NREMT EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS
Cardiogenic shock - Answer - -the type of shock caused by inadequate function of the
heart. This develops when the heart cannot maintain sufficient output to meet the
demands of the body
-caused by any disease or event which prevents heart pumping
-can occur directly after AMI up to 24 hours
Obstructive shock - Answer - The type of shock that results when conditions that cause
mechanical obstruction of the cardiac muscle also impact pump function
Ex. Cardiac tamponade, tension pneumothorax
Beck's triad - Answer - Signs of a cardiac tamponade. JVD, narrowing BP pressures,
muffled heart sounds
Distributive shock - Answer - The type of shock when there is widespread dilation of the
small arterioles, venules, or both. Blood pools in the expanded vascular beds and tissue
perfusion decreases
Types of distributive shock - Answer - Septic shock caused by severe infections;
neurogenic shock caused by damage to the spinal cord (bradycardia, low BP, warm skin);
anaphylactic shock caused by allergic reaction; psychogenic shock
Hypovolemic shock - Answer - The type of shock that results from an inadequate amount
of fluid or volume in the system
-15% of blood volume
How do you treat for shock? - Answer - Keep the patient warm, control bleeding, put the
patient in a position of comfort, and administer high-flow oxygen
Brain damage without oxygen - Answer - -without enough oxygen, cardiac arrest or brain
damage occurs within about 4 minutes
-permanent brain damage within 6 minutes
-death likely within 10 minutes
FBAO - Answer - -signs of blockage include inability to cough or speak or inability to
ventilate patient
,-bending patient forward at the waist, support chest with one hand, use heel of hand to
give 5 back blows between shoulder blades
-then 5 abdominal thrusts
-alternate between the two until object is dislodged
-if patient loses consciousness, give CPR starting with chest compressions
-given even if patient has a pulse, so don't check
-before giving breaths, look inside mouth for any visible objects
FBAO in children - Answer - -using thigh for support, lay facing down along forearm;
ensure head is lower than the body
-give 5 firm back blows between blades
-5 chest thrusts; place 2 to 3 fingers in the middle of the chest just below the nipples.
Push down 1.5 inches.
-alternate, unless lose consciousness, then CPR
Mouse to mouth/mouth to nose - Answer - -mouth to mouth performed when patient does
not have adequate breathing and artificial ventilation not available
-open airway
-place barrier device
-pinch nose and form seal around patient's mouth
-check for FBAO if you do not see chest rise and fall
-give 1 breath every 5 to 6 seconds for adults and 1 every 3 for peds
Steps of CPR - Answer - Determine unresponsiveness. Check for breathing for up to 10
seconds. Check carotid pulse for up to 10 seconds. Begin CPR until AED is available.
Give 30 compressions at 100 beats/min and then 2 breaths over the course of 1 second.
Once an advanced airway is inserted, ventilate at a rate of 8-10 breaths/min and do not
stop compressions.
This is exactly the same for children, except two-rescuer CPR is 15:2. If patient
experiences a return of spontaneous circulation, ventilate at a rate of 10-12 breaths/min.
Compression to breath ratios - Answer - under 8 years old:
-2 provider: 15:2
-1 provider: 30:2
-one third of chest diameter
Older:
-30:2 always
-2 inches
,AED procedure - Answer - -if cardiac arrest was not seen by EMS, give 5 cycles of 30:2
before defibrillating
-if cardiac arrest was seen, one EMT begins compressions and the other applies AED
-if only one EMT available, apply AED immediately
-check for pulse 2 minutes after defib
-if no shockable rhythm, wait 2 minutes and re-analyze
When to place left lateral - Answer - If patient has adequate breathing and is uninjured.
To maintain a patent airway in an unresponsive patient.
What to do if you fail to ventilate - Answer - If the breath doesn't go in successfully,
reposition the patient and try again. If there is still nothing, assume there is a foreign body
obstruction and begin CPR on an unresponsive apneic patient. Continue to attempt
ventilations and open the mouth and look in every time.
