NREMT Medical, Obstetrics, and Gynecology Practice Exam

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• Which finding indicates anticholinergic toxicity?
• In a postmenopausal woman with pelvic pain and vaginal bleeding, what is the most appropriate action during transport?
• A 32-year-old woman reports a throbbing, unilateral headache with photophobia and nausea. Which type of headache is most consistent with her symptoms?
• For a patient with severe unilateral flank pain and stable vital signs, what is the most appropriate EMS action?
• In the hip fracture scenario, which action aligns with the recommended approach when the patient is in hospice and declines transport?
• Which respiratory pattern is typical in opioid overdose?
• An 86-year-old female complains of pain in her sacral area. You observe a four-centimeter decubitus ulcer in the area. Her son tells you that she is bedridden and that he cares for her. Her bedding is wet and smells like urine. You should suspect:
• During transport of a morbidly obese patient with chest pain, which of the following reflects a key priority regarding breathing?
• Following delivery of a neonate with greenish amniotic fluid and the baby crying, what is the initial action by EMS?
• A 58-year-old female who has been sexually assaulted has minor vaginal bleeding and pelvic pain. She wants to use the bathroom before transport. Which approach is appropriate?
• An unresponsive 67-year-old male near spilled pesticide; clonic seizures; after assuring PPE, you should next:
• In a patient presenting with signs of thyrotoxicosis in the field, the most appropriate action is to:
• Which transport position is most appropriate for a patient with suspected abdominal appendicitis in the field?
• Which statement describes the mechanism of action of naloxone in reversing opioid overdoses?
• An 86-year-old female with a history of tuberculosis has rhonchi in the left lower lung. After donning an N-95 respirator, which oxygen delivery method is appropriate?
• Which source should you contact for the most up-to-date poison information?
• A febrile 66-year-old female who recently removed a tick presents with a 3 cm erythema migrans lesion. What is the most appropriate immediate action?
• A 57-year-old male with fatigue after climbing stairs and pale conjunctiva. He refuses hospital. Which action is appropriate?
• When placing a morbidly obese patient on a stretcher, why should you avoid placing them supine or in full Fowler's position?
• A 19-year-old female who is in her third trimester complains of blurred vision and a headache. She tells you the baby is moving, and she denies contractions. Her vital signs are P 84, R 16, BP 152/94, and SpO2 is 97% on room air. You should:
• In a patient who had a convulsive seizure and is now unresponsive with a brief tonic phase followed by clonic activity, what is the most appropriate next action?
• An 84-year-old male tells you that he is hearing and seeing demons. He has a history of schizophrenia. He denies any other complaints. His vital signs are P 64, R 12, BP 122/74, and SpO2 is 98% on room air. You should:
• A 3-year-old is lethargic and has been drinking more fluids than normal for weeks. Conjunctivae are dry. Vital signs show tachycardia. What should you suspect?
• A 10-month-old male is stung by a bee. The skin around the site is reddened with localized swelling; lungs are clear; vitals are stable. What is the most appropriate action?
• A 54-year-old male complains of abdominal pain. He tells you he has had generalized crampy pain and diarrhea for three days. His abdomen is soft to palpation. His vital signs are P 90, R 16, BP 142/86, and SpO2 is 96% on room air. You should suspect:
• In a child with sickle cell crisis presenting with chest pain, the underlying cause is most likely occlusion of which structure?
• A 67-year-old female with leg and abdominal swelling and scleral icterus from alcohol use, which organ is not functioning properly?
• What is the most common cause of seizures in adults?
• A drowsy 36-year-old female took 20 amitriptyline 150 mg tablets 15 minutes ago. She states she wants to die. What should you do?
• Why are the signs and symptoms of ectopic pregnancy potentially life-threatening?
• A 70-year-old patient with abdominal pain and vomiting brown material after significant stress; which diagnosis is most likely?
• A 45-year-old female complains of palpitations. She tells you she feels nervous and tired. She has a history of a panic disorder. Her vital signs are P 100, R 24 and deep, BP 142/84, and SpO2 is 100% on room air. You should:
• A febrile 80-year-old male complains of generalized weakness and foot pain. His left foot is swollen, red, and pus is draining from the wound. He tells you he has MRSA in the wound. His vital signs are P 108, R 22, BP 88/62, and SpO2 is 94% on room air. You should:
• A 32-year-old female took several lorazepam tablets; slight decreased LOC; rapid eye movements; Pupils 3 millimeters. What is the most appropriate management?
• Which of the following is least dependent on insulin to move glucose into the cells?
• Law enforcement officers requested your assistance with a 24-year-old male who is acting aggressively. He has removed his clothing, is shouting, and throwing heavy furniture around in his apartment. Law enforcement tells you he has a history of diabetes and cocaine use. You should suspect:
• What is the recommended initial treatment for suspected hypoglycemia in a conscious patient?
• Why administer a DuoDote autoinjector after exposure to sarin gas?
• Which site is preferred for blood pressure measurement in a patient with a left-arm arteriovenous fistula used for hemodialysis?
• Which statement about diaphragm movement and obesity is accurate in the context of stretcher transport?
• A 16-year-old male tells you he is allergic to bees and that he was stung. Five minutes ago, he used his epinephrine autoinjector and felt better, but now he is having increasing difficulty breathing. You hear audible stridor and wheezes. You should first:
• A 70-year-old male with abdominal pain and vomiting dark material after a period of stress; which diagnosis is most likely?
