NREMT Pocket Prep (2025 NREMT PARAMEDIC EXAM) Questions and Answers, Exams of Medicine

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PARAMEDIC EXAM) questions and

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What are the late signs of hemorrhagic shock? - correct answer ✅Rapid breathing, cool clammy skin, dull slightly dilated pupils Is carbon monoxide an internal factor or external factor for respiration? - correct answer ✅External Name 3 of the AHA reccomended managment principles for ROSC patients. - correct answer ✅Initiate Targeted Temperature Management if patient is comatose, Administer colloid/vasopressor to a goal blood pressure of <90 systolic or MAP <65mmHg, and obtain 12-lead. (THINK TAKE PT TO THE MOVIES) According to the NREMT, what is the dose of NARCAN for a patient with suspected opiod overdose? - correct answer ✅Narcan 2mg IN (1mg per nare) Name 3 WMD chemical agent exposures that a paramedic can see symptoms of on scene? - correct answer ✅Pulmonary agents, nerve agents, and vesicant agents. (Vesicant agents include mustard gas and primarily affect DNA to cause cellular damage) Why is an uncuffed ET tube appropriate for a 6 year old child? - correct answer ✅Pediatrics of this age range have a narrowing of the trachea at the level of the cricoid cartilage. Name the major signs of hypothermia. - correct answer ✅Lack of coordination, confusion and memory loss, lack of shivering, weak pulses, slowed speech, drowsiness and very low energy, and slow shallow breathing.

PARAMEDIC EXAM) questions and

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In dislocations and fractures, splinting is normally done in the position it is found. If circulation is comprimised, a paramedic may attempt to manipulate the injury one time to regain circulation. What is the one anatomical location that is the exception to this rule and therefore contraindicated in the prehospital setting? - correct answer ✅Elbow dislocations and fractures, due to the anatomical position of these injuries. Name 3 common SSRI medications. - correct answer ✅Zoloft (Sertaline), Prozac (Fluoxetine), and Paxil (Paroxetine) Define how to calculate the rate of an irregular rhythm and how and why it should be used. - correct answer ✅The range of an irregular heart rate can be determined by calculating the heart rate of the QRS complexes closest together and the QRS complexes furthest apart. The two rates can be calculated using the block or memory method. Regarding irregular heart rates, how do you perform the 6 second method? How do you perform the 10 second method? *NOTE, NREMT DOES NOT BELIEVE THIS METHOD EXISTS, BUT IT IS GOOD TO KNOW ANYWAY - correct answer ✅Viewing the rhythm strip, on a 6-second strip count the number of QRS complexes and multiply by 10. For a 10 second strip, count the number of QRS complexes and multiply by 6. Why is cystic fibrosis not considered a lower airway infection? - correct answer ✅Cystic fibrosis is caused by genetic factors, not an infection.

PARAMEDIC EXAM) questions and

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A patient is having an allergic reaction. Patient complains of itching with angioedema and shortness of breath, but denies swelling of the tongue or airway. What medication class (with example) is therefore indicated? - correct answer ✅During an allergic reaction or anaphylaxis, it is appropriate to administer a beta- agonist, such as albuterol, in an attempt to reverse the bronchospasm and increase the patient's alveolar ventilation. What is the dose formula for morphine sulfate in a PEDIATRIC patient? - correct answer ✅0.1-0.2mg/kg IV Name the signs of heatstroke (7 answers) - correct answer ✅Core temperature of <104.0 degrees F, altered mental status, alteration in sweating, nausea/emesis, tachypnea, tachycardia, and headache. For a traumatic patient with significant blood loss, what is likely to be administered upon hospital arrival and why? - correct answer ✅Packed red blood cells are commonly used in the US emergency departments. They have a hemoglobin volume of two units in every single unit and do not contain plasma. This makes it less likely the patient will experience fluid overload or an infusion reaction from the infusion. O-negative packed red blood cells would quickly be administered to a hypovolemic female of childbearing age after three liters of lactated Ringer's solution fail to improve her blood pressure. Which of the following injury types is most likely to occur if your adult patient strikes his head on the bottom of a shallow pool while attempting to dive? - correct answer ✅Axial loading is often referred to as vertical compression of the spine when direct forces are sent down the length of the spinal column from the top of the head. The forces involved can produce compression fractures or

