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NREMT Practice Test Bank - Multiple Choice questions and answers
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NREMT Practice Test Bank - Multiple Choice questions and answers
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NREMT Practice Test Bank - MultipleChoice
A 16-year-old, 125-pound male ingested a bottle of aspirin approximately 20 minutes ago.
Medical control orders you to administer activated charcoal in a dose of 1 g/kg. How much
activated charcoal should you administer?
• A:54 g
• B:60 g
• C:51 g
• D:57 g - questions and answers-You selected D; This is correct!
Reason: First, you must determine the patient's weight in kilograms (kg). Either of the following
formulae can be used to convert pounds to kilograms: Formula 1: weight (in pounds) ÷ 2.2 =
weight in kg. Formula 2: weight (in pounds) ÷ 2 - 10% = weight in kg. On the basis of the above
formulae, a 125-pound patient weighs 57 kg. Using formula 1, the equation is as follows: 125
(weight in pounds) ÷ 2.2 = 56.81 (57 [rounded to the nearest tenth]). Using formula 2, the
equation is as follows: 125 (weight in pounds) ÷ 2 = 62.5 (63 [rounded to the nearest tenth] - 6.3
(10% of 63) = 56.7 (57 [rounded to the nearest tenth]). Since the drug order is for 1 g/kg, you
should administer 57 g of activated charcoal to your 125-pound patient.
A 19-year-old female has a closed, swollen deformity to her left forearm. You are unable to
palpate a radial pulse and the skin distal to the injury is cold and pale. Several attempts to
contact medical control have failed and you are approximately 45 miles away from the closest
hospital. You should:
• A:apply an air splint to her forearm, keep her arm below the level of her heart, place an
icepack over the injury, and transport.
• B:begin transport at once, gently manipulate her arm en route until distal circulation is
restored, and apply an air splint.
• C:splint her entire arm with rigid board splints, elevate the limb above the level of her heart,
and transport immediately.
• D:make one attempt to restore distal circulation by applying gentle manual traction in line with
the long axis of the limb. - questions and answers-The correct answer is D;
Reason:
Cold, pale skin and an absent distal pulse indicates that blood flow distal to the injury is
compromised. You should notify medical control, who will likely direct you to attempt to restore
distal circulation. However, if you are unable to contact medical control and your transport time
will be lengthy, you should make ONE attempt to restore distal circulation by applying gentle
manual traction in line with the long axis of the limb. Be careful, as excessive manipulation can
worsen the vascular problem. If you are unsuccessful after one attempt, splint the limb in the
most comfortable position for the patient and transport at once. If distal circulation is restored,
splint the limb in whatever position allows the strongest distal pulse. You should elevate the limb
,above the level of the heart to help minimize swelling. An icepack may also help reduce pain
and swelling.
A 19-year-old male was assaulted and has trauma to multiple body systems. After performing
your primary assessment and treating any immediate life-threatening injuries, you should:
• A:obtain a full set of baseline vital signs.
• B:transport at once and intercept with ALS.
• C:perform a rapid head-to-toe assessment.
• D:fully immobilize his spine and transport. - questions and answers-You selected D; The
correct answer is C;
Reason:
After treating all life-threatening conditions found in the primary assessment, you should perform
a rapid head-to-toe assessment (rapid body scan) to look for and treat other life threats. In many
cases, patients with trauma to multiple body systems have other life-threatening injuries that are
not readily apparent during the primary assessment. You should obtain baseline vital signs as
soon as possible; however, this should not delay or interrupt your primary or rapid head-to-toe
assessments. After performing the primary and rapid head-to-toe assessments, fully immobilize
the patient's spine and transport to an appropriate hospital. Consider an advanced life support
(ALS) intercept, as long as it does not cause a significant delay in transport.
A 21-year-old male was bitten on the left forearm by a dog. He is conscious and alert and
denies any other injuries. An animal control officer is at the scene and has contained the dog.
Your assessment of the patient's arm reveals a large avulsion with a peeled back flap of skin.
Distal circulation is adequate and the patient is able to feel and move his fingers. In addition to
bleeding control, you should:
• A:perform a rapid head-to-toe assessment.
• B:irrigate the wound for at least 15 minutes.
• C:replace the avulsed flap to its original position.
• D:apply oxygen via a nonrebreathing mask. - questions and answers-The correct answer is C;
Reason:
An avulsion is an injury that separates various layers of soft tissue, usually between the
subcutaneous layer and fascia, so that they become completely detached or hang as a flap. The
patient's injury is isolated and not life-threatening; therefore, a rapid head-to-toe assessment is
not indicated. Unless your protocols specify otherwise, oxygen is usually not necessary for
patients with isolated, non-life-threatening soft tissue injuries. If the avulsed tissue is hanging
from a small piece of skin, circulation through the flap may be at risk. If you can, replace the
avulsed flap to its original position, as long as it is not visibly contaminated with dirt and/or other
foreign materials, and then cover the wound with a dry sterile dressing. Unless the wound is
grossly contaminated with dirt or debris, irrigation is usually deferred until the patient is
evaluated by a physician. Furthermore, flushing an open wound may force dirt or other debris
into the wound, increasing the risk of infection.
