NREMT AEMT Exam Questions

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21.

The AEMT should ensure what chest compression rate for an adult in cardiac arrest? 

  • 100 to 120 per minute

  • 80-100 per minute

  • 90-100 per minute

  • 130-160 per minute

Correct answer: 100 to 120 per minute

The most important factor in cardiac arrest survival is adequate chest compressions, which should be given at a rate of 100–120 per minute for an adult. Limiting interruptions in chest compressions is vital to maintaining the adequate rate per minute. 

22.

Which of the following is not a sign or symptom found in the sedative-hypnotic toxidrome? 

  • Dilated pupils 

  • Ataxia 

  • Altered mental status

  • Respiratory depression 

Correct answer: Dilated pupils 

Sedative-hypnotics are a group of drugs that cause Central Nervous System (CNS) depression. Benzodiazepines and barbiturates are the most commonly used agents in this class. Signs and symptoms in the sedative-hypnotic toxidrome include drowsiness, disinhibition, ataxia, respiratory depression, altered mental status, and hypotension. Dilated pupils are found in the sympathomimetic/stimulant toxidrome, not sedative-hypnotic.  

23.

The sensation when broken bone ends grind together is called which of the following?

  • Crepitus

  • Displacement

  • Epiphyseal imperfection

  • Osteogenesis imperfecta

Correct answer: Crepitus

Crepitus describes the grating, crackling, or popping sounds and sensations experienced under the skin and joints or a crackling sensation due to the presence of air in the subcutaneous tissue. Other types of crepitus include bone crepitus, when two fragments of a fracture are moved against each other, and joint crepitus, when the affected joint is passively moved with one hand while the other hand is placed on the joint to feel the crepitus.

The term displacement is often used as a specific term to describe loss of bone alignment along its long axis. Loss of alignment, or displacement, is usually accompanied by some degree of angulation, rotation, or change in bone length.

Epiphyseal imperfection and osteogenesis imperfecta are congenital bone disorders.

24.

Supplemental oxygen should be administered to:

  • Any patient with potential hypoxia

  • All patients

  • Patients with cardiac arrest

  • Patients with respiratory arrest

Correct answer: Any patient with potential hypoxia

By enriching atmospheric air with supplemental oxygen, you can increase oxygen to cells and reduce pain. You should administer supplemental oxygen to any patient showing signs of potential hypoxia.

Current guidelines from the American Heart Association state that any patient with chest pain or evidence of acute coronary syndrome who is not experiencing respiratory distress and has an oxygen saturation level greater than or equal to 94% does not require supplemental oxygen. To put it simply, not every patient requires supplemental oxygen.

Evidence shows that oxygen is helpful to patients with hypoxia, so if you are in doubt about the oxygenation status, administer supplemental oxygen. Follow all protocols.

25.

What is the correct treatment for a term newborn who is not breathing?

  • Provide positive pressure ventilation with room air

  • Provide positive pressure ventilation with 21% oxygen

  • Provide positive pressure ventilation with 24% oxygen

  • Provide blow-by oxygen via a non-rebreather mask

Correct answer: Provide positive pressure ventilation with room air

A newborn who is not breathing requires positive pressure ventilation. It is preferred to begin ventilations with room air, as oxygen may not be initially necessary. If central cyanosis remains, add oxygen and continue PPV with 100% oxygen. Reassess the newborn every 30 seconds. If the heart rate is at least 100 beats per minute and the infant is breathing adequately, you may stop ventilations and assess the newborn's color.

If the newborn's heart rate is less than 60 bpm, provide ventilation and begin chest compressions.

26.

Which of the following is not a factor that affects a patient's risk of exposure?

  • Mental status

  • Physical condition

  • Age

  • Nutrition and hydration status

Correct answer: Mental status

Four factors that affect exposure are 1) the physical condition of the patient, 2) the patient's age, 3) the patient's nutrition and hydration status, and 4) environmental conditions. Patients who are already ill or in poor physical condition may not be able to tolerate extreme temperatures as well as healthy patients. Those at extremes of age, the very young or very old, are more likely to experience illness as a result of temperature extremes. Malnourished or emaciated patients may not have enough calories to function.

Conditions such as air temperature, humidity, and wind complicate environmental situations further. Move your patient out of the temperature-extreme environment as quickly as possible.

27.

You arrive on scene to discover a patient whose family reports that he seemed fine several hours ago. He responds only to painful stimuli; breathing at a rate of 8 breaths per minute, his lips and nail beds are cyanotic. SpO2 is 78%. There are no obvious causes for bradypnea or hypoxia. Which acid-base disorder do you suspect?

