NREMT Crash Course Practice Exam 3rd Edition

You are called for a 6-month-old infant with respiratory distress. Which of the following is true about patients in this age group? (Select the TWO answer options that apply.)

-Infants are obligate nose breathers. -Infants often develop bradycardia due to hypoxia.

You and your partner are preparing to lift the stretcher into the ambulance with a 300-pound patient. To protect yourself from injury, you should do which of the following? (Select the TWO answer options that apply.)

-Keep the weight close to your body. -Keep your back straight and bend at the knees.

You are first on the scene of a motor vehicle collision involving multiple vehicles. Which of the following should you do first? (Select the TWO answer options that apply.)

-Request additional resources. -Determine scene safety.

A patient with an isolated concussion injury will likely:

-progressively improve over time.

Epinephrine is indicated for anaphylaxis because it has which of the following effects? (Select the THREE answer options that apply.)

-tachycardia -peripheral vasoconstriction -bronchodilation A reduction in airway resistance caused by the relaxation of airway smooth muscle. It is the opposite of bronchoconstriction. Peripheral vasoconstriction plays a vital role in regulating body temperature by adjusting heat exchange with the external environment.

Your patient has a partial thickness burn to his anterior chest. It is about the size of the palm of his hand. What is the approximate total body surface area of the burn?

1%

You are caring for a 3-year-old patient in cardiac arrest. What is the correct compression-to-ventilation ratio for two-person CPR on this patient?

15 compressions to 2 ventilations

A patient is being ventilated by mouth-to-mask ventilations without supplemental oxygen. What percentage of oxygen is the patient receiving?

16% -Exhaled air contains about 16% oxygen; consequently, a patient receiving mouth to mask ventilations without supplemental oxygen will receive about 16% oxygen. Atmospheric air contains 21% oxygen

When there are signs and symptoms that your patient is hypoxic, you should do which of the following?

Administer oxygen at 15 lpm via nonrebreather mask. -Patients with signs of hypoxia should be placed on supplemental oxygen. Oxygen administration should not be delayed in order to obtain a pulse oximeter reading when there are signs of hypoxia

When a pulse oximeter is available, how should oxygen be administered to a patient experiencing chest pain?

Administer oxygen to maintain a pulse oximeter reading of at least 95%.

You are caring for a 6-year-old patient with respiratory distress. The pulse oximeter ( Sp02) reads 93%. Your management of the patient should include:

Administer sufficient oxygen to maintain a pulse oximeter reading of at least 95%.

While assessing an unresponsive patient, you discover a penetrating wound to the anterior chest. You should first do which of the following?

Apply an occlusive dressing.

Which of the following describes the purpose of administering aspirin to a suspected myocardial infarction patient?

Aspirin reduces platelet aggregation in the coronary arteries.

You are treating a 35-year-old man who was stung by a bee. He is allergic to bees and has a prescribed epinephrine auto-injector. His breath sounds are clear and non-labored. His BP is 130/82. How should you manage this patient?

Assess the patient for signs of hypoxia, administer oxygen as needed, and transport.

You are caring for a patient who was ejected during a single-vehicle rollover. The patient responds incoherently to verbal commands. You should do which of the following first?

Assess the patient's airway.

Your 5-year-old patient is unresponsive. A carotid pulse is present at 40 beats per minute. Breaths are shallow at six per minute. You should immediately do which of the following?

Begin chest compressions.

You are caring for a confused and restless 16-year-old female with blunt chest trauma following a single vehicle accident. She complains of severe dyspnea. You note a reduced tidal volume, cyanosis, and tachycardia. Which of the following should be done first?

Begin positive pressure ventilations. -The patient has inadequate ventilations. Positive pressure ventilations should be initiated before other assessments are performed

You are dispatched to a soccer game for a 12-year-old female with signs and symptoms of an allergic reaction. Upon arrival, the patient's mother hands you an epinephrine auto-injector. You should do which of the following?

Begin the primary assessment -A primary assessment must be conducted before determining if an epi-pen should be administered.

An elderly patient reportedly collapsed on a golf course almost 10 minutes ago. You assess her level of consciousness and determine she is unresponsive. Which of the following should you do first?

Check a pulse and begin CPR if needed.

Your patient is unresponsive following blunt trauma to the head. Which of the following is the EMT's first priority for an unresponsive patient?

Determine if CPR is indicated.

The primary assessment of an adult with chest pain includes:

Determine the transport priority.

Your 6-year-old patient jumped from a swing and injured his right leg. You note deformity to the right leg above the ankle. The patient most likely has a fracture to the

Distal tibia. -The radius and ulna are located in the arm, not the leg. A proximal fibula injury would be closer to the knee, not the ankle

Which of the following statements about distributive shock is correct?

