Free Practice Questions for NREMT EMT Exam

The correct answer is A because primary blast injuries are caused by the blast wave itself , and that pressure wave most strongly affects gas-containing organs such as the lungs, ears, and bowel . Authoritative blast-injury references specifically state that primary blast injury damages gas-filled organs, while the other blast phases involve fragments, body displacement, burns, or other associated effects. ( NCBI )

The correct answer is B because in EMS, the patient care report is the official record of the assessment, treatment, and transport decision-making provided to the patient. Authoritative EMS documentation guidance explains that the PCR is essential to communicate patient assessment and treatment and to support ongoing care; if it is incomplete, it suggests the care itself may not have been thorough or cannot be shown to have been thorough. In EMS practice, incomplete documentation is commonly treated as incomplete patient care documentation, which reflects poorly on the thoroughness of care. ( NCBI )

Hepatitis A virus is transmitted exclusively via the fecal-oral route. Ingesting contaminated food or water allows the virus to enter the digestive tract, infecting liver cells. It ' s often spread through poor hand hygiene or unsanitary food handling.

It is not bloodborne, unlike Hepatitis B and C. It is not commonly spread through saliva or urine.

The correct answers are A, B, and C . Proper lung auscultation technique includes listening to at least one full respiratory cycle at each location and placing the stethoscope on bare skin rather than over clothing. Authoritative respiratory examination guidance also emphasizes comparing both sides systematically. ( PMC )

For a patient with congestive heart failure , it is appropriate to auscultate the bilateral lung bases first because CHF commonly produces bilateral basal crackles from pulmonary edema, often most noticeable at the posterior bases. ( NCBI )

A good way to separate AMI from more typical angina is to look for signs that the pain is more severe, more persistent, and less responsive to the usual triggers and relief measures .

That is why A, D, and F are the best answers here. A patient having an acute myocardial infarction may look pale or gray , which reflects poor perfusion and sympathetic stress during a cardiac event. Chest pain that lasts longer than 10 minutes points away from classic stable angina, which is often brief and improves with rest. And when nitroglycerin gives little or no relief , that raises concern that the problem is more serious than routine angina. The American Heart Association notes that stable angina usually happens with activity or strong emotions and is often treated with rest, medication, or both , while worsening or persistent chest discomfort is more concerning for a heart attack or other serious heart problem. ( www.heart.org )

From an EMT test-taking perspective, B and C sound more like classic stable angina patterns: pain brought on by exertion or stress and pain that improves with rest. Also, while nitroglycerin response by itself is not a perfect diagnostic tool in real-world medicine, NREMT-style questions commonly use poor relief with nitro plus prolonged pain as clues that the patient may be having an AMI rather than angina . Merck also notes that nitroglycerin response alone should not be used to diagnose chest pain, which is why the whole pattern matters. ( Merck Manuals )

The correct answer is B. Ventricular tachycardia only.

Key Concept: Shockable Rhythms and Pulse Presence

The two primary shockable rhythms are:

Ventricular fibrillation (VF)

Ventricular tachycardia (VT)

Ventricular Fibrillation (VF):

Chaotic, disorganized electrical activity

No effective cardiac output

Always pulseless

NREMT-aligned reference:

“Ventricular fibrillation results in no pulse due to ineffective quivering of the ventricles.”

Ventricular Tachycardia (VT):

Rapid, organized ventricular rhythm

May be:

Pulseless VT (cardiac arrest)

Perfusing VT (with a pulse)

NREMT-aligned reference:

“Ventricular tachycardia may present with or without a pulse.”

Why B is correct:

Only ventricular tachycardia can sometimes produce a pulse

VF never produces a pulse

Why the other options are incorrect:

A. VF only → Incorrect; VF is always pulseless

C. Both → Incorrect; VF cannot produce a pulse

D. Neither → Incorrect; VT can produce a pulse

Exact Extracts (NREMT/AHA-aligned references):

“Shockable rhythms include ventricular fibrillation and pulseless ventricular tachycardia.”

“Ventricular tachycardia may be with or without a pulse.”

“Ventricular fibrillation produces no cardiac output.”

Clinical Priority Summary:

Among shockable rhythms, only ventricular tachycardia can still produce a pulse, making B the correct answer.

The correct answer is D. applying direct pressure.

A perineal tear after childbirth is a form of external soft-tissue bleeding. The primary prehospital treatment for any external bleeding, including obstetric perineal tears, is direct pressure with sterile dressings.

According to NREMT EMT-level obstetrics care guidelines, bleeding control in the postpartum patient should follow standard hemorrhage control principles, with emphasis on direct pressure as the first-line intervention.

Why D is correct:

Direct pressure is the most effective and immediate method to control bleeding from a perineal tear.

It helps reduce blood loss and prevents further complications such as shock.

Why the other options are incorrect:

A. Packing her vagina with gauze → This is not appropriate in the prehospital setting and may cause further injury or infection.

B. Elevating her pelvis → Not a recognized or effective method for controlling perineal bleeding.

C. Having her keep her legs flexed → This does not control bleeding and has no role in treatment.

Exact Extracts:

“Control external bleeding with direct pressure using sterile dressings.”

“Postpartum bleeding should be managed with standard hemorrhage control techniques.”

“Direct pressure is the first step in controlling soft-tissue hemorrhage.”

This is a classic presentation of hypovolemic shock due to traumatic blood loss (open femur fracture, pelvic instability). Indicators include:

Low BP (86/42) = hypotension

High pulse (P 136) = compensation

Mental status decline (responsive only to voice) = indicates decompensated shock

Obstructive and distributive shock are not applicable. Compensated shock would show normal BP and alert mental status.

The correct answers are A and B because standard EMT care for epistaxis (nosebleed) includes having the patient lean forward and applying direct pressure by pinching the nostrils .

Leaning forward prevents blood from draining into the airway or stomach, reducing the risk of aspiration or vomiting. Pinching the nostrils provides direct pressure to control bleeding , which is the primary intervention emphasized in NREMT-aligned bleeding control guidelines.

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