NREMT EMT Emergency Medical Technicians Exam Exam Practice Test

Comprehensive and Detailed Explanation From Exact Extract:

Thereassessment phasein the EMT patient assessment model starts with repeating theprimary survey(also called the primary assessment), which includes:

Airway

Breathing

Circulation

Disability (mental status)

Exposure/environment

The purpose is to identify any changes or deterioration in the patient’slife-threatening conditions, especially in dynamic or unstable patients. Only after this do EMTs check vitals and reevaluate secondary complaints.

Comprehensive and Detailed Explanation From Exact Extract:

Missing dialysis leads tofluid overload, causing:

Pulmonary edema, evident bycrackleson auscultation

Dyspnea and chest discomfort

Bradycardia is less likely; patients more often present withtachycardiadue to volume stress. Fever would suggest infection (not stated here), and hypotension can occur later, but hypertension is more common in early fluid overload.

Comprehensive and Detailed Explanation From Exact Extract:

Mental statusreflects perfusion and oxygen delivery to thebrain, which is highly sensitive to hypoxia and hypercapnia. Even if respiratory rate and SpO₂ are normal, altered mental status suggests ineffective gas exchange or hypoperfusion.

Pulse oximetry may be falsely normal in CO poisoning or poor perfusion. Skin color is subjective and not as sensitive or specific as neurological status.

Comprehensive and Detailed Explanation From Exact Extract:

To establishnegligence, four legal elements must be proven:

Duty to act– a legal obligation to provide care.

Breach of duty– failing to meet the standard of care.

Damages– harm occurred.

Proximate causation– the breach directly caused the damage.

"Proximate causation" means the EMT’s action or inaction is closely linked to the harm suffered by the patient.

Comprehensive and Detailed Explanation From Exact Extract:

Compared to adults, pediatric patients have:

Aproportionately larger tongue, which increases the risk of airway obstruction

Alarger occiput, which causes natural neck flexion when lying supine, potentially occluding the airway

This anatomical difference is why EMS providers often use ashoulder rollinstead of a head tilt to maintain aneutral airwayin infants and toddlers.

Comprehensive and Detailed Explanation From Exact Extract:

Defusingis an informal, short-term intervention after acritical incident. It should:

Occur within hoursof the event (ideally the same shift)

Encourage voluntary open discussionin a confidential setting

It isnot a full debriefor counseling session and doesn’t requiremental health professionalspresent. Forcing participation or waiting too long (e.g., 72+ hours) can reduce its effectiveness.

Comprehensive and Detailed Explanation From Exact Extract:

Anepidural hematomaclassically presents with a“lucid interval”— a brief period of regained consciousness following head trauma, followed by rapid deterioration. This is due to arterial bleeding, often from themiddle meningeal artery, leading to increasing intracranial pressure.

Signs include:

High blood pressure

Decreasing respiratory rate

Altered LOC or unresponsiveness

Subdural hemorrhages are slower venous bleeds, common in elderly patients. Subarachnoid hemorrhage often presents with "worst headache of life." Intracerebral bleeds are less commonly linked to lucid intervals.

Comprehensive and Detailed Explanation From Exact Extract:

This is a classic presentation ofhypovolemic shockdue to traumaticblood loss(open femur fracture, pelvic instability). Indicators include:

Low BP (86/42)= hypotension

High pulse (P 136)= compensation

Mental status decline (responsive only to voice)= indicatesdecompensatedshock

Obstructive and distributive shock are not applicable. Compensated shock would shownormal BPandalert mental status.

Comprehensive and Detailed Explanation From Exact Extract:

Perfusionrefers to delivery of oxygen and nutrients to tissues. It depends on three essential components:

Patent airway: Ensures oxygen reaches lungs

Intact microcirculation: Capillary-level exchange must function

Sufficient blood volume: Maintains blood pressure and oxygen transport

Hypoxic drive relates toCOPD physiology, not perfusion.High alveolar pressure(like from CPAP) mayimpede venous return, and alow ventilation-perfusion ratiomeans poor oxygenation efficiency, which negatively affects perfusion.

