NREMT Paramedic Questions and Answers: Latest 2025 Edition, Exams of Medicine

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NREMT Paramedic Questions with

Answers Latest 2025

What is Transposition of the Great Arteries (TGA) ✔ Systemic and Pulmonary circulations are parallel rather than in a series What is Total Anomalous Pulmonary Venous Return (TAPVR) ✔ Congenital heart defect in which 4 pulmonary veins that carry 02 rich blood back to the heart from the heart from the lungs are not properly attached to the atrium What causes Respiratory Alkalosis ✔ Hyperventilation, anxiety, Pulmonary Embolism, fear, mechanical ventilation What are symptoms of Respiratory Alkalosis ✔ Deep rapid ventilation, hypokalemia, nausea and vomit, tachycardia, lethargy/confusion, numbness and tingling, low or normal BP, light headed-ness, raised PH level, Lowered PC What causes Respiratory Acidosis ✔ Hypoventilation, overdose on sedatives, aspiration, atelectasis, pneumothorax, emphesema What are symptoms of Respiratory Acidosis ✔ muscle weakness, unconsciousness, headache, drowsiness, palpitations, dizziness, ventricular fibrillation What causes Metabolic Alkalosis ✔ severe vomiting, excessive suctioning, diuretic use, excessive NaHC What are symptoms of Metabolic Alkalosis ✔ restless/lethargy, confusion (lowered level of conscious, dizzy, irritable), tachy dysrhythmias, nausea, vomit and diarrhea, tremors, muscle cramps, hypokalemia What causes Metabolic Acidosis ✔ Increases (H) acid production, DKA, hypermetabolism, lowered H elimination (renal failure), lowered HC03 production (dehydration, liver failure), raised HC03 elimination (diarrhea) What are symptoms of Metabolic Acidosis ✔ headache, muscle twitch, lowered BP, vasodilation (warm, flushed skin), hyperkalemia, nausea/vomit, decreased muscle tone, kussmaul respirations, lowered reflexes Official Name

✔ followed by the initials USP or NF, most cases official name is the same as the generic name What is Pharmacokinetics ✔ the study of how the body handles a drug over a period of time What is Pharmacodynamic ✔ the study of how drugs act on a living organism Cholinergic Drug ✔ Parasympathomimetic Cholinergic Blocking Drug ✔ Parasympatholytic Adrenic Drug ✔ Sympathomimetic Adrenergic Blocking Drugs ✔ Sympatholytic Parasympathomimetic ✔ mimic the actions of the parasympathetic nervous system Parasympatholytic ✔ block the actions of the parasympathetic nervous system Sympathomimetic ✔ mimics the actions of the sympathetic nervous system Sympatholytic ✔ blocks the actions of the sympathetic nervous system What are the signs/symptoms of Ruptured Ovarian Cyst ✔ localized, one-sided lower abdominal pain. Onset of pain associated with minimal abdominal trauma, sex or exercise vaginal bleed or late/missed period at time of rupture What are the signs/symptoms of Ovarian Torsion ✔ sudden onset of lower abdomen pain (usually right sided), may radiated to back, pelvis or thigh begins with exercise, sharp/stab pain with nausea or vomit Cystitis ✔ (frequent urge to urinate, with little urine) painful urination, fever, chills, lower abdominal pain, foul smell/blood

✔ local anesthetic -vir ✔ antivirus -micin ✔ antibiotic -olol ✔ beta blocker -lam ✔ anti-anxiety agents -pam ✔ anti-anxiety agents Sellick's maneuver ✔ cricoid pressure that occludes esophagus Beta 2 Blocker ✔ affects the lungs Symptoms of Shock ✔ low systolic BP, raised pulse, raised respirations Cushing's Triad ✔ raised systolic BP, lowered pulse, lowered respirations Late Signs of Hypoxia ✔ Bradycardia, Extreme restless, Dyspnea Beta 1 Blocker ✔ affects the heart Nasal Cannula ✔ 24-44% O 1-6 L/min (flow rate) well tolerated Non Rebreather Mask ✔ 80-95% O 10-15 L/min or higher fit firmly on face reservoir never less than 2/3 full

