Paramedic Coaches Official NREMT FINAL Practice Exam

You arrive on scene to a 23 year-old male with complaints of difficulty breathing after playing a game of football with friends. You notice he is in the tripod position and his skin is pale. He states he has no past medical history of respiratory problems and has no known allergies. His vital signs are as follows: BP 114/76, HR 110, RR 28 and shallow, SpO2 95% on room air. You should...

Administer oxygen with nonrebreather mask and rapid transport

3 multiple choice options

You arrive on scene to a patient that has crashed his car into a tree on a quiet street. No other cars were involved. He was wearing a seatbelt. Upon assessment, you determine he is unresponsive, has no pulse, and is not breathing. You notice there are no signs of trauma. What do you suspect MOST likely caused this patient to crash?

Acute coronary syndrome

3 multiple choice options

You arrive on scene to a 7 year-old female who is having a seizure. She begins to vomit. How long should you suction for?

10 seconds

3 multiple choice options

You arrive on scene to a 82 year-old female in a nursing home. The nursing staff tells you she has become increasingly short of breath and they are not sure why. Which of the following are early signs and symptoms of respiratory distress?

Tachycardia, diaphoresis, headache

3 multiple choice options

Which of the following is the appropriate method to correct an error in your documentation?

Cross out the error with a line, initial it, then continue with your documentation

3 multiple choice options

Your patient is a 32 year-old male who was in a motorcycle accident. He sustained multiple rib fractures on the left side of his chest. How many lobes of the lung could be affected on the left side?

2

3 multiple choice options

You are off duty at the grocery store when you witness an elderly male collapse in front of you. You have a worker call 911 and have another grab the AED while you confirm he is pulseless and apneic. What should you do next?

Apply an AED, analyze rhythm and shock if advised

3 multiple choice options

You arrive on scene to a 72 year-old male with severe difficulty breathing. His spouse tells you he has COPD. You notice cyanosis around his lips and nailbeds, and he is having a hard time keeping his eyes open. He is unresponsive to any of your commands and flexes in reaction to pain. He is currently on oxygen by nasal cannula at 3 LPM. What is the next best step?

Provide ventilations with bag-valve mask

3 multiple choice options

You are treating a 32 year-old male who was penetrated in the left upper neck with a knife. You are successfully managing his hemorrhage and hypotension while in transport. After a few minutes, the patient states his face is numb and you notice the right side of his face is drooping. What do you suspect?

Ischemic stroke

3 multiple choice options

You arrive on scene to a 28 year-old male who fell off a 10 foot ladder after trying to clean his roof. He is lying unresponsive on the ground. You notice cyanosis around his lips and nailbeds and hear gurgling respirations. His respiratory rate is 4 breaths per minute and he has a weak radial pulse. Select TWO next best steps to perform to manage this patient.

Maintain cervical spine and Suction to clear possible fluids

3 multiple choice options

Which of the following is the function of the right ventricle?

Pump deoxygenated blood to pulmonary artery

3 multiple choice options

Which of the following is the normal ETCO2 level in an adult?

35-45 mmHg

3 multiple choice options

You arrive on scene to a 20 year-old male shot in the upper right chest. He is lying supine and looks anxious. You notice when he inhales his wound makes a gurgling sound. His vital signs are as follows: BP 86/78, HR 128, RR 40 breaths per minute and shallow, SpO2 93%. What is the next best step?

Apply 3-sided occlusive dressing, provide ventilations with bag valve mask, rapidly transport

3 multiple choice options

Which of the following best describes the purpose of pursed lip breathing?

Prevent collapse of bronchioles during exhalation

3 multiple choice options

How does the NFPA diamond represent when there is multiple chemicals at a location?

Represents overall hazard at the location

3 multiple choice options

You respond to a 86 year-old male lying unresponsive on his bathroom floor. His wheelchair is next to him. His home health aide states she found him like this and is unsure what happened. His pulse is 54 beats per minute and strong. What is the next best step?

Jaw-thrust maneuver

3 multiple choice options

Which of the following is a sign of heart failure?

