NREMT Practice Test Bank - Multiple
Choice
A 16-yr-old, one hundred twenty five-pound male ingested a bottle of aspirin approximately 20
mins in the past. Medical control orders you to manage activated charcoal in a dose of 1 g/kg.
How tons activated charcoal must you administer?
• A:54 g
• B:60 g
• C:51 g
• D:57 g - ANS-You selected D; This is correct!
Reason: First, you should determine the patient's weight in kilograms (kg). Either of the
following formulae may be used to transform kilos to kilograms: Formula 1: weight (in pounds) ÷
2.2 = weight in kg. Formula 2: weight (in kilos) ÷ 2 - 10% = weight in kg. On the basis of the
above formulae, a 125-pound patient weighs fifty seven kg. Using formula 1, the equation is as
follows: one hundred twenty five (weight in kilos) ÷ 2.2 = 56.81 (57 [rounded to the nearest
tenth]). Using formulation 2, the equation is as follows: a hundred twenty five (weight in kilos) ÷
2 = 62.Five (sixty three [rounded to the nearest tenth] - 6.Three (10% of sixty three) = fifty six.7
(57 [rounded to the nearest tenth]). Since the drug order is for 1 g/kg, you ought to administer
57 g of activated charcoal for your one hundred twenty five-pound affected person.
A 19-yr-vintage woman has a closed, swollen deformity to her left forearm. You are not able to
palpate a radial pulse and the skin distal to the harm is cold and pale. Several attempts to
contact medical manipulate have failed and you're about forty five miles faraway from the
nearest hospital. You have to:
• A:apply an air splint to her forearm, preserve her arm beneath the extent of her coronary heart,
place an icepack over the damage, and transport.
• B:start delivery immediately, gently manage her arm en direction until distal flow is restored,
and apply an air splint.
• C:splint her entire arm with rigid board splints, raise the limb above the extent of her coronary
heart, and delivery at once.
• D:make one try to repair distal move via making use of mild guide traction consistent with the
lengthy axis of the limb. - ANS-The accurate answer is D;
Reason:
Cold, pale pores and skin and an absent distal pulse suggests that blood glide distal to the
injury is compromised. You need to notify scientific manage, who will possibly direct you to try to
repair distal stream. However, if you are unable to touch clinical manage and your shipping time
could be lengthy, you should make ONE try to restore distal move through applying gentle
manual traction in keeping with the long axis of the limb. Be cautious, as immoderate
,manipulation can worsen the vascular problem. If you are unsuccessful after one try, splint the
limb inside the maximum comfy role for the affected person and delivery immediately. If distal
move is restored, splint the limb in some thing role allows the most powerful distal pulse. You
ought to increase the limb above the level of the coronary heart to assist minimize swelling. An
icepack can also assist reduce ache and swelling.
A 19-yr-old male changed into assaulted and has trauma to a couple of body systems. After
acting your number one evaluation and treating any immediately life-threatening accidents, you
must:
• A:achieve a complete set of baseline critical signs and symptoms.
• B:delivery at once and intercept with ALS.
• C:perform a fast head-to-toe evaluation.
• D:absolutely immobilize his backbone and transport. - ANS-You decided on D; The accurate
answer is C;
Reason:
After treating all life-threatening conditions found inside the number one evaluation, you have to
carry out a rapid head-to-toe evaluation (speedy frame test) to look for and treat other existence
threats. In many cases, patients with trauma to multiple body structures have other
existence-threatening accidents that are not quite simply obvious during the number one
evaluation. You have to gain baseline important signs as quickly as feasible; however, this must
no longer put off or interrupt your primary or fast head-to-toe assessments. After performing the
primary and speedy head-to-toe checks, fully immobilize the affected person's backbone and
transport to the correct health facility. Consider a sophisticated existence support (ALS)
intercept, as long as it does no longer purpose a great postpone in shipping.
A 21-yr-old male became bitten at the left forearm by a dog. He is conscious and alert and
denies another accidents. An animal control officer is on the scene and has contained the
canine. Your assessment of the affected person's arm well-knownshows a massive avulsion
with a peeled back flap of skin. Distal circulate is ok and the affected person is able to feel and
move his fingers. In addition to bleeding manage, you ought to:
• A:carry out a speedy head-to-toe evaluation.
• B:irrigate the wound for as a minimum 15 mins.
• C:replace the avulsed flap to its authentic position.
• D:observe oxygen through a nonrebreathing mask. - ANS-The accurate answer is C;
Reason:
An avulsion is an harm that separates various layers of gentle tissue, normally among the
subcutaneous layer and fascia, so that they emerge as completely indifferent or hang as a flap.
The patient's injury is isolated and not lifestyles-threatening; therefore, a speedy head-to-toe
assessment isn't always indicated. Unless your protocols specify otherwise, oxygen is typically
no longer vital for sufferers with isolated, non-life-threatening soft tissue accidents. If the avulsed
tissue is hanging from a small piece of skin, circulate via the flap may be at danger. If you could,
replace the avulsed flap to its authentic position, as lengthy because it is not visibly infected with
dirt and/or other overseas substances, and then cowl the wound with a dry sterile dressing.