Inferior MI shows which response ✔ parasympathetic (low BP) Anterior MI shows ✔ sympathetic response (normal or high BP) Right Ventricular Heart Failure ✔ results from left ventricular failure caused by: chronic hypertension, COPD, PE signs: edema, tachycardia, venous distension What is another name for Simple Pneumothorax ✔ Closed Pneumothorax Simple Pneumothorax ✔ Presence of air in pleural space partial or total lung collapse caused by: fracture rib, excessive pressure on chest wall against a closed glottis, rupture or tear in lung with no cause What is another name for Open Pneumothorax ✔ Communicating Pneumothorax Open Pneumothorax ✔ develops when chest injury exposes pleural space to atmospheric pressure; injured lung can shift to uninjured side symptoms: short of breath, pain, sucking or gurgling sound as air moves Tension Pneumothorax ✔ occurs when air in thoracic cavity cannot exit pleural space air leaks into pleural space (inspiration) becomes trapped during exhilation Pleural pressure increases, shift in mediastinum, compress uninjured lung and vena cava, tracheal deviation (late sign), hypotension/unexplained shock, subcutaneous emphysema, distended neck veins Hemothorax ✔ accumulation of blood in pleural space blood loss massive (30-40% or 2000-3000 mL) have hypovolemia and hypoxemia signs: tachypnea, dyspnea, cyanosis, decreased lung sounds, dullness on percussion, hypovolemic shock, narrow pulse pressure, tracheal deviation and pressure vent, re- expand lung needle chest decompression Hemopneumothorax ✔ collection of air and blood in pleural space

Spontaneous Abortion ✔ nontherapeutic termination of pregnancy from any cause before 20 weeks most frequent cause of vaginal bleeding (coin size or profuse) cramp-like lower back pain ask if tissue passed with blood Ectopic Pregnancy ✔ fertilized ovum implants anywhere other than uterus known as great imitator- ruptured ovarian cyst, pelvic inflam mation disease, appendicitis, abortion Signs/symptoms: abdominal pain (radiates to neck and shoulders, worsens in inspiration), vaginal bleeding, amenorrhea or oligomenorrhea Cephalopelvic Disproportion ✔ newborn's head is too large or mother's birth canal too small to allow normal birth Breech Presentation ✔ when the infant's head is delivered last Frank Breech ✔ butt first, legs above head (60-65%) Complete Breech ✔ butt first, legs and hip bent (5%) Incomplete Breech ✔ one or both hips incompletely flexed foot first (25-30%) Shoulder Dystocia ✔ fetal shoulders wedged against maternal symphysis pubis turtle sign, brachial plexus damage, fractured clavicle, fetal anoxia deliver anterior shoulder immediately after head Shoulder Presentation (transverse) ✔ when fetus lies perpendicular to mother no way to birth normally, rapid transport, c-section, fetal arm/hand presenting part Cord Presentation (prolapsed cord) ✔ occurs when cord slips down into or out of vagina after amniotic sac ruptured push infant back into vagina, elevate presenting part, rapid transport, cover cord in moist sterile dressing, instruct mother to pant

Premature Infant ✔ born before 37 weeks low birth rate, high risk for hypothermia, cardio-respiratory distress ask mother about tocolytic agents: magnesium sulfate nicardipine nifedipine ritodrine terbutaline indomethacin Premature Rupture of Membranes ✔ rupture of amniotic sac before the onset of labor history of trickle or gush of fluid Amniotic Fluid Embolism ✔ amniotic fluid enters maternal circulation during labor, delivery or immediately after delivery mortality is high signs/symptoms same as PE Congenital Anomalies ✔ defects that occur during fetal development Diaphragmatic Hernia ✔ malformation of the diaphragm during fetal development Omphalocele ✔ type of hernia- infant's intestines protrude through the umbilicus intact-still in sac non-intact- rutured 3 major changes during birth ✔ 1. emptying fluids from lungs and begin ventilating