PARAMEDIC EXAM) questions and

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crushed vertebral bodies without spinal cord injury and normally occurs from the area of T12-L2. Which of the following is most likely to present with unequal pupillary response, neck stiffness, and can be fatal in minutes? - correct answer ✅A subarachnoid hematoma refers to intracranial bleeding that enters the cerebrospinal fluid, resulting in bloody cerebrospinal fluid and meningeal irritation. Bleeding results from trauma and other means. Patients with this type of hemorrhage often complain of the worst headache of their life with sudden-onset dizziness and blurred vision. Bleeding is often sudden and severe with this injury and can be deadly in minutes in some cases. Patients may also have unequal pupillary response and neck stiffness associated with meningeal irritation. Name the volume lost in each of the four classes of hemorrhage. - correct answer ✅Class I >15%, Class II 15-30%, Class III 30-40%, Class IV <40% Patients exposed to a housefire who have inhaled smoke may be exposed to what 3 gases? - correct answer ✅Carbon monoxide, hydrogen sulfate, and hydrogen cyanide. Periumbilical bruising indicates what type of injury? - correct answer ✅Retroperitoneal hemorrhage Which of the following incomplete spinal cord syndromes commonly occurs with hyperextension and/or flexion cervical spine injuries and presents with a greater loss of function in the upper extremities than in the lower extremities? - correct answer ✅Central spinal cord syndrome presents with some hyperextension and/or

PARAMEDIC EXAM) questions and

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In regards to increased ICP, what drug may be indicated when attempting to intubate? - correct answer ✅Lidocaine has been shown to control increases in intracranial pressure in closed-head injury patients that may occur during intubation. When extricating a stable patient from a vehicle seated in the drivers seat and the drivers side door is damaged too much to open, what is the safest way to extricate the patient? - correct answer ✅Open the passenger's side door and extricate the patient through the passenger's side. Interference from other electrical devices will present as what kind of artifact on the EKG? - correct answer ✅60 cycle interference, appears as fibrillation-type waves between QRS complexes that is too rapid to be caused by a dysrhythmia. What EKG abnormalities are present with WPW syndrome? - correct answer ✅Delta waves (slurred upstroke in the QRS complex), widened QRS complex, and short PR interval (>120ms) How will hip dislocations present? - correct answer ✅Most dislocations at the hip will involve anterior rotation, and shortening of the affected leg with internal rotation. Mesentric ischemia is rare, but when it is present it is caused by what 3 things? - correct answer ✅Arterial thrombosis, arterial embolism, and vasospasm.

PARAMEDIC EXAM) questions and

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Satolol is used for what condition, and what drug class is it considered? - correct answer ✅Class III, for wide complex tachycardia Define chronotropic - correct answer ✅rate of heartbeat Define dromotropic - correct answer ✅conductivity of heart Define inotropic - correct answer ✅The strength of the contractility Why is a patient in hypovolemic shock likely to develop increased dyspnea even after bleeding is controlled? - correct answer ✅Loss of erythrocytes decreases the bloods ability to carry oxygen, thus increasing respiratory rate. According to the AHA, what kind of electrical shock is required when a patient presents with monomorphic VTACH? - correct answer ✅Synchronized cardioversion. Defibrillation is indicated when the VTACH is polymorphic, and in cases that one is unable to distinguish the two, treat as polymorphic. What would be the proper way to administer epinephrine to the patient without IV/IO access who is intubated while en route to the hospital? - correct answer ✅Through the patient's ET tube at 2.0-2.5 times the normal dose, diluted in 5- mL of sterile water What is true concerning J point elevation? - correct answer ✅The J point elevation is a type of ST segment elevation seen in normal hearts. It is seen in young,

PARAMEDIC EXAM) questions and

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According to research, approximately what percent of patients experiencing a STEMI do not receive pre-hospital ECGs because they do not present with chest pain? - correct answer ✅25% All of the following arrhythmias cause a decrease in cardiac output except: (a) atrial fibrillation (b) multifocal atrial tachycardia (c) wandering atrial pacemaker (d) premature atrial complexes - correct answer ✅(d) premature atrial complexes Which crainal nerves play a role in the act of swallowing? - correct answer ✅X, V, and VII (X controlling the vagus nerve, V controlling sensations in your face, cheeks, as well as taste and jaw movement, and VII controling facial expressions and sense of taste) Which EKG waveform abnormality occurs when the right atrium pumps against a closed tricuspid valve sending waves of pressure through the jugular veins? - correct answer ✅Cannon A waves are waves of the pulse pressure visible in the jugular veins of a patient in Supra-Ventricular Tachycardia (SVT). They may also be seen in Ventricular Tachycardia (VTACH) with a pulse Which treatments are AHA recommendations for management of SVT in the adult patient? - correct answer ✅SVT is treated with vagal maneuvers, adenosine, β- blocker or calcium channel blocker.