Decreased cardiac output

3 multiple choice options

Which of the following is the most common airway obstruction in an adult?

Tongue

3 multiple choice options

You arrive on scene to a 7 year-old child in cardiac arrest. Which of the following is the proper sequence when performing pediatric CPR?

Chest compressions, airway, breathing

3 multiple choice options

Which of the following neurological signs is associated with increased mortality and poor patient outcomes?

Decerebrate posturing

3 multiple choice options

All of the following should be assessed with respiratory quality EXCEPT:

Minute volume

3 multiple choice options

Which of the following occurs during isovolumetric contraction in ventricular systole?

Semilunar and atrioventricular valves close

3 multiple choice options

You respond to a 3 year-old female choking at a restaurant. You notice she has a weak cry and cough. You can hear inspiratory stridor. You should...

Abdominal thrusts

3 multiple choice options

Which of the following occurs to the minute volume during hyperventilation?

Decreases due to less air reaching the alveoli

3 multiple choice options

You arrive on scene to a family barbecue where a 57 year-old male is lying supine on the grass. His family states he was choking then went unconscious. You try to open the airway but are not successful. How should you proceed?

Begin chest compressions

3 multiple choice options

You are performing triage and your patient is a 32 year-old female who can walk, but has respirations of 28 breaths per minute, a 3 inch laceration oozing blood on her forehead, and a suspected right humerus fracture. What should you tag this patient?

Green

3 multiple choice options

You arrive on scene to a motor vehicle accident of a 23 year-old male. You notice jugular vein distension and auscultate muffled heart sounds. You suspect cardiac tamponade. Which of the following types of shock can occur with cardiac tamponade?

Obstructive shock

3 multiple choice options

Which of the following patients MOST likely will require CPR?

A 49 year-old female unresponsive with gasping respirations

3 multiple choice options

You arrive on scene to a 62 year-old male who fell in the grocery store and is currently conscious. A bystander tells you he caught him before he fell so he did not hit his head. You assess he is unresponsive to verbal commands, flexes to withdraw from pain, and has an intact gag reflex. His vital signs are as follows: BP 164/88, HR 102, RR 8 breaths per minute, SpO2 86% on room air. What is the next best step?

Insert nasopharyngeal airway

3 multiple choice options

Where should your hands be located when administering abdominal thrusts in a choking patient?

Between umbilicus and xiphoid process

3 multiple choice options

All of the following conditions may cause congestive heart failure EXCEPT:

Pulmonary edema

3 multiple choice options

You arrive on scene to a 72 year-old male having a COPD exacerbation. You notice his skin is cool and clammy and he is slightly altered mental status. His spouse states he is prescribed an inhaler for his COPD. You assess his respirations at 8 breaths per minute, shallow and labored. You contact medical control and they order you to assist the patient in assisting administering his inhaler. The patient attempts to administer his inhaler but is unable to due to his slight altered mental status. How should you proceed?

Administer oxygen and call for ALS backup

3 multiple choice options

You arrive on scene to a 5 year-old male in respiratory distress. His mother states he was playing with some toys when she suddenly heard him breathing "not right". She states he is severely allergic to bees and was outside in the yard about an hour ago. What do you suspect?

Foreign body airway obstruction

3 multiple choice options

You arrive to a nursing home where nursing staff tell you a 97 year-old male was found lying supine in his bed, unable to wake him up. They are unsure how long he has been like this. You notice he is pulseless and apneic. How should you proceed?

Perform 5 cycles of CPR before applying AED

3 multiple choice options

You and your partner respond to a 48 year-old female. Your partner tries to gather a history from the patient but she refuses to tell him what is wrong. Your partner asks you to step in. How should you proceed?

Ask open-ended questions

3 multiple choice options

You are managing a cardiac arrest patient. The AED has delivered six consecutive shocks without a change in the patient's status. What is the next best step?

Follow local protocols and initiate transport

3 multiple choice options

You respond to a 67 year-old male who is unconscious on the floor of his kitchen. You assess he has shallow respirations at a rate of 32 breaths per minute. What is the next best step?