2. changing their circulatory pattern
3. maintaining body temp 5 steps to care for newborns ✔ 1. provide warmth
4. clear airway

Pneumonia ✔ acute infection of lower airway that involves alveolar walls of alveoli lowered breath sounds in affected area, fever, pain in chest, rales in area, rhonchi, tachypnea Meningitis ✔ inflammation of the fluid containing membranes around the brain and spinal cord Brudzinski's sign Kernig's sign rash Epistaxis ✔ bleeding from the nose Chemical Name ✔ exact description describes the chemical composition of the drug also describes molecular structure Trade Name ✔ brand or property name trademark name designated by the drug company that sells the medication proper nouns first, letter capitalized Sepsis ✔ body temp of 100.4 degrees or 96.8 degrees profuse sweating, nausea, vomit, diarrhea, abdominal pain, tachycardia, hypotension, elevated white blood cell count, altered mental status Pulmonary Embolism ✔ sudden onset chest pain, shortness of breath, tachycardia, hypotension Cheyne-Stokes Respirations ✔ regular, periodic pattern of breathing with equal intervals of apnea with crescendo- decrescendo sequence represent cortical dysfunction of brain some in sleep Eupnea ✔ Normal breathing Kussmaul Respirations ✔ Abnormally deep, very rapid sighing respiratory pattern characteristic of diabetic ketoacidosis or metabolic acidosis Cincinnati Prehospital Stroke Scale ✔ facial droop, arm drift, speech

Los Angeles Prehospital Stroke Screen ✔ asymmetry in facial smile, grip, arm strength Glucagon ✔ opposite of insulin, raised blood glucose, one is the breakdown of liver glycogen, generation of glucose Hypoglycemia ✔ nervousness, trembling, irritability, combative behavior, weakness and in- coordination, confusion, appearance of intoxication, weak rapid pulse, cold clammy skin, drowsiness, seizures, coma, cardiac arrest Pelvic Inflammatory Disease ✔ diffuse lower abdominal pain, low grade fever, vaginal discharge, dyspareunia (painful sex) Bartholin's Abscess ✔ accumulation of pus that forms a lump swelling and inflammation, visible lump on one side of the vaginal opening. Activity cases severe pain Coelenterates (Jellyfish, Sea Anemones, Fire Coral) Stings ✔ Remove visible tentacle fragments with forceps, immediately wash with vinegar or baking soda, instruct pt to take hot shower or submerge in hot water, administer analgesics Echinoderms (Sea Urchins, Starfish, Sea Cucumbers) ✔ care for puncture wounds, remove spines with forceps (wear protective gloves), submerge in hot water Stingrays ✔ care directed at life support, alleviation of pain, inactivation of venom, prevention of infection; irrigate with saline, venom apparatus removed, immersed in hot water Pre-incident Phase ✔ prevention of intentional and unintentional trauma deaths Incident Phase ✔ the trauma event Post-incident Phase ✔ delivery of emergency care to patients Resources for Optimal Care of the Injured Patient

