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NREMT Paramedic Cognitive Exam practice questions

217 free questions with answers and explanations.

Practice test
  1. 1.A paramedic is called to a local high school for a 16-year-old male who collapsed during a soccer game. The patient is unresponsive, apneic, and pulseless. Bystander CPR is in progress. The AED advises 'No Shock Advised.' What is the MOST appropriate next step for the paramedic?Operations
  2. 2.A paramedic is preparing to administer 10 mg of Ondansetron (Zofran) intravenously to an adult patient experiencing severe nausea and vomiting. The medication is supplied in a prefilled syringe containing 4 mg/2 mL. How many milliliters should the paramedic administer?Operations
  3. 3.A paramedic is dispatched to a residence for a 5-year-old child experiencing a severe asthma exacerbation. The child is in severe respiratory distress, with audible wheezing, retractions, and an SpO2 of 88% on room air. After administering oxygen and assisting ventilations, what is the MOST appropriate next pharmacological intervention?Operations
  4. 4.A paramedic is performing a rapid trauma assessment on a patient involved in a high-speed motor vehicle collision. Which of the following findings would be considered the most critical to address immediately during this assessment?Operations
  5. 5.A paramedic is operating an ambulance under emergency conditions, transporting a critical patient. While approaching an intersection with a red light, the paramedic observes cross-traffic and pedestrians. Which of the following is the most appropriate action for the paramedic to take?Operations
  6. 6.A paramedic is completing a patient care report (PCR) for a 72-year-old male who experienced a syncopal episode. The patient is now alert and oriented, but the paramedic noted transient confusion during the initial assessment. Which of the following statements BEST reflects objective documentation of the patient's mental status?Operations
  7. 7.A paramedic is responding to a single-vehicle collision on a rural highway. Upon arrival, the paramedic observes a heavily damaged vehicle with a patient entrapped. The scene environment includes spilled fluids, a strong smell of gasoline, and downed power lines across the road. What is the MOST immediate priority for the paramedic upon arrival?Operations
  8. 8.A paramedic is dispatched to a rural area for a patient experiencing a severe allergic reaction. Upon arrival, the patient is unresponsive, hypotensive, and has audible stridor. The paramedic has limited resources on scene and is awaiting backup. What is the most immediate and critical intervention for this patient?Operations
  9. 9.A paramedic is transporting a critically ill patient who requires continuous positive pressure ventilation via an endotracheal tube. The patient's condition suddenly deteriorates, and during assessment, the paramedic notes absent breath sounds on the left side, tracheal deviation to the right, and increasing difficulty with ventilations. What is the most appropriate immediate action?Operations
  10. 10.A paramedic is completing a patient care report (PCR) for a patient who refused transport against medical advice. Which of the following is the most crucial element to include in the documentation to protect the paramedic and EMS agency?Operations
  11. 11.A paramedic is dispatched to a scene where a 4-year-old child has ingested an unknown quantity of caustic drain cleaner. The child is conscious, crying, and has burns around the mouth. Which of the following prehospital interventions is contraindicated?Operations
  12. 12.During a multi-agency response to a large-scale incident, a paramedic is assigned to the 'Treatment Unit Leader' role under the Incident Command System (ICS). What is the primary responsibility of this role?Operations
  13. 13.A paramedic is responding to a mass casualty incident (MCI) where multiple patients have crush injuries after a building collapse. During triage using the START method, a patient is found to have absent radial pulses, respirations of 28/min, and is unable to follow commands. What triage category should this patient be assigned?Operations
  14. 14.A paramedic is preparing to transport a patient with suspected bacterial meningitis. The patient is exhibiting fever, headache, and a stiff neck. Which of the following precautions is most appropriate for the paramedic to implement during patient contact and transport?Operations
  15. 15.A paramedic is completing a patient care report (PCR) for a 55-year-old male who experienced a syncopal episode. The paramedic documented that the patient 'appeared to be malingering due to lack of objective findings.' This statement is an example of which of the following documentation errors?Operations
  16. 16.A paramedic is called to a scene where a patient is combative and threatening self-harm. Law enforcement is present and has the patient secured. The patient refuses all medical assessment and transport. What legal principle should guide the paramedic's actions in this situation?Operations
  17. 17.A paramedic is working at a large-scale incident involving a train derailment with multiple casualties. The Incident Commander has requested a rapid assessment of all patients to determine their priority for immediate treatment and transport. Which of the following triage systems is MOST appropriate for this initial assessment?Operations