Pneumothorax signs - Answer - -dyspnea, pleuritic chest pain that worsens during
inspiration and expiration, absent or decreased breath sounds
-rupture of visceral lining
Pulmonary embolism signs - Answer - -dyspnea, acute chest pain, hemoptysis, cyanosis,
tachypnea, hypoxia, tachycardia?**
GCS Eye Opening - Answer - Spontaneous = 4
To voice = 3
To pain = 2
None = 1
GCS Verbal Response - Answer - Oriented = 5
Confused = 4
Inappropriate words = 3
Incomprehensible words = 2
None = 1
GCS Motor Response - Answer - Obeys commands = 6
Localizes pain = 5
Withdraws (pain) = 4
Flexion (pain) = 3
Extension (pain) = 2
None = 1
, Rule of nines (adults) - Answer - Head = 9%
Front = 18%
Back = 18%
Each arm = 9%
Groin = 1%
Each leg = 18%
Rule of nines (child) - Answer - Head = 18%
Front = 18%
Back = 18%
Each arm = 9%
Each leg = 14%
Cushing's triad - Answer - Sign there might be an increase in intracranial pressure.
Hypertension, bradycardia, and abnormal breathing.
Appendicitis pain - Answer - -pain to the RLQ
-rebounding pain
-fever
Peritonitis - Answer - -inflammation of peritoneum
-abdominal pain, lack of appetite, markle test
Markle heel drop - Answer - markle test; used to assess a patient with abdominal pain,
patient drops down onto heels, pain will be felt in region of pain source
Cholecystitis pain - Answer - RUQ pain, referred to the right shoulder
Gastrointestinal bleeding - Answer - -hematemesis
-hematochezia (blood in stool)
-melena (dark, tarry stool)
Esophageal varices - Answer - -weakening of blood vessels in esophagus
-alcoholism
-vomiting large amounts of bright red blood
Aortic aneurysm pain - Answer - Lower back and lower quadrants pain; tearing
DETAILED ANSWERS
Cardiogenic shock - Answer - -the type of shock caused by inadequate function of the
heart. This develops when the heart cannot maintain sufficient output to meet the
demands of the body
-caused by any disease or event which prevents heart pumping
-can occur directly after AMI up to 24 hours
Obstructive shock - Answer - The type of shock that results when conditions that cause
mechanical obstruction of the cardiac muscle also impact pump function
Ex. Cardiac tamponade, tension pneumothorax
Beck's triad - Answer - Signs of a cardiac tamponade. JVD, narrowing BP pressures,
muffled heart sounds
Distributive shock - Answer - The type of shock when there is widespread dilation of the
small arterioles, venules, or both. Blood pools in the expanded vascular beds and tissue
perfusion decreases
Types of distributive shock - Answer - Septic shock caused by severe infections;
neurogenic shock caused by damage to the spinal cord (bradycardia, low BP, warm skin);
anaphylactic shock caused by allergic reaction; psychogenic shock
Hypovolemic shock - Answer - The type of shock that results from an inadequate amount
of fluid or volume in the system
-15% of blood volume
How do you treat for shock? - Answer - Keep the patient warm, control bleeding, put the
patient in a position of comfort, and administer high-flow oxygen
Brain damage without oxygen - Answer - -without enough oxygen, cardiac arrest or brain
damage occurs within about 4 minutes
-permanent brain damage within 6 minutes
-death likely within 10 minutes
FBAO - Answer - -signs of blockage include inability to cough or speak or inability to
ventilate patient
,-bending patient forward at the waist, support chest with one hand, use heel of hand to
give 5 back blows between shoulder blades
-then 5 abdominal thrusts
-alternate between the two until object is dislodged
-if patient loses consciousness, give CPR starting with chest compressions
-given even if patient has a pulse, so don't check
-before giving breaths, look inside mouth for any visible objects
FBAO in children - Answer - -using thigh for support, lay facing down along forearm;
ensure head is lower than the body
-give 5 firm back blows between blades
-5 chest thrusts; place 2 to 3 fingers in the middle of the chest just below the nipples.
