NREMT Paramedic Exam questions and answers 2025, Exams of Medicine

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answers 2025

stridor - correct answer ✅Harsh or high-pitched respiratory sound, swelling, fb in upper airway. Croup is an example Snoring - correct answer ✅The sound of the soft tissue of the upper airway creating a partial obstruction of air flow. The tongue blocking the airway is an example. gurgling - correct answer ✅indicates presence of fluid in the upper airway, need for suctioning Decorticate - correct answer ✅elbows and hands flexed, and legs flexed. They are internally rotated (the lets look bowlegged) (make an O with their arms: corticate) Decerebrate (worse) - correct answer ✅Stiffened and internally rotated elbows and legs, teeth clenched, legs stiff and feet extended. Babinski's response - correct answer ✅dorsiflexion (splaying) of toes -abnormal plantae reflex response if over 18 months mydriasis - correct answer ✅dilation of the pupil. Appears in cardiac arrest, shock, cerebral hypoxia, cocaine, epinephrine, and amphetamines. Miosis - correct answer ✅Constricted pupils. Narcotics, CNS disorder, glaucoma medication, bright light

answers 2025

anisocoria - correct answer ✅unequal pupil size that may indicate serious neurologic dysfunction nystagmus - correct answer ✅involuntary rapid eye movements - often reported as horizontal, vertical, or rotary subcutaneous emphysema - correct answer ✅Air under the skin; crepitus sound rales (crackles) - correct answer ✅Fluid in small airways (aveoli). Common in CHF, pulonary edema, drowning, pneumonia, and COPD Rhonchi - correct answer ✅Coarse, low-pitched breath sounds heard in patients with chronic mucus in the upper airways. Found in Bronchitus, COPD, and pneumonia. Wheezing - correct answer ✅The production of whistling sounds during expiration such as occurs in asthma and bronchiolitis. Bronchial lung sounds - correct answer ✅heard over trachea/upper sternum; expiratory sound predominates; is higher pitched and louder; if heard in other locations it indicates consolidation -- a space that usually contains air now has fluid Bronchovesicular - correct answer ✅Heard over scapula and 2/3rd intercostal space lateral to sternum.

answers 2025

Right Lower Quadrant - correct answer ✅Appendix, right ovary, and tube. Bladder if distended Left Upper Quadrant - correct answer ✅Spleen, stomach, liver, and pancreas left lower quadrant - correct answer ✅Left ovary and tube. Bladder if distended Visceral Pain - correct answer ✅Internal organs damaged or injured. Vague, not well organized, pressure like, or dull aching, can't point to pain with one finger. Hollow organs stretches, ischemia, inflammation. somatic pain - correct answer ✅Pain that originates from skeletal muscles, ligaments, or joints. Peritoneal linining sharp, localized, throbbing, deep breath increases pain Cullen's sign - correct answer ✅ecchymosis in umbilical area, seen with pancreatitis. aka bleeding in abdominal cavity Grey Turner's Sign (ecchymosis in flank area) - correct answer ✅Chronic hemorrhagic from kidneys and pancreatitis Kehr's sign - correct answer ✅Referred pain down the left shoulder; indicative of a ruptured spleen. Murphy's sign - correct answer ✅Pain with palplation of gall bladder (seen with cholecystitis)

answers 2025

Brudzinski's sign - correct answer ✅pain with resistance and involuntary flex of hip/knee when neck is flexed to chest when lying supine. Seen in meingitis Hamman's sign - correct answer ✅Cruching shound on auscultation Emphysematous mediastinum Seen with Boerhaave's syndrome, pneumomediastinum, etc. Homan's sign - correct answer ✅DVT Kernig's sign - correct answer ✅Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees. Clubbing of fingers - correct answer ✅Caused by chronic hypoxia. Presence of this is suggestive of pulmonary disease. Orthostatic tilt test - correct answer ✅Supine, Sitting, and standing. BP raising 20 systolic, increase in heart rate by 20, and decrease in diastolic by 10 MAP (mean arterial pressure) - correct answer ✅The average pressure for the entire cardiac cycle MAP=Diastolic Pressure + 1/3 of the Pulse Pressure Pediatric Assessment Triangle (PAT) - correct answer ✅A structured assessment tool that allows you to rapidly form a general impression of the infant or child