  18. 18.A paramedic is called to a nursing home for an 85-year-old female patient with a suspected hip fracture after a fall. Upon arrival, the paramedic performs a rapid assessment and finds the patient conscious, alert, and in severe pain. The patient has a valid Physician Orders for Life-Sustaining Treatment (POLST) form indicating 'Comfort Measures Only.' How should the paramedic proceed with pain management?Operations
  19. 19.A paramedic is teaching a community CPR class. When discussing the chain of survival for out-of-hospital cardiac arrest, which of the following links should the paramedic emphasize as the single most critical factor influencing patient outcome?Operations
  20. 20.A 45-year-old male presents with severe chest pain. During transport, the patient becomes unresponsive and pulseless. The cardiac monitor shows ventricular fibrillation. After initiating CPR, what is the most appropriate next intervention for this patient?Operations
  21. 21.A paramedic is assessing a 4-year-old child who ingested an unknown quantity of household cleaning product. The child is crying, has burns around the mouth, and is drooling excessively. Vomiting has occurred once. What is the MOST critical immediate intervention for this patient?Operations
  22. 22.A paramedic is managing a patient with suspected tension pneumothorax. After needle decompression, the patient's condition improves temporarily, but then deteriorates again. What is the most likely cause of this deterioration?Operations
  23. 23.A paramedic is called to a scene where a 68-year-old male is experiencing sudden onset shortness of breath and chest pain. The patient is anxious and diaphoretic. During the assessment, the paramedic notes jugular venous distension (JVD) and dependent edema. Lung sounds are clear. What is the most likely underlying condition?Operations
  24. 24.A paramedic is transporting a patient with a suspected ruptured abdominal aortic aneurysm (AAA). The patient is hypotensive and tachycardic. During transport, the patient's blood pressure drops further, and they become unresponsive. What is the MOST appropriate immediate intervention for the paramedic?Operations
  25. 25.A paramedic is assessing a 28-year-old female complaining of acute, severe, tearing back pain radiating to the abdomen. She is pale, diaphoretic, and hypotensive (BP 80/40 mmHg) with a weak, rapid pulse of 120 bpm. What is the most critical prehospital intervention for this patient?Operations
  26. 26.A paramedic is preparing to administer Adenosine for a stable adult patient experiencing supraventricular tachycardia (SVT). The patient weighs 70 kg. What is the correct initial dose of Adenosine to administer?Operations
  27. 27.A paramedic is managing a 72-year-old female with suspected sepsis. Her blood pressure is 88/50 mmHg, heart rate 118 bpm, respiratory rate 24 bpm, and she is lethargic. Her temperature is 101.5°F (38.6°C). After ensuring airway and breathing, which of the following interventions should the paramedic prioritize?Operations
  28. 28.A paramedic is managing a 34-year-old male with a severe traumatic brain injury (TBI) from a motor vehicle collision. The patient is unconscious, GCS 6, and has signs of increasing intracranial pressure (ICP), including Cushing's triad. Which of the following interventions is the most appropriate initial treatment to manage ICP in the prehospital setting?Operations
  29. 29.A paramedic is called to a local park where an 8-year-old child has fallen from a swing set, landing on their head. The child is conscious but disoriented, has a palpable deformity to the left parietal area, and is experiencing recurrent vomiting. The child's Glasgow Coma Scale (GCS) score is 13. Given these findings, what is the MOST appropriate transport decision?Operations
  30. 30.A paramedic is evaluating a 65-year-old male with a history of heart failure who presents with acute dyspnea, orthopnea, and bilateral crackles on auscultation. His blood pressure is 160/90 mmHg, heart rate 110 bpm, and SpO2 88% on room air. The patient is anxious and states he feels like he's drowning. Which of the following medications is MOST appropriate to administer to reduce preload and improve respiratory effort in this patient?Operations
  31. 31.A paramedic is assessing a 6-month-old infant who is unresponsive and apneic. The infant's pulse is 50 bpm. What is the most appropriate initial intervention?Operations
  32. 32.A paramedic is responding to a motor vehicle collision involving a single vehicle that struck a tree. The driver is entrapped and conscious, but screaming in pain. Fire department personnel are actively working to extricate the patient. Which of the following is the paramedic's primary responsibility during this phase of the incident?Operations
  33. 33.A paramedic is called to the home of a 78-year-old female who has a 'Do Not Resuscitate' (DNR) order. The patient is pulseless and apneic. Her family states they want 'everything done.' What is the most appropriate action for the paramedic?Operations
  34. 34.A paramedic is asked to review a patient care report (PCR) written by a new EMT. The report states, 'Patient appeared intoxicated and uncooperative.' Which of the following is the most appropriate feedback regarding this statement?Operations
