NREMT Paramedic Prep Exam 2026–2027
Accurate Real Exam Questions and Verified
Correct Answers JUST RELEASED
Practice Test Bank - Multiple Choice
Which of the following conditions would be the LEAST likely to be present in a
patient who was submerged in water?
• A:Spinal injury
• B:Gastric distention
• C:Hyperglycemia
• D:Laryngospasm - ANSWER -You selected C; This is correct!
Reason: Many factors can contribute to or result from a submersion injury (eg,
drowning, near-drowning). It is not uncommon for a person to experience a spinal
injury after diving head first into shallow water, especially if he or she is under the
influence of alcohol. When a swimmer panics, he or she initially swallows large
amounts of water, resulting in gastric distention. Gastric distention can cause
aspiration if the patient regurgitates water during rescue breathing; protect the
airway! During the panic phase, the victim expends a tremendous amount of
energy (and glucose) from flailing around in the water, possibly resulting in
hypoglycemia. Inhaling even a small amount of fresh or salt water can severely
irritate the larynx, which sends the muscles of the larynx and vocal cords into
spasm (laryngospasm), resulting in airway blockage and hypoxia.
A 42-year-old male presents with fever, a severe headache, and a stiff neck. He is
conscious, but confused. His wife tells you that he does not have any medical
problems and does not take any medications. You should be MOST suspicious for:
• A:acute stroke.
• B:influenza.
• C:meningitis.
• D:tuberculosis.
( - ANSWER -You selected C; This is correct!
Reason:Meningitis is an inflammation of the protective coverings of the brain and
spinal cord (meninges). Common signs and symptoms of meningitis include fever,
headache, neck stiffness (nuchal rigidity), and vomiting. An altered mental status is
,common in severe cases. Meningococcal meningitis, caused by a bacterium, is the
most contagious and potentially fatal type of meningitis. The patient's signs and
symptoms are not consistent with acute stroke, tuberculosis (TB), or influenza (the
flu). Although fever is common with both TB and the flu, neither causes neck
stiffness. Acute stroke may be associated with a headache, especially a
hemorrhagic stroke; however, stroke patients typically do not have a fever.
All of the following are signs of gastrointestinal bleeding, EXCEPT:
• A:melena.
• B:hematemesis.
• C:tachycardia.
• D:hemoptysis. - ANSWER -You selected D; This is correct!
Reason:Signs and symptoms of gastrointestinal (GI) bleeding include abdominal
pain; vomiting blood (hematemesis); the passage of dark, tarry stools (melena);
and bright red rectal bleeding (hematochezia). If blood loss is significant, the
patient may have signs of shock (eg, tachycardia, diaphoresis, tachypnea,
hypotension). Hemoptysis (coughing up blood) is a sign of a pulmonary injury, not
GI bleeding.
A 24-year-old female presents with a rash to her left leg and swollen, painful knee
joints. She tells you that she and her friends returned from a hiking trip in the
mountains a week ago. She is conscious and alert with a blood pressure of 112/62
mm Hg, a pulse of 84 beats/min, and respirations of 14 breaths/min. Her symptoms
are MOST likely the result of:
• A:Rocky Mountain spotted fever.
• B:tetanus.
• C:Lyme disease.
• D:a localized allergic reaction. - ANSWER -You selected C; This is correct!
Reason:The patient's symptoms and her history of a recent hiking trip are
consistent with Lyme disease, which was the result of a tick bite. Ticks can carry
two infectious diseases: Lyme disease and Rocky Mountain spotted fever. Both are
spread through the tick's saliva, which is injected into the skin when the tick
attaches itself. The first symptom of Lyme disease, a rash that may spread to
several parts of the body, begins about 3 days after the bite of an infected tick. The
rash may eventually resemble a target bull's-eye pattern in one third of patients.
After a few more days or weeks, painful swelling of the joints, particularly the
knees, occurs. If recognized and treated promptly with antibiotics, many patients
recover completely. Rocky Mountain spotted fever, which is not limited to the
Rocky Mountains, occurs within 7 to 10 days after being bitten by an infected tick.
