NREMT AEMT Exam Questions

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61.

What is the process of sorting patients based on severity of injury and medical need?

  • Triage

  • Categorizing 

  • Tagging

  • Prioritization

Correct answer: Triage

Triage is the process of sorting patients based on severity of injury and medical need to establish treatment and transportation priorities. During large incidents, a number of triage personnel may be needed, and the triage supervisor is ultimately in charge of counting and prioritizing these patients. One of the difficult aspects of being a triage supervisor is that treatment must not begin until all patients are triaged or the efforts will be compromised.

62.

Seizures or convulsions that may occur one week after a woman has delivered a newborn are called what?

  • Postpartum eclampsia

  • Preeclampsia

  • Eclampsia

  • Hyperemesis gravidarum

Correct answer: Postpartum eclampsia

Postpartum eclampsia is eclampsia that occurs after a woman has delivered a newborn. It can occur weeks after birth.

Preeclampsia is characterized by hypertension, protein in the urine, and edema during pregnancy. Eclampsia is convulsions or seizures resulting from severe hypertension during pregnancy. Hyperemesis gravidarum is persistent nausea and vomiting during pregnancy.

63.

Your patient is an eight-year-old 49-pound female who is complaining of severe abdominal pain and vomiting. Her skin is warm, flushed, and dry. Her vitals are BP 78/56; HR 132; RR 38; SpO2 95%. She has no known medical conditions. Her parents report that her symptoms started four days ago and have progressed. She has been urinating frequently and you note her mucus membranes are extremely dry. What should the AEMT suspect? 

  • This patient is an undiagnosed Type I diabetic in DKA

  • This patient has appenticitis 

  • This patient is in septic shock 

  • This patient has a severe urinary tract infection

Correct answer: This patient is an undiagnosed Type I diabetic in DKA

Type I diabetes is commonly diagnosed before age 12, and the most common presenting condition in which it is diagnosed is Diabetic Ketoacidosis (DKA). The signs of DKA include rapid, deep respirations, dry mucous membranes, frequent urination, abdominal pain, nausea, warm flushed skin, and vomiting. Signs of Type I diabetes include frequent urination, thirst, hunger, and unexplained weight loss. 

This patient has not had a fever, and frequent urination would not be common in sepsis or appendicitis. Urinary Tract Infections (UTI's) are common in children, and occur more frequently in females. A UTI is unlikely to lead to these severe symptoms in healthy adolescent patients. 

64.

Which of the following is a modular, organized structure applicable to all incidents?

  • Incident Command System

  • National Highway Transportation Safety Administration

  • Occupational Safety and Health Administration

  • National Institute for Occupational Safety and Health

Correct answer: Incident Command System

The Incident Command System (ICS) is an important component of the National Incident Management System (NIMS). It is a standardized, on-scene emergency management model specifically designed to provide for integrated organizational structure flexible to the complexity and demands of an incident.

65.

Your patient has sustained multi-system trauma in a motor vehicle crash, is in shock and requires positive pressure ventilatory support. As ventilations are delivered, what would be the AEMT's primary concern? 

  • A drop in blood pressure due to increased interthoracic pressure 

  • A drop in pulse rate due to increased interthoracic pressure 

  • A decrease in exhaled carbon dioxide from ventilations

  • An increase in exhaled carbon dioxide from ventilations  

Correct answer: A drop in blood pressure due to increased interthoracic pressure

A critical concept that EMS providers must understand is that when the natural act of breathing changes from negative pressure to artificial ventilation via positive pressure, this increases interthoracic pressure and reduces blood return to the heart. This can result in decompensation of the cardiac system in shock, as well as diminished preload and cardiac output. 

Ventilation does affect exhaled carbon dioxide levels, but this would not be the primary concern in this patient; these would be more important as ongoing ventilation and resuscitation continues. A patient in shock who requires ventilator support will have abnormal exhaled carbon dioxide levels, and focusing on end tidal levels may result in over ventilation, which is lethal for these patients. 

66.

What is the volume of the size D oxygen cylinder?

  • 350 L

  • 500 L

  • 625 L

  • 3,000 L

Correct answer: 350 L

Oxygen cylinders are available in several sizes, sizes D and M being most often used. D tanks are portable and can be carried from your unit to the patient, and M tanks remain in your unit as a main supply tank.

Oxygen Cylinder Volumes:

  • D: 350 L
  • Jumbo D: 500 L
  • E: 625 L
  • M (MM): 3,000 L
  • G: 5,300 L
  • H, A (M4), K: 6,900

Always check that the cylinders are properly labeled and that testing dates are current.

67.

Bulging of the eyes is known as which of the following?

  • Exophthalmos

  • Mydriasis

  • Miosis

  • Anisocoria

Correct answer: Exophthalmos

Exophthalmos (also called exophthalmus, exophthalmia, proptosis, or exorbitism) is a bulging of the eye anteriorly out of the orbit.