Unless the wound is grossly contaminated with dirt or debris, irrigation is normally deferred till
,the patient is evaluated by means of a doctor. Furthermore, flushing an open wound may force
dirt or other particles into the wound, increasing the chance of infection.
A 21-12 months-antique man in part amputated his right arm when the chainsaw he become
using to trim bushes slipped. You can experience a weak radial pulse and his arm is cool to the
touch. Dark purple blood is flowing closely from the wound. You must:
• A:manipulate the bleeding, manage the arm to enhance movement, and follow a splint.
• B:observe cumbersome compression dressings to the wound and splint the extremity.
• C:carefully % sterile dressings into the wound and absolutely splint the extremity.
• D:practice a tourniquet proximal to the injury and tighten it till the bleeding stops. - ANS-The
accurate solution is B;
Reason:
When being concerned for a partially amputated extremity, manage bleeding with cumbersome
compression (stress) dressings and splint the extremity to save you in addition damage. If direct
stress does no longer right away manipulate the bleeding, but, a proximal tourniquet have to be
carried out at once. Never % dressings into a wound; this can cause in addition damage and
increases the chance of infection. Although your affected person's radial pulse is susceptible, it's
far present and shows blood go with the flow distal to the damage. Do not manage his arm;
doing so may also lacerate or compress an artery and compromise distal circulation.
A 22-12 months-vintage girl fell on her knee and is in excessive ache. Her knee is flexed and
severely deformed. Her leg is bloodless to the touch and you're unable to palpate a distal pulse.
You must:
• A:cautiously straighten her leg until you restore a distal pulse and then observe padded board
splints.
• B:observe mild longitudinal traction as you straighten her leg after which observe a traction
splint.
• C:manually stabilize her injury and contact clinical manipulate for in addition stabilization
commands.
• D:vicinity a pillow at the back of her knee and stabilize the damage by making use of padded
board splints. - ANS-The accurate answer is C;
Reason:
A dislocated knee takes place while the proximal cease of the tibia completely displaces from its
juncture with the distal femur. In a few instances, the popliteal artery in the back of the knee may
be compressed, ensuing in compromised distal blood go with the flow. Signs of this encompass
absent distal pulses and a light extremity that is cool or bloodless. Manually stabilize the knee
and assess for distal pulses. If distal pulses are absent, contact medical control straight away
for similarly stabilization instructions. Medical manage may also coach you to make ONE
attempt to realign the knee to reduce compression of the popliteal artery and repair distal
movement. If you're not able to restore distal flow or clinical control advises you no longer to
control the harm, splint the knee in the function it turned into determined and transport promptly.
Traction splints are contraindicated in any injury to or close to the knee
, A 22-year-old lady lady changed into shot by her husband. Law enforcement is at the scene and
has the husband in custody. The affected person is aware, however extremely stressed, and is
pale and diaphoretic. As your associate administers excessive-drift oxygen, you must:
• A:hold her warm by making use of blankets.
• B:take her BP to locate hypotension.
• C:evaluate her carotid and radial pulses.
• D:look for and manipulate any bleeding. - ANS-You decided on D; This is accurate!
Reason:
The primary evaluation of any patient consists of making sure a patent airway, assessing
respiratory adequacy, administering excessive-float oxygen or helping ventilations, assessing
circulation, and controlling all lively bleeding. You and your companion ought to paintings as a
team; as your associate administers excessive-go with the flow oxygen, you ought to be seeking
out her gunshot wound(s) and making sure that every one bleeding is controlled. After the
number one evaluation and management, begin treating her for shock (eg, applying a blanket,
elevating her decrease extremities [if local protocol permits]) and perform a speedy head-to-toe
evaluation to look for different injuries that may not have been obvious in the course of the
primary assessment. Assess the affected person's essential signs and symptoms in the end
life-threatening injuries or conditions were recognized and corrected.
A 22-12 months-antique man changed into stabbed in the chest with a massive knife. The
affected person is pulseless and apneic, and the knife is impaled in the middle of his chest.
Treatment should encompass:
• A:stabilizing the knife, beginning CPR, and supplying rapid transport.
• B:doing away with the knife, making use of an occlusive dressing, and presenting fast delivery.
• C:putting off the knife, starting CPR, and offering speedy delivery.
• D:stabilizing the knife, applying an occlusive dressing, and offering speedy delivery. - ANS-The
correct answer is C;
Reason:
There are warning signs for casting off an impaled object: whilst the object is causing airway
compromise and while the object interferes along with your ability to perform CPR. A knife
impaled within the middle of the chest, that's in which chest compressions are achieved, in a
affected person who is in cardiac arrest should be carefully removed. Quickly cover the wound
to control any bleeding (an occlusive dressing protected with the aid of a sterile dressing is
desired) and begin CPR immediately.
A 23-yr-vintage unrestrained lady struck the steering wheel along with her chest whilst her
passenger vehicle collided with a tree at a high price of velocity. Your evaluation famous that
she is aware, but has symptoms of surprise and an irregular pulse. The MOST appropriate
treatment for this affected person consists of:
• A:high-drift oxygen, summoning a paramedic unit to the scene to assess her cardiac rhythm, a
cervical collar, and delivery as quickly as feasible.
• B:insertion of an oral airway, assisted ventilations with a bag-mask tool, full spinal precautions,
and rapid transport.
