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NREMT Paramedic Practice Test Updated 2023 WITH Rationale

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NREMT Practice Test Exam/ NREMT Paramedic Practice Test Updated Latest Version Correct Answers and Rationale (TESTBANK 585 QUESTIONS AND ANSWERS) While caring for a trauma patient, blood splashes into an EMT's eyes. This is an example of: • A:infection. • B:indirect contact. • C:tran...

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  • October 3, 2023
  • 185
  • 2023/2024
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NREMT Practice Test Exam/ NREMT Paramedic
Practice Test Updated 2023-2024 Latest Version
Correct Answers and Rationale (TESTBANK 585
QUESTIONS AND ANSWERS)
While caring for a trauma patient, blood splashes into an EMT's eyes. This is an
example of:
• A:infection.
• B:indirect contact.
• C:transmission.
• D:exposure. --------- Correct Answer --------- You selected D; This is correct!

Reason: Exposure occurs when an individual comes in direct contact with blood or other
bodily fluids. Examples of direct exposure include blood splashing into the eyes or
mouth and an accidental stick with a contaminated needle or other sharp object.
Exposure does not always result in disease transmission and subsequent infection; that
depends on whether the patient has an infectious disease. Routine use of standard
precautions will afford the EMT the best protection from exposure to an infectious
disease.

You are transporting a 30-year-old man who is experiencing an emotional crisis. The
patient does not speak when you ask him questions. How should you respond to his
unwillingness to speak?
• A:Remain silent until the patient speaks to you.
• B:Do not speak to the patient, even if he begins to speak to you.
• C:Tell the patient that you cannot help if he won't talk.
• D:Continually encourage the patient to talk to you. --------- Correct Answer --------- You
selected A; This is correct!

Reason:When dealing with a psychiatric patient who is silent and unwilling to speak to
you, do not fear the silence. The patient simply does not wish to speak. You should not
press the issue, for doing so may upset the patient. You should remain calm until the
patient speaks to you, and then respond accordingly.

An elderly man is found unresponsive in his kitchen. The patient's wife tells you that her
husband has diabetes and that he took his insulin, but did not eat anything. You should
suspect:
• A:diabetic coma.
• B:hypoglycemia.
• C:ketoacidosis.
• D:hyperglycemia. --------- Correct Answer --------- The Correct Answer is B;

,Reason:Several factors point to a field impression of hypoglycemia. First, the patient is
known to have diabetes and second, he took his insulin but did not eat. Because insulin
promotes the uptake of glucose into the cells, if the patient does not replace this
glucose by eating, the glucose level in the blood will fall to dangerously low levels.
Hypoglycemia can also occur when a patient takes too much of his or her insulin.
Hyperglycemia occurs when a patient does not take his or her insulin. In such cases,
glucose accumulates in the bloodstream and is not able to enter the cell. In the absence
of glucose, the cells begin to metabolize fat, which results in the production of ketoacids
and leads to hyperglycemic ketoacidosis (diabetic coma, hyperglycemic crisis).

You and your partner arrive at the home of a 60-year-old man with shortness of breath.
As you enter the residence, you find the patient sitting in his recliner; he is in obvious
respiratory distress. As you approach him, he becomes verbally abusive, stating that it
took you too long to get to his home. A small handgun is sitting on a table next to his
recliner. You should:
• A:verbally distract the patient as your partner attempts to retrieve the gun.
• B:slowly back your way out of the residence and call law enforcement.
• C:turn around, rapidly exit the residence, and notify law enforcement.
• D:explain the reason for your delay as your partner administers oxygen. ---------
Correct Answer --------- You selected B; This is correct!

Reason:There is an immediate threat to you and your partner's safety! The patient is
verbally abusive and has a firearm within arm's reach. In this situation, you and your
partner should slowly back away from the patient, exit the residence, and notify law
enforcement. Do NOT take your eyes off of the patient; if you turn your back, you may
take a bullet in the back! Backing away gives you the opportunity to take cover if you
see the patient reach for his gun. Remember, your safety comes before all else.

A 55-year-old woman with a history of diabetes is found unresponsive with rapid,
shallow respirations. The patient's husband tells you that he does not know when his
wife last took her insulin. Management of this patient should include:
• A:subcutaneous injection of insulin and 100% oxygen.
• B:oral glucose and oxygen via nonrebreathing mask.
• C:assisted ventilations and oral glucose.
• D:assisted ventilations and rapid transport. --------- Correct Answer --------- You
selected D; This is correct!

Reason:Without knowing if and when the patient last took her insulin, it is difficult to
determine if she is experiencing diabetic coma or insulin shock. Nonetheless, her rapid,
shallow respirations—which are likely not producing adequate tidal volume—should be
treated with ventilation assistance. Because she is unresponsive and obviously unable
to swallow, oral glucose is contraindicated. Assess the patient's blood glucose level and
pass this information along to the hospital; if possible, arrange for a paramedic intercept
so she can receive intravenous dextrose. If the patient is experiencing diabetic coma,
insulin is what she truly needs; however, insulin is rarely, if ever, administered in the

,prehospital setting—even by paramedics. After ensuring adequate oxygenation and
ventilation, transport the patient without delay.

When treating an unresponsive man who was struck by lightning, you should:
• A:manually stabilize his head and open his airway.
• B:apply full spinal precautions before moving him.
• C:begin CPR at once if he is apneic and pulseless.
• D:ensure that you and the patient are in a safe place. --------- Correct Answer ---------
You selected D; This is correct!
Reason: Contrary to popular belief, lightning can (and does) strike in the same place
twice. After lightning strikes, the ground remains electrically charged for a period of
time; this increases the chance of a second strike within a short period of time. You
must first ensure that you and the patient are safe by moving to a sheltered area,
preferably indoors. After you have ensured the safety of yourself and the patient, begin
treatment as dictated by the patient's condition. Do not let the life you save, or attempt
to save, TAKE your own!

Hypoglycemia and acute ischemic stroke can present similarly because:

• A:both oxygen and glucose are needed for brain function.
• B:the majority of stroke patients have a history of diabetes.
• C:the most common cause of a stroke is hypoglycemia.
• D:they are both caused by low levels of glucose in the blood. --------- Correct Answer --
------- • A:both oxygen and glucose are needed for brain function.

Reason: Although stroke and hypoglycemia are two distinctly different conditions, their
signs and symptoms are often similar. This is because the brain requires both oxygen
and glucose to function normally. An acute ischemic stroke is caused by a lack of
oxygen to a part of the brain due to a blocked cerebral artery, whereas hypoglycemia
(low blood glucose level) deprives the entire brain of glucose. In either case, the patient
presents with signs of impaired brain function (ie, slurred speech, weakness, altered
mental status). Both conditions may lead to permanent brain damage or death if not
treated promptly.

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. --------- Correct 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. --------- Correct 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 --------- Correct 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 --------- Correct 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

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