NREMT EXAM REVIEW 1 QUESTIONS
COMPLETE WITH VERIFIED ANSWERS |
CERTIFIED
/. While obtaining a SAMPLE history from a 58 year old suspected cardiac patient with
severe chest pain and diaphoresis, you are informed that the patient had open heart
surgery three years ago. Under which "letter" of the acronym SAMPLE should this
information be placed?
S
E
P
L - Answer-✅P
"P" is the pertinent past history, such as previous open heart surgery. "L" is last oral
intake. "S" stands for signs and symptoms the patient is having. "E" stands for events
leading up to the problem, such as the patient's activity level when the symptoms
started. The two letters not listed are "A," which stands for allergies, and "M," which is
for medications the patient is currently taking.
/.You arrive at the scene of a reported domestic dispute near your station. Due to the
rapid response time you arrive before the police. As you cautiously approach the front
door you hear loud shouting and what sounds like glass breaking coming from within.
What should you do in this instance?
Clear the scene, return to the station, and wait for dispatch to resend you to the address
after the police arrive.
Stand to the side of the door and knock loudly.
Return to ambulance and stage a few blocks away while waiting for police
Cautiously peer in the windows to see what is going on. - Answer-✅Return to
ambulance and stage a few blocks away while waiting for police
In any situation where the EMT may be harmed, the best course of action is to retreat
from the scene to a safe location, even if that is staging in your ambulance a few blocks
away. Dangerous scenes, especially domestic disputes can easily "spill" into the streets
and the EMT should not be anywhere near should more trouble erupt. Once the police
have arrived and cleared the scene of hazards, the EMT can again cautiously approach.
,/.A 4 month old male is in respiratory arrest. Before initiating positive pressure
ventilations, you should
pad behind his shoulders to account for his large occiput.
hyperextend his neck to open the airway.
pad behind his occiput to place him in the sniffing position.
flex his neck to put him in the neutral position. - Answer-✅pad behind his shoulders to
account for his large occiput.
The occipital regions in small children are often large. Having these children lie flat can
actually occlude the airway by causing hyperflexion. Padding behind the occiput can
exacerbate this problem. Hyperextension or flexion would be inappropriate and not
open the airway.
/.You are en route to a motor vehicle crash where you will back up an EMS unit already
on scene. They advise you by radio that you will be picking up an unresponsive female
patient with a head injury. They add that she is currently breathing spontaneously at
34/minute, pulses are present, all active bleeding has been managed, and the vitals are
stable. Given this, what vital aspect of the primary survey did they not advise you of?
Airway patency
SAMPLE history and OPQRST findings
Actual heart rate
Patient's weight and ethnicity - Answer-✅Airway patency
Given the findings presented through the radio transmission, one missing aspect of the
primary survey is the determination of airway patency. Although the patient's weight and
ethnicity are often determined during the general assessment step of the primary, rarely
will that information make a critical difference in the management of an unstable patient.
Finally, an actual heart rate is less important to know during the primary - rather, just an
estimation of the heart rate in general (too fast, normal, too slow, or absent) is sufficient
to start treatment.
/.You respond to a serious motor vehicle crash where it is apparent that a young woman
has been killed. Her family arrives on scene. When speaking with them, you should tell
them
you know how they feel.
,crews are doing everything they can.
their daughter has died.
everything will be okay. - Answer-✅their daughter has died.
Being honest is an important element of approaching a death and dying scenario.
Clearly in this case everything will not be okay, and there is really nothing more the
crews can do. Although you may know how they feel, often we have no idea what the
family is going through and it is best to avoid statements to that effect.
/.You are caring for a 19 year old female who is complaining of an acute onset of
abdominal pain with dizziness. You find the patient to be tachypneic, tachycardic,
nervous, and very scared. Skin is pale and diaphoretic. She admits to being sexually
active, but "always" uses some type of prophylactic. Her last menstrual cycle was 25
days previously. Abdominal assessment is benign other than slight tenderness to
palpation. The most likely reason for the patient's pain is
sexually transmitted disease.
pelvic inflammatory disease.
menstrual cramps.
ectopic pregnancy. - Answer-✅ectopic pregnancy.
Sudden onset of abdominal pain in a sexually active female should always be assumed
as ectopic pregnancy, and the patient should be managed and transported
expeditiously to the hospital. A patient with pelvic inflammatory disease or a sexually
transmitted disease rarely has a sudden onset, and menstrual cramps have a typically
slower onset.
