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NREMT Paramedic Cognitive Exam practice questions

217 free questions with answers and explanations.

Practice test
  1. 151.A 30-year-old male presents with palpitations, lightheadedness, and a heart rate of 190 bpm. His ECG shows a regular narrow-complex tachycardia. He is alert and oriented, and his blood pressure is 110/70 mmHg. After attempting vagal maneuvers, which of the following is the most appropriate next intervention?Cardiology & Resuscitation
  2. 152.A 55-year-old male presents with sudden onset of severe, tearing chest pain radiating to his back. He has a history of uncontrolled hypertension. His vital signs are BP 180/100 mmHg (right arm) and 160/90 mmHg (left arm), HR 110 bpm, RR 22 bpm. His skin is pale and clammy. What is the MOST critical immediate management priority for this patient?Cardiology & Resuscitation
  3. 153.A 75-year-old female is found unresponsive and pulseless. CPR is in progress. The cardiac monitor displays a rhythm with no electrical activity, appearing as a flat line. What is the most appropriate next step in management?Cardiology & Resuscitation
  4. 154.A 60-year-old male presents with sudden onset of substernal chest pressure, radiating to his left arm and jaw. He is diaphoretic and dyspneic. His vital signs are BP 140/90 mmHg, HR 98 bpm, RR 20 bpm, SpO2 94% on room air. An ECG shows ST elevation in leads II, III, and aVF. Which of the following medications is MOST likely to be contraindicated in this patient due to the ECG findings?Cardiology & Resuscitation
  5. 155.A 40-year-old female is experiencing chest pain, diaphoresis, and shortness of breath. Her blood pressure is 70/40 mmHg, heart rate 130 bpm, and respiratory rate 28 bpm. Her skin is cool and clammy. Which of the following types of shock is she most likely experiencing?Cardiology & Resuscitation
  6. 156.A 40-year-old female presents with sudden onset of dizziness, weakness, and lightheadedness. Her skin is cool, pale, and clammy. Vital signs are BP 80/50 mmHg, HR 120 bpm, RR 24 bpm, SpO2 96%. Her ECG shows sinus tachycardia. What type of shock is MOST likely occurring?Cardiology & Resuscitation
  7. 157.A 70-year-old female is found unresponsive and pulseless. CPR is immediately initiated. The cardiac monitor shows disorganized, chaotic electrical activity with no discernible P waves, QRS complexes, or T waves. What is the MOST appropriate next intervention?Cardiology & Resuscitation
  8. 158.A 62-year-old male with a history of hypertension and diabetes presents with discomfort in his left arm, jaw pain, and generalized weakness for the past 2 hours. He denies typical 'chest pain.' His ECG shows ST depression in leads V4-V6 and T-wave inversions in leads I and aVL. His vital signs are stable. What is the most likely diagnosis?Cardiology & Resuscitation
  9. 159.A 58-year-old male is experiencing crushing substernal chest pain radiating to his left arm. He is diaphoretic and anxious. His ECG shows ST elevation in leads V2, V3, and V4. His vital signs are BP 140/90 mmHg, HR 90 bpm, RR 18 bpm, SpO2 96% on room air. After administering aspirin and oxygen, what is the MOST critical next action in prehospital care?Cardiology & Resuscitation
  10. 160.A 30-year-old male presents with palpitations, lightheadedness, and a heart rate of 190 bpm. His blood pressure is 100/70 mmHg, and he is alert but anxious. The ECG shows a regular, narrow-complex tachycardia. After attempting vagal maneuvers without success, what is the MOST appropriate next intervention?Cardiology & Resuscitation
  11. 161.A 70-year-old female presents with sudden onset of dizziness, weakness, and syncope. Her ECG shows a heart rate of 40 bpm, regular rhythm, with P waves present before each QRS complex, but the PR interval is constant and prolonged (0.32 seconds). Her blood pressure is 80/50 mmHg. What type of heart block does this patient exhibit?Cardiology & Resuscitation
  12. 162.A 62-year-old female with a history of hypertension and diabetes presents with discomfort in her jaw and left arm that began an hour ago. She denies typical chest pain. Her ECG shows ST depression in leads V4-V6 and T wave inversions in leads II, III, aVF. Cardiac markers are pending. Which of the following is the most appropriate initial treatment priority?Cardiology & Resuscitation
  13. 163.A 68-year-old female presents with acute onset of shortness of breath, orthopnea, and bilateral crackles. Her blood pressure is 180/100 mmHg, heart rate 110 bpm, and SpO2 88% on room air. She has a history of congestive heart failure. Which of the following interventions is most appropriate to initiate FIRST?Cardiology & Resuscitation
  14. 164.A 40-year-old female is experiencing chest pain, diaphoresis, and shortness of breath. Her blood pressure is 70/40 mmHg, heart rate 130 bpm, and lung sounds reveal bilateral crackles. Her ECG shows ST elevation in multiple leads. What type of shock is MOST likely occurring?Cardiology & Resuscitation
  15. 165.A 68-year-old male is in cardiac arrest. After 2 minutes of CPR, the rhythm check reveals asystole. The team has established IV access. What is the MOST appropriate next medication to administer?Cardiology & Resuscitation
  16. 166.A 55-year-old male presents with severe epigastric pain, nausea, and vomiting. He denies chest pain. His vital signs are BP 110/70 mmHg, HR 90 bpm, RR 18 bpm, SpO2 97%. A 12-lead ECG shows ST-segment depression in leads V1-V3 and tall R waves in V1. What is the MOST likely cardiac event occurring?Cardiology & Resuscitation
