Free NREMT sample questions

Correct answer: Apply calcium gluconate gel liberally to the affected areas and establish cardiac monitoring.

The unique danger of hydrofluoric acid is not just the chemical burn but its systemic toxicity, specifically causing life-threatening hypocalcemia. The SDS identifies calcium gluconate as the antidote. Therefore, the most critical priority is to neutralize the fluoride ions in the skin by applying the topical antidote while simultaneously monitoring for the primary systemic effect, which is cardiac dysrhythmias. The other interventions are important but secondary to stopping the chemical process and monitoring for its most lethal complication.

Correct answer: 18%

In the adult Rule of Nines, the entire trunk (front and back) is 36%. This is divided into the anterior trunk (chest and abdomen), which accounts for 18%, and the posterior trunk (back), which accounts for another 18%. Each full arm is 9%, each full leg is 18%, the head is 9%, and the genital area is 1%.

Correct answer: Anticholinergic

The patient's signs and symptoms align with the classic anticholinergic toxidrome, often remembered by the mnemonic: 'Hot as a hare (hyperthermia), blind as a bat (dilated pupils), dry as a bone (dry skin/mucous membranes), red as a beet (flushed skin), and mad as a hatter (delirium/hallucinations)'. Sympathomimetic toxidromes are similar but typically present with moist or diaphoretic skin, not dry skin.

Correct answers: Initiate two large-bore IVs.; Provide gentle, rapid transport to an appropriate facility.; Provide pain management as per protocol.

Establishing IV access is critical in case the patient rapidly decompensates and requires fluid or medication administration.

This is a time-sensitive surgical emergency. Minimizing on-scene time and transporting to a hospital capable of cardiothoracic surgery is vital. Gentle handling is important to avoid exacerbating the dissection.

The pain from an aortic dissection is severe. Providing analgesia is important for patient comfort and can also help reduce heart rate and blood pressure, which are key treatment goals.

Correct answer: postictal

The postictal phase is the period immediately following a seizure. It is characterized by altered consciousness, confusion, lethargy, and sometimes combativeness as the brain recovers. The aura is a pre-seizure sensation, and the tonic and clonic phases describe the seizure activity itself.

Correct answer: Widespread dilation of blood vessels, causing a relative hypovolemia.

Distributive shock (e.g., septic, anaphylactic, neurogenic) is caused by massive systemic vasodilation. This increases the size of the 'container' (the vascular system) without a change in the amount of fluid. The blood volume becomes insufficient to fill the dilated vessels and perfuse tissues, leading to a state of 'relative hypovolemia'. Cardiogenic shock is a pump problem, and hypovolemic shock is a fluid loss problem.

Correct answer: Provide positive-pressure ventilations with a BVM.

According to neonatal resuscitation guidelines, if a newborn's heart rate is below 100 bpm after initial steps (drying, warming, stimulating), the most critical intervention is to provide positive-pressure ventilations (PPV). Most neonatal bradycardia is due to hypoxia, and correcting ventilation and oxygenation will typically resolve the heart rate. Chest compressions are only initiated if the heart rate remains below 60 bpm despite effective PPV.

Correct answer: Prioritize patient care while making a conscious effort to minimize disturbance of the scene.

The absolute priority for EMS is patient care. However, providers should be mindful that they are in a crime scene. They should not actively collect evidence but should aim to preserve it by disturbing the scene as little as possible. This includes noting the patient's position, not cutting through holes in clothing from bullets or weapons if possible, and avoiding moving items unnecessarily. This balances the need for medical care with the legal requirements of the investigation.

Correct answer: Hyperkalemia

The kidneys are responsible for excreting potassium. In ESRD, this function is lost. When a patient misses dialysis, potassium levels can build up in the blood, leading to hyperkalemia. Severe hyperkalemia is cardiotoxic and can cause fatal dysrhythmias, such as peaked T waves, widened QRS, and eventually ventricular fibrillation or asystole. This is the most immediate life-threatening complication of a missed dialysis treatment.

Correct answer: The decompression needle has become clogged or kinked; perform a second needle decompression.

When a tension pneumothorax reaccumulates after a successful initial decompression, the most common cause is that the catheter has become occluded (e.g., by a blood clot) or has kinked. The underlying air leak is still present, allowing the pleural space to refill with air. The appropriate management is to perform a second needle decompression, typically adjacent to the first site, to re-establish a patent opening for air to escape.