NREMT COGNITIVE EXAM (AFTER YOU
PASS YOUR CLASS AND FORGET
EVERYTHING) QUESTIONS AND
ANSWERS WITH SOLUTIONS 2024
In trauma a low pulse pressure suggests? - ANSWER Significant blood loss
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Blood pressure has a direct effect on? - ANSWER The perfusion of the bodys tissues
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Cells that die during a stroke are called? - ANSWER Infarcted cells
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You are called to a home where a 91 year old man has had a syncopal episode and is vomiting. The careg
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iver who called 911 stated that the patient's bowel movements have been bright red since yesterday. Th
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e patient has not complained of any pain, but is nauseated. What is most likely wrong with this man and
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which choice includes appropriate treatment steps?
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Choices:
A. He has an upper GI bleed and should be transported sitting up with high flow O2 administered via a n
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on rebreather mask at 15 LPM.
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B. He has had a TIA and should be given high flow oxygen via NRB and transported on his effected side to
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the nearest hospital.
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C. He has pancreatitis and should be given high flow O2 via NRB at 15 LPM. Rapid transport in a left later
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al recumbent position while keeping him warm will help avoid shock.
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D. He has a lower GI bleed and should be given O2 via nasal cannula at 4LPM and transported in a positi
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on of comfort while t -
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ANSWER D. He has a lower GI bleed and should be given O2 via nasal cannula at 4LPM and transported i
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n a position of comfort while treating for shock
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,Rationale: The bright red blood in the bowel movements is indicative of a lower GI bleed. Answer 1,2, an
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d 3 all utilize an NRB to deliver high flow O2. Given that the patient is vomiting and nauseated, it would b
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e advisable to use a nasal cannula, rather than an NRB, to help avoid potential airway compromise if the
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patient continues to vomit.
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If a patient was feeling nauseated this would likely be a_______________response. If a person was tachy
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cardic it would likely be a___________________ response. - ANSWER Parasympathetic/Sympathetic
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You are assessing an 84 year old man. Upon auscultation of the lungs you discover crackles or rale sound
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s. He is complaining of chest pain and congestion. These signs and symptoms can indicate?
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Choices:
A. An embolism
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B. Collapse of the vena cava
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C. Left ventricular failure
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D. Right ventricular failure - ANSWER C. Left ventricle failure
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Rationale: These are signs and symptoms of a possible failure of the left ventricle. The pump portion of t
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he heart is unable to pump efficiently and fluid begins to back up into the lungs.
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A child between 3-5 would have normal vitals if they were?
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Choices:
A. 35 breaths a minute, pulse of 88, and Systolic BP of 100
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B. 24 breaths a minute, pulse of 76, and Systolic BP of 98
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C. 20 breaths a minute, pulse of 100, and Systolic BP of 110
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,D. 20 breaths a minute, pulse of 120, and Systolic BP of 120 -
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ANSWER 20 breaths a minute, pulse of 100, and Systolic BP of 110
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Rationale: A child between 3 and 5 (preschool-age) should have respirations between 20-
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30, a pulse of 80-120, and a systolic BP of 80 - 110.
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(Toddler 12 to 36 months) G G G G
The pediatric assessment triangle is composed of three elements:
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Choices:
A. Muscle Tone, Respiratory depth and rate, Perfusion
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B. Circulation, Appearance, Work of Breathing
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C. Level of Consciousness, Quality of Respirations, General Appearance
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D. Blood pressure, Pulse rate, Respiratory Rate - ANSWER B. Circulation, Appearance, Work of Breathing
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Rationale: PAT is Work of Breathing, Skin Circulation, Appearance. The pediatric assessment triangle is us
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ed to form a rapid general impression of a child without making physical contact. Look at the child's app
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earance and muscle tone. Look at the work of breathing for signs of respiratory distress. Tachypnea or re
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tractions of sternum and or intercostal muscles is a sign of respiratory difficulty. Look at the skin as a quic
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k reference for circulation. Pallor can be a sign of poor circulation.
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The patient is a 6 year old girl whose mother says has been sick for a few days and then started having br
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eathing problems this morning. Upon assessment, you notice the child is flaring her nostrils and has a ho
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arse voice when talking. What is she most likely suffering from and what should you do?
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Choices:
A. She could have croup and needs to be transported with a nasal cannula at 4 lpm
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B. She could have tonsillitis and will require transport to the hospital in a position of comfort
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, C. She could have SARS and should be transported wearing a HEPA mask
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D. She could have epiglottitis and needs to be transported with high flow O2 on an NRB -
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ANSWER D. She could have epiglottitis and needs to be transported with high flow O2 on an NRB
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Rationale: Epiglottitis is known to strike children in this age group. Croup is usually in younger children. T
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ransporting with airway support is the best answer.
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What is pulse pressure? -
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ANSWER The difference between the systolic and diastolic measurements of the blood pressure
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A 57 year old woman is complaining of chest pain. Her blood pressure is 109/88 and her respirations are
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at 22 per minute. What condition does the patient's blood pressure indicate?
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A. Paradoxical Pressure
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B. Low pulse pressure
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C.Systolic transcardiac eschemia G G
D. Martiners Rule - ANSWER B. Low pulse pressure
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Rationale: A pulse pressure is considered abnormally low if it is less than 25% of the systolic value. In this
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question it is about 20% of the systolic value. The pulse pressure is the difference between the systolic a
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nd diastolic measurements of the blood pressure. 109 systolic -
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88 diastolic = 21 mmHg. In trauma a low pulse pressure suggests significant blood loss. If the pulse press
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ure is extremely low, i.e. 25 mmHg or less, the cause may be low stroke volume, as in Congestive Heart F
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ailure and/or shock. A low pulse pressure can also be caused by aortic valve stenosis and cardiac tampon
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ade.
Which of the following choices is a normal systolic blood pressure in a child?
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Choices:
A.Greater than 120 mm Hg G G G G
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