Mydriasis is dilation of the pupil. Miosis is excessive constriction of the pupil. Anisocoria refers to pupils of unequal size; this may be congenital or an indication of serious injury or illness of the eye or brain.

68.

Which of the following are considered links in the "out-of-hospital chain of survival" of cardiac arrest? 

Select the four answer choices that are correct. 

  • Recognition and activation of EMS

  • Immediate High-Quality CPR

  • Rapid Defibrillation

  • Advanced Life Support and Post-Cardiac Arrest Care

  • Optimize oxygenation

  • Early therapeutic hypothermia

The links in the "chain of survival" include:

  • Recognition of Cardiac Arrest and Activation of EMS
  • Immediate High-Quality CPR
  • Rapid Defibrillation
  • Basic and Advanced Emergency Medical Service
  • Advanced Life Support and Post-Cardiac Arrest Care
  • Recovery

69.

Which of the following is also called an open pneumothorax?

  • Sucking chest wound

  • Hemothorax

  • Tension pneumothorax

  • Blunt trauma

Correct answer: Sucking chest wound

An open pneumothorax can occur with penetrating trauma to the chest. The presence of a defect in the chest wall should be observed during the primary assessment, and air motion may be seen at the site of injury during respiration. A sucking sound may be heard during the inspiratory phase of respiration, as air is drawn into the chest cavity, hence the alternative term "sucking chest wound."

Hemothorax is an accumulation of blood in the pleural cavity. Tension pneumothorax is an accumulation of air or gas in the pleural space that progressively collapses the lung, displaces the mediastinum, and compresses the heart. Blunt trauma is the result of force to the body that causes injury without penetrating soft tissue.

70.

The ideal size of landing zone for an air medical helicopter is how many feet? 

  • 100 x 100

  • 50 x 50 

  • 200 x 200

  • 80 x 80

Correct answer: 100 x 100 

The recommended size of landing zone for an air medical helicopter is 100 feet by 100 feet, with a minimal size of 50 x 50 feet. 

71.

Scene

Based on the findings and history, what condition should the AEMT most strongly suspect as the cause of this patient's seizure?

  • Eclampsia

  • Hyperglycemia 

  • Hypoglycemia 

  • Pregnancy induced hypotension 

Correct answer: Eclampsia

There are several classifications of hypertensive disorders of pregnancy (HDP). Preeclampsia is a progressive disorder that can progress to eclampsia. Signs and symptoms of preeclampsia include edema, hypertension, blurred vision, and headaches. Preeclampsia becomes eclampsia with the onset of seizures. If preeclampsia or eclampsia is suspected, request paramedic assistance or air medical transport, if available, according to protocols. Keep in mind the risk for seizures, placental abruption, and pulmonary edema, and reassess the patient frequently.

Her blood glucose level was normal, so glucose disturbances are unlikely. This patient has hypertension, not hypotension. There is no such condition called pregnancy-induced hypotension.

72.

The volume of air moved through the lungs in one minute, less dead space, is called what?

  • Alveolar minute volume

  • Alveolar ventilation

  • Tidal volume

  • Minute volume

Correct answer:  Alveolar minute volume

Alveolar minute volume is the volume of air moved through the lungs in one minute, less dead space; it is calculated by multiplying tidal volume (minus dead space) and respiratory rate.

Alveolar ventilation is the volume of air that reaches the alveoli; it is calculated by subtracting the amount of dead space air from the tidal volume.

Tidal volume is the amount of air that is moved in or out of the lungs during one breath.

Minute volume is the volume of air moved through the lungs in one minute; it is calculated by multiplying tidal volume and respiratory rate.

73.

Scene

The patient in this scenario is prescribed an albuterol inhaler and nitroglycerin and has both with him. Which of the following is correct?

  • You should contact medical control for permission to administer nitroglycerin

  • You should contact medical control for permission to administer the albuterol inhaler

  • You should avoid starting an IV on this patient

  • You should initiate a 500 mL IV fluid bolus for this patient

Correct answer: You should contact medical control for permission to administer nitroglycerin

This patient is exhibiting signs and symptoms of cardiogenic pulmonary edema due to heart failure. The key treatments for this condition include CPAP and nitroglycerin administration. You should request permission to administer nitroglycerin. Patients with this condition frequently need multiple doses of nitroglycerin, so be prepared to repeat the treatment.

Albuterol will not help this patient's condition, and administering an inhaler would require you to interrupt the CPAP, which is a key intervention for this patient. This patient does require IV access but you should not administer large amounts of fluid to heart failure patients, as this can worsen the condition.

74.

What is the span of control of one supervisor in the Incident Command System (ICS)?

  • Three to seven workers

  • Seven to ten workers

  • Two groups

  • Three groups 

Correct answer: Three to seven people 

In the ICS, the span of control for supervisors is three to seven workers. A supervisor to whom more than seven workers are report to should delegate and divide tasks, and assign other supervisors. A group leader is responsible for only one group, which may include multiple supervisors. 