,Its symptoms include nausea, vomiting, headache, weakness, paralysis, and
possibly cardiopulmonary failure.
A 50-year-old woman who is conscious and alert complains of a severe migraine
headache. When caring for her, you should generally avoid:
• A:transporting her in a supine position.
• B:shining a light into her pupils.
• C:dimming the lights in the ambulance.
• D:applying ice packs to her forehead. - ANSWER -You selected B; This is
correct!
Reason:Patients with migraine or cluster headaches typically have photophobia
(light sensitivity). Any type of bright light, especially if shone directly into the
eyes, will cause the patient with a headache unnecessary severe pain. Dimming the
lights in the ambulance and making the patient as comfortable as possible are the
treatments of choice for a patient with a headache. Some patients benefit from ice
packs applied to the forehead; just be sure to wrap the ice pack with roller gauze.
Oxygen also should be administered as needed. Typically, the patient will prefer to
lie supine or on the side
A patient who overdosed on heroin would be expected to present with:
• A:tachycardia.
• B:hyperpnea.
• C:hypotension.
• D:dilated pupils. - ANSWER -The correct ANSWER is C;
Reason:Heroin is a Schedule I (illegal) narcotic that is typically injected. As with
all narcotics, legal or illegal, overdose causes depression of the central nervous
system (CNS), resulting in a decreased level of consciousness; bradycardia;
hypotension; and slow, shallow (reduced tidal volume) breathing. Hyperpnea (deep
breathing) would not be present in a patient who overdosed on a narcotic. In a
narcotic overdose, the pupils are typically constricted (miosis). Barbiturates, such
as phenobarbital, are also CNS depressants and cause the same symptoms seen
with narcotic overdose. The patient's pupils, however, are typically dilated
(mydriasis), not constricted.
When caring for any patient with a decreased level of consciousness, your primary
concern should be the:
• A:potential for airway compromise.
• B:patient's blood glucose level.
• C:possibility of a spinal injury.
, • D:possibility of a drug overdose. - ANSWER -You selected A; This is correct!
Reason:Altered mental status could be caused by a high or low blood glucose
level, drug overdose, or head injury, among other causes. Furthermore, the
possibility of a spinal injury should be considered if the patient was injured.
However, your primary concern should be the status of the patient's airway.
Patients with a decreased level of consciousness are at risk for aspiration if
vomiting occurs. Unless spinal trauma is present or the patient is breathing
inadequately (eg, fast or slow rate, shallow breathing [reduced tidal volume]),
place him or her in the recovery position to facilitate drainage if vomiting occurs.
Remember this: no airway, no patient!
A 16-year-old, 125-pound male ingested a bottle of aspirin approximately 20
minutes ago. Medical control orders you to administer activated charcoal in a dose
of 1 g/kg. How much activated charcoal should you administer?
• A:54 g
• B:60 g
• C:51 g
• D:57 g - ANSWER -You selected D; This is correct!
Reason: First, you must determine the patient's weight in kilograms (kg). Either of
the following formulae can be used to convert pounds to kilograms: Formula 1:
weight (in pounds) ÷ 2.2 = weight in kg. Formula 2: weight (in pounds) ÷ 2 - 10%
= weight in kg. On the basis of the above formulae, a 125-pound patient weighs 57
kg. Using formula 1, the equation is as follows: 125 (weight in pounds) ÷ 2.2 =
56.81 (57 [rounded to the nearest tenth]). Using formula 2, the equation is as
follows: 125 (weight in pounds) ÷ 2 = 62.5 (63 [rounded to the nearest tenth] - 6.3
(10% of 63) = 56.7 (57 [rounded to the nearest tenth]). Since the drug order is for 1
g/kg, you should administer 57 g of activated charcoal to your 125-pound patient.
Which of the following is the MOST significant finding in a patient with a severe
headache?
• A:Pain in both legs
• B:Chest discomfort
• C:Unilateral weakness
• D:Abdominal tenderness - ANSWER -You selected C; This is correct!