Provide ventilations at rate of 1 breath every 5-6 seconds

3 multiple choice options

What does the diastolic number represent in a blood pressure?

Pressure in arteries during resting phase of heart

3 multiple choice options

You respond to a 18 year-old female who is profusely bleeding after cutting her hand with a knife while cooking. You apply direct pressure with gauze but after 5 minutes it continues to bleed. What is the next best step?

Apply tourniquet proximal to injury

3 multiple choice options

You respond to a 34 year-old female who complains of sharp chest pain. She states it has become gradually worse over the past 2 days. She states she is currently dealing with a cold. She has no past medical history or known allergies. Her vital signs are as follows: BP 148/80, HR 124, RR 20 breaths per minute, SpO2 92%, temp 100.2 degrees F. What is the next best step?

Administer oxygen with nasal cannula

3 multiple choice options

You are caring for a mother undergoing an imminent delivery in her home. You can see copious amounts of meconium staining while delivering the child. What should you do?

Wipe the face and clear any secretions

3 multiple choice options

It is your first week working in the field. You and your paramedic partner respond to a 4 year-old female whose parents report he broke his arm after "accidentally falling down the steps entering the house". You also noticed some bruising of various degrees over her abdomen and face. You tell your partner you suspect it may be child abuse, but your partner disagrees and does not think you should report the case. You should...

Notify law enforcement

3 multiple choice options

Your AED states that no shock is advised. How should you proceed?

Resume CPR for 5 cycles

3 multiple choice options

Which of the following best describes respiration?

Gas exchange between body and its environment

3 multiple choice options

You are transporting a 70 year old male to the hospital for chest pain. While you are driving, your partner is in the back treating him. About halfway to hospital, your partner shouts the patient suddenly became unconscious and his EKG shows he is in cardiac arrest. You are 8 minutes from the hospital. How should you proceed?

Call for backup, pull over, and help your partner with CPR

3 multiple choice options

You respond to a 30 year-old who was burned in a house fire. He has burns to his torso and back and both arms. According to the Rule of Nines, what percent of his body surface area is burned?

54%

3 multiple choice options

Which of the following best describes infarction?

Cellular death of a tissue

3 multiple choice options

Which of the following symptoms is MOST common with aortic aneurysms?

Chest pain

3 multiple choice options

You are performing chest compressions on an adult cardiac arrest patient. Which of the following is true about compressions?

Push hard and fast, compressing deeper versus too shallow

3 multiple choice options

Which of the following complications is more common with lacerations versus penetrating injuries?

Nerve damage

3 multiple choice options

You respond to a 12 year-old female with complaints of difficulty breathing. Upon auscultation, you hear a a high-pitched whistling sound on exhalation. What do you suspect?

Bronchoconstriction

3 multiple choice options

You arrive on scene to a 88 year-old male who complains of crushing chest pain. You notice his breathing is slightly labored and his skin is warm and dry. He states his daily medications consist of aspirin and metformin, which he took this morning. He tells you he is also prescribed nitroglycerin but he has not taken it yet. His vital signs are as follows: BP 86/62, HR 96, RR 24 and shallow, and SpO2 93%. You administer supplemental oxygen, gather the patient's history, and perform your detailed patient assessment. What is the next best step?

Rapid transport

You arrive on scene to a patient with a laceration to the leg that is bleeding dark red, flowing blood. Which of the following blood vessels causes this types of bleed?

Veins

3 multiple choice options

How do nerve agents like organophosphates affect the body?

Affect ability to absorb oxygen

3 multiple choice options

You are transporting a patient lights and sirens on a rainy day. You suddenly come up to a large area of standing water on the highway. How should you proceed?

Brake slowly and prepare for hydroplanning

3 multiple choice options

Which of the following is one of the first signs of carbon monoxide poisoning?

Headache

3 multiple choice options

You are assessing a 32 year-old female who is 40 weeks pregnant. Where would you locate the fundus?

Xiphoid process

3 multiple choice options

You arrive on scene to a 7 year-old female who drowned in a pool after diving head first. Her family pulled her from the pool and she is now laying unconscious on the ground. When she is placed in the recovery position she coughs up water. You notice her breathing is very shallow and gasping. Her vital signs are as follows: BP 58/42, HR 48, RR 50 breaths per minute. What do you suspect?