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hypocarbia - correct answer ✅insufficient carbon dioxide, hyperventilation syndrome. Kussmaul's breathing HC03 (bicarbonate) - correct answer ✅22-26. above 26 (metabolic alkalosis), below 22 (metabolic acidosis) examples include shock, dka, aspirin overdose, cardiac arrest, lactic acid (waste product). hypovolemic shock - correct answer ✅shock resulting from blood or fluid loss (burns or dehydration). High heart rate, high respiration, eventually low BP, pale or cyanotic, flat neck veins. Pale skin. Management- Airway, O2, BVM, if needed, control bleeding, position flat, isotonic crystalloid, keep warm cardiogenic shock - correct answer ✅Shock caused by inadequate function of the heart, or pump failure. High or low heart rate, may have pulmonary edema, pale, or cyanotic. Management- Airway, O2, BVM, restrict fluids, and dopamine (vasopressor/inotropic agent Adult dose- 5-20 mcg/kg per minute. Pediatric- 5- mcg/kg per minute) anaphylactic shock (distributive shock) - correct answer ✅A severe reaction that occurs when an allergen is introduced to the bloodstream of an allergic individual. Characterized by bronchoconstriction, labored breathing, widespread vasodilation, circulatory shock, and sometimes sudden death. Angioedema, hives, stridor, wheezing, vasodilation.

answers 2025

Management- Airway, O2, BVM, beta 2 agonist, epi (adults 0.3-0.5 mg, peds- 0.01mg/kg) or benadryl (adults 25-50 mg, peds-1 to 2mg/kg) neurogenic shock (distributive shock) - correct answer ✅a state of shock (hypo- perfusion) caused by nerve paralysis that sometimes develops from spinal cord injuries. Management- Airway, O2, dopamine (vasopressor/intropic 5-20 mcg/kg). Flat position, spinal precautions if needed. septic shock - correct answer ✅a serious condition that occurs when an overwhelming bacterial infection affects the body. Low BP, temp may be high, low or normal skin- pale, cyanotic or red, vasodilation. Rhonci obstructive shock - correct answer ✅Shock that occurs when there is a block to blood flow in the heart or great vessels, causing an insufficient blood supply to the body's tissues. Causes- Pulmonary embolus, cardiac tamponade, tension pneumothorax. Management- Rapid transport, airway, O2, pleural decompression for tension. antagonist drugs - correct answer ✅drugs that block or change the effects of an addictive drug agonist drug - correct answer ✅mimics and enhances a neurotransmitter's effect

answers 2025

Half-life of a medication - correct answer ✅the amount of time it takes for half of the drug to be eliminated. Liver and kidney disease, aging, absence of food, and slowed metabolic rate prolong half-life because of their effects on metabolism and excretion. Pontentiation - correct answer ✅ Summation of drug effects - correct answer ✅ SLUDGEM - correct answer ✅Salivation, sweating Lacrimation (excessive tearing) Urination Defecation, drooling, diarrhea Gastric upset and cramps Emesis (vomiting) Muscle twitching/miosis (pinpoint pupils) Alpha blockers - correct answer ✅Vasodilate by blocking smaller blood vessels cells from receiving vasoconstriction signals. AKA constricts Beta Blockers - correct answer ✅decrease heart rate and dilate arteries by blocking beta receptors. Dialates Beta 1 receptors - correct answer ✅increase heart rate

answers 2025

Beta 2 - correct answer ✅Respiratory, Bronchodilation, Vasodilation Inotropic - correct answer ✅strength of contraction Catecholamines - correct answer ✅dopamine, norepinephrine, epinephrine 5 Rights of patient medication delivery - correct answer ✅Right medication Right dose Right patient Right route Right time Right documentation intramuscular injection - correct answer ✅an injection into deep muscle tissue, usually of the buttock, thigh, or upper arm Subcutaneous drug administration - correct answer ✅under the skin Inhaled drug administration - correct answer ✅ nasal drug administration - correct answer ✅

answers 2025

Adult Dose- 6 mg Rapid IV Push followed my 10 mL saline flush; If no response, 12 mg rapid push; total max dosage 30 mg. Pediatric Dose: 0.1mg/kg rapid iv push. if no response 0.2 mg/kg; max dose 12 mg Side effects- Brief asystole, facial flushing, SOB, CP, headache, hypotension, headache, palpitations, metallic taste. Albuterol - correct answer ✅(Proventil) Beta 2 agonist. Indications- Bronchospasm in COPD and patients with Asthma. Dosage: 2.5mg in 3 mL in a nebulizer with 6-10 LPM O2. May cause tachycardia and anxiety Amiodarone - correct answer ✅Antidysrhythmic, potassium channel blocker. Mechanism- Blocks cardiac NA and K channels, delaying repoloarization. Indications- VF, VT VF/pulseless VT: 300 mg as iv bolus; 150 mg after 3-5 minutes if no response; Stable VT with pulses: 150mg over 10 minutes.

