Free Practice Questions for NREMT EMT Exam

Comprehensive and Detailed Explanation From Exact Extract:

The patient's symptoms are consistent with a stroke (CVA). Proper prehospital care focuses on maintaining airway, breathing, circulation, and protecting the affected limbs. Positioning the patient with head elevated (not supine) reduces intracranial pressure and aspiration risk.

Protecting the paralyzed side (e.g., left arm) from injury during transport is critical. EMS should still communicate with the patient — even if speech is impaired — and perform a stroke assessment using tools like Cincinnati Prehospital Stroke Scale (CPSS) or FAST.

Positive pressure ventilation (PPV) forces air into the lungs under pressure rather than relying on negative intrathoracic pressure. NREMT education emphasizes that while PPV is lifesaving, it carries important risks—most notably decreased venous return to the heart.

Option C (Profound hypotension) is correct because increased intrathoracic pressure reduces preload by compressing the vena cava, which can significantly lower cardiac output and blood pressure. This effect is especially pronounced in hypovolemic or trauma patients.

Option A is incorrect because diaphragmatic movement is not a complication.

Option B is unrelated to ventilation.

Option D describes a ventilation parameter, not a complication.

NREMT stresses careful ventilation rates and volumes to avoid hypotension, gastric inflation, and barotrauma.

Comprehensive and Detailed Explanation From Exact Extract:

Children compensate for shock through increased heart rate, respiratory rate, and vasoconstriction, which delays blood pressure drop. Therefore:

Tachycardia is often the first sign

Prolonged capillary refill (>2 seconds) is an early indicator

Tachypnea supports perfusion

Blood pressure is a late sign in pediatric shock. SpO₂ is helpful but does not specifically indicate shock. Blood glucose may be abnormal in other metabolic conditions but is not an early marker of volume loss.

Comprehensive and Detailed Explanation From Exact Extract:

Mechanism of Injury (MOI) assessment is a cornerstone of trauma care. It helps providers determine:

Extent of injury: High-speed collisions, falls from height, or penetrating trauma suggest internal injuries even if external signs are limited.

Need for additional resources: MOI may indicate the necessity of ALS backup, air transport, or technical rescue.

MOI cannot determine a patient’s medical history or guarantee survival predictions. The destination facility depends on multiple factors including triage protocols, vital signs, and local trauma system regulations.

Comprehensive and Detailed Explanation From Exact Extract:

The position of the patient’s head within the aircraft affects access to airway management and crew maneuverability. If the head is oriented away from providers or toward a non-accessible bulkhead, this can delay critical interventions (airway suctioning, ventilations).

Use of air splints, maintaining oxygen saturation, or environmental humidity are not major complications relative to physical positioning and in-cabin access limitations.

Comprehensive and Detailed Explanation From Exact Extract:

An epidural hematoma classically presents with a “lucid interval” — a brief period of regained consciousness following head trauma, followed by rapid deterioration. This is due to arterial bleeding, often from the middle meningeal artery, leading to increasing intracranial pressure.

Signs include:

High blood pressure

Decreasing respiratory rate

Altered LOC or unresponsiveness

Subdural hemorrhages are slower venous bleeds, common in elderly patients. Subarachnoid hemorrhage often presents with "worst headache of life." Intracerebral bleeds are less commonly linked to lucid intervals.

Comprehensive and Detailed Explanation From Exact Extract:

The patient’s symptoms are consistent with acute coronary syndrome (ACS). The first-line treatments are:

Aspirin (160–325 mg): inhibits platelet aggregation, reducing clot progression.

Oxygen: administered when SpO₂ <94% or signs of hypoxia/distress are present.

CPAP is for pulmonary edema or respiratory failure. Nitroglycerin requires BP >90 systolic and medical direction approval. Laying the patient supine may increase myocardial workload and is inappropriate unless hypotension occurs.

Comprehensive and Detailed Explanation From Exact Extract:

In cases of sexual assault, preserving evidence integrity is critical. Clothing or other forensic evidence must be placed in paper bags. Plastic or non-breathable materials can trap moisture, promoting mold or degradation of evidence like DNA or bodily fluids.

This approach follows chain-of-custody protocols used by law enforcement and medical facilities for handling forensic material.

If a patient is responsive, they must have adequate cerebral perfusion, meaning a pulse is present—even if it is difficult to palpate. NREMT guidelines emphasize that EMTs should not assume cardiac arrest based solely on an inability to feel a pulse.

Option C is correct because the EMT should continue the primary assessment, reassessing airway, breathing, and circulation using additional indicators such as skin condition, mental status, and breathing quality.

Option A is incorrect because CPR is only initiated in unresponsive, pulseless patients.

Option B is incorrect because AED use is indicated only for unresponsive, pulseless patients.

Option D may be appropriate later for shock but does not address the assessment discrepancy.

NREMT teaches that patient responsiveness is a reliable indicator of circulation and that EMTs must avoid unnecessary resuscitative interventions.

NREMT hemorrhage-control education emphasizes wound packing for severe external bleeding that cannot be controlled with direct pressure or a tourniquet, particularly in junctional areas. Junctional areas are regions where tourniquets are ineffective due to proximity to the torso.

Option B (Left axilla) is correct. The axilla is a classic junctional site where major vessels are present and tourniquets cannot be applied effectively.

Option A (Left hip) is correct because wounds near the inguinal region are considered junctional and are appropriate for wound packing.

Option C (Left shoulder) is also considered a junctional area where wound packing may be used if bleeding is severe and not amenable to tourniquet placement.

Option D (Right temple) is incorrect because wound packing is contraindicated in the skull.

Option E (Right forearm) is incorrect because tourniquets are preferred on extremities.

Option F (Right upper abdominal quadrant) is incorrect because wound packing is not performed in the abdominal cavity.

NREMT stresses early hemorrhage control as a top trauma priority due to preventable death from bleeding.