Download NREMT Final Exam Real Questions and Revised Answers 100% Correct and more Exams Nursing in PDF only on Docsity!
This exam features: 150 multiple-choice ques & Ans
1. A 65-year-old male who has a history of congestive heart failure is slumped in
a chair not responding to you. His wife tells you that his difficulty breathing started an hour ago and has been getting worse. He is tachypneic, and you auscultate rales in all fields. You should first:
A. assist his ventilation.
B. administer oxygen by non-rebreather mask.
C. apply CPAP.
D. assess his vital signs. Ans:
A assist his ventilation.
2. Patients who have chronic bronchitis may have which of the following?
A. Persistent productive cough, thickening of walls of bronchioles, excessive
mucus production
B. Increased sensitivity of lower airways to irritants, bronchospasm, edema
C. Destruction of alveolar walls, distention of alveolar sacs, reduced area for
NREMT FINAL EXAM
Real Questions and Revised Answers
100% Guarantee Pass Score
gas exchange
D. Acute infectious disease, lung inflammation, pus-filled alveoli
Ans: A Persistent productive cough, thickening of walls of bronchioles, excessive mucus production
3. A 70-year-old male has difficulty breathing. When assessing him, which of the
following should influence your decision to assist his ventilation with a BVM?
A. A decrease in his mental status
B. An SpO2 below 90% on room air
C. An increase in his respiratory rate
D. A history of COPD
Ans: A A decrease in his mental status
4. You are assisting the ventilation of a 57-year-old female who is in respiratory
failure. Her initial vital signs were P 102, R 32, BP 142/84, and SpO2 was 88% on room air. After five minutes of assisted ventilation, her vital signs are P 96, R 18 assisted with slight chest rise, BP 108/80, and SpO2 is 95% on oxygen 15 L/minute by BVM. You should:
A. decrease the tidal volume of your ventilation.
B. increase the tidal volume of your ventilation.
C. increase the oxygen flow rate.
D. decrease your ventilation rate. Ans:
D decrease your ventilation rate.
C. decrease the flow rate to 6 L/minute.
D. transport her.
Ans: B switch to a simple face mask.
6. Which of the following prevents the over-inflation of the lungs during normal
respiration?
A. Cushing reflex
B. Baroreceptor reflex
C. Chemoreceptors
D. Stretch receptors
Ans: D Stretch receptors
7. Which of the following sounds indicates an upper airway obstruction in a
child who is in respiratory distress?
A. Rales
B. Wheezes
C. Stridor
D. Rhonchi Ans:
C Stridor
8. A 16-year-old female complains of a runny nose and a low-grade fever. She
has a burst of rapid coughing with an inspiratory whooping sound. While she is coughing her skin becomes cyanotic. After she stops coughing her skin color returns to normal. You should suspect:
A. pneumonia.
B. pertussis.
C. rubella.
D. tuberculosis.
Ans: B pertussis.
9. What causes the prolonged expiratory phase of the respiratory cycle in a
patient who is having an asthma attack?
A. Bronchiole constriction
B. Pulmonary venous hypertension
C. Thick, sticky mucus production
D. Ruptured blebs
Ans: A Bronchiole constriction
10. A 64-year-old male is having an asthma attack. Which class of
medication can help improve his alveolar ventilation?
A. Beta2 agonist
B. Beta1 antagonist
C. Beta1 agonist
D. Beta2 antagonist
Ans: A Beta2 agonist
11. A 47-year-old male complains of difficulty breathing, and he cannot stop
coughing. His conjunctivae are pale and moist. He has a 40 pack-year smoking history. You should first:
14. A febrile 69-year-old male complains of body aches and decreased ap- petite.
He tells you he has had the flu for a week. His skin is cyanotic and diaphoretic. You auscultate rhonchi and decreased lung sounds over his left lower lung. His vital signs are P 102, R 26, BP 116/90, and SpO2 is 91% on room air. You should suspect:
A. pneumonia.
B. influenza.
C. septic shock.
D. pleurisy.
Ans: A pneumonia.
15. Why can pulmonary embolisms cause a V/Q mismatch?
A. They block bronchiole airflow.
B. They block bronchial airflow.
C. They block pulmonary venous blood flow.
D. They block pulmonary arterial blood flow.
Ans: D They block pulmonary arterial blood flow.
16. Why would a 46-year-old male who inhaled steam from a malfunctioning
boiler have stridor in his upper airway and wheezes in his lower airway?
A. Steam can irritate both upper and lower airways causing bronchoconstric-
tion.
B. Steam can burn both upper and lower airways causing edema.
C. Steam can irritate the upper airway causing bronchoconstriction and burn
the lower airway causing edema.