  17. 167.A 40-year-old male is found unresponsive. CPR is in progress. The cardiac monitor shows a wide, irregular rhythm with varying QRS morphology. There is no palpable pulse. What is the MOST likely rhythm and appropriate immediate intervention?Cardiology & Resuscitation
  18. 168.A 45-year-old male with no known medical history suddenly collapses while exercising. CPR is immediately initiated by bystanders. Upon your arrival, the cardiac monitor shows ventricular fibrillation. What is the most critical intervention to perform next?Cardiology & Resuscitation
  19. 169.A 70-year-old male with a history of hypertension and hyperlipidemia complains of intermittent chest discomfort that occurs during exertion and is relieved by rest. This pattern has been consistent for several months. What is the MOST likely diagnosis?Cardiology & Resuscitation
  20. 170.A 40-year-old male is found unresponsive after a fall from a ladder. He has a GCS of 8, unequal pupils, and decerebrate posturing. His blood pressure is 180/100 mmHg, heart rate 50 bpm, and respirations are irregular and slow. Which of the following is the most critical intervention to perform immediately after securing the airway and ventilation?Trauma
  21. 171.A 20-year-old male is experiencing severe pain to his right forearm after a motorcycle collision. His forearm is swollen, tense to palpation, and he complains of numbness and tingling in his fingers. Distal radial pulse is present but weak. These findings are most concerning for which of the following conditions?Trauma
  22. 172.A 35-year-old male is found unconscious after being struck by a vehicle while riding his bicycle. He has a GCS of 6, unequal pupils, and decerebrate posturing. His blood pressure is 180/100 mmHg, heart rate 55 bpm, and respiratory rate 8 irregular breaths per minute. Which of the following is the MOST appropriate immediate intervention?Trauma
  23. 173.A 50-year-old male is involved in a high-speed rollover motor vehicle collision. He is unresponsive, GCS 3, with snoring respirations. He has significant facial trauma and a suspected cervical spine injury. What is the most appropriate initial airway management strategy?Trauma
  24. 174.A 45-year-old male presents with severe right upper quadrant pain after being struck by a baseball bat. He is hypotensive (BP 90/60 mmHg), tachycardic (HR 120 bpm), and tachypneic (RR 24 bpm). Physical examination reveals guarding and rigidity in the right upper quadrant. Based on the mechanism of injury and clinical presentation, which of the following organs is most likely injured?Trauma
  25. 175.A 32-year-old male presents after a motorcycle collision. He was not wearing a helmet. GCS is 13, and he is complaining of a severe headache. Pupils are equal and reactive to light. Blood pressure is 160/90 mmHg, heart rate is 68 bpm, and respiratory rate is 12 bpm. Based on these findings, which of the following is the most likely cause of his current vital signs?Trauma
  26. 176.A 22-year-old male sustains a deep laceration to his right forearm from a broken window. Bright red blood is spurting rhythmically from the wound. Direct pressure has been applied but bleeding continues. What is the next most appropriate step to control the hemorrhage?Trauma
  27. 177.A 19-year-old male is found at the base of a cliff after falling approximately 50 feet. He is unconscious, GCS 4. His pupils are unequal, with the right pupil dilated and fixed. Vitals are BP 180/80 mmHg, HR 55 bpm, RR 8 bpm. There is no external bleeding. Based on these findings, which of the following is the most likely underlying injury?Trauma
  28. 178.A 70-year-old male is found unresponsive after a house fire. He has full-thickness burns to his entire left arm and superficial partial-thickness burns to his entire chest. His body weight is 70 kg. How much intravenous fluid should he receive in the first 8 hours according to the Parkland formula?Trauma
  29. 179.A 60-year-old male presents with severe abdominal pain after being struck by a car while crossing the street. He is hypotensive (BP 80/50 mmHg), tachycardic (HR 120 bpm), and pale. His abdomen is rigid and distended. What is the most appropriate immediate intervention?Trauma
  30. 180.A 70-year-old female fell down five stairs. She complains of pain to her left hip and cannot move her left leg. Her left leg appears shortened and internally rotated. Pulses are present and strong in both feet. What is the most appropriate prehospital management for this injury?Trauma
  31. 181.A 4-year-old child presents with full-thickness burns to both legs. Using the Lund-Browder chart, which of the following is the most accurate estimation of the total body surface area (TBSA) affected by these burns?Trauma
  32. 182.A 75-year-old female fell and sustained a fracture to her right humerus. She has a history of osteoporosis and is on anticoagulant medication. Which of the following is the most significant concern regarding her risk of hemorrhage?Trauma
  33. 183.A 55-year-old male is found unconscious in his garage with a running engine. He has cherry-red skin, a pulse oximetry reading of 99%, and a GCS of 3. What is the most appropriate initial treatment for this patient?Trauma
