Medical Tests Medical Tests Certifications NREMT Questions & Answers

• Question 61:

  You have a patient that has suffered frostbite to his fingers. How should you prepare the patient's fingers for transport?

  A. Message the fingers and hands in an effort to restore circulation.

  B. Wrap the fingers individually.

  C. Place a heat pack in the palm of the patient's hands.

  D. Submerge the fingers in warm water.

  Correct Answer: B

  When a patient has suffered frostbite to his fingers, the digits should be wrapped individually to prevent the digits from freezing together and producing more damage. The digits may be submerged in room temperature water if there is no risk of them refreezing. The fingers should never be massaged. This causes the very sharp ice crystals to pierce the cells and cause cellular death.

• Question 62:

  A 65-year-old male with terminal brain cancer calls 911 for shortness of breath. The patient has a Do Not Resuscitate order. What should you do for this patient?

  A. Discuss the situation with the family and try to persuade them not to have the patient transported.

  B. Administer oxygen and transport the patient to the most appropriate emergency room.

  C. Contact medical direction about administering oxygen and not transporting the patient.

  D. Contact the patient's oncologist for directions on the patient's care.

  Correct Answer: B

  The patient has the right to comfort care even if he is a DNR. This means that the patient has the right to receive oxygen and medications for pain. The patient has the right to make his own medical decisions unless his family has the medical power of attorney to decide if the patent is transported. Patients have the right to die with dignity.

• Question 63:

  Your patient has indicated fear about his illness, stating that he is afraid that he may die. This has made the interview difficult, as you have been unable to get the patient to give you many details regarding his symptoms or the events preceding them. Which of the following techniques is an acceptable method to focus the interview and get the needed information?

  A. Repeat back to the patient whatever relevant information you have obtained, and then ask him for further information.

  B. Reassure the patient by telling him everything will be fine.

  C. Sternly tell the patient that he must focus and tell you what you need to know.

  D. Decrease the physical distance between you and the patient, and relay to him that he may get worse if you can't obtain the needed information.

  Correct Answer: A

  Repeating your understanding of the situation back to the patient is useful is helping them realize what relevant information they have not yet revealed. It is typically not advisable to take an authoritarian role with a patient, as this may add to their emotional distress and worsen their communication ability. It is also not a good idea to give patients false assurances, such as telling them that they will be fine. Decreasing the physical distance can be intimidating to the patient, as can telling them that they may worsen if you can't get the necessary information. Both of these techniques will increase patient apprehension and will likely have a negative impact on communication.

• Question 64:

  Which of the following vital signs would be most indicative of a patient who has entered the decompensated stage of shock?

  A. Heart rate of 110, respirations of 24, and a blood pressure of 128/90 mmHg

  B. Heart rate of 92, respirations of 18, and a blood pressure of 124/72 mmHg

  C. Heart rate 64, respirations of 8, and a blood pressure of 82/40 mmHg

  D. Heart rate of 128, respirations of 26, and a blood pressure of 82/62 mmHg

  Correct Answer: D

  Decompensated shock physiologically occurs as the precapillary sphincters that guard the peripheral capillary beds relax secondary to local blood chemistry changes due to shock. The opening of these sphincters allows blood to flow back into the stagnant capillary beds which decreases the available blood volume for core perfusion, and, results in a significant drop in systemic vascular resistance. Thus the clinical finding consistent with decompensated drop is a sudden decrease in blood pressure, tachypnea, and continued elevation of the heart rate.

• Question 65:

  You are transporting a patient that is having night sweats, mild fever, and a productive cough. He states that the health department has been treating him at home for a respiratory condition. How should the patient be transported to the hospital?

  A. In a position of comfort

  B. With a mask on the patient and the EMT

  C. In a calm, passive manner

  D. In the left lateral recumbent position

  Correct Answer: B

  The patient that has possible TB should wear either a surgical mask or a nonrebreather mask. This is used to prevent the spread of the disease and to protect the safety of the health care provider.

• Question 66:

  Status epilepticus is a seizure that:

  A. Lasts longer than 5 minutes.

  B. Is experienced only on one side of the body.

  C. Produces apnea.

  D. Begins again after one seizure stops without the patient regaining consciousness.

  Correct Answer: D

  Status epilepticus is defined as a seizure that lasts longer than 10 minutes or a seizure that begins again after one seizure stops without that patient regaining consciousness. It is a dire medical emergency, as the patient may sustain bone fractures, airway occulsion, and possible death.

• Question 67:

  You have been called to the top of a mountain resort for a patient that is complaining of a sudden onset of shortness of breath and coughing. Your assessment of the patient reveals an anxious patient with basilar crackles in his lungs. The patient's vital signs include a heart rate of 136, respirations of 28, and a blood pressure of 176/94 mmHg. What is your field diagnosis of this patient?

  A. High altitude pulmonary edema

  B. New onset congestive heart failure

  C. Pneumonia

  D. High altitude congestive heart failure

  Correct Answer: A

  High-altitude pulmonary edema (HAPE) usually occurs in an unacclimatized individual who rapidly ascends to an altitude that exceeds 8,000 feet. HAPE develops as a result of increased pulmonary pressure and hypertension caused by changes in blood flow at high altitudes.

• Question 68:

  The physiological function of insulin is to promote utilization of glucose by the cells. What would happen to a patient with a low level of insulin?

  A. Glucose would remain in the cell and would not be functional.

  B. The level of insulin outside of the cell would be insufficient and would not break down the glucose.

  C. The level of insulin inside the cell would be insufficient and would not break down the glucose.

  D. Glucose would remain on the outside of the cell and would not be broken down.

  Correct Answer: D

  Insulin is a hormone that is responsible for transporting glucose into the cell where it can be metabolized and made into energy. With a low level of insulin, very little sugar can be metabolized; the result is that the cells' ability to function is drastically reduced.

• Question 69:

  You have responded for a 17 year-old male who has had a sudden onset of shortness of breath. During your evaluation of the patient, he tells you that he has a history of Marfan's syndrome. The patient is dyspneic and has decreased lung sounds on the left side of his chest. What do you think is the most likely cause of this patient's shortness of breath?

  A. Pneumonia

  B. Pulmonary embolis

  C. Spontaneous pneumothorax

  D. Congenital lung disease

  Correct Answer: C

  A common complication seen in the patient with Marfan's syndrome is a spontaneous pneumothorax. Marfan's syndrome is a connective tissue disorder that results in weak organ and tissue structure. Along with spontaneous pneumothoracies, they are also more likely to develop aortic aneurysms.

• Question 70:

  Which of the following medications would you expect to find a patient who is being treated for peptic ulcer disease to be taking?

  A. Non-steroidal anti-inflammatory

  B. Calcium channel blocker

  C. Aspirin

  D. Antibiotic

  Correct Answer: D

  It is estimated that about 80 percent of all cases of peptic ulcer disease are caused by the presence of Helicobacter pylori (H pylori) bacteria. The bacteria damage the protective mucosal lining of the stomach and/or duodenum, allowing it to be damaged by the strong gastric acids used for digestion. Consequently, ulcerations in the mucosal lining and tissue occur. Antibiotic therapy can control the population of H pylori and definitively treat the ulcerative disease. Non-steroidal anti-inflammatory medications, including aspirin, increase acid production and can worsen or exacerbate peptic ulcer disease. While calcium channel blockers can be used in the treatment of gastro-esophageal reflux disease (decrease spasm of the lower esophageal sphincter), they are not indicated in the management of peptic ulcer disease.