✔ complex of congenital abnormalities including: small mandible, tongue falls back into airway, cleft palate symptoms: high arched palate, receeding chin, tongue too large for jaw, natal teeth Anticholinergic (Dry) Drugs ✔ antihistamines, atropine, antidepressants, antiparkinsons, antipsychotic, skeletal muscle relaxer Signs/Symptoms of Anticholinergic (dry) Overdose ✔ delirium, tachycardia, dry/flushed skin, dilated pupils, seizures, dysrhthmias Treatment for Anticholinergic (dry) OD ✔ diazepam (valium), activated charcoal, physostigmine (antilirium) Cholinergics (Wet) ✔ pesticides, nerve agents (sarin/soman) Signs/Symptoms of Cholinergic OD ✔ headache, dizziness, weakness, nausea, SLUDGE, bradycardia, wheezing, seizures Treatment for Cholinergic OD ✔ Atropine, pralidoxime (2 PAM Chloride), diazepam, activated charcoal Antidotes for Organophosphates and Carbamates ✔ atropine, pralidoxime chloride, diazepam, lorazepam DUMBBELLS Acronym ✔ Diarrhea/Diaphoresis, Urination, Miosis/Muscle fasciculations, Bronchospasm, Bradycardia, Emesis, Lacrimation, Lethargy, Salivation used for poisonings Traumatic Asphyxia ✔ severe crushing injury to chest and abdomen; results from increased in intrathoracic pressure signs/symptoms: red/purple discoloration, JVD, swelling and hemorrhage of conjuctiva expect hypotension when pressure released Myocardial Contusion (blunt myocardial injury) ✔ usually caused by vehicle collisions; extent of injury varies: extreme- cardiac rupture- MI signs/symptoms:

chest pain, EKG abnormal, new cardiac murmur, pericardial friction rub (late), persistent tachycardia, palpitations treat as MI Beck's Triad ✔ elevated central venous pressure (evident JVD), muffled heart sounds, hypotension What is Pericardial Tamponade ✔ compression of heart by fluid in pericardial sac increased pressure prevents heart from expanding- decreased stroke volume and cardiac output What are the symptoms or Pericardial Tamponade ✔ peripheral vasoconstriction diastolic BP higher than systolic beck's triad, tachycardia, respiratory distress, narrow pulse pressure, cyanosis of head and neck, pulses paradoxus, electrical alternans (EKG waveform lower with other cardiac cycle) Moderate DAI ✔ concussion, most have basilar fracture immediate unconscious, persistent confusion, amnesia and disorient, focal deficit, inability to concentrate, mood swings, smell altered Severe DAI ✔ concussion, prolonged posturing common other signs of increased ICP HYPOXIA MUST BE PREVENTED Concussion or Mild DA ✔ rapid return to normal, confusion, disorientation, amnesia of event Increased ICP, lower brain/ medulla involved ✔ blown pupil- same side as injury, ataxic respirations, flaccid, labile pulse, QRS S-T and T wave changes, lower BP, not considered survivable Increased ICP, middle brainstem involved ✔ wide pulse pressure, bradycardia, pupils nonreactive or sluggish, central neurogenic hyperventilation (CNH) 5 Classifications of Shock ✔ Hypovolemic, Cardiogenic, Neurogenic, Anaphylactic, Septic 4 Stages of Shock ✔ 1. Vasoconstriction 2. Capillary and Venule Opening 3. Disseminated Intravascular Coagulation (Refractory) 4. Multiple Organ Failure

-statin ✔ antihyperlipidemics -mide ✔ diuretics Partial Rebreather Mask ✔ 35-60% O2 6-10 L/min Fill reservoir before use Cyanide Symptoms ✔ cytotoxic hypoxia, rapid progression of symptoms: dyspnea, paralysis, unconsciousness, death, fatal within minutes, characteristic odor of bitter almonds on breath Cyanide Treatment ✔ Amyl nitrite by inhalation, Sodium nitrite 300 mg IV, Sodium thiosulfate 12.5 mg Common Benzodiazepines ✔ Diazepam (Valium), Alprazolam (Xanax), Lorazepam (Ativan) Benzodiazepines Symptoms ✔ excessive drooling, staggering gait, paradoxal excitability, respiratory depression Benzodiazepine Treatment ✔ Flumazenil reverses effects Simple Face Mask ✔ 35-60% O2 6-10 L/min (flow rate) CO2 collects in mask if rate is <6 L/min Basilar Skull Fractures ✔ usually associated with major impact trauma battle's sign, raccoon eyes, hemotympanum, cerebrospinal fluid leakage can result in meningitis Kinematics ✔ process of predicting injury patterns Third Trimester Bleeding ✔ results of abruption placentae, placenta previa, uterine rupture Hyperemesis Gravidarum ✔ severe nausea, vomiting, weight loss, electrolyte disturbance, "severe case of morning sickness"

