NREMT PRACTICE EXAM UPDATED QUESTIONS AND ANSWERS
2024/2025
1. 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.
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 andsymptoms are not consistent with
acute stroke, tuberculosis (TB), or influenza (theflu). 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.
2. When dealing with an emotionally disturbed patient, you should be MOSTconcerned
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.:
•
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 isyour 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.
3. 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.:
,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.
4. How should you classify a patient's nature of illness if he or she has a lowblood glucose
level, bizarre behavior, and shallow breathing?
• A:Behavioral emergency
• B:Altered mental status
• C:Respiratory emergency
• D:Cardiac compromise:
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 withany fluctuation in
level of consciousness, which can range from bizarre behavior tocomplete
unresponsiveness. Causes of an altered mental status include hypo- or hyperglycemia, head
trauma, stroke, behavioral crises, drug overdose, and shock,among others.
5. 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:
Reason: Of the drugs listed, cocaine would be the least likely cause of the patient'scondition.
Cocaine is a central nervous system (CNS) stimulant; you would expecther 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-hypnoticdrug, 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.
6. 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
Reason:Activated charcoal adsorbs (sticks to) many ingested substances, prevent-ing
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 consciousnessand cannot protect
their own airway, or who are unable to swallow.
7. The MOST obvious way to reduce heat loss from radiation and convectionis 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
Reason:In a cold environment, the body has two ways of staying warm: generatingheat
(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 standsin 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 contact, as when a warm hand touches
cold metal or ice. Themost obvious way to decrease heat loss by conduction is to remove your
hand fromthe cold object.
8. A near-drowning is MOST accurately defined as:
• A:complications within 24 hours following submersion in water.
• B:immediate death due to prolonged submersion in water.
• C:survival for at least 24 hours following submersion in water.
• D:death greater than 24 hours following submersion in water.:
, Reason:Collectively, drowning and near-drowning are referred to as submersion injuries.
Drowning is defined as death after submersion in a liquid medium, usuallywater. In a
drowning, death is either immediate or occurs within 24 hours following submersion. Near-
drowning is defined as survival, at least temporarily (24 hours), af- ter submersion. It should be
noted, however, that complications such as pneumoniaand pulmonary edema can cause death
greater than 24 hours following submersion.For this reason, all patients with a submersion
injury should be transported to the hospital, even if they appear fine at the scene.
9. 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.:
Reason: Although stroke and hypoglycemia are two distinctly different conditions, their signs
and symptoms are often similar. This is because the brain requires bothoxygen 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 eithercase, 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.
10. A young woman reports significant weight loss over the last month, per- sistent
fever, and night sweats. When you assess her, you note the presenceof dark purple lesions
covering her trunk and upper extremities. You shouldsuspect:
• A:end-stage cancer.
• B:HIV/AIDS.
• C:tuberculosis.
• D:rheumatic fever.:
Reason:Weight loss, fever, and night sweats could indicate tuberculosis or HIV/AIDS;
however, the dark purple lesions on the skin, which are called Kaposi's sarcoma, are
malignant skin tumors and are a classic finding in patients in the laterstages of AIDS.
2024/2025
1. 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.
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 andsymptoms are not consistent with
acute stroke, tuberculosis (TB), or influenza (theflu). 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.
2. When dealing with an emotionally disturbed patient, you should be MOSTconcerned
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.:
•
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 isyour 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.
3. 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.:
,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.
4. How should you classify a patient's nature of illness if he or she has a lowblood glucose
level, bizarre behavior, and shallow breathing?
• A:Behavioral emergency
• B:Altered mental status
• C:Respiratory emergency
• D:Cardiac compromise:
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 withany fluctuation in
level of consciousness, which can range from bizarre behavior tocomplete
unresponsiveness. Causes of an altered mental status include hypo- or hyperglycemia, head
trauma, stroke, behavioral crises, drug overdose, and shock,among others.
5. 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:
Reason: Of the drugs listed, cocaine would be the least likely cause of the patient'scondition.
Cocaine is a central nervous system (CNS) stimulant; you would expecther 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-hypnoticdrug, 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.
6. 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
Reason:Activated charcoal adsorbs (sticks to) many ingested substances, prevent-ing
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 consciousnessand cannot protect
their own airway, or who are unable to swallow.
7. The MOST obvious way to reduce heat loss from radiation and convectionis 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
Reason:In a cold environment, the body has two ways of staying warm: generatingheat
(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 standsin 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 contact, as when a warm hand touches
cold metal or ice. Themost obvious way to decrease heat loss by conduction is to remove your
hand fromthe cold object.
8. A near-drowning is MOST accurately defined as:
• A:complications within 24 hours following submersion in water.
• B:immediate death due to prolonged submersion in water.
• C:survival for at least 24 hours following submersion in water.
• D:death greater than 24 hours following submersion in water.:
, Reason:Collectively, drowning and near-drowning are referred to as submersion injuries.
Drowning is defined as death after submersion in a liquid medium, usuallywater. In a
drowning, death is either immediate or occurs within 24 hours following submersion. Near-
drowning is defined as survival, at least temporarily (24 hours), af- ter submersion. It should be
noted, however, that complications such as pneumoniaand pulmonary edema can cause death
greater than 24 hours following submersion.For this reason, all patients with a submersion
injury should be transported to the hospital, even if they appear fine at the scene.
9. 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.:
Reason: Although stroke and hypoglycemia are two distinctly different conditions, their signs
and symptoms are often similar. This is because the brain requires bothoxygen 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 eithercase, 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.
10. A young woman reports significant weight loss over the last month, per- sistent
fever, and night sweats. When you assess her, you note the presenceof dark purple lesions
covering her trunk and upper extremities. You shouldsuspect:
• A:end-stage cancer.
• B:HIV/AIDS.
• C:tuberculosis.
• D:rheumatic fever.:
Reason:Weight loss, fever, and night sweats could indicate tuberculosis or HIV/AIDS;
however, the dark purple lesions on the skin, which are called Kaposi's sarcoma, are
malignant skin tumors and are a classic finding in patients in the laterstages of AIDS.
