drowning and near-
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drowning are referred to as submersion injuries. Drowning is defined as death after submersion in a
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liquid medium, usually water. In a drowning, death is either immediate or occurs within 24 hours f
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ollowing submersion. Near- zm zm
drowning is defined as survival, at least temporarily (24 hours), after submersion. It should be note
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d, however, that complications such as pneumonia and pulmonary edema can cause death greater th
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an 24 hours following submersion. For this reason, all patients with a submersion injury should be t
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ransported to the hospital, even if they appear fine at the scene.
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QUESTION 8 zm
A young woman reports significant weight loss over the last month, persistent fever, a
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nd night sweats. When you assess her, you note the presence of dark purple lesions c
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overing her trunk and upper extremities. You should suspect: • A:end-
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stage cancer. • B:HIV/AIDS. • C:tuberculosis. • D:rheumatic fever.
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ANSWER
You selected B; This is correct! Reason:Weight loss, fever, and night sweats could indicate tuberculos
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is or HIV/AIDS; however, the dark purple lesions on the skin, which are called Kaposi's sarcoma, ar
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e malignant skin tumors and are a classic finding in patients in the later stages of AIDS.
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QUESTION 9 zm
, A 42-year-
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old male presents with fever, a severe headache, and a stiff neck. He is conscious, but
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confused. His wife tells you that he does not have any medical problems and does not
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mtake any medications. You should be MOST suspicious for: • A:acute stroke. • B:influe
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nza. • C:meningitis. • D:tuberculosis. (
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ANSWER
You selected C; This is correct! Reason:Meningitis is an inflammation of the protective coverings of t
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he brain and spinal cord (meninges). Common signs and symptoms of meningitis include fever, head
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ache, neck stiffness (nuchal rigidity), and vomiting. An altered mental status is common in severe ca
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ses. Meningococcal meningitis, caused by a bacterium, is the most contagious and potentially fatal ty
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pe of meningitis. The patient's signs and symptoms are not consistent with acute stroke, tuberculosi
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s (TB), or influenza (the flu). Although fever is common with both TB and the flu, neither causes ne
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ck stiffness. Acute stroke may be associated with a headache, especially a hemorrhagic stroke; howe
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ver, stroke patients typically do not have a fever.
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QUESTION 10 zm
All of the following are signs of gastrointestinal bleeding, EXCEPT: • A:melena. • B:he
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matemesis. • C:tachycardia. • D:hemoptysis. zm zm zm zm
ANSWER
You selected D; This is correct! Reason:Signs and symptoms of gastrointestinal (GI) bleeding include
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abdominal pain; vomiting blood (hematemesis); the passage of dark, tarry stools (melena); and brigh
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t red rectal bleeding (hematochezia). If blood loss is significant, the patient may have signs of shock
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m(eg, tachycardia, diaphoresis, tachypnea, hypotension). Hemoptysis (coughing up blood) is a sign of
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a pulmonary injury, not GI bleeding.
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QUESTION 11 zm
A 50-year-
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old woman who is conscious and alert complains of a severe migraine headache. Whe
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n caring for her, you should generally avoid: • A:transporting her in a supine position.
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• B:shining a light into her pupils. • C:dimming the lights in the ambulance. • D:applyi
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ng ice packs to her forehead.
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ANSWER
You selected B; This is correct! Reason:Patients with migraine or cluster headaches typically have ph
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otophobia (light sensitivity). Any type of bright light, especially if shone directly into the eyes, will c
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ause the patient with a headache unnecessary severe pain. Dimming the lights in the ambulance and
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mmaking the patient as comfortable as possible are the treatments of choice for a patient with a hea
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dache. Some patients benefit from ice packs applied to the forehead; just be sure to wrap the ice pa
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ck with roller gauze. Oxygen also should be administered as needed. Typically, the patient will prefe
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r to lie supine or on the side
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QUESTION 12 zm