Reason: Unilateral weakness (weakness on one side of the body) is a clinically
significant finding in a patient with a headache because it could indicate a stroke
(ischemic or hemorrhagic). Abdominal, chest, and leg pain are not common
Accurate Real Exam Questions and Verified
Correct Answers JUST RELEASED
Practice Test Bank - Multiple Choice
Which of the following conditions would be the LEAST likely to be present in a
patient who was submerged in water?
• A:Spinal injury
• B:Gastric distention
• C:Hyperglycemia
• D:Laryngospasm - ANSWER -You selected C; This is correct!
Reason: Many factors can contribute to or result from a submersion injury (eg,
drowning, near-drowning). It is not uncommon for a person to experience a spinal
injury after diving head first into shallow water, especially if he or she is under the
influence of alcohol. When a swimmer panics, he or she initially swallows large
amounts of water, resulting in gastric distention. Gastric distention can cause
aspiration if the patient regurgitates water during rescue breathing; protect the
airway! During the panic phase, the victim expends a tremendous amount of
energy (and glucose) from flailing around in the water, possibly resulting in
hypoglycemia. Inhaling even a small amount of fresh or salt water can severely
irritate the larynx, which sends the muscles of the larynx and vocal cords into
spasm (laryngospasm), resulting in airway blockage and hypoxia.
A 42-year-old male presents with fever, a severe headache, and a stiff neck. He is
conscious, but confused. His wife tells you that he does not have any medical
problems and does not take any medications. You should be MOST suspicious for:
• A:acute stroke.
• B:influenza.
• C:meningitis.
• D:tuberculosis.
( - ANSWER -You selected C; This is correct!
Reason:Meningitis is an inflammation of the protective coverings of the brain and
spinal cord (meninges). Common signs and symptoms of meningitis include fever,
headache, neck stiffness (nuchal rigidity), and vomiting. An altered mental status is
,common in severe cases. Meningococcal meningitis, caused by a bacterium, is the
most contagious and potentially fatal type of meningitis. The patient's signs and
symptoms are not consistent with acute stroke, tuberculosis (TB), or influenza (the
flu). Although fever is common with both TB and the flu, neither causes neck
stiffness. Acute stroke may be associated with a headache, especially a
hemorrhagic stroke; however, stroke patients typically do not have a fever.
All of the following are signs of gastrointestinal bleeding, EXCEPT:
• A:melena.
• B:hematemesis.
• C:tachycardia.
• D:hemoptysis. - ANSWER -You selected D; This is correct!
Reason:Signs and symptoms of gastrointestinal (GI) bleeding include abdominal
pain; vomiting blood (hematemesis); the passage of dark, tarry stools (melena);
and bright red rectal bleeding (hematochezia). If blood loss is significant, the
patient may have signs of shock (eg, tachycardia, diaphoresis, tachypnea,
hypotension). Hemoptysis (coughing up blood) is a sign of a pulmonary injury, not
GI bleeding.
A 24-year-old female presents with a rash to her left leg and swollen, painful knee
joints. She tells you that she and her friends returned from a hiking trip in the
mountains a week ago. She is conscious and alert with a blood pressure of 112/62
mm Hg, a pulse of 84 beats/min, and respirations of 14 breaths/min. Her symptoms
are MOST likely the result of:
• A:Rocky Mountain spotted fever.
• B:tetanus.
• C:Lyme disease.
• D:a localized allergic reaction. - ANSWER -You selected C; This is correct!
Reason:The patient's symptoms and her history of a recent hiking trip are
consistent with Lyme disease, which was the result of a tick bite. Ticks can carry
two infectious diseases: Lyme disease and Rocky Mountain spotted fever. Both are
spread through the tick's saliva, which is injected into the skin when the tick
attaches itself. The first symptom of Lyme disease, a rash that may spread to
several parts of the body, begins about 3 days after the bite of an infected tick. The
rash may eventually resemble a target bull's-eye pattern in one third of patients.
After a few more days or weeks, painful swelling of the joints, particularly the
knees, occurs. If recognized and treated promptly with antibiotics, many patients
recover completely. Rocky Mountain spotted fever, which is not limited to the
Rocky Mountains, occurs within 7 to 10 days after being bitten by an infected tick.
,Its symptoms include nausea, vomiting, headache, weakness, paralysis, and
possibly cardiopulmonary failure.
