Free Practice Questions for NREMT EMT Exam

The correct answer is A. Remove the airway and ventilate him.

In pediatric patients, improper placement or incorrect sizing of an oropharyngeal airway (OPA) can cause:

Airway obstruction instead of opening

Worsening hypoxia

Leading to cyanosis and bradycardia

The patient’s cyanosis (low oxygen) and bradycardia (late hypoxia sign) indicate that the airway intervention has failed or worsened the situation.

Immediate action is to:

Remove the OPA

Provide effective ventilations with BVM

B. Continue ventilation with the airway in place → Incorrect because the airway is likely malpositioned or obstructing airflow

C. Increase ventilation rate to 40–60 → Excessive and inappropriate; does not correct obstruction

D. Start CPR if HR < 100 → In pediatrics, CPR begins if HR < 60 with poor perfusion, not < 100

“If an airway adjunct worsens ventilation, it should be removed immediately.”

“Bradycardia in infants is a sign of hypoxia.”

“Ensure adequate ventilation before initiating compressions.”

The correct answer is D. 60 seconds.

This question is testing the special consideration of hypothermia in cardiac arrest assessment. In a patient found unresponsive in the snow, there is a high likelihood of severe hypothermia, which significantly slows metabolism and heart rate.

In hypothermic patients, pulses may be very slow and difficult to detect, so the EMT must take extra time to accurately determine whether a pulse is present before initiating CPR.

Standard pulse checks in normothermic patients are limited to no more than 10 seconds, but hypothermic patients are an exception.

Why 60 seconds is correct:

NREMT-aligned EMS guidelines emphasize that in severe hypothermia, the provider should assess the pulse for up to 60 seconds before concluding that the patient is pulseless. This is because hypothermia can produce extremely slow heart rates (bradycardia), and premature CPR could be inappropriate if a pulse is actually present.

Why the other options are incorrect:

A. 10 seconds: This is correct for standard cardiac arrest assessment in normothermic patients, but not for hypothermia.

B. 15 seconds and C. 30 seconds: These are not recommended durations in NREMT or AHA guidelines for pulse checks.

Exact Extracts:

“In a hypothermic patient, check the pulse for 30–60 seconds before determining pulselessness.”

“Severely hypothermic patients may have very slow heart rates that are difficult to detect.”

“Do not assume cardiac arrest until a careful and prolonged pulse assessment has been performed.”

NREMT legal education differentiates between slander and libel, both forms of defamation.

Option D (Libel) is correct because libel involves false written statements that harm a person’s reputation. In this scenario, the partner’s written claim falsely attributes improper treatment to you.

Option A (Slander) refers to spoken false statements.

Option B (Malice) describes intent, not a legal category of defamation.

Option C (Battery) is unlawful physical contact with a patient.

Understanding legal terminology helps EMTs protect themselves professionally and legally.

The correct answer is D. Peripheral vasodilation.

Why D is correct (Peripheral vasodilation):

Neurogenic shock occurs due to loss of sympathetic nervous system tone, usually from a spinal cord injury. This leads to:

Widespread peripheral vasodilation

Pooling of blood in the extremities

Decreased venous return

Hypotension

Additionally, patients often present with:

Warm, dry skin (unlike other shock types)

Bradycardia (due to unopposed parasympathetic tone)

NREMT-aligned guidance states:

“Neurogenic shock results from loss of sympathetic tone leading to vasodilation.”

“Peripheral vasodilation causes hypotension and inadequate perfusion.”

Why the other options are incorrect:

A. Central vasodilation: Not a recognized defining feature; neurogenic shock primarily affects peripheral vessels.

B. Peripheral vasoconstriction: Seen in hypovolemic shock, not neurogenic shock.

C. Central vasoconstriction: Not associated with neurogenic shock.

Exact Extracts:

“Neurogenic shock is caused by loss of sympathetic tone.”

“This results in widespread peripheral vasodilation.”

“Patients may present with hypotension and bradycardia.”

The correct answer is C. false imprisonment.

In EMS legal concepts, false imprisonment is defined as the unauthorized confinement or restraint of a person without legal justification or consent. This can occur if an EMT prevents a patient from leaving when the patient has the right to refuse care.

Why C is correct:

False imprisonment involves restricting a person’s freedom of movement without proper authority.

In EMS, this includes situations where a competent patient is held against their will.

Why the other options are incorrect:

A. Battery → Involves unlawful physical contact or touching without consent

B. Kidnapping → Involves unlawful transport or movement of a person, typically with criminal intent

D. Assault → Involves threatening harm or creating fear of harm, not confinement

Exact Extracts:

“False imprisonment is the unauthorized confinement of a person.”