answers 2025

May increase hypotension Amyl Nitrite - correct answer ✅Antidote, cyanide poisoning adjunct. 1-2 ampules crushed inhale for 30 seconds or until patient is conscious. Aspirin - correct answer ✅Antiplatelet used for cp of cardiac origin 324mg chewed. Not for peds!! Atropine - correct answer ✅Anticholinergic. Inhibits ACH at postsynaptic receptors; increase heart rate in sinus bradydysrhythmias. Indications- Hemodynamically significant bradycardia and organophosphate poisoning. Contraindications: AMI and myocardial ishchemia.

answers 2025

Diazepam (Valium) - correct answer ✅Benzodiazepine. Long acting sedative hypnotic; anticonvulsant; schedule IV drug. Mechanism of Action- Potentiates effects of inhibitory neurotransmitters. Induces sedation and amnesia. Indications- Used for acute anxiety states and agitation , acute alcohol withdrawls, muscle relaxant, seizure activity. Contraindications: glaucoma, myasthenia gravis, and respiratory depression. Dose: Adult 5mg IV over 5 minutes or 10 mg IM. Peds: 0.05 to 0.1 o 2 mg/kg im. Diltiazem (Cardizem) - correct answer ✅Calcium channel blocker, antidysrhythmic Indications- Stable narrow QRS tachycardia despite vagal manuvers, adenosine. Contraindications- Cardiogenic shock, wide complex tachycardia, 2nd or 3 rd degree heart block. Dose- Adult 0.5 mg/kg iv over 2 minutes. If inadequate, repeat in 15 minutes. Diphenhydramine (Benadryl) - correct answer ✅

answers 2025

Olfactory (I) Nerve - correct answer ✅relating to the sense of smell. Not usually assessed. Optic Nerve (II) - correct answer ✅sensory, vision. Identify Something Oculomotor (III) Nerve - correct answer ✅Motor cranial nerve. Originates in the midbrain. Supply extrinsic eye muscles to control movements of the eyeball and upper eyelid. Trochlear (IV) Nerve - correct answer ✅Motor cranial nerve Smallest of the 12 cranial nerves Origin: midbrain Controls upward movement of the eyeball Trigeminal (V) - correct answer ✅Number: 5 Type: Mixed Function: Sensations of the head and face, chewing movements, and muscle sense. Abducens (VI) - correct answer ✅Lateral Rectus Muscle of the Eye (Somatic Motor) Facial (VII) Nerve - correct answer ✅Mixed cranial nerve

answers 2025

aVF lead - correct answer ✅Uses the left foot electrode as positive and both arm electrodes as a common ground (negative). aVR lead - correct answer ✅lead AVR: points towards right arm, normally should be negative, no electrical conductivity aiming towards right side aVL lead placement - correct answer ✅augmented vector left; positive lead is on the left shoulder. Lead 1 - correct answer ✅right arm to left arm On Lead III, which is the positive lead - correct answer ✅left leg lateral leads on EKG - correct answer ✅I, aVL, V5, V inferior leads on EKG - correct answer ✅II, III, aVF septal leads on EKG - correct answer ✅V1, V anterior leads on EKG - correct answer ✅V3, V Junctional Rhythm - correct answer ✅The presence of an inverted or absent P wave indicates what type of arrhythmia?

answers 2025

(Hint: 2 words) Right Bundle Branch Block - correct answer ✅widened QRS (>0.12s); double peaked QRS in V1 (best to look in V1 and V2); T wave can look abnormal - inverted (does not indicate ischemia) Left Bundle Branch Block - correct answer ✅"LBBB" a block in the electrical conduction through the left bundle; evidenced by a wide QRS in lead 1 and V Often Oprah Orders Tasty Treats and Finally Enjoys Growing Voluptuous and Happy. - correct answer ✅Olfactory (Smell), Optic (Visual acuity), Oculomotor (eye movement/pupil Dilation), Trochlear (vertical eye movement), Trigeminal (Facial sensation/Facial movement), Abducens (hearing and balance), Glossopharyngeal (Taste/swallowing), Vagus (Sensation in throat and visceral muscles/Vocal cords, peristanisis Accessory (head and shoulder movements), hypoglossal (tongue movement) Some Say Making Money Matters But my brother says baking brownies matters more - correct answer ✅Sensory, Sensory, Motor, Motor, Motor, Both, Motor, Both, Sensory, Both, Both, Motor, Motor National Incident Management System (NIMS) - correct answer ✅the management system used by federal, state, and local governments to manage emergencies in the United States. Grave's Disease/ hyperthyroidism - correct answer ✅hyperactivity, sensitivity to heat, weight loss, tachycardia, diarhea, expphthalumis( bulging eyes), nervousness, jittery, irradiation, surgery, light cloth