Comprehensive and Detailed Explanation From Exact Extract:

Children compensate for shock through increasedheart rate,respiratory rate, andvasoconstriction, which delays blood pressure drop. Therefore:

Tachycardiais often thefirst sign

Prolonged capillary refill(>2 seconds) is an early indicator

Tachypneasupports perfusion

Blood pressureis alate signin pediatric shock. SpO₂ is helpful but does not specifically indicate shock. Blood glucose may be abnormal in other metabolic conditions but is not an early marker of volume loss.

Comprehensive and Detailed Explanation From Exact Extract:

In pediatric START orJumpSTARTtriage, a "delayed" status is appropriate if the child is breathing adequately, has palpable pulses, and follows commands. The respiratory rate of 16 is normal for a 9-year-old, and being able to walk also supports the “delayed” tag.

"Mottled skin" and "breathing only after airway opening" would more likely lead to "immediate" or even "expectant" categories depending on associated symptoms.

Comprehensive and Detailed Explanation From Exact Extract:

Laundry detergent ingestion — especially in the case ofliquid detergent pods— is associated withcaustic airway and gastrointestinal injuries. The presence ofcracklesanddrowsinessare signs of aspiration and possiblerespiratory failure. Vomiting increases the risk ofaspiration pneumonitis, andesophageal perforationis a life-threatening complication from corrosive ingestion.

While seizure and hypoglycemia are possible complications of toxic ingestion, they are not as immediately linked to the detergent profile as airway injury and aspiration risk.

Comprehensive and Detailed Explanation From Exact Extract:

Givenfall with head traumaandabsent respirations, the most concerning cause isspinal injury, particularly acervical spine fracture. Ahigh cervical injury (C1–C4)canparalyze the diaphragm, leading toapnea despite a beating heart.

Brain herniation can also depress respirations but often presents withunequal pupils,posturing, andCushing’s triad(not described here).Commotio cordisis sudden cardiac arrest from blunt chest trauma (not head).Open pneumothoraxaffects chest mechanics, not directly linked here.

Comprehensive and Detailed Explanation From Exact Extract:

Pulmonary edemais caused by fluid accumulation in the alveoli, impairing gas exchange. It is typically due to:

Left-sided heart failure: Blood backs up into the pulmonary circulation

Hypertensive crisis: Increases hydrostatic pressure in the lungs

Anaphylaxis causesvasodilation and bronchospasm, not fluid overload. Increased oncotic pressure wouldretainfluid in capillaries — the opposite of edema.

Comprehensive and Detailed Explanation From Exact Extract:

Heat exhaustionresults from prolonged exposure to elevated temperatures, leading tofluid and electrolyte loss(especially sodium and water), causinghypovolemia. This can result in:

Tachycardia

Weakness

Dizziness

Profuse sweating

Unlikeheat stroke, mental status is typically preserved in heat exhaustion. Hypertension and bradycardia are not characteristic.

Comprehensive and Detailed Explanation From Exact Extract:

These symptoms are classic forendometriosis, whereendometrial tissue grows outside the uterus. Symptoms often include:

Pelvic pain

Painful menstruation (dysmenorrhea)

Painful bowel movements or intercourse

Spontaneous abortion does not apply here due to lack of pregnancy. Premature menopause is rare at this age and presents differently. Infection is less likely in the absence of recent sexual activity or fever.

Comprehensive and Detailed Explanation From Exact Extract:

SALT(Sort, Assess, Lifesaving interventions, Treatment/Transport) is a mass casualty triage method recommended by theCDC and the National Association of EMS Physicians (NAEMSP). During the"Assess" step, responders:

Checkrespirations

Providelifesaving interventionssuch asrescue breathsif the patient is not breathing but has a pulse

Evaluatementation(e.g., ability to follow commands)

Airway adjuncts and full transport do not happen at this stage. Scorecards and pediatric-specific modifications are addressed later in the protocol.

Comprehensive and Detailed Explanation From Exact Extract:

In cases ofsexual assault, preservingevidence integrityis critical. Clothing or other forensic evidence must be placed inpaper bags. Plastic or non-breathable materials can trap moisture, promotingmold or degradation of evidencelike DNA or bodily fluids.

This approach follows chain-of-custody protocols used by law enforcement and medical facilities for handling forensic material.