Korsakoff's Psychosis ✔ this is irreversible; often paired with Wernicke's apathy, poor retentive memory, retrograde amnesia (makes stories to fill gaps), dementia (caused by severe alcoholism) Wernicke's Encephalopathy ✔ usually develops suddenly, manifests with: ataxia, nystagmus, speech and gait disturbances, signs of neuropathy, stupor, coma administer thiamine and glucose in pts with altered LOC or coma (caused by severe alcoholism) Wernicke- Korsakoff Syndrome ✔ reduction in intestinal absorption and metabolism of thiamine caused by alcohol 2 stages: Wernicke encephalopathy Korsakoff's psychosis Aortic Dissection/ Rupture ✔ rupture of aorta that's thought to be a result of sheering forces usual damages to distal arch (beyond branching of left subclavian artery and proximal to ligamentum ateriosum) Aortic Dissection/ Rupture Signs and Symptoms ✔ BP normal or elevated, BP different in each arm, elevated extremity hypertension with lower femoral pulses, harsh systolic murmur Myocardial Rupture ✔ occurs when heart is compressed with enough force to rupture chamber wall, septum or valve ALMOST ALWAYS IMMEDIATELY FATAL; RAPID TRANSPORT signs/symptoms same as CHF and cardiac tamponade 3 Stages of Shock ✔ Compensated, Uncompensated and Irreversible Rouleaux Formation ✔ aggregation of red cells, looks like stack of coins or checkers Angina Pectoris ✔ onset begins after period of activity pain from MI after rest Pediatric Symptoms of Hypoxia ✔ Feeding difficulties, Inspiratory stridor, Nasal flare, Expiratory grunt, Sternal retractions Early Symptoms of Hypoxia

✔ spontaneous or traumatic rupture of uterine wall sudden abdominal pain, steady "tearing" pain, active labor, early signs of shock, bleeding, abdominal rigidness Parturition ✔ process by which an infant is born Postpartum Hemorrhage ✔ more than 500 mL of blood loss after delivery of newborn Uterine Atony ✔ lack of uterine tone management: massage uterus, encourage infant to breastfeed, administer oxytocin Choanal Atresia ✔ bony or membrane occlusion that blocks passage between nose and pharynx Tracheosophageal Fistula ✔ abnormal connection between esophagus and trachea commonly occurs with esophageal atresia (incomplete formation of esophagus) Cleft Lip ✔ incomplete closure of infants lip Cleft Palate ✔ Fissure in the hard palate of roof of mouth that runs along midline Septal Defects ✔ "hole in the heart" Atrial (ASD) hole between atriums ventricular (VSD) hole between ventricles Tetralogy of Fallot (TOF) ✔ involves 4 heart defects:

1. Large ventricle septal defect (VSD)
2. Pulmonary stenosis
3. Right ventricular hypertrophy
4. Overriding aorta Glascow Coma Scale ✔ used to assess LOC Eye Opening: Spontaneous 4 Command 3 Pain 2 None 1 Verbal Response:

Oriented 5 Confused 4 Inappropriate 3 Incomprehendable 2 None 1 Motor Response: Obey 6 Localizes pain 5 Withdraws 4 Flex 3 Extension 2 None 1 D-fib for pediatric pt dose ✔ 2 Jules per kg max dose 4 J/kg burn formula ✔ body surface area x weight(kg) x 4 mL passive rewarming ✔ removing out of cold, removing wet clothes, etc active rewarming ✔ applying heat hyphema ✔ bleeding from eyes veins ✔ carry blood to heart arteries ✔ carry blood away from heart cholecystitis ✔ inflammation of the gallbladder Diverticulitis ✔ inflammation of the intestines macro ✔ 10 drops= 1 mL micro ✔ 60 drops= 1 mL