NREMT Paramedic Prep - 200 Questions and Answers 2025, Exams of Medicine

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You are called to assist an adult with chest pain. The patient has a cardiac history of two-posterior myocardial infarctions. He is conscious and alert, stating he is having a hard time breathing, and the chest pain worsens when he attempts to lay flat on his back. His skin is pale and hot, while auscultation of his lung sounds reveals mild crackles. He reports the pain worsens on deep inspiration and movement. Based on the patient's history, and signs and symptoms, which of the following should you suspect? A. Unstable angina pectoris B. Pericarditis C. Myocardial infarction D. Cardiomyopathy - correct answer ✅B. You are the first ambulance to arrive on the scene of a single-car accident. As you approach the scene, you see four patients, two have been ejected from their vehicle, and two are still in the vehicle. What should be your next course of action?

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A.

Call medical control, and advise them of the situation B. Request additional resources, such as fire rescue, and additional ambulances to respond to the scene C. Begin immediate triage and treatment of the two patients ejected first while awaiting fire department response D. Notify the local trauma center so they can prepare for the patients - correct answer ✅B. A patient is experiencing a possible neurological emergency from a blunt force closed head injury. He is found to have abnormal pupillary reactions to light and has lost the ability to move his eyes from side to side to follow your finger movements. He is also unable to identify the number of fingers you are holding up. He reports he is able to see the fingers but is not able to focus enough to identify how many fingers are present. Which of the following cranial nerves should you suspect may be involved in his injury?

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D.

Toxic shock syndrome - correct answer ✅C. Which of the following is responsible for initiating the sympathetic response to shock during a traumatic event? A. Increased oxygen level and increased PCO B. Increased peripheral vascular resistance and alkalosis C. Decreased perfusion and increased acidosis D. Peripheral vasodilation and increased capillary permeability - correct answer ✅C. During which wave, complex, interval, or segment of an electrocardiogram tracing does the absolute refractory period take place in a normally functioning heart? A. S-T segment

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B.

P-R interval C. P wave D. Q-T interval - correct answer ✅D. You are preparing to perform synchronized electrical cardioversion with a biphasic defibrillator on your unstable adult patient who is experiencing supraventricular tachycardia at 160 beats per minute on the monitor. Which of the following initial energy settings would be recommended if he was exhibiting a narrow complex, regular supraventricular tachycardia, in which his palpable carotid pulse matches the rhythm on the monitor? A. Synchronized cardioversion at 50-100 joules B. Defibrillation at 100 joules C. Synchronized cardioversion at 360 joules

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A.

She can be treated under implied consent because her injury may become life- threatening B. She is not an American citizen, visiting on a student visa C. She is an emancipated minor granted by the court D. She is an orphaned minor who lives alone - correct answer ✅C. Your adult patient is showing signs and symptoms of being severely hyperkalemic. Medical control recommends the administration of a high-dose nebulized albuterol treatment as well as calcium chloride. Why is high-dose albuterol being recommended for this patient? A. To improve the patient's ventilatory status B. To assist with metabolic acidosis

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C.

To increase the amount of available calcium at the cellular level D. To help lower dangerous potassium levels - correct answer ✅D. When monitoring the electrical activity of a patient's heart, which standard limb lead records the difference in electrical potential between the left leg and the right arm when the left leg is positive and the right arm is negative? A. Augmented limb lead aVL B. Bipolar limb lead II (LII) C. Bipolar limb lead III (LIII) D. Bipolar limb lead I (LI) - correct answer ✅B.

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A.

The low blood sugar levels stimulate the sympathetic nervous system to trigger the release of epinephrine into the bloodstream to promote liver glycogenolysis B. Low blood sugar levels mimic alcohol intoxication in the brain because of elevated insulin levels in the bloodstream C. The elevated heart rate and respirations stimulate the adipose tissue to increase glucose and fatty acid uptake in an attempt to correct the blood glucose level D. The heart rate and r - correct answer ✅A. You are on scene at a motor vehicle accident, and your 20-year-old patient is entrapped. He is unconscious, unresponsive, and has a palpable carotid pulse that is weak and thready. His breathing is slow and shallow at four times a minute with equal chest wall expansion. There are no obvious deformity injuries or hemorrhage noted. Fire department on-scene has stabilized the vehicle and provided you and your partner a relatively safe environment to manage the entrapped patient. However, access is limited to the seated patient, and extrication is expected to take another twenty minutes. After having your partner maintain cervical spine stabilization, which of the following would be the best choice for securing the patient's airway?

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A.