Distributive shock is caused by widespread vasodilation. -Vasodilation is the medical term for when blood vessels in your body widen, allowing more blood to flow through them and lowering your blood pressure. Distributive shock is a life-threatening event that results from a lack of adequate blood flow and blood pressure throughout the body and loss of blood volume through capillary leakage.

You are on the scene of a motor vehicle accident. The driver is trapped in a vehicle that is smoking and leaking an unknown fluid. When is it appropriate to enter the vehicle and begin patient care?

Do not enter until trained rescuers determine the vehicle is safe to enter.

Which of the following is the first priority at a hazardous material incident?

Ensure your own safety.

While attempting to restrain a combative patient, your partner is bitten on the arm. Which of the following is true of bite wounds?

Human bites pose a high risk of infection.

Shock is caused by

Inadequate tissue perfusion. -Shock (hypoperfusion) develops as a result of inadequate tissue perfusion and disrupts the body's homeostasis

You are dispatched for a homeless person found unresponsive. You find the patient prone on the sidewalk unresponsive to pain. You should do which of the following first?

Log-roll the patient into a supine position. -The first priority for an unresponsive patient is to initiate CPR if needed. To do this, the patient must be supine.

Your 8-year-old patient has blunt chest trauma after being struck by a car. The patient is alert. His airway is clear, breathing is adequate, and pulses are present but weak at 110 beats per minute. Which of the following should you do next?

Perform a rapid scan.

Your patient is a construction worker who fell from a residential rooftop. He is responsive to pain. Breaths are shallow and irregular. You should do which of the following?

Provide artificial ventilations with a bag-mask device and high-flow oxygen. -BVM ventilations are indicated. Do not withhold ventilations to obtain a pulse oximeter reading. The NRB and nasal cannula are inappropriate for patients with inadequate ventilations.

You have just loaded your patient into the ambulance for transport to the hospital. Which of the following should always be done before initiating transport?

Put on your seat belt.

You arrive at the residence of an ill person. A child opens the door and says his dad is locked in the bedroom with his gun. You should do which of the following?

Retreat to safety and request law enforcement.

Which of the following is true regarding the Emergency Response Guide (ERG)?

The ERG helps identify the evacuation distance for specific hazardous materials.

You are caring for a multi-system trauma patient with possible internal bleeding. Select the correct statement about the rapid scan for a multi-system trauma patient:

The rapid scan is used to identify life-threatening conditions

Which of the following is true during inhalation of a spontaneously breathing patient?

There is a drop in pressure within the thorax. -During inhalation of a spontaneously breathing patient, the diaphragm and intercostal muscles are contracting. There is a drop in pressure within the thorax and air is pulled in, not pushed

You are caring for an unresponsive diabetic patient with deep, rapid respirations. The patient's blood glucose is 480 mg/dL. Which of the following is most likely correct?

This patient is likely hyperventilating due to severe acidosis. -Acidosis is a condition in which there is too much acid in the body fluids.

An oropharyngeal airway is indicated for which of the following patients?

a 44-year-old unconscious patient

Shallow respirations and bradypnea will likely cause

a decrease in minute volume.

Your patient exhibits crepitus to the thorax, paradoxical motion, and signs of hypoxia. You should suspect

a flail chest.

Which of the following patients should be your highest transport priority?

a full-thickness burn with respiratory compromise -Any burn patient with respiratory compromise should be considered a high transport priority. Patients with first degree (superficial) burns or pain would be considered a lower transport priority in comparison.

An elderly female reportedly had a severe headache for the last 24 hours. She was recently found unconscious in bed. Her family reports she has a history of hypertension and transient ischemic attacks (TIAs). The patient's current condition is most likely due to which of the following?

a hemorrhagic stroke -The patient's signs and symptoms are consistent with a stroke, not a cardiac emergency or migraine headache. Signs of a TIA are similar to a stroke but resolve within 24 hours

Your patient was injured during an industrial accident. He has an abdominal laceration with internal organs protruding. You should apply

a moist, sterile dressing

Which of the following adult patients is breathing adequately?

a patient with respirations at 16 per minute and equal chest rise and fall

Your adult patient reportedly smoked an unknown substance and passed out. The patient has inadequate ventilations and your partner begins ventilating with the BVM. Which of the following is the best indicator your patient is being ventilated adequately?

adequate bilateral chest rise and fall during BVM ventilation

A 36-year-old female presents with a sudden onset of difficulty breathing. She is anxious, has intercostal retractions, and nasal flaring. Her respiratory rate is 24 breaths per minute. You do not have a pulse oximeter. You should

administer oxygen via nonrebreather mask at 15 lpm.

Treatment should begin at a mass casualty incident

after triage has been completed.

