Free Practice Questions for NREMT EMT Exam

NREMT guidelines emphasize that patient refusal is only valid if the patient has decision-making capacity. This patient has a severe headache with critically elevated blood pressure, which raises concern for conditions such as hypertensive emergency, intracranial hemorrhage, or stroke—all of which can impair cognition.

Option D is correct because the EMT must first determine whether the patient is alert, oriented, understands the risks, and can communicate a rational decision. Without capacity, a refusal is not legally or ethically valid.

Option A is incorrect because a refusal form should only be signed after capacity is confirmed.

Option B does not address the legal and ethical priority.

Option C is unnecessary unless the patient lacks capacity and poses a danger to themselves or others.

NREMT stresses that EMTs must protect patient autonomy while ensuring informed refusal, especially in high-risk presentations.

Organophosphates are commonly found in pesticides and insecticides, which are often stored in tool sheds. NREMT training emphasizes recognition of cholinergic toxidrome, frequently summarized by the mnemonic SLUDGE (Salivation, Lacrimation, Urination, Defecation, Gastrointestinal distress, Emesis).

Option C is correct because the patient’s symptoms—drooling, tearing, abdominal pain, and runny nose—are hallmark signs of organophosphate poisoning.

Option A (naphthalene) primarily causes hemolysis and neurologic symptoms.

Option B (hydrogen sulfide) causes respiratory distress and altered mental status, not secretions.

Option D causes chemical pneumonitis, not cholinergic symptoms.

NREMT stresses early identification of toxic exposures, scene safety, decontamination awareness, and rapid transport for definitive care.

This scenario suggests a potential multiple-casualty incident with a possible environmental hazard, such as carbon monoxide or another toxic gas. NREMT places strong emphasis on scene size-up as the first and most critical step in EMS operations.

Option B is correct because determining the size and scope of the incident allows the EMT to assess scene safety, identify hazards, estimate the number of patients, and determine the need for additional resources. Entering the scene without this assessment could result in responder injury or death.

Option A is incorrect because establishing command typically follows an initial size-up. Command cannot be effectively established without understanding the nature of the incident.

Option C is incorrect because announcing the presence of poisonous gas without confirmation may cause panic and is not an appropriate first action.

Option D is incorrect because attempting rescue before confirming scene safety violates NREMT’s core principle that rescuer safety comes first.

NREMT standards clearly state that EMTs must never enter a potentially hazardous scene until it has been properly assessed and deemed safe or appropriate resources are requested.

Comprehensive and Detailed Explanation (Based on NREMT standards):

This patient has signs of penetrating chest trauma, severe hypotension, tachycardia, and respiratory distress. A gurgling chest wound suggests an open pneumothorax, which can progress to tension pneumothorax.

Option C (Obstructive shock) is correct because air trapped in the chest can compress the heart and great vessels, preventing adequate cardiac output.

Option A is less likely because although blood loss may be present, the chest injury suggests impaired circulation due to pressure.

Option B involves pump failure, not trauma-related compression.

Option D involves abnormal vessel dilation, not mechanical obstruction.

NREMT emphasizes rapid recognition of obstructive shock and immediate intervention with occlusive dressings and rapid transport.

Return of spontaneous circulation (ROSC) indicates that the patient has regained a perfusing rhythm. If the patient is pushing away the BVM, this suggests improving mental status and spontaneous respirations.

Option D is correct because NREMT post-resuscitation care requires EMTs to reassess airway, breathing, and circulation, including confirming a pulse, and transition from assisted ventilations to supplemental oxygen if the patient is breathing adequately.

Options A and B are inappropriate because restraining a post-ROSC patient is rarely indicated and may worsen agitation.

Option C omits reassessment of circulation, which is critical after ROSC.

NREMT stresses frequent reassessment and supportive care following successful resuscitation.

Comprehensive and Detailed Explanation From Exact Extract:

Clavicle deformity suggests potential rib or thoracic trauma. Unequal chest rise may indicate a flail segment, pneumothorax, or hemothorax. Subcutaneous emphysema, the presence of air under the skin, is a classic finding in pneumothorax or tracheobronchial injury.

Occipital depression is not chest related; epigastric distension is a GI symptom; and jugular vein distention would suggest tension pneumothorax or cardiac tamponade, which are more advanced complications.

Comprehensive and Detailed Explanation From Exact Extract:

Altered mental status, combined with pale, cool, and clammy skin, is strongly suggestive of hypoglycemia (low blood sugar). Hypoglycemia is especially dangerous in diabetics who take insulin or oral hypoglycemics. The body's adrenergic response causes the "cool and clammy" presentation.

Hyperglycemia typically presents with warm, dry skin and develops more slowly. EMTs should administer oral glucose if the patient can swallow.

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.

Even in high-acuity situations, NREMT standards require EMTs to perform a scene size-up before patient contact. Scene size-up includes ensuring scene safety, determining the mechanism of injury, identifying hazards, and assessing the need for additional resources. Entering a scene without confirming safety places the EMT at risk and can result in additional victims.

Although the patient is unresponsive and apneic, EMTs must first confirm the scene is safe to enter. Only after scene safety is established should patient care begin.

Option B is incorrect because CPR cannot be initiated until the EMT has safely accessed the patient.

Option C is incorrect because airway maneuvers are performed after scene safety and patient access are confirmed.

Option D is incorrect because spinal stabilization occurs after initial access and assessment.

NREMT emphasizes: rescuer safety always comes first, even in life-threatening emergencies.

Comprehensive and Detailed Explanation (Based on NREMT standards):

For a conscious adult with complete airway obstruction, abdominal thrusts are typically indicated. However, NREMT guidelines specify that chest thrusts should be used instead for patients who are morbidly obese or pregnant, because abdominal thrusts may be ineffective or unsafe.

Option D is correct because chest thrusts provide effective airway clearance while accommodating body habitus.

Options A and B are inappropriate for a conscious patient.

Option C is incorrect because abdominal thrusts may not be effective in morbidly obese patients.

NREMT stresses modifying airway obstruction techniques based on patient size and condition.