D. Steam can burn the upper airway causing edema and irritate the lower
airway causing bronchoconstriction. Ans: B Steam can burn both upper and lower airways causing edema.
17. An unresponsive 88-year-old male was found by nursing home staff having
difficulty breathing. His skin is pale and febrile. You auscultate diminished lung sounds throughout his chest and faint rhonchi in his upper chest. His vital signs are P 104, R 26 and shallow, BP 112/86, and SpO2 is 89 % on room air. You should:
A. assist his ventilation.
B. administer oxygen by non-rebreather mask.
C. administer oxygen by venturi mask.
D. apply CPAP.
Ans: A assist his ventilation.
18. A 70-year-old male who has a history of emphysema complains of difficulty
breathing. He has four-word dyspnea, and you auscultate a slight wheeze in his lower lung fields. His vital signs are P 102, R 22, and BP 152/88. His SpO2 is 92% on home oxygen 2 L/minute by nasal cannula attached to 100 feet of extension tubing. You should:
A. administer oxygen by simple face mask.
B. increase his home oxygen flow rate to 4 L/minute.
C. administer oxygen by non-rebreather mask.
gas exchange
B. Acute infectious disease, lung inflammation, pus-filled alveoli
C. Persistent productive cough, thickening of walls of bronchioles, excessive
mucus production
D. Increased sensitivity of lower airways to irritants, bronchospasm, edema
Ans: D Increased sensitivity of lower airways to irritants, bronchospasm, edema
22. A 12-year-old male has difficulty breathing. He tells you he has had a cold all
week. You auscultate rhonchi in his left lower chest. His vital signs are P 104, R 28, BP 104/74, and SpO2 is 89% on room air. You should suspect:
A. respiratory distress.
B. chronic asthma.
C. respiratory failure.
D. septic shock.
Ans: A respiratory distress.
23. An unresponsive 4-year-old female is apneic but has a carotid pulse of 52.
You should first:
A. attach the AED.
B. administer oxygen.
C. begin chest compressions.
D. insert an oropharyngeal airway Ans:
D insert an oropharyngeal airway
24. The serum concentration of which of the following gases increases during
respiratory failure?
A. Oxygen
B. Carbon monoxide
C. Carbon dioxide
D. Nitrogen
Ans: C Carbon dioxide
25. How does positive pressure ventilation impact cardiac output?
A. It decreases intrathoracic pressure which increases preload.
B. It increases systemic vascular resistance.
C. It decreases myocardial oxygen demand.
D. It increases intrathoracic pressure which decreases preload.
Ans: D It increases intrathoracic pressure which decreases preload.
26. A 67-year-old female has a history of emphysema. She tells you that she
suddenly started to have sharp right shoulder pain and increased difficulty breathing after placing items on a high shelf. Her skin is pale and diaphoretic. You auscultate slight wheezes in both bases and absent lung sound in the apex of her right lung. Her vital signs are P 88, R 22, BP 138/84, and SpO2 is 87% on home oxygen 3 L/minute by nasal cannula. You should:
A. administer oxygen by non-rebreather mask.
B. position her in the right lateral recumbent position.
B. hypoglycemia.
C. alcohol intoxication.
D. respiratory arrest.
Ans: D respiratory arrest.
30. A 34-year-old female was rescued from a house fire. She complains of
difficulty breathing. You do not observe any burns to her face or singed hair, but she is coughing up black-tinged phlegm. You should suspect:
A. smoke inhalation.
B. lower airway burns.
C. upper airway burns.
D. a low SpO2 reading.
Ans: A smoke inhalation.
31. A 39-year-old male starts to have difficulty breathing while hiking at 9000
feet above sea level. He is coughing, and you observe pink, frothy sputum. His skin is pale and moist. You auscultate rales in all fields. His vital signs are P 96, R 22, BP 118/68, and SpO2 is 89% on room air. You should:
A. administer oxygen by non-rebreather mask while moving him to a lower
elevation.
B. administer nitroglycerin while moving him to a lower elevation.
C. administer nitroglycerin and wait for aeromedical evacuation.
D. administer oxygen by nasal cannula and wait for aeromedical evacuation.: -
A. administer oxygen by non-rebreather mask while moving him to a lower elevation.
32. A 32-year-old female complains of sharp, stabbing pain to the left side of her
chest and difficulty breathing. She recently fractured her left tibia, and she has a cast on her leg. You auscultate clear lung sounds. Her vital signs are P 94, R 26, BP 118/64, and SpO2 is 92% on room air. You should suspect:
A. tension pneumothorax.
B. pulmonary embolism.
C. pneumonia.
D. pleurisy.
Ans: B pulmonary embolism.