Insert a nasal airway and administer high-flow oxygen therapy B. Use nasotracheal intubation techniques to gain complete control of the patient's airway and assist ventilation C. Intub - correct answer ✅D. You are on-scene with a 60-year-old COPD patient complaining of shortness of breath. During your exam, you note the presence of clubbed fingertips. Which of the following is most likely to cause this finding? A. Congestive heart failure especially left ventricular failure B. Long-term hypoxemia C. Hypocapnia resulting from low carbon-dioxide levels

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B.

A 15-year-old patient with full-thickness burns on the left upper/lower arm, non- circumferential Which of the following patients best fits the criteria for a critical burn? A. A 10-year-old patient with superficial burns over 60% of the body B. A 15-year-old patient with full-thickness burns on the left upper/lower arm, non- circumferential C. A 60-year-old patient with partial-thickness burns across 25% of the body, not involving the hands, feet, face, or genitals D. A 20-year-old patient with partial-thickness burns on 25% of the body, not including the hands, feet, face, or genitals D. A 20-year-old patient with partial-thickness burns on 25% of the body, not including the hands, feet, face, or genitals - correct answer ✅C.

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Which of the following common toxic substances is a colorless, flammable, and extremely hazardous gas that smells like rotten eggs and is capable of affecting several body systems, especially the nervous system? A. Hydrogen sulfide B. Methyl bromide C. Halogenated hydrocarbon D. Hydrogen cyanide - correct answer ✅A. Your adult respiratory insufficiency patient's respirations are shallow and irregular at six times per minute. His SpO2 is 76 mm Hg, and you suspect carbon dioxide retention due to the decreased respiratory effort. Which of the following should you suspect? A. Respiratory alkalosis

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D.

Ascites - correct answer ✅A. You are treating a 68-year-old cardiac history patient experiencing chest pain. If it is determined at the hospital that he experienced an acute myocardial infarction of the septal wall, which of the coronary arteries was most likely occluded? A. Circumflex artery B. Right main coronary artery C. Posterior descending artery D. Left main coronary artery - correct answer ✅D. You are on-scene with a 70-year-old female who complains of being awakened in the middle of the night by sudden onset dyspnea and sweating. She is breathing 32 times per minute with inspiratory/expiratory wheezing and rales auscultated in all fields bilaterally, with an SpO2 of 88 percent on room air. Her heart rate is 136 beats per minute, showing an irregularly irregular sinus tachycardia on the monitor.

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Which of the following is most likely causing the patient's current signs and symptoms? A. Acute renal failure B. Chronic bronchitis C. Paroxysmal nocturnal dyspnea D. Acute respiratory distress syndrome - correct answer ✅C. Your adult female postpartum patient delivered her newborn with the assistance of her husband five minutes prior to your arrival on the scene. The infant's Apgar score is 10, and the baby seems to be fine. However, the mother continues to bleed heavily after an adequate fundal massage and encouraging the infant to breastfeed. Her current heart rate is 125 bpm; her blood pressure is 108/60, and she is breathing 22 times a minute with an SpO2 of 97. After ensuring a second infant is not present, which of the following interventions would medical command most likely recommend?

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right arms. Which of the following conditions is most likely to cause the patient's presentation? A. A pulmonary embolus B. An aortic aneurysm dissection C. A cardiac tamponade D. A myocardial infarction - correct answer ✅B. You are ordered to administer 3 mg/min of lidocaine via intravenous infusion to your cardiac patient who presents with a heart rate greater than 130 beats per minute as well as greater than 10 multifocal PVCs every minute. Therefore, you quickly but carefully mix 2 grams of the medication in 500 mL of normal saline and attach micro-drip tubing to the solution bag. Which of the following drip rates would effectively deliver the ordered dose of lidocaine? A. 15 gtts/min B. 30 gtts/min C. 60 gtts/min

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D. 45 gtts/min - correct answer ✅D. You are ordered to administer 0.3 mL of epinephrine for a moderate allergic reaction. What is the preferred initial route of administration of epinephrine for an allergic reaction? A. Subcutaneous B. Intramuscular C. Intravenous D. Endotracheal - correct answer ✅B. You are called to assist an adult diabetic who was found unconscious in bed. On arrival, your patient is unresponsive with snoring respirations and cool, clammy skin. Your glucometer will not power up, so blood glucose analysis is impossible at the present time. Which of the following would be most appropriate after controlling the patient's airway and delivering high-flow oxygen therapy? A. Administer glucagon to the patient intramuscularly in a large muscle group like the gluteal muscles B. Start an intravenous line, draw blood samples, and administer one amp of dextrose 50 percent (D50) C. Start an intravenous line, and draw blood samples before administering a glucose-containing IV fluid bolus