,A 21-year-old man partially amputated his right arm when the chainsaw he was using to trim
trees slipped. You can feel a weak radial pulse and his arm is cool to the touch. Dark red blood
is flowing heavily from the wound. You should:
• A:control the bleeding, manipulate the arm to improve circulation, and apply a splint.
• B:apply bulky compression dressings to the wound and splint the extremity.
• C:carefully pack sterile dressings into the wound and fully splint the extremity.
• D:apply a tourniquet proximal to the injury and tighten it until the bleeding stops. - questions
and answers-The correct answer is B;
Reason:
When caring for a partially amputated extremity, control bleeding with bulky compression
(pressure) dressings and splint the extremity to prevent further injury. If direct pressure does not
immediately control the bleeding, however, a proximal tourniquet should be applied without
delay. Never pack dressings into a wound; this may cause further damage and increases the
risk of infection. Although your patient's radial pulse is weak, it is present and indicates blood
flow distal to the injury. Do not manipulate his arm; doing so may lacerate or compress an artery
and compromise distal circulation.
A 22-year-old female fell on her knee and is in severe pain. Her knee is flexed and severely
deformed. Her leg is cold to the touch and you are unable to palpate a distal pulse. You should:
• A:carefully straighten her leg until you restore a distal pulse and then apply padded board
splints.
• B:apply gentle longitudinal traction as you straighten her leg and then apply a traction splint.
• C:manually stabilize her injury and contact medical control for further stabilization instructions.
• D:place a pillow behind her knee and stabilize the injury by applying padded board splints. -
questions and answers-The correct answer is C;
Reason:
A dislocated knee occurs when the proximal end of the tibia completely displaces from its
juncture with the distal femur. In some cases, the popliteal artery behind the knee may be
compressed, resulting in compromised distal blood flow. Signs of this include absent distal
pulses and a pale extremity that is cool or cold. Manually stabilize the knee and assess for distal
pulses. If distal pulses are absent, contact medical control immediately for further stabilization
instructions. Medical control may instruct you to make ONE attempt to realign the knee to
reduce compression of the popliteal artery and restore distal circulation. If you are unable to
restore distal circulation or medical control advises you not to manipulate the injury, splint the
knee in the position it was found and transport promptly. Traction splints are contraindicated in
any injury to or near the knee
A 22-year-old female woman was shot by her husband. Law enforcement is at the scene and
has the husband in custody. The patient is conscious, but extremely restless, and is pale and
diaphoretic. As your partner administers high-flow oxygen, you should:
• A:keep her warm by applying blankets.
• B:take her BP to detect hypotension.
, • C:compare her carotid and radial pulses.
• D:look for and control any bleeding. - questions and answers-You selected D; This is correct!
Reason:
The primary assessment of any patient includes ensuring a patent airway, assessing breathing
adequacy, administering high-flow oxygen or assisting ventilations, assessing circulation, and
controlling all active bleeding. You and your partner must work as a team; as your partner
administers high-flow oxygen, you should be looking for her gunshot wound(s) and ensuring that
all bleeding is controlled. After the primary assessment and management, begin treating her for
shock (eg, applying a blanket, elevating her lower extremities [if local protocol permits]) and
perform a rapid head-to-toe assessment to search for other injuries that may not have been
obvious during the primary assessment. Assess the patient's vital signs after all life-threatening
injuries or conditions have been identified and corrected.
A 22-year-old man was stabbed in the chest with a large knife. The patient is pulseless and
apneic, and the knife is impaled in the center of his chest. Treatment should include:
• A:stabilizing the knife, starting CPR, and providing rapid transport.
• B:removing the knife, applying an occlusive dressing, and providing rapid transport.
• C:removing the knife, starting CPR, and providing rapid transport.
• D:stabilizing the knife, applying an occlusive dressing, and providing rapid transport. -
questions and answers-The correct answer is C;
Reason:
There are two indications for removing an impaled object: when the object is causing airway
compromise and when the object interferes with your ability to perform CPR. A knife impaled in
the center of the chest, which is where chest compressions are performed, in a patient who is in
cardiac arrest must be carefully removed. Quickly cover the wound to control any bleeding (an
occlusive dressing covered by a sterile dressing is preferred) and begin CPR immediately.
A 23-year-old unrestrained female struck the steering wheel with her chest when her passenger
car collided with a tree at a high rate of speed. Your assessment reveals that she is conscious,
but has signs of shock and an irregular pulse. The MOST appropriate treatment for this patient
includes:
• A:high-flow oxygen, summoning a paramedic unit to the scene to assess her cardiac rhythm, a
cervical collar, and transport as soon as possible.
• B:insertion of an oral airway, assisted ventilations with a bag-mask device, full spinal
precautions, and rapid transport.
• C:applying an AED in case she develops cardiac arrest, high-flow oxygen, full spinal
precautions, and rapid transport.
• D:high-flow oxygen or assisted ventilations as needed, full spinal precautions, blankets to keep
her warm, and rapid transport. - questions and answers-You selected D; This is correct!
Reason:
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