A 50-year-old woman who is conscious and alert complains of a severe migraine
headache. When caring for her, you should generally avoid:
• A:transporting her in a supine position.
• B:shining a light into her pupils.
• C:dimming the lights in the ambulance.
• D:applying ice packs to her forehead. - ANSWER -You selected B; This is
correct!
Reason:Patients with migraine or cluster headaches typically have photophobia
(light sensitivity). Any type of bright light, especially if shone directly into the
eyes, will cause the patient with a headache unnecessary severe pain. Dimming the
lights in the ambulance and making the patient as comfortable as possible are the
treatments of choice for a patient with a headache. Some patients benefit from ice
packs applied to the forehead; just be sure to wrap the ice pack with roller gauze.
Oxygen also should be administered as needed. Typically, the patient will prefer to
lie supine or on the side
A patient who overdosed on heroin would be expected to present with:
• A:tachycardia.
• B:hyperpnea.
• C:hypotension.
• D:dilated pupils. - ANSWER -The correct ANSWER is C;
Reason:Heroin is a Schedule I (illegal) narcotic that is typically injected. As with
all narcotics, legal or illegal, overdose causes depression of the central nervous
system (CNS), resulting in a decreased level of consciousness; bradycardia;
hypotension; and slow, shallow (reduced tidal volume) breathing. Hyperpnea (deep
breathing) would not be present in a patient who overdosed on a narcotic. In a
narcotic overdose, the pupils are typically constricted (miosis). Barbiturates, such
as phenobarbital, are also CNS depressants and cause the same symptoms seen
with narcotic overdose. The patient's pupils, however, are typically dilated
(mydriasis), not constricted.
When caring for any patient with a decreased level of consciousness, your primary
concern should be the:
• A:potential for airway compromise.
• B:patient's blood glucose level.
• C:possibility of a spinal injury.
, • D:possibility of a drug overdose. - ANSWER -You selected A; This is correct!
Reason:Altered mental status could be caused by a high or low blood glucose
level, drug overdose, or head injury, among other causes. Furthermore, the
possibility of a spinal injury should be considered if the patient was injured.
However, your primary concern should be the status of the patient's airway.
Patients with a decreased level of consciousness are at risk for aspiration if
vomiting occurs. Unless spinal trauma is present or the patient is breathing
inadequately (eg, fast or slow rate, shallow breathing [reduced tidal volume]),
place him or her in the recovery position to facilitate drainage if vomiting occurs.
Remember this: no airway, no patient!
A 16-year-old, 125-pound male ingested a bottle of aspirin approximately 20
minutes ago. Medical control orders you to administer activated charcoal in a dose
of 1 g/kg. How much activated charcoal should you administer?
• A:54 g
• B:60 g
• C:51 g
• D:57 g - ANSWER -You selected D; This is correct!
Reason: First, you must determine the patient's weight in kilograms (kg). Either of
the following formulae can be used to convert pounds to kilograms: Formula 1:
weight (in pounds) ÷ 2.2 = weight in kg. Formula 2: weight (in pounds) ÷ 2 - 10%
= weight in kg. On the basis of the above formulae, a 125-pound patient weighs 57
kg. Using formula 1, the equation is as follows: 125 (weight in pounds) ÷ 2.2 =
56.81 (57 [rounded to the nearest tenth]). Using formula 2, the equation is as
follows: 125 (weight in pounds) ÷ 2 = 62.5 (63 [rounded to the nearest tenth] - 6.3
(10% of 63) = 56.7 (57 [rounded to the nearest tenth]). Since the drug order is for 1
g/kg, you should administer 57 g of activated charcoal to your 125-pound patient.
Which of the following is the MOST significant finding in a patient with a severe
headache?
• A:Pain in both legs
• B:Chest discomfort
• C:Unilateral weakness
• D:Abdominal tenderness - ANSWER -You selected C; This is correct!
Reason: Unilateral weakness (weakness on one side of the body) is a clinically
significant finding in a patient with a headache because it could indicate a stroke
(ischemic or hemorrhagic). Abdominal, chest, and leg pain are not common