You are dispatched for a possible stroke. Upon arrival, you determine the patient is responsive to painful stimuli. Which of the following should be assessed first for this patient?

airway

You are dispatched to a neighborhood park on a warm day for an 8-year-old with difficulty breathing. You find the patient breathing adequately but with some accessory muscle use. You note expiratory wheezes and a persistent cough. The patient states, "I need my medicine!" The patient is likely experiencing which of the following?

an asthma attack

Your patient has partial thickness burns over 35% of his body surface area. You should

apply a dry, sterile burn sheet -Partial thickness burns should be covered with a sterile burn sheet. Immersing a burn over a large surface area in water or applying ice increases the risk of hypothermia. Leaving the burn area exposed increases the risk of infection

Your patient has severe bleeding to her forearm. If direct pressure does not control the bleeding, you should immediately

apply a tourniquet.

A nonrebreather mask should be administered to patients who

are breathing adequately with signs of hypoxia. -A nonrebreather mask is indicated for spontaneously breathing patients with adequate ventilations and signs of hypoxia. Patients with inadequate, slow, or shallow ventilations should be ventilated

You are the first ambulance on the scene of a motor vehicle accident. Your first action upon arrival should be to

assess the scene for hazards.

Your 67-year-old patient recently began taking a new medication. He is complaining of a sudden onset of severe respiratory distress. He quickly becomes semi-conscious and unable to follow verbal commands. His pulse oximeter (SpO2) is 89%. You should

assist ventilations with a BVM.

During a hazardous materials incident, you should take standard precautions

before making contact with the patient.

You respond to a preschool facility for an ill child. Upon arrival, you find an unresponsive 8-month-old. The infant has a palpable pulse of 50 beats per minute. Your next action should be to

begin chest compressions

You are dispatched to the local jail for a prisoner found unresponsive in her cell. Her airway is clear. Respirations are rapid and shallow. The pulse oximeter reads 90%. Your first action should be to

begin positive pressure ventilations.

To determine if CPR is indicated for an unresponsive patient less than one year of age, you should assess the

brachial pulse.

Which of the following signs of respiratory distress is more common in pediatric patients? (Select the THREE answer options that apply.)

bradycardia head bobbing nasal flaring

In unresponsive patients over one year of age, you should palpate which of the following?

carotid pulse

Nerve agents and choking agents are examples of Which of the following describes the purpose of administering aspirin to a suspected myocardial infarction patient?

chemical agents.

Which of the following accurately describes supine hypotensive syndrome?

compression of the inferior vena cava by the uterus -Supine hypotensive syndrome occurs when the weight of the fetus and uterus compresses the inferior vena cava. This reduces the return of blood to the heart, reducing cardiac output and blood pressure.

Which of the following provides oxygenated blood directly to the heart?

coronary arteries -The coronary arteries provide oxygenated blood to the heart. The carotid and cerebral arteries provide blood to the brain. The femoral arteries are located in the leg

Carbon monoxide exposure is dangerous because it

displaces oxygen in the blood.

The most common weapon of mass destruction used by terrorists is which of the following?

explosive weapons

Continuous positive airway pressure (CPAP) can reduce respiratory distress by

helping to keep the alveoli open. -CPAP is a treatment for sleep apnea and can help avoid intubation.

Inadequate oxygen delivery to the body's tissues is called

hypoxia. -Inadequate oxygen delivery to the body is hypoxia. Hypercarbia is abnormally high carbon dioxide levels. Shock and hypoperfusion both refer to inadequate tissue perfusion.

The foramen magnum

is an opening at the base of the skull.

Which of the following interventions should be performed first for an unresponsive patient with a suspected spinal cord injury?

jaw thrust maneuver

How should you open the airway of an unresponsive patient with an unknown mechanism of injury?

jaw-thrust maneuver

Which of the following conditions would most likely cause hypovolemic shock?

laceration of the liver

You are treating a patient with respiratory distress. He has a history of multiple myocardial infarctions. Lung sounds indicate pulmonary edema. You note the patient does NOT have any JVD or pedal edema. The patient is most likely experiencing

left heart failure. -Pulmonary edema indicates possible left heart failure. Pedal edema and JVD indicate possible right heart failure

Which of the following is considered a normal capillary refill time for infants and children?

less than 2 seconds

You are ventilating a patient with a stoma. You note air is escaping from the mouth and nose with each breath. You should

manually seal the mouth and nose.

Which of the following medications is intended to decrease myocardial workload and increase myocardial blood flow?

nitroglycerin -Nitroglycerin is a vasodilator, which will increase blood flow to the heart and reduce systemic vascular resistance.