/.A 74 year old COPD patient complains of difficulty breathing. She has an increased
respiratory rate and you note cyanosis around her lips. After ensuring an open airway
and adequate breathing, you should
administer high concentration oxygen via non-rebreather mask.
assess her mental status using the Glascow Coma Score.
conduct a focused assessment of her chest.
assess her radial pulse. - Answer-✅administer high concentration oxygen via non-
rebreather mask.
The chief complaint and the findings of tachypnea and cyanosis indicate the need for
high-concentration oxygen. It is important to immediately treat problems found in the
primary assessment, so continuing on to assess the pulse, obtain a Glasgow Coma
, Score, or conduct a focused assessment prior to administering oxygen would be
incorrect.
/.A 17 year old was slashed in the abdomen during a knife fight. When you arrive, you
observe that part of the patient's large intestine is eviscerated. Which one of the
following is the most appropriate way to care for the protruding intestine?
Apply a moistened dressing and then an occlusive covering.
Replace the protruding intestine in the abdomen.
Flush the wound with saline and then cover it with an occlusive dressing.
Wrap the protruding section with dry sterile gauze dressing. - Answer-✅Apply a
moistened dressing and then an occlusive covering.
A protruding section of intestine should be covered with a sterile dressing moistened
with sterile saline, and then it should be covered with an occlusive dressing. The
protruding intestine should finally be covered with a bulky dressing to keep that section
of the intestine warm. The intestine should not be touched or placed back into the
abdominal cavity.
/.A 44 year old male tells you he is suicidal and plans to hang himself with the rope next
to his bed. He does not wish to be transported to the hospital. You should
allow the patient to refuse care.
speak to the patient calmly about why he is suicidal.
await law enforcement and transport this patient against his will.
attempt to restrain this patient and transport him to the hospital. - Answer-✅await law
enforcement and transport this patient against his will.
RATIONALE
Suicidal patients can be dangerous to EMTs. In this case, it is best to await law
enforcement assistance. Although a suicidal patient cannot refuse care, it would be
better to involve the police than attempt to restrain the patient alone. Most states give
the authority to order transport of patients against their will to the police. Speaking
calmly is important, but transport is necessary.
/.A 55 year old female complains of acute onset palpitations and chest pain. She is alert
but pale and diaphoretic. Her vitals are P 220, R 28, BP 88/60. These findings most
likely indicate
anaphylaxis due to an allergic reaction.
COMPLETE WITH VERIFIED ANSWERS |
CERTIFIED
/. While obtaining a SAMPLE history from a 58 year old suspected cardiac patient with
severe chest pain and diaphoresis, you are informed that the patient had open heart
surgery three years ago. Under which "letter" of the acronym SAMPLE should this
information be placed?
S
E
P
L - Answer-✅P
"P" is the pertinent past history, such as previous open heart surgery. "L" is last oral
intake. "S" stands for signs and symptoms the patient is having. "E" stands for events
leading up to the problem, such as the patient's activity level when the symptoms
started. The two letters not listed are "A," which stands for allergies, and "M," which is
for medications the patient is currently taking.
/.You arrive at the scene of a reported domestic dispute near your station. Due to the
rapid response time you arrive before the police. As you cautiously approach the front
door you hear loud shouting and what sounds like glass breaking coming from within.
What should you do in this instance?
Clear the scene, return to the station, and wait for dispatch to resend you to the address
after the police arrive.
Stand to the side of the door and knock loudly.
Return to ambulance and stage a few blocks away while waiting for police
Cautiously peer in the windows to see what is going on. - Answer-✅Return to
ambulance and stage a few blocks away while waiting for police
In any situation where the EMT may be harmed, the best course of action is to retreat
from the scene to a safe location, even if that is staging in your ambulance a few blocks
away. Dangerous scenes, especially domestic disputes can easily "spill" into the streets
and the EMT should not be anywhere near should more trouble erupt. Once the police
have arrived and cleared the scene of hazards, the EMT can again cautiously approach.
,/.A 4 month old male is in respiratory arrest. Before initiating positive pressure
ventilations, you should
pad behind his shoulders to account for his large occiput.
hyperextend his neck to open the airway.
pad behind his occiput to place him in the sniffing position.
flex his neck to put him in the neutral position. - Answer-✅pad behind his shoulders to
account for his large occiput.
The occipital regions in small children are often large. Having these children lie flat can
actually occlude the airway by causing hyperflexion. Padding behind the occiput can
exacerbate this problem. Hyperextension or flexion would be inappropriate and not
open the airway.