  • Respiratory acidosis

  • Respiratory alkalosis

  • Metabolic acidosis

  • Metabolic alkalosis

Correct answer: Respiratory acidosis

The ineffective respiration rate means that CO2 is not being exchanged at the alveolar level and will be building up in the blood, causing a drop in pH. This patient is in respiratory acidosis.

Respiratory alkalosis results from hyperventilation.

Acid-base disorders that are not immediately corrected by innate buffering (bicarbonate) systems result in compensatory mechanisms. Respiratory responses are the fastest means to rebalance acid-base disorders, but they are unsustainable over long periods of time. Renal compensation (through changes in production of bicarbonate) takes time to initiate, and generally implies a chronic condition such as diabetes, prolonged vomiting, or renal failure.

It is also possible to have both metabolic and respiratory derangement at the same time if compensatory mechanisms are impaired, but that is something less likely to be addressed in the field.

28.

Which of the following is a written document that specifies medical treatment for a competent patient in case they become unable to make decisions for themselves?

  • Advance directive

  • Power of attorney

  • Health care proxy

  • Health care advocate

Correct answer: Advance directive

The written documentation that specifies medical treatment for a competent patient in case they become unable to make decisions for themselves is an advance directive. It is also sometimes called a living will or a health care directive. These documents (or verbal instructions) specify patients' wishes regarding care if they become unable to speak for themselves. Examples of advance directives include DNR, organ donation, and living will instructions.

Some patients designate a durable power of attorney for health care or a health care proxy as a surrogate decision-maker in the event they become incapacitated. These roles have no voice in decisions if the patient remains competent.

Power of attorney, without the designation "for health care" has no decision-making role if the person becomes incapacitated.

A health care advocate is a person (family member, friend, or hired professional) that assists in providing information to physicians as well as helping the patient remember questions to ask and helping them understand recommendations, treatment, and procedures. This is an advisory-only role with no decision-making capacity.

29.

Which of the following medication types may be used to treat hypertension? 

Select the three answer choices that are correct. 

  • ACE Inhibitor

  • Beta Blocker

  • Diuretic 

  • Anticoagulant

  • Sodium channel blockers 

Hypertension can be treated with many different types of medication. The treatment largely depends on the cause of the hypertension. 

Beta blockers, also known as beta-adrenergic blocking agents, are medications used to treat hypertension. Beta blockers work by blocking the effects of the sympathetic nervous system.

Angiotensin-Converting Enzyme (ACE) inhibitors are medications that help relax the veins and arteries to lower blood pressure.

Diuretics remove fluid from the body, which decreases the amount of fluid in blood vessels. This reduces blood pressure.

Anticoagulants prevent blood clots from forming, and are not used to treat hypertension. 

Sodium channel blockers are used to slow heart rate or reduce nerve impulse transmission. They are not used to treat hypertension. 

30.

The normal pulse rate of a six-year-old patient who is awake and alert is which of the following?

  • 108

  • 148 

  • 128 

  • 138 

Correct answer: 110

The normal pulse rate of school-age patients (ages 6 to 12) is 75 to 118 while awake and 58 to 90 while asleep.

31.

Tension pneumothorax results in decreased cardiac output and shock secondary to which of the following?

  • Myocardial compression and decreased cardiac preload

  • Blood accumulation in the pleural space

  • Decreased intrathoracic pressure and increased cardiac preload

  • Intrapulmonary shunting and hypoxia

Correct answer: Myocardial compression and decreased cardiac preload

A tension pneumothorax can develop if a penetrating chest wound is bandaged tightly and air from a damaged lung cannot escape. Accumulating air in the pleural space eventually compresses the heart and great vessels, preventing proper diastolic filling, resulting in decreased preload and reduced cardiac output.

Accumulation of blood in the pleural space is a hemothorax. Intrapulmonary shunting and hypoxia result when a ventilation-perfusion mismatch occurs, such as in pneumonia.

32.

Sorting and categorizing patient condition at incident sites is called:

  • primary triage

  • secondary triage

  • tertiary triage

  • first aid

Correct answer: primary triage

Primary triage is the initial triage done in the field, allowing you to quickly and accurately categorize the patient's condition and transport needs.

Secondary triage is done as patients are brought to the treatment area, where they're briefly assessed and identified in some way, such as by attaching a triage tag or triage tape. The main information needed on the tag is a unique number and a triage category.

33.