You are first on the scene of an overturned container truck. You note a placard, but do not recognize the ID number. There is fluid leaking from the vehicle. You should

notify your dispatcher a hazardous materials team is needed.

You are caring for a 12-year-old who was injured at the neighborhood skate park. He was not wearing a helmet and is responsive to pain. You note snoring respirations and deformity to the left ankle. You should first

open the airway with spinal precautions. -The patient's airway should be opened manually with the jaw thrust maneuver before suctioning the airway, securing to a spine board, or applying a splint.

You are treating an unresponsive patient with slow, shallow respirations and pinpoint pupils. Which of the following conditions is most likely?

opioid overdose -Bradypnea, shallow respirations, and pinpoint pupils are common signs with an opioid overdose.

The hypoxic respiratory drive works by monitoring:

oxygen levels.

Which of the following physiological responses helps protect the body from overheating?

peripheral vasodilation -Peripheral vasodilation helps the body dissipate body heat. Peripheral vasoconstriction helps the body conserve body heat. Shivering helps generate body heat. Syncope can result from overheating; it is not a protective mechanism.

You are considering administration of oral glucose to your diabetic patient. This drug is contraindicated when it

poses a significant risk of harm. -Aspirin reduces platelet aggregation in the coronary arteries. Aspirin does not dilate coronary arteries, reduce chest pain due to MI, or reduce acidosis.

You are called for a 40-year-old female with a severe headache. She is 32 weeks pregnant. The patient history reveals she also has nausea, blurred vision, and sudden edema in her face and hands. Her blood pressure is 156/96. The patient is most likely experiencing

preeclampsia. -happens when you're pregnant and have high blood pressure, too much protein in your pee, and also swelling in your legs, feet, and hands.

Life-threatening bleeding should be found and treated during which of the following?

primary assessment

Which of the following vessels carries deoxygenated blood?

pulmonary arteries -The pulmonary arteries are the only arteries which carry deoxygenated blood. The pulmonary veins are the only veins which carry oxygenated blood

The left side of the heart receives oxygenated blood from the

pulmonary veins. -The left side of the heart receives oxygenated blood from the pulmonary veins. The right side of the heart receives deoxygenated blood from the vena cava. Deoxygenated blood leaves the right heart through the pulmonary arteries.

You are conducting a primary assessment on an elderly fall victim who complains of hip pain. While assessing circulation, you should check

pulses, external bleeding, and skin condition. -Pulses, bleeding, and skin condition are three components of circulation that should be included in the primary assessment.

Coordinating efforts through a unified command system at a mass casualty incident will likely

reduce duplication of effort and freelancing.

A 16-year-old male is unconscious following an assault. When you insert an OPA, the patient begins gagging. You should

remove the OPA and suction as needed.

You are caring for a 22-year-old female who complains of respiratory distress after exercising. She is alert, speaking full sentences, and has a persistent cough. She is most likely experiencing which of the following?

respiratory distress with adequate breathing

A 19-year-old female is found unconscious in her apartment living room. While surveying the apartment, your partner yells from the patient's bedroom, "She has an SVN machine in here!" This suggests the patient has a history of

respiratory problems.

You are called for a drowning victim at a family barbecue. Upon arrival, two family members approach you yelling, swearing, and demanding to know what took so long. One of the family members pushes you. You should

retreat and request immediate assistance from law enforcement.

Which of the following signs of respiratory distress is more commonly found in pediatric patients?

see-saw respirations

A 30-year-old male was stabbed in the abdomen during an assault. The knife is impaled in his right lower abdominal quadrant. It is important to

stabilize the knife in place.

While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He is unable to speak, has a faint inspiratory stridor and cyanosis around the lips. You should

stand behind him and administer abdominal thrusts.

Which of the following findings indicates partial obstruction of the upper airway?

stridor -Stridor occurs in the upper airway. Rales, rhonchi and wheezes occur in the lower airway.

When caring for a patient with a behavioral emergency, it is critical to bear in mind that

the behavior may be caused by a physiological condition.

The rapid extrication technique should be used at a motor vehicle accident when

the patient has life-threatening injuries.

You are transporting a pregnant patient from an urgent care center to a high-risk OB facility. The transferring physician tells you the patient may have an abruptio placenta. This means

the placenta is prematurely separating from the uterine wall

Which of the following is the most frequent cause of airway obstruction?

the tongue

Your patient has been exposed to a chemical that overstimulate the parasympathetic nervous system. You would expect this patient to exhibit which of the following?

vomiting -The parasympathetic nervous system exerts control over digestive functions. Overstimulation can lead to vomiting. Dilated pupils, dry mouth, and hypertension are more likely caused by stimulation of the sympathetic nervous system.

Your pediatric patient has spontaneous respirations. This means the patient is breathing

without assistance.