75.

Which of the following are cortical signs of a Large Vessel Occlusion (LVO) stroke? 

Select the three answer choices that are correct. 

  • Agnosia

  • Gaze Deviation

  • Aphasia

  • Bradykinesia

Large Vessel Occlusion (LVO) strokes are a type of ischemic stroke and occur when a major artery in the brain is blocked. There are distinct signs, known as the cortical signs, of an LVO. These include gaze deviation (usually toward the side of the occlusion), aphasia (difficulty of understanding spoken or written words), and agnosia (the inability to recognize an object or person).

Bradykinesia can occur with a stroke, but it is not considered one of the cortical signs. 

76.

You are preparing to administer a fluid bolus to a nine-year-old, 62 pound, female patient with suspected septic shock. What is the correct dose of fluid to infuse? 

  • 560 mL

  • 620 mL

  • 380 mL

  • 56 mL

Correct answer: 560 mL 

The dose for fluid boluses for children is 20 mL/kg. This patient weighs 62 pounds. To convert pounds to kg, divide by 2.2. 

62 ➗ 2.2= 28. 

Then:

28kg x 20mL = 560 mL

77.

An unconscious patient requires immediate airway suctioning. You do not suspect trauma. What is the best method of opening the airway before suctioning?

  • Tongue-jaw lift maneuver

  • Turn the patient's head to one side 

  • Jaw-thrust maneuver 

  • "Ramped" position

Correct answer: Tongue-jaw lift maneuver

The tongue-jaw lift maneuver is the best way to open an airway in preparation for suctioning. This procedure should only be done in unconscious patients, as the AEMT (Advanced Emergency Medical Technician) must insert a thumb into the patient’s mouth, under the incisors or gumline, and pull straight up to open the mouth. This method of opening the airway should be used for suctioning only and cannot be used to maintain an open airway for ventilation.

The head tilt-chin lift maneuver relieves an airway obstruction in an unconscious patient. The patient’s tongue is placed in a position where it cannot obstruct the airway by placing one hand on the patient’s forehead and one under the chin and tilting the head backward. This method is not used for suctioning as the hand under the chin keeps the mouth shut. The technique is ideal for ventilating a patient with a bag-valve mask.

The jaw-thrust maneuver is used to open the airway of a patient who you suspect has suffered a spinal cord injury. An AEMT can open the patient’s airway by pressing upward on the angles of the lower jaw and moving the mouth forward, all while keeping the cervical spine in a neutral position.

The “ramped” position is used when the AEMT suspects managing the patient’s airway will be difficult. Signs of a difficult airway include obesity, limited neck mobility, a large tongue, and a larger patient head size. Ramping the patient can be done by placing pillows or towels under the patient’s shoulders until the head falls into a neutral position.

Turning the patient's head to one side is helpful if they are actively vomiting, but it is not the way to open an airway in preparation for suctioning. 

78.

What is an emergency situation with the potential to overwhelm available resources?

  • Mass-casualty incident

  • Multiple-casualty incident

  • Weapon of mass destruction 

  • System status management 

Correct answer: Mass-casualty incident

A mass-casualty incident is an emergency situation that can place great demand on the equipment or personnel of the EMS system or has the potential to overwhelm available resources.

A multiple-casualty incident involves several patients and places a great strain but does not overwhelm available resources.  

A weapon of mass destruction is a chemical, biological, or radioactive weapon capable of causing widespread death and destruction.

System status management means strategically positioning ambulances in geographic locations during various times of the day based on historical data that can aid in predicting operational demands.

79.

Which of the following is the most worrisome sign in assessing the breathing of an infant?

  • Head bobbing

  • Pale skin

  • Excessive crying

  • Barking cough

Correct answer: Head bobbing

Although a barking cough is a serious concern, the recruitment of accessory muscles is a compensatory response that indicates significant work of breathing and cannot be sustained.

In children, work of breathing is a more accurate indicator of adequate respiration than rate or breath sounds on auscultation. Compensation for abnormalities in respiratory function can manifest as abnormal airway sounds (barking cough or stridor), abnormal positioning (tripoding, refusing to lie down), retractions (accessory muscle use), and nasal flaring.

Head bobbing is a form of accessory muscle use in infants.

80.

You arrive on the scene of a motor vehicle crash and see a placard on a truck that is diamond-shaped, with red and white stripes, and a flame in the center. This placard indicates that the truck is carrying what type of  hazardous material? 

  • Flammable solids

  • Flammable liquids

  • Flammable gases

  • Flammable metals

Correct answer: Flammable solids 

A DOT placard with red and white stripes, and a flame in the center indicates the vehicle is transporting flammable solids, such as certain metallic hydrides, metallic sodium and potassium, oily fabrics, processed metals, matches, or nitrocellulose products.