NREMR FINAL EXAM COMPLETE
QUESTIONS WITH 100% CORRECT
ANSWERS AND DETAILED RATIONALE
1. A 45-year-old complains of sudden, severe “tearing” chest pain
radiating to the back. One arm has a weaker pulse than the other. You
suspect:
A) Acute coronary syndrome
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis
Correct answer: C
Rationale: Tearing chest pain radiating to the back with pulse deficits is
classic for aortic dissection. ACS pain is more pressure-like, PE causes
sudden dyspnea, pericarditis pain is sharp and positional.
2. Which of the following is the first step in the primary assessment of a
responsive adult?
A) Check pulse
B) Open airway
C) Form a general impression
D) Apply cervical collar
Correct answer: C
,Rationale: Primary assessment begins with forming a general
impression (age, position, chief complaint, level of consciousness) to
identify life threats.
3. A patient has been pulled from a lake after 10 minutes submersion.
They are apneic and pulseless. Your first action is:
A) Abdominal thrusts for water removal
B) High-flow oxygen via non-rebreather
C) Begin CPR with compressions
D) Suction the airway for 30 seconds
Correct answer: C
Rationale: In drowning, start CPR immediately—compressions first (C-
A-B). Water is rarely an airway obstruction; suction only if visible
material.
4. What is the recommended compression-to-ventilation ratio for two-
rescuer adult CPR?
A) 15:2
B) 30:2
C) 30:1
D) 15:1
Correct answer: B
Rationale: AHA 2020 guidelines: 30:2 for all adult CPR (single or two
rescuer) unless advanced airway placed, then continuous compressions
at 100–120/min with 1 breath q6s.
,5. A confused diabetic patient has cool, clammy skin and a blood
glucose of 55 mg/dL. They are able to follow simple commands. You
should:
A) Administer intramuscular glucagon
B) Give oral glucose between cheek and gum
C) Start an IV with D50
D) Call ALS for insulin administration
Correct answer: B
Rationale: Hypoglycemia with intact airway and ability to swallow →
oral glucose. Glucagon IM used if unconscious or no IV access. D50 is
ALS skill.
6. When caring for an open chest wound with a sucking sound, the EMR
should FIRST:
A) Cover with an occlusive dressing taped on three sides
B) Apply direct pressure with a gauze pad
C) Insert a needle into the second intercostal space
D) Seal completely on all four sides
Correct answer: A
Rationale: Three-sided occlusive dressing allows air to escape during
exhalation but prevents air entry on inhalation, reducing tension
pneumothorax risk.
7. A patient with severe abdominal pain presents with a rigid, board-like
abdomen. This is most concerning for:
A) Constipation
B) Peritonitis
, C) Gastroenteritis
D) Renal colic
Correct answer: B
Rationale: Board-like rigidity indicates peritoneal irritation (peritonitis)
from e.g., ruptured appendix or perforated ulcer. Requires rapid
transport.
8. During a heat wave, you find an unconscious patient in a closed
garage. Skin is hot and dry, core temperature 106°F. Priority
intervention:
A) Give cold water orally
B) Aggressive external cooling (ice packs to neck/axillae/groin)
C) Wrap in blankets for shivering prevention
D) Administer aspirin for fever
Correct answer: B
Rationale: Heat stroke (hot, dry skin, altered mental status) requires
rapid cooling. Oral water unsafe if unconscious. Aspirin ineffective and
may cause harm.
9. A 6-year-old has a fever, drooling, tripod positioning, and stridor. You
suspect:
A) Asthma exacerbation
B) Epiglottitis
C) Croup
D) Anaphylaxis
Correct answer: B
Rationale: Tripod + drooling + stridor + fever = epiglottitis (life-
QUESTIONS WITH 100% CORRECT
ANSWERS AND DETAILED RATIONALE
1. A 45-year-old complains of sudden, severe “tearing” chest pain
radiating to the back. One arm has a weaker pulse than the other. You
suspect:
A) Acute coronary syndrome
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis
Correct answer: C
Rationale: Tearing chest pain radiating to the back with pulse deficits is
classic for aortic dissection. ACS pain is more pressure-like, PE causes
sudden dyspnea, pericarditis pain is sharp and positional.
2. Which of the following is the first step in the primary assessment of a
responsive adult?
A) Check pulse
B) Open airway
C) Form a general impression
D) Apply cervical collar
Correct answer: C
,Rationale: Primary assessment begins with forming a general
impression (age, position, chief complaint, level of consciousness) to
identify life threats.
3. A patient has been pulled from a lake after 10 minutes submersion.
They are apneic and pulseless. Your first action is:
A) Abdominal thrusts for water removal
B) High-flow oxygen via non-rebreather
C) Begin CPR with compressions
D) Suction the airway for 30 seconds
Correct answer: C
Rationale: In drowning, start CPR immediately—compressions first (C-
A-B). Water is rarely an airway obstruction; suction only if visible
material.
4. What is the recommended compression-to-ventilation ratio for two-
rescuer adult CPR?
A) 15:2
B) 30:2
C) 30:1
D) 15:1
Correct answer: B
Rationale: AHA 2020 guidelines: 30:2 for all adult CPR (single or two
rescuer) unless advanced airway placed, then continuous compressions
at 100–120/min with 1 breath q6s.
,5. A confused diabetic patient has cool, clammy skin and a blood
glucose of 55 mg/dL. They are able to follow simple commands. You
should:
A) Administer intramuscular glucagon
B) Give oral glucose between cheek and gum
C) Start an IV with D50
D) Call ALS for insulin administration
Correct answer: B
Rationale: Hypoglycemia with intact airway and ability to swallow →
oral glucose. Glucagon IM used if unconscious or no IV access. D50 is
ALS skill.
6. When caring for an open chest wound with a sucking sound, the EMR
should FIRST:
A) Cover with an occlusive dressing taped on three sides
B) Apply direct pressure with a gauze pad
C) Insert a needle into the second intercostal space
D) Seal completely on all four sides
Correct answer: A
Rationale: Three-sided occlusive dressing allows air to escape during
exhalation but prevents air entry on inhalation, reducing tension
pneumothorax risk.
7. A patient with severe abdominal pain presents with a rigid, board-like
abdomen. This is most concerning for:
A) Constipation
B) Peritonitis
, C) Gastroenteritis
D) Renal colic
Correct answer: B
Rationale: Board-like rigidity indicates peritoneal irritation (peritonitis)
from e.g., ruptured appendix or perforated ulcer. Requires rapid
transport.
8. During a heat wave, you find an unconscious patient in a closed
garage. Skin is hot and dry, core temperature 106°F. Priority
intervention:
A) Give cold water orally
B) Aggressive external cooling (ice packs to neck/axillae/groin)
C) Wrap in blankets for shivering prevention
D) Administer aspirin for fever
Correct answer: B
Rationale: Heat stroke (hot, dry skin, altered mental status) requires
rapid cooling. Oral water unsafe if unconscious. Aspirin ineffective and
may cause harm.
9. A 6-year-old has a fever, drooling, tripod positioning, and stridor. You
suspect:
A) Asthma exacerbation
B) Epiglottitis
C) Croup
D) Anaphylaxis
Correct answer: B
Rationale: Tripod + drooling + stridor + fever = epiglottitis (life-