  35. 35.A paramedic is preparing to administer 2 mg of Naloxone IV push. The medication is supplied in a vial containing 0.4 mg/mL. How many milliliters should the paramedic administer?Operations
  36. 36.A paramedic is documenting a patient encounter where a 35-year-old male refused transport after a minor motor vehicle collision. The patient is alert and oriented, denies injury, and signed the refusal form. Which of the following details is MOST important to include in the patient care report (PCR) regarding this refusal?Operations
  37. 37.A paramedic is administering a medication via intraosseous (IO) route to a patient in cardiac arrest. After successful insertion of the IO needle into the proximal tibia, the paramedic attempts to flush with saline but meets significant resistance. Which of the following is the most appropriate next step?Operations
  38. 38.A paramedic crew responds to a mass casualty incident (MCI) involving a chemical spill. Upon arrival, they observe victims fleeing the hot zone exhibiting respiratory distress and skin irritation. What is the immediate priority for the arriving paramedic crew?Operations
  39. 39.A paramedic is evaluating a 28-year-old female patient complaining of sudden onset, severe, sharp, unilateral flank pain radiating to the groin. She reports associated nausea and vomiting. Her vital signs are stable. Physical exam reveals tenderness to palpation in the affected flank. What is the MOST likely cause of her symptoms?Operations
  40. 40.A paramedic is preparing to administer Dextrose 10% (D10) IV to an adult patient with altered mental status and a blood glucose level of 45 mg/dL. The standing order is to administer 12.5 grams of Dextrose. The D10 solution is supplied in a 250 mL bag. How many milliliters (mL) of D10 should the paramedic administer?Operations
  41. 41.A 65-year-old male with a history of COPD is experiencing an acute exacerbation. He is alert but fatigued, with a respiratory rate of 26 breaths/min and shallow. His SpO2 is 87% on 2 L/min nasal cannula. You apply a non-rebreather mask at 10 L/min, and his SpO2 improves to 90%. What is the most appropriate next step in his respiratory management?Airway, Respiration & Ventilation
  42. 42.A 30-year-old male with a history of asthma is experiencing a severe exacerbation. His peak expiratory flow (PEF) is 40% of his personal best. He is alert but anxious, with prolonged expiratory phase and diffuse wheezing. Which of the following medications is indicated to address the bronchoconstriction?Airway, Respiration & Ventilation
  43. 43.A 25-year-old female is experiencing a severe asthma attack. She is receiving nebulized albuterol and ipratropium, but her condition is not improving, and she remains in severe respiratory distress with an SpO2 of 88%. Her breath sounds are diminished, and wheezing is less prominent. This change in breath sounds indicates:Airway, Respiration & Ventilation
  44. 44.A 4-year-old child presents with sudden onset of severe inspiratory stridor, high fever (103°F/39.4°C), drooling, and appears anxious, preferring to sit in the 'tripod' position. The child's voice is muffled. What is the most critical immediate intervention?Airway, Respiration & Ventilation
  45. 45.A 70-year-old male with a history of heart failure and recent surgery presents with sudden onset of severe shortness of breath, sharp chest pain that worsens with inspiration, and a feeling of impending doom. His SpO2 is 86% on room air, heart rate 110 bpm, and respiratory rate 30 breaths/min. Lung sounds are clear bilaterally. Which of the following is the most likely cause of his symptoms?Airway, Respiration & Ventilation
  46. 46.A 68-year-old male is found unresponsive and apneic. You immediately begin bag-valve-mask (BVM) ventilation. After several ventilations, you notice significant gastric distension and hear gurgling sounds from the patient's stomach. What is the MOST appropriate immediate action to address this?Airway, Respiration & Ventilation
  47. 47.A 5-year-old child weighing 44 lbs (20 kg) is experiencing severe respiratory distress due to an asthma exacerbation. After administering albuterol via nebulizer, the patient's condition has not improved, and he remains tachypneic with significant retractions and diffuse wheezing. What is the appropriate dose of intravenous (IV) methylprednisolone to administer?Airway, Respiration & Ventilation
  48. 48.A 55-year-old male is found unresponsive with sonorous respirations and an SpO2 of 85%. He has a strong radial pulse. After opening the airway with a head-tilt-chin-lift maneuver, his SpO2 improves to 92% and respirations become less noisy but remain shallow at 8 breaths per minute. What is the most appropriate next step in airway management?Airway, Respiration & Ventilation
  49. 49.A 50-year-old male is found unconscious with agonal respirations. His pulse is weak and thready at 120 bpm. You are preparing to insert a supraglottic airway device. Which of the following is an absolute contraindication for the insertion of a supraglottic airway?Airway, Respiration & Ventilation
  50. 50.A 60-year-old male with a history of COPD is receiving oxygen via nasal cannula at 2 L/min. His current SpO2 is 92%, and he is alert and oriented. He reports feeling 'a little more breathless' than usual. What is the most appropriate initial action regarding his oxygen therapy?Airway, Respiration & Ventilation