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NREMT EXAM, PRACTICE EXAM AND STUDY GUIDE

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NREMT EXAM, PRACTICE EXAM AND STUDY GUIDE

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NREMT EXAM, PRACTICE EXAM AND STUDY GUIDE




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%

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