Spinal nerve damage

3 multiple choice options

Select TWO of the following patients that display signs of inadequate breathing.

6 year-old female with a respiratory rate of 32 and 22 year-old male with nasal flaring

1 multiple choice option

Which of the following explains why burns to a child are more serious than burns to an adult?

Children have a higher ratio of skin surface area to total body mass

3 multiple choice options

You arrive on shift and see you will be working on a type II ambulance today. Which of the following best describes the style of a type II ambulance?

Raised roof passenger compartment on van chassis

3 multiple choice options

Which of the following is the proper method in suctioning a newborn's airway?

Suction mouth first then nose

3 multiple choice options

You are transporting a 74 year-old female for a fall. As you are loading her into the ambulance, you notice a 3 inch laceration on her calf oozing blood that you missed in your rapid trauma assessment. You should...

Treat injury in route when you have a chance

3 multiple choice options

You respond to a 35 year-old female with complaints of severe pressure in her pelvic area. She states she is 31 weeks pregnant. You notice vaginal discharge upon assessment. What is the next best step?

Prepare for imminent delivery

3 multiple choice options

You respond to a mass casualty event at an office building. Which of the following officers coordinates moving a patient from the treatment area to the ambulance?

Transportation officer

3 multiple choice options

You arrive on scene to a 24-year old male in a motorcycle accident. Upon assessment you notice multiple rib fractures on his left side. Select TWO complications rib fractures may cause:

Decreased lung expansion and Decreased respiratory rate

3 multiple choice options

You arrive on scene to a 4 month-old infant who is unresponsive. You notice cyanosis around his lips. His vitals signs are as follows: heart rate 60 beats per minute, respiratory rate 22 breaths per minute, SpO2 90%. You should...

Provide ventilations with bag valve mask

3 multiple choice options

You are delivering a newborn out in the field. How many seconds should you coach the mother to push and rest for?

10 seconds push, 10 seconds rest

3 multiple choice options

You respond to a 18 year-old soccer player who was hit in the head with the ball and has a minor laceration on his leg. He opens his eyes when you ask, but otherwise he keeps them closed. When he tries to respond to your questions his words do not make sense. You attempt to reposition his leg and he moves it away. What is this patient's Glasgow Coma Score (GCS)?

11

3 multiple choice options

Which of the following helps easily identify hazardous materials by their name or division number?

Emergency Response Guidebook

3 multiple choice options

Which organ is located in the right lower quadrant of the abdomen?

Ascending colon

3 multiple choice options

You arrive on scene to a 25 year-old female with complaints of severe lower abdominal pain. You notice her skin is flushed and hot to touch. She states she feels she has a frequent urge to urinate and has notice slight blood in her urine. Her vital signs are as follows: BP 110/68, HR 106, RR 16 breaths per minute, SpO2 98%. What do you suspect?

Urinary tract infection

3 multiple choice options

Which of the following is a subdivision of the autonomic nervous system?

Parasympathetic nervous system

3 multiple choice options

You are dispatched to a remote location with no phone or radio reception. What are you working off of?

Off-line medical control

3 multiple choice options

You respond to a 78 year-old female lying on her bathroom floor after her daughter was worried about not hearing from her in 2 days. She responds to painful stimuli. Her skin is pale and cool. Her vital signs are as follows: BP 82/54, HR 64 and weak, RR 10 breaths per minute and shallow. Her capillary refill time is 4 seconds and GCS is 9. Which of the following vital signs listed is inaccurate?

Capillary refill time

3 multiple choice options

You respond to a 57 year old male complaining of chest pain when he woke up this morning. He called 911 right away and has not taken his daily medications yet. His vital signs are as follows: BP 160/90, HR 96, RR 18 breaths per minute, and SpO2 97% on room air. Which medication should you administer first?

Aspirin 324 mg PO

3 multiple choice options

Which of the following patients would be LEAST likely to be affected by hyperthermia?

