NREMT PRACTICE Exam updated Questions and Answers WITH RATIONALE 2023/2024

NREMT
PRACTICE Exam
updated
Questions and
Answers WITH
RATIONALE
2023/2024
A 42-year-old male presents with fever, a severe
headache, and a stiff neck. He is conscious, but confused.
His wife tells you that he does not have any medical
problems and does not take any medications. You should
be MOST suspicious for:
• A:acute stroke.
• B:influenza.
• C:meningitis.
• D:tuberculosis.
( - ANSWER-You selected C; This is correct!
Reason:Meningitis is an inflammation of the protective
coverings of the brain and spinal cord (meninges).
Common signs and symptoms of meningitis include
fever, headache, neck stiffness (nuchal rigidity), and
vomiting. An altered mental status is common in severe
cases. Meningococcal meningitis, caused by a bacterium,
is the most contagious and potentially fatal type of
meningitis. The patient's signs and symptoms are not
consistent with acute stroke, tuberculosis (TB), or
influenza (the flu). Although fever is common with both
TB and the flu, neither causes neck stiffness. Acute stroke
may be associated with a headache, especially a
hemorrhagic stroke; however, stroke patients typically
do not have a fever.
When dealing with an emotionally disturbed patient, you
should be MOST concerned with:
• A:gathering all of the patient's medications.
• B:safely transporting to the hospital.
• C:whether the patient could harm you.
• D:obtaining a complete medical history. - ANSWER-You
selected C; This is correct!
Reason: When managing any patient with an emotional
or psychiatric crisis, your primary concern is your own
safety. Safely transporting the patient to the hospital is
your ultimate goal. If possible, you should attempt to
obtain a medical history and should take any of the
patient's prescribed medications to the hospital.
However, this should not supercede your own safety or
interfere with safely transporting the patient.
You are at the scene where a man panicked while
swimming in a small lake. Your initial attempt to rescue
him should include:
• A:rowing a small raft to the victim.
• B:reaching for the victim with a long stick.
• C:throwing a rope to the victim.
• D:swimming to the victim to rescue him. - ANSWER-You
selected B; This is correct!
Reason: General rules to follow when attempting to
rescue a patient from the water include "reach, throw,
row, and then go." In this case, you should attempt to
reach the victim by having him grab hold of a large stick
or similar object. If this is unsuccessful, throw the victim
a rope or flotation device (if available). If these are not
available, row to the patient in a small raft (if available).
Going into the water to retrieve the victim is a last resort.
The rescuer must be a strong swimmer because patients
who are in danger of drowning are in a state of blind
panic and will make every attempt to keep themselves
afloat, even if it means forcing the rescuer underwater.
How should you classify a patient's nature of illness if he
or she has a low blood glucose level, bizarre behavior,
and shallow breathing?
• A:Behavioral emergency
• B:Altered mental status
• C:Respiratory emergency
• D:Cardiac compromise - ANSWER-The correct answer is
B;
Reason: The nature of illness (NOI) is the medical
equivalent to mechanism of injury (MOI). Altered mental
status should be the suspected NOI in any patient with
any fluctuation in level of consciousness, which can range
from bizarre behavior to complete unresponsiveness.
Causes of an altered mental status include hypo- or
hyperglycemia, head trauma, stroke, behavioral crises,
drug overdose, and shock, among others.
A young female is unresponsive after overdosing on an
unknown type of drug. Her respirations are slow and
shallow and her pulse is slow and weak. Which of the
following drugs is the LEAST likely cause of her condition?
• A:Seconal
• B:Heroin
• C:Cocaine
• D:Valium - ANSWER-The correct answer is C;
Reason: Of the drugs listed, cocaine would be the least
likely cause of the patient's condition. Cocaine is a
central nervous system (CNS) stimulant; you would
expect her to be hypertensive, tachycardic, tachypneic,
and perhaps even violent. Heroin, Valium, and Seconal
are all CNS depressants and could explain her condition.
Heroin is an illegal narcotic (opiate), Valium is a
benzodiazepine sedative-hypnotic drug, and Seconal is a
barbiturate. Narcotics, benzodiazepines, and
barbiturates are all CNS depressants. When taken in
excess, they cause a decreased level of consciousness,
respiratory depression, bradycardia, and hypotension.
Activated charcoal is contraindicated for a patient who is:
• A:conscious and alert and has ingested a large amount
of Motrin.
• B:emotionally upset and has ingested two bottles of
aspirin.
• C:agitated and claims to have ingested a bottle of
Tylenol.
• D:awake and alert and has swallowed a commercial
drain cleaner. - ANSWER-You selected D; This is correct!
Reason:Activated charcoal adsorbs (sticks to) many
ingested substances, preventing them from being
absorbed into the body by the stomach or intestines. In
some cases, you may give activated charcoal to patients
who have ingested certain substances, if approved by
medical control or local protocol. Activated charcoal is
contraindicated for patients who have ingested an acid
or alkali (ie, drain cleaner) or a petroleum product (ie,
gasoline), who have a decreased level of consciousness
and cannot protect their own airway, or who are unable
to swallow.
The MOST obvious way to reduce heat loss from
radiation and convection is to:
• A:move away from a cold object.
• B:increase metabolism by shivering.
• C:wear a thick wind-proof jacket.
• D:move to a warmer environment. - ANSWER-you
selected D; This is correct!
Reason:In a cold environment, the body has two ways of
staying warm: generating heat (thermogenesis) and
reducing heat loss. Radiation is the transfer of heat by
radiant energy. The body can lose heat by radiation, such
as when a person stands in a cold room. Convection
occurs when heat is transferred to circulating air, as
when cool air moves across the body's surface. A person
standing in windy cold weather, wearing lightweight
clothing, is losing heat to the environment mostly by
convection. The quickest and most obvious way to
decrease heat loss from radiation and convection is to
move out of the cold environment and seek shelter from
wind. Shivering increases the body's metabolism and is a
mechanism for generating heat, not reducing heat loss.
Layers of clothing trap air and provide excellent
insulation; thus, layered clothing decreases heat loss
better than a single, thick jacket. Conduction is the direct
transfer of heat from a part of the body to a colder
object by direct contact, as when a warm hand touches
cold metal or ice. The most obvious way to decrease heat
loss by conduction is to remove your hand from the cold
object.