PARAMEDIC EXAM) questions and

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What are the "AHA 8 D's" of stroke care? - correct answer ✅Detection: rapid recognition of stroke signs and symptoms Dispatch: early activation and dispatch of EMS by phoning 9-1- Delivery: rapid EMS stroke identification, management, triage, transport, and prehospital notification Door: emergent ED/imaging suite triage and immediate assessment by the stroke team Data: rapid clinical evaluation, laboratory testing, and brain imaging Decision: establishing stroke diagnosis and determining optimal therapy selection Drug/Device: administration of fibrinolytic and/or EVT if eligible Disposition: rapid admission to the stroke unit or critical care unit, or emergent interfacility transfer for EVT What is Wolff-Parkinson-White syndrome? - correct answer ✅Congenital malformation resulting in incomplete separation of the atria from the ventricles during foetal maturation This leads to the presence of an extra 'accessory' bundle connecting the ventricles and the atria Because in this accessory bundle there is no AV node to delay conduction a wave of depolarisation reaches the ventricle early pre-excitation occurs.

PARAMEDIC EXAM) questions and

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A patient is experiencing an anterior myocardial infarction. In which leads are you MOST LIKELY to see evidence of the infarction? - correct answer ✅V3 and V What is agnosia? - correct answer ✅An inability to recognize objects What is aphasia? - correct answer ✅An impairment of language What is dysarthria? - correct answer ✅Presence of slurred speech A patient with increased intercranial pressure to the midbrain will show what signs and symptoms? - correct answer ✅Patients with increased intracranial pressure at the level of the middle brainstem will likely present with a widened pulse pressure, bradycardia, and abnormal posturing (extension). A patient is found unconscious, tachycardia too fast to palpate accurately, and hypotension. EKG shows Torsades de Pointe, what is the most appropriate intervention for this patient? - correct answer ✅A high energy unsynchronized shock (Also acceptable: defibrillation) At what temperature range should a patient be kept if they are recieving Targeted Temperature Management and for how long? What kind of patients should receive this treatment post cardiac arrest? - correct answer ✅32 degrees C to 36 degrees C for at least 24 hours if found to be comatose post cardiac arrest

PARAMEDIC EXAM) questions and

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Active core rewarming procedures are considered invasive and reserved for the controlled environment of the hospital. However, some active core rewarming procedures are acceptable to initiate in the pre-hospital setting. Name one example of invasive active core rewarming that may be done in the prehospital setting? - correct answer ✅Administration of warm IV fluids and humidified O What measure of time on the EKG does the PR segment measure? - correct answer ✅The end of atrial depolarization to the start of ventricular depolarization Describe the procedure for orogastric tube placement in an unresponsive patient.

• correct answer ✅The steps for placing an orogastric tube in an unresponsive patient are:

1. Position the head in a slightly flexed position
2. Measure from mouth to ear to xiphoid process
3. Lubricate the tube with water-soluble gel and introduce the tube at the midline; advance it gently into the oropharynx, continuing into the stomach
4. Confirm placement
5. Apply suction to the tube
6. Secure the tube in place If you suspect that the ET tube has advanced too far and gone down the left bronchus, how far back should the ET tube be pulled after the cuff is deflated? - correct answer ✅2-3 cm

PARAMEDIC EXAM) questions and

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What is a naturally occurring steroidal hormone produced by the adrenal cortex to help regulate the sodium/potassium balance in the blood? - correct answer ✅Aldosterone What treatment is indicated for a patient presenting with atrial fibrillation lasting less than 48 hours? - correct answer ✅Synchronized cardioversion What would a paramedic expect to see in a patient with a chronic adrenal dysfunction such as Addison's disease? - correct answer ✅Darkened skin, anorexia, hypoglycemia, nausea, and vomiting. Patients who present with unusually darkened skin patches, especially in areas such as the underarms and behind the knees, anorexia, hypoglycemia, nausea, and vomiting are most likely suffering from the long-term effects of Addison's disease due to corticosteroid deficiency. Where in the body has a patient been struck if you suspect they are experiencing commotio cordis? - correct answer ✅The chest by a fast moving object (most often in sports; such as a baseball or hockey puck) What is myasthenia gravis? - correct answer ✅It is an autoimmune neuromuscular disease that affects the motor cranial nerves. It is the GRAVE MUSCLE WEAKNESS. Exacerbation and remissions are parts of the disease which tend to be progressive over time.