  34. 184.A 50-year-old male is entrapped in a vehicle after a head-on collision. He is complaining of severe pain to his left lower extremity. On assessment, his left femur appears severely deformed and shortened. Distal pulses are absent in the left foot. What is the MOST appropriate immediate action after ensuring scene safety and ABCs?Trauma
  35. 185.A 68-year-old female fell, sustaining an angulated open fracture of her left tibia. She has a strong distal pulse, warm skin, and good capillary refill. After controlling bleeding and covering the wound with a sterile dressing, what is the next most appropriate intervention for the angulation?Trauma
  36. 186.A 45-year-old construction worker falls 20 feet from scaffolding, landing on his feet. He complains of severe back pain and numbness in both legs. Which of the following is the MOST appropriate initial immobilization device for this patient?Trauma
  37. 187.A 28-year-old male is involved in a high-speed motor vehicle collision. On assessment, he is conscious but disoriented. He has paradoxical chest wall movement on the left side, crepitus over the ribs, and diminished breath sounds on the left. His vital signs are BP 100/60 mmHg, HR 118 bpm, RR 28 breaths per minute. Which of the following conditions is MOST likely present?Trauma
  38. 188.A 16-year-old male is involved in a high-speed ATV crash. He is complaining of severe pain to his left lower leg, which appears shortened and internally rotated. Palpation reveals tenderness and crepitus over the proximal femur. Distal pulses are strong, and sensation is intact. What type of splint is most appropriate for this injury?Trauma
  39. 189.A 40-year-old male is found unresponsive after being struck by lightning. He has full-thickness burns to his left arm and leg, and his heart rate is 40 bpm. Respirations are apneic. What is the MOST critical immediate action?Trauma
  40. 190.A 55-year-old male is found unresponsive with a large, rapidly expanding hematoma to his left neck after being assaulted. He has gurgling respirations, and his airway appears to be rapidly occluding. What is the most immediate priority intervention?Trauma
  41. 191.A 22-year-old male is found unconscious after being struck in the chest with a baseball bat. He is unresponsive, apneic, and pulseless. ECG shows ventricular fibrillation. What is the most likely cause of his cardiac arrest?Trauma
  42. 192.A 28-year-old male is ejected from a vehicle during a high-speed collision. He is unconscious, GCS 6, with unequal pupils (left pupil dilated and sluggishly reactive, right pupil normal). He has a laceration to his left temple. His blood pressure is 160/90 mmHg, heart rate 60 bpm, and respirations 8 with irregular pattern. These findings are most indicative of which type of intracranial hemorrhage?Trauma
  43. 193.A 35-year-old male is impaled through his left thigh by a metal rod. The rod is approximately 2 feet long and cannot be easily removed. He is conscious and alert, with stable vital signs. There is moderate bleeding around the entry site. What is the most appropriate initial management for this injury?Trauma
  44. 194.A 25-year-old male is suspected of having a spinal cord injury after a diving accident. He is conscious and alert but complains of tingling in both hands and feet. His blood pressure is 100/70 mmHg, heart rate is 60 bpm, and skin is warm and dry below the neck. These findings are most consistent with which type of shock?Trauma
  45. 195.A 28-year-old male is found unresponsive after a high-speed motor vehicle collision. He has paradoxical chest wall movement on the right side. His jugular veins are distended, and breath sounds are absent on the right. Tracheal deviation is not noted. Which of the following conditions is most consistent with these findings?Trauma
  46. 196.A 30-year-old male sustained a fall from a height of 15 feet, landing on his feet. He complains of severe bilateral heel pain and lower back pain. Which of the following spinal injuries should the paramedic be most concerned about?Trauma
  47. 197.A 65-year-old male with a history of hypertension and diabetes presents with sudden onset of severe, tearing chest pain radiating to his back. His blood pressure is 180/100 mmHg in the right arm and 140/80 mmHg in the left arm. His heart rate is 98 bpm and regular. Which of the following is the MOST appropriate initial medication to administer?Cardiology & Resuscitation
  48. 198.A 35-year-old male falls 20 feet from a ladder, landing on his back. He is conscious and complaining of severe back pain. Assessment reveals tenderness and crepitus over his mid-thoracic spine. His lower extremities are weak with diminished sensation. Vital signs are stable. Which of the following is the MOST critical immediate intervention for this patient?Trauma
  49. 199.A paramedic is managing a 45-year-old male with a suspected opioid overdose. The patient is apneic and pulseless. After initiating high-quality CPR, the paramedic prepares to administer naloxone. The protocol states 2 mg IV/IO. The medication is supplied in a prefilled syringe containing 4 mg in 10 mL. How many milliliters should the paramedic administer?Operations
  50. 200.A 50-year-old male presents with sudden onset of severe epigastric pain, nausea, and vomiting. He denies chest pain. His ECG shows ST elevation in leads II, III, and aVF. His blood pressure is 130/80 mmHg, heart rate 90 bpm, and SpO2 96% on room air. Which of the following findings would be MOST concerning if nitroglycerin were administered?Cardiology & Resuscitation