“A patient who is competent has the right to refuse care and transport.”

“Restraining a patient without legal authority may constitute false imprisonment.”

The correct answers are B. Respiratory rate of 32 and C. Decorticate posturing.

This question is based on START triage (Simple Triage and Rapid Treatment), which is used in mass casualty incidents to rapidly categorize patients.

Red (Immediate) category includes patients with:

Respiratory rate greater than 30 breaths/min

Poor perfusion (capillary refill > 2 seconds or no radial pulse)

Altered mental status (unable to follow commands)

Why B is correct:

A respiratory rate of 32 breaths per minute exceeds the START triage threshold of 30.

NREMT triage guidance states:

“If respirations are greater than 30 per minute, tag the patient as immediate (red).”

Why C is correct:

Decorticate posturing indicates severe brain injury and altered mental status.

These patients cannot follow commands, placing them in the red (immediate) category.

Why the other options are incorrect:

A. Pulselessness: In START triage, pulseless and apneic patients are categorized as black (deceased/expectant), not red.

D. Controlled major hemorrhage: If bleeding is controlled and no other critical findings are present, the patient may be delayed (yellow).

E. Inability to flex the right knee: This is an isolated orthopedic injury and typically categorized as minor (green) or delayed.

Exact Extracts:

“Respirations greater than 30 per minute → Immediate (red).”

“Patients unable to follow commands are categorized as immediate.”

“Apneic patients who do not resume breathing are tagged deceased.”

The correct answer is B. Abrasion.

An abrasion is a superficial injury caused by scraping or rubbing force that damages the epidermis (outer layer of skin). This type of injury is commonly referred to as a “scrape” or “road rash.”

Why B is correct:

Abrasions occur when the skin is rubbed or scraped against a rough surface.

They involve only the epidermis and are usually superficial.

Minimal bleeding may occur, but the main concern is pain and risk of infection.

Why the other options are incorrect:

A. Avulsion → Involves tearing away of skin or tissue, often deeper and more severe

C. Puncture → Caused by a sharp, pointed object penetrating the skin

D. Laceration → A cut or tear in the skin, typically deeper than an abrasion

Exact Extracts:

“An abrasion is a wound caused by scraping or rubbing of the skin.”

“It involves damage to the epidermis.”

“Abrasions are usually superficial but can be painful and prone to infection.”

The correct answer is C. Bradycardia.

In pediatric patients, it is critical to distinguish between respiratory distress and respiratory failure.

Respiratory distress includes early compensatory signs such as:

Intercostal retractions

Audible wheezes

Tachypnea

These findings indicate that the child is still attempting to compensate and maintain adequate oxygenation.

Respiratory failure, however, represents a late and life-threatening stage where the child can no longer maintain adequate oxygenation and ventilation.

Bradycardia is a key late sign of respiratory failure in infants and children and indicates severe hypoxia and impending cardiac arrest.

According to NREMT-aligned educational material:

“Bradycardia in pediatric patients is often the result of hypoxia.”

“Late signs of respiratory failure include decreased mental status and bradycardia.”

Why the other options are incorrect:

A. Intercostal retractions: Early sign of respiratory distress (increased work of breathing)

B. Audible wheezes: Indicates airway narrowing, typically seen in distress

D. Tachypnea: Early compensatory mechanism to improve oxygenation

NREMT guidance emphasizes:

“Increased work of breathing and abnormal breath sounds are signs of respiratory distress, not failure.”

Exact Extracts:

“Bradycardia in pediatric patients is usually caused by hypoxia.”

“Late signs of respiratory failure include bradycardia and decreased mental status.”

“Retractions and tachypnea are signs of respiratory distress.”

CPAP works by delivering continuous positive pressure to keep alveoli open and improve oxygenation. However, complications include:

Hypotension: Due to reduced venous return and cardiac preload

Feeling of suffocation: Common psychological reaction to a tight-fitting mask and forced airflow

It is used to treat, not cause, pulmonary edema. It does not induce bronchospasm or myocardial infarction.

Given fall with head trauma and absent respirations, the most concerning cause is spinal injury, particularly a cervical spine fracture. A high cervical injury (C1–C4) can paralyze the diaphragm, leading to apnea despite a beating heart.

Brain herniation can also depress respirations but often presents with unequal pupils, posturing, and Cushing’s triad (not described here). Commotio cordis is sudden cardiac arrest from blunt chest trauma (not head). Open pneumothorax affects chest mechanics, not directly linked here.