Push down 1.5 inches.
-alternate, unless lose consciousness, then CPR
Mouse to mouth/mouth to nose - Answer - -mouth to mouth performed when patient does
not have adequate breathing and artificial ventilation not available
-open airway
-place barrier device
-pinch nose and form seal around patient's mouth
-check for FBAO if you do not see chest rise and fall
-give 1 breath every 5 to 6 seconds for adults and 1 every 3 for peds
Steps of CPR - Answer - Determine unresponsiveness. Check for breathing for up to 10
seconds. Check carotid pulse for up to 10 seconds. Begin CPR until AED is available.
Give 30 compressions at 100 beats/min and then 2 breaths over the course of 1 second.
Once an advanced airway is inserted, ventilate at a rate of 8-10 breaths/min and do not
stop compressions.
This is exactly the same for children, except two-rescuer CPR is 15:2. If patient
experiences a return of spontaneous circulation, ventilate at a rate of 10-12 breaths/min.
Compression to breath ratios - Answer - under 8 years old:
-2 provider: 15:2
-1 provider: 30:2
-one third of chest diameter
Older:
-30:2 always
-2 inches
,AED procedure - Answer - -if cardiac arrest was not seen by EMS, give 5 cycles of 30:2
before defibrillating
-if cardiac arrest was seen, one EMT begins compressions and the other applies AED
-if only one EMT available, apply AED immediately
-check for pulse 2 minutes after defib
-if no shockable rhythm, wait 2 minutes and re-analyze
When to place left lateral - Answer - If patient has adequate breathing and is uninjured.
To maintain a patent airway in an unresponsive patient.
What to do if you fail to ventilate - Answer - If the breath doesn't go in successfully,
reposition the patient and try again. If there is still nothing, assume there is a foreign body
obstruction and begin CPR on an unresponsive apneic patient. Continue to attempt
ventilations and open the mouth and look in every time.
Pneumothorax signs - Answer - -dyspnea, pleuritic chest pain that worsens during
inspiration and expiration, absent or decreased breath sounds
-rupture of visceral lining
Pulmonary embolism signs - Answer - -dyspnea, acute chest pain, hemoptysis, cyanosis,
tachypnea, hypoxia, tachycardia?**
GCS Eye Opening - Answer - Spontaneous = 4
To voice = 3
To pain = 2
None = 1
GCS Verbal Response - Answer - Oriented = 5
Confused = 4
Inappropriate words = 3
Incomprehensible words = 2
None = 1
GCS Motor Response - Answer - Obeys commands = 6
Localizes pain = 5
Withdraws (pain) = 4
Flexion (pain) = 3
Extension (pain) = 2
None = 1
, Rule of nines (adults) - Answer - Head = 9%
Front = 18%
Back = 18%
Each arm = 9%
Groin = 1%
Each leg = 18%
Rule of nines (child) - Answer - Head = 18%
Front = 18%
Back = 18%
Each arm = 9%
Each leg = 14%
Cushing's triad - Answer - Sign there might be an increase in intracranial pressure.
Hypertension, bradycardia, and abnormal breathing.
Appendicitis pain - Answer - -pain to the RLQ
-rebounding pain
-fever
Peritonitis - Answer - -inflammation of peritoneum
-abdominal pain, lack of appetite, markle test
Markle heel drop - Answer - markle test; used to assess a patient with abdominal pain,
patient drops down onto heels, pain will be felt in region of pain source
Cholecystitis pain - Answer - RUQ pain, referred to the right shoulder
Gastrointestinal bleeding - Answer - -hematemesis
-hematochezia (blood in stool)
-melena (dark, tarry stool)
Esophageal varices - Answer - -weakening of blood vessels in esophagus
-alcoholism
-vomiting large amounts of bright red blood
Aortic aneurysm pain - Answer - Lower back and lower quadrants pain; tearing