/.You are en route to a motor vehicle crash where you will back up an EMS unit already
on scene. They advise you by radio that you will be picking up an unresponsive female
patient with a head injury. They add that she is currently breathing spontaneously at
34/minute, pulses are present, all active bleeding has been managed, and the vitals are
stable. Given this, what vital aspect of the primary survey did they not advise you of?
Airway patency
SAMPLE history and OPQRST findings
Actual heart rate
Patient's weight and ethnicity - Answer-✅Airway patency
Given the findings presented through the radio transmission, one missing aspect of the
primary survey is the determination of airway patency. Although the patient's weight and
ethnicity are often determined during the general assessment step of the primary, rarely
will that information make a critical difference in the management of an unstable patient.
Finally, an actual heart rate is less important to know during the primary - rather, just an
estimation of the heart rate in general (too fast, normal, too slow, or absent) is sufficient
to start treatment.
/.You respond to a serious motor vehicle crash where it is apparent that a young woman
has been killed. Her family arrives on scene. When speaking with them, you should tell
them
you know how they feel.
,crews are doing everything they can.
their daughter has died.
everything will be okay. - Answer-✅their daughter has died.
Being honest is an important element of approaching a death and dying scenario.
Clearly in this case everything will not be okay, and there is really nothing more the
crews can do. Although you may know how they feel, often we have no idea what the
family is going through and it is best to avoid statements to that effect.
/.You are caring for a 19 year old female who is complaining of an acute onset of
abdominal pain with dizziness. You find the patient to be tachypneic, tachycardic,
nervous, and very scared. Skin is pale and diaphoretic. She admits to being sexually
active, but "always" uses some type of prophylactic. Her last menstrual cycle was 25
days previously. Abdominal assessment is benign other than slight tenderness to
palpation. The most likely reason for the patient's pain is
sexually transmitted disease.
pelvic inflammatory disease.
menstrual cramps.
ectopic pregnancy. - Answer-✅ectopic pregnancy.
Sudden onset of abdominal pain in a sexually active female should always be assumed
as ectopic pregnancy, and the patient should be managed and transported
expeditiously to the hospital. A patient with pelvic inflammatory disease or a sexually
transmitted disease rarely has a sudden onset, and menstrual cramps have a typically
slower onset.
/.A 74 year old COPD patient complains of difficulty breathing. She has an increased
respiratory rate and you note cyanosis around her lips. After ensuring an open airway
and adequate breathing, you should
administer high concentration oxygen via non-rebreather mask.
assess her mental status using the Glascow Coma Score.
conduct a focused assessment of her chest.
assess her radial pulse. - Answer-✅administer high concentration oxygen via non-
rebreather mask.
The chief complaint and the findings of tachypnea and cyanosis indicate the need for
high-concentration oxygen. It is important to immediately treat problems found in the
primary assessment, so continuing on to assess the pulse, obtain a Glasgow Coma
, Score, or conduct a focused assessment prior to administering oxygen would be
incorrect.
/.A 17 year old was slashed in the abdomen during a knife fight. When you arrive, you
observe that part of the patient's large intestine is eviscerated. Which one of the
following is the most appropriate way to care for the protruding intestine?
Apply a moistened dressing and then an occlusive covering.
Replace the protruding intestine in the abdomen.
Flush the wound with saline and then cover it with an occlusive dressing.
Wrap the protruding section with dry sterile gauze dressing. - Answer-✅Apply a
moistened dressing and then an occlusive covering.
A protruding section of intestine should be covered with a sterile dressing moistened
with sterile saline, and then it should be covered with an occlusive dressing. The
protruding intestine should finally be covered with a bulky dressing to keep that section
of the intestine warm. The intestine should not be touched or placed back into the
abdominal cavity.
/.A 44 year old male tells you he is suicidal and plans to hang himself with the rope next
to his bed. He does not wish to be transported to the hospital. You should
allow the patient to refuse care.
speak to the patient calmly about why he is suicidal.
await law enforcement and transport this patient against his will.
attempt to restrain this patient and transport him to the hospital. - Answer-✅await law
enforcement and transport this patient against his will.
RATIONALE
Suicidal patients can be dangerous to EMTs. In this case, it is best to await law
enforcement assistance. Although a suicidal patient cannot refuse care, it would be
better to involve the police than attempt to restrain the patient alone. Most states give
the authority to order transport of patients against their will to the police. Speaking
calmly is important, but transport is necessary.
/.A 55 year old female complains of acute onset palpitations and chest pain. She is alert
but pale and diaphoretic. Her vitals are P 220, R 28, BP 88/60. These findings most
likely indicate
anaphylaxis due to an allergic reaction.