33. When assessing lung sounds in an adult who is sitting upright, where
should you place your stethoscope to auscultate alveolar ventilation?
A. Sixth intercostal space, midscapular line
B. Second intercostal space, midclavicular line
C. Fourth intercostal space, midaxillary line
D. Third intercostal space, anterior axillary line
Ans: A Sixth intercostal space, mid- scapular line
34. An unresponsive 76-year-old female is lying in bed, and you hear snoring
respirations. What should you suspect is partially occluding her airway?
A. Her tongue
B. Liquid
C. administer oxygen by non-rebreather mask.
D. assess her oxygen saturation level. Ans:
B assist her ventilation with a BVM.
37. Which of the following describes how albuterol helps a patient who is
having an asthma attack?
A. It reduces inflammation in the bronchus.
B. It increases airway pressure in the alveoli.
C. It relaxes the smooth muscles of the bronchioles.
D. It decreases pulmonary capillary pressure.
Ans: C It relaxes the smooth muscles of the bronchioles.
38. A 59-year-old female was working on a boiler when it vented super-heated air
into her face. You see partial-thickness burns to her face, and she tells you her throat is swelling up.You auscultate stridor in her upper airway.You should immediately:
A. transport her.
B. assess her vital signs.
C. apply a cold pack to her face.
D. administer oxygen.
Ans: A transport her.
39. A 24-year-old female complains of right-sided chest pain and trouble
breathing. She tells you she felt a pop in her chest while coughing before the pain and difficulty breathing started. Her lungs are clear to auscultation. Her vital signs are P 82, R 20, BP 108/72, and SpO2 is 97% on room air. You should suspect:
A. tension pneumothorax.
B. pleural effusion.
C. neoplasm.
D. spontaneous pneumothorax. Ans:
D spontaneous pneumothorax.
40. A 52-year-old male complains of difficulty breathing. He tells you he has a
history of asthma. He used his albuterol inhaler twice without relief. You auscultate wheezes in all fields. His vital signs are P 72, R 20, BP 142/78, and SpO2 is 90 % on room air. You should administer oxygen and:
A. transport.
B. place him supine.
C. have him use his inhaler.
D. assist his ventilation.
Ans: C have him use his inhaler.
41. A 34-year-old female complains of difficulty swallowing. Her voice is muf- fled
as she tells you that she has had a cold for a week. She is sitting leaning forward, and you hear audible stridor. You should suspect:
A. epiglottitis.
B. influenza.
B. administer oxygen by venturi mask.
C. apply CPAP.
D. assist his ventilation. Ans:
D assist his ventilation.
45. A 20-year-old male is coughing after inhaling chlorine gas. He was moved
outside to fresh air by coworkers. His only complaints are that his throat is burning, and it is hard to catch his breath because of the coughing.You should first:
A. collect a sample of his phlegm.
B. decontaminate the affected area.
C. administer oxygen.
D. allow him to drink water.
Ans: C administer oxygen.
46. A 34-year-old female tells you she has trouble breathing. She has stage three
lung cancer and is receiving radiation therapy. You auscultate rhonchi and fine crackles over her right upper chest. Her vital signs are P 88, R 20, BP 118/68, and SpO2 is 92% on room air. You should:
A. assist her ventilations with a BVM.
B. assist with the administration of her bronchodilator.
C. administer oxygen by nasal cannula.
D. administer oxygen by non-rebreather mask.
Ans: C administer oxygen by nasal cannula.
47. A febrile 52-year-old female complains of coughing up blood. She tells you that
she has had recent unexplained weight loss. You auscultate rhonchi over the right upper lung. Her vital signs are P 86, R 16, BP 138/84, and SpO2 is 95% on room air. You should suspect:
A. emphysema.
B. chronic bronchitis.
C. tuberculosis
D. congestive heart failure.
Ans: C tuberculosis
48. Why can inhalation exposure to carbon monoxide be toxic?
A. It is a respiratory irritant.
B. It suppresses the Hering-Breuer reflex.
C. It displaces oxygen from hemoglobin
D. It prevents oxygen from participating in ATP production.
Ans: C It displaces oxygen from hemoglobin
49. A 17-year-old female complains of difficulty swallowing after smoking crack
earlier today. Her voice is quiet, and she is leaning forward and drooling. Her lungs are clear to auscultation. Her vital signs are P 16, R 14, BP 116/ 76, and SpO2 is 94% on room air. You should suspect:
A. cocaine overdose.
B. epiglottitis.
C. excited delirium.