A 30 year-old female who is 28 weeks pregnant

3 multiple choice options

You arrive on scene to a 15 year-old male who fell off his skateboard and landed on his left shoulder. He states it hurts the most on the top of his shoulder and when he shrugs or tries to raise his arms. Which of the following joints do you suspect is injured?

Acromioclavicular joint

3 multiple choice options

All of the following are predictors of serious internal injury for an adult EXCEPT:

Fall off a 12 foot ladder

3 multiple choice options

You are driving the ambulance no lights or sirens on a single lane road. The vehicle in front of you does not see you coming and does not pull over on the side of the road. How should you proceed?

Slow down until the vehicle pulls over

3 multiple choice options

Which part of the body retains the water from the food we eat?

Large intestine

3 multiple choice options

While performing a delivery you notice the umbilical cord is prolapsed around the newborn's neck. You try to slip it over but it is wrapped too tight. What is the next best step?

Clamp the cord and cut it, then continue with delivery

3 multiple choice options

You respond to a 56 year-old male in a hypertensive emergency. As you are transporting him, he suddenly complains of nausea and vomits. What is this a sign of?

Increased intracranial pressure

3 multiple choice options

Which of the following is NOT a way the body will compensate for severe blood loss?

Vasodilation

3 multiple choice options

Which of the following does the blue portion of the National Fire Protection Association (NFPA) diamond represent?

Health hazard

3 multiple choice options

Which of the following routes of administration and their absorption rate is incorrect?

Sublingual is a slow absorption rate

3 multiple choice options

A newborn is startled by a loud sound and flings his arms outward and starts to cry. Which of the following reflexes does this describe?

Moro reflex

3 multiple choice options

You and your partner are performing 2-person CPR on a newborn. What is the proper hand placement to provide chest compressions?

Both hands around body with thumbs pressing just below nipple line

3 multiple choice options

You arrive on scene to a 4 year-old female whose teacher found her unresponsive in the playground during recess. Her respiratory rate is 4 breaths per minute and she has a heart rate of 42 beats per minute. You should...

Provide ventilations with bag-valve mask

3 multiple choice options

When should a patient be transported head first on the backboard?

Going upstairs

3 multiple choice options

Select THREE of the following cranial nerves responsible for swallowing:

Glossopharyngeal (IX), Spinal accessory (XI), Vagus (X)

1 multiple choice option

You respond to a 29 year-old female who is 35 weeks pregnant. She complains of sudden, bright red vaginal bleeding that she noticed after she finished cleaning the house. What do you suspect?

Placenta previa

3 multiple choice options

Which of the following is necessary to make ATP in anaerobic metabolism?

Glucose

3 multiple choice options

A 32 year-old conscious male was slashed along the abdomen with an axe. He has a portion of small intestines protruding through the laceration. You should...

Check for ABCs, then cover the protrusion with moist sterile dressing

3 multiple choice options

You respond to a 31 year-old male who is refusing transport. He is conscious, alert and oriented. He wants to sign a patient refusal form, but there are no witnesses present. What should you do?

Have him sign the patient refusal form without a witness present

3 multiple choice options

You arrive on scene to a 69 year-old male complaining of chest pain and difficulty breathing. You assess his ABCs and find no immediate life threats. What is the next best step?

Give aspirin 324 mg chewable

3 multiple choice options

Which TWO components make up cardiac output?

Heart rate and Stroke volume

3 multiple choice options

Which of the following is a common side effect after administration of nitroglycerin?

Headache

3 multiple choice options

You respond to a 54 year old male working at a construction site who was impaled by a metal rod in his left hip. He is bleeding profusely and showing signs of hypovolemic shock. What is the next best step?

Apply direct pressure and bulking dressing around object and rapid transport

3 multiple choice options

You respond to a 9 month-old infant diagnosed with RSV two days ago. Her mother states her breathing has got worse. You notice the infant is extremely lethargic, has intercostal retractions and nasal flaring. Which of the following vital signs would be MOST concerning in this infant?

Respiratory rate: 62 breaths per minute

3 multiple choice options