The manner in which you are required to act or behave with patients as an AEMT is called:

  • standard of care

  • duty to act

  • scope of practice

  • standing orders

Correct answer: standard of care

Regardless of activity, AEMTs are required by law to behave and act in a certain definable manner, known as a standard of care, which describes how a reasonably prudent person with similar training and experience would act under similar circumstances. If extenuating circumstances require you to deviate from the standard of care, the best protection is high-quality documentation. For example, if you place a patient with respiratory distress on a nasal cannula rather than a non-rebreather or BVM because they will not tolerate it, be sure to document the details in the narrative portion of your patient care report (PCR).

34.

Which of the following is not an IM injection site?  

  • Trapezius

  • Vastus lateralis 

  • Rectus femoris

  • Deltoid 

Correct answer: Trapezius 

The trapezius is the muscle extending over the back of the neck and shoulders and is not a site used for IM injection.

Sites used for IM injection include the vastus lateralis, rectus femoris (muscles of the thigh), and the deltoid (muscle of the upper arm). The upper lateral portion of the gluteal muscle may also be used for IM injection but is not commonly used by EMS.  

35.

You respond to a 911 call for an unresponsive male. Upon arrival to the scene, you find a 67-year-old male unresponsive in a recliner with irregular, slow, snoring respirations, and are unable to palpate a caratoid pulse. Which of the following is the most appropriate action? 

  • Move him to the floor 

  • Begin chest compressions

  • Open his airway 

  • Begin bag mask ventilations

Correct answer: Move him to the floor 

CPR is indicated for this patient, and you will need to move him to the floor immediately to provide chest compressions and to manage his airway. You should move him to the floor, position him supine, open his airway, and begin chest compressions.

36.

What is the cellular mechanism that allows myocardial cells to initiate an organized heart rate?

  • Automaticity

  • Conduction

  • Depolarization

  • Repolarization

Correct answer: Automaticity

Automaticity allows cardiac muscle cells to contract spontaneously without stimulus from a nerve. Normal cardiac impulses begin at the SA node. If no impulse arrives from the SA, other myocardial cells are capable of automaticity and stimulating contraction of the heart, although at a slower rate.

Conduction is the process by which electrical impulses are conveyed across the cardiac tissue. Depolarization and repolarization relate to the electrical charge that exists, and is altered, across a cell membrane.

37.

Which of the following conditions would most likely cause hematemesis?

Select the two answer choices that are correct. 

  • Gastric Ulcer

  • Esophogeal varices

  • Ulcerative colitis 

  • Crohn's Disease 

Upper GI bleeding may cause hematemesis. Gastric ulcers and esophageal varices are causes of upper GI bleeding. The other conditions listed may cause lower GI bleeding, which would not likely result in hematemesis. 

38.

Fluid in the fetal lungs is replaced with air during a process called which of the following?

  • Fetal transition

  • Foramen ovale

  • Hyperemesis gravidarum

  • Vernix caseosa

Correct answer: Fetal transition 

Fetal transition is the process through which the fluid in the fetal lungs is replaced with air, the ductus arteriosus constricts, and the neonate begins adequate oxygenation of its own blood.

Foramen ovale is an opening between the two atria that is present in the fetus but usually closes shortly after birth. Hyperemesis gravidarum is a condition of persistent nausea and vomiting during pregnancy. Vernix caseosa is a white, cheesy substance that covers the fetus.

39.

You're called to the scene of a robbery where a police officer was shot by the assailant. The scene is deemed safe, and you have completed your primary assessment of the patient. With regard to the multiple gunshot wounds, the most important thing is to do which of the following?

  • Count the number of penetrating injuries.

  • Determine which are entrance wounds.

  • Determine which are exit wounds.

  • Determine the caliber of weapon.

Correct answer: Count the number of penetrating injuries.

Gunshot wounds have some unique characteristics that require special skill. The amount of damage from a gunshot wound is directly related to the size, shape, and speed of the bullet; therefore, it is important to find out the caliber of gun that was used, but do not let this delay patient transport. With regard to this patient, more important than the caliber is the number of injuries, that is, the number of holes in the patient. Determination of entrance and exit wounds is best left to hospital personnel.

40.

Which of the following is a consistent nationwide approach to enabling federal, state, and local governments and private-sector and nongovernmental organizations that assume a role in emergency management to work together effectively?

  • National Incident Management System

  • Occupational Safety and Health Administration

  • National Institute for Occupational Safety and Health

  • Incident Command System

Correct answer: National Incident Management System

The National Incident Management System (NIMS) provides a consistent, nationwide approach to incident management, enabling governmental and nongovernmental organizations that assume a role in emergency management to work together effectively and efficiently.

Two important underlying principles of the NIMS are flexibility and standardization. Flexibility of the organizational structure allows rapid adaptation for use in any situation; standardization provides consistent terminology, resource classification, and training and provides for agencies of different types and from different jurisdictions to communicate with each other.