Free NREMT sample questions

Correct answer: Initiating Continuous Positive Airway Pressure (CPAP).

This patient's presentation is classic for acute cardiogenic pulmonary edema. CPAP is the primary intervention for these patients. It works by increasing intrathoracic pressure, which decreases venous return (preload) and pushes fluid out of the alveoli back into the capillaries, improving gas exchange. The patient meets the criteria for CPAP: alert, able to follow commands, in severe respiratory distress, and hypertensive. Bronchodilators are for bronchoconstriction (e.g., asthma/COPD), and laying the patient supine would worsen their condition.

Correct answer: 60-70 mmHg

The presence of peripheral versus central pulses can provide a rough estimation of systolic blood pressure (SBP). The presence of a carotid pulse indicates an SBP of at least 60-70 mmHg. If a femoral pulse were present, it would suggest an SBP of 70-80 mmHg, and a radial pulse suggests an SBP of at least 80-90 mmHg. The absence of a radial pulse but presence of a carotid pulse strongly suggests significant hypotension, likely in the 60-70 mmHg range.

Correct answers: Sepsis; Pneumonia

The patient's history of infection (cough, fever) combined with signs of systemic inflammatory response and organ dysfunction (AMS, hypotension, tachycardia, tachypnea) are classic indicators of sepsis.

The productive cough and fever strongly suggest a respiratory infection, with pneumonia being a very common cause in elderly patients. The pneumonia is the likely source of the systemic infection leading to sepsis.

Correct answer: True

This statement is true. Hyperventilation (ventilating too fast) or using excessive force increases the pressure in the airway, which can overcome the esophageal opening pressure. This forces air into the stomach (gastric distention) instead of the lungs. Gastric distention can compromise ventilations by pushing up on the diaphragm and significantly increases the risk of regurgitation and aspiration of gastric contents.

Correct answer: 6 mg rapid IV push followed by a 20 mL saline flush.

Adenosine has an extremely short half-life (less than 10 seconds). To be effective, it must reach the AV node quickly. The correct procedure is to administer the initial dose of 6 mg as a rapid IV push (over 1-2 seconds) in a large proximal vein, immediately followed by a rapid 20 mL normal saline flush to propel the medication to the heart. A slow push would allow the drug to be metabolized before it could work. The 12 mg dose is considered only if the initial 6 mg dose is ineffective.

Correct answer: Place bag directly on ice

The incorrect step is placing the bag directly on ice. This can cause frostbite and damage the tissue, making reattachment less likely. The correct procedure is to wrap the amputated part in saline-moistened gauze, place it in a sealed plastic bag, and then place that bag into a second container with a mixture of ice and water. This keeps the part cool without freezing it.

Correct answer: Establish command and perform a scene size-up.

In a multiple-casualty incident (MCI), the first arriving unit's primary responsibility is to establish command, ensure scene safety, and perform a rapid size-up to determine the nature of the incident and resource needs. This involves providing an initial report to dispatch about the location, type of incident, number of patients, and any immediate hazards. This step is crucial for organizing the chaos and getting the necessary help en route before individual patient care begins.

Correct answer: Ruptured ectopic pregnancy.

The combination of a missed menstrual period, sudden unilateral abdominal pain, and signs of shock (pallor, tachycardia, hypotension) in a female of childbearing age is the classic presentation for a ruptured ectopic pregnancy. This is a true surgical emergency due to the risk of life-threatening internal hemorrhage. While other conditions can cause abdominal pain, none fit this specific cluster of signs and symptoms as well.

Correct answer: Apply calcium gluconate gel liberally to the affected areas and establish cardiac monitoring.

The unique danger of hydrofluoric acid is not just the chemical burn but its systemic toxicity, specifically causing life-threatening hypocalcemia. The SDS identifies calcium gluconate as the antidote. Therefore, the most critical priority is to neutralize the fluoride ions in the skin by applying the topical antidote while simultaneously monitoring for the primary systemic effect, which is cardiac dysrhythmias. The other interventions are important but secondary to stopping the chemical process and monitoring for its most lethal complication.

Correct answer: 18%

In the adult Rule of Nines, the entire trunk (front and back) is 36%. This is divided into the anterior trunk (chest and abdomen), which accounts for 18%, and the posterior trunk (back), which accounts for another 18%. Each full arm is 9%, each full leg is 18%, the head is 9%, and the genital area is 1%.