• A 91-year-old female complains of generalized weakness. She tells you that she is depressed because her husband died last month and she keeps forgetting to take her diabetes medication. Her skin is warm and dry. Her vital signs are P 98, R 16, BP 112/78, and SpO2 is 97% on room air. You should:
• A 9-year-old boy experiences episodes of sitting at his desk staring into space with brief unresponsiveness during class. He answers questions correctly and does not recall the episodes. What type of seizure is most likely?
• How does the renal system help the body compensate for shock?
• Which exposure is most likely to transmit hepatitis C?
• A 54-year-old male with right flank pain severe enough to induce vomiting; he was sitting and watching TV when it started. What is the most likely diagnosis?
• A 24-year-old male experiences a single generalized seizure after missing his medication. He is awake on arrival with stable vital signs. What is the most appropriate initial action?
• A 73-year-old woman presents with lower abdominal pain and foul-smelling vaginal discharge, with pain on intercourse. Which diagnosis is most likely?
• An infant with a bulge near the umbilicus that worsens with coughing is most consistent with which diagnosis?
• A 25-year-old female tells you her water broke. On examination you observe a greenish amniotic fluid and the neonate's head crowning. Immediately after delivery, the male neonate is crying, has cyanotic hands and feet, and is moving all extremities. What is your first action?
• When does a hernia become a life threat?
• A 37-year-old female is 36 weeks pregnant. She tells you that she has a severe headache and blurred vision. She describes decreased fetal activity today. Her vital signs are P 86, R 14, BP 138/90, and SpO2 is 96% on room air. You should transport her:
• Which of the following signs most strongly supports dehydration in a dehydrated infant with diarrhea?
• In a pregnant patient with suspected preeclampsia, which transport position is preferred to optimize maternal and fetal outcomes?
• A 34-year-old male complains of dizziness and feels like he is going to pass out. He tells you he just took naproxen for the first time for joint pain. You observe urticaria and angioedema. His vital signs are P 104, R 20, BP 78/58, and SpO2 is unobtainable. You should:
• When a patient with a terminal illness has a suspected hip fracture and requests not to be transported, what is the recommended EMS action?
• A dialysis patient who misses several sessions may present with symptoms that mimic which condition?
• A 59-year-old male has superficial lacerations across wrists; self-harm; you should apply sterile dressings and:
• During a panic attack, which action best helps reduce symptoms?
• A febrile 32-year-old female reports right-sided pelvic pain with abdominal heaviness. What is the most appropriate action?
• In an elderly patient with a bed sore and incontinence, which form of neglect or mistreatment is most consistent?
• During a delivery involving multiple gestation where the second baby is delivering, which action is appropriate?
• An unresponsive 2-month-old has a single seizure that lasted about two minutes. The child then has another generalized seizure. What should you do first?
• A febrile 24-year-old female reports severe abdominal pain that began around the navel and moved to the right lower quadrant. Vital signs are stable. What should you do?
• During assessment of an 84-year-old male who ingested medication in a suicide attempt, which information is most important to obtain?
• A 34-year-old female has severe anxiety and tells you she is having a panic attack. She tells you she has been depressed since her son was born two months ago. Her vital signs are P 88, R 18, BP 132/84, and SpO2 is 99% on room air. You should:
• Which organ assists in regulating the acid-base balance of the circulatory system by producing bicarbonate?
• A 62-year-old female spilled an industrial cleaning liquid on her forearm; severe itching and redness; after flushing, before transport you should request a:
• A 21-year-old female has sudden left lower quadrant pain and vaginal bleeding and denies pregnancy. Which diagnosis is most likely?
• A patient with renal failure and pulmonary edema presents with hypoxemia; which oxygen delivery device is appropriate?
• One minute after birth, a newborn is pink with blue extremities, a strong cry, and active movement. Which statement best describes the newborn's condition?
• Which feature most strongly suggests a migraine rather than a tension-type headache?
• A 26-year-old male was acting bizarre and violent toward you and your partner. While law enforcement officers assisted you in restraining him, you note he is unexpectedly strong. His skin is hot and diaphoretic. During transport, he suddenly calms down and stops thrashing against his restraints. You should immediately:
• An 83-year-old male with persistent unilateral epistaxis after blowing his nose and a history of atrial fibrillation should be managed by which action?
• A 38-year-old female complains of sneezing and mild trouble breathing after inhaling an unknown substance. You auscultate wheezes in all fields. Her vital signs are P 88, R 20, BP 138/68, and SpO2 is 92% on room air. What type of reaction should you suspect?
• A confused 74-year-old female has left-sided weakness and a blood glucose of 52 mg/dL. You should:
• In suspected coral snake envenomation, what is the most important initial management?
• Which description best describes absence seizures in children?
• In evaluating a patient who has been raped, which examination is most appropriate to perform first?
• A 44-year-old male with priapism and sickle cell anemia presents for EMS. What is the initial intervention you should perform?
• A 3-month-old cries inconsolably with poor feeding and diarrhea; the fontanel is sunken and there are no tears. Which finding best supports dehydration?
• In the immediate care of a term newborn, which action is performed first after delivery?
• A confused 54-year-old female did not eat lunch but took her insulin. She has diabetes and back pain. She localizes to stimuli with both hands equally. Which condition should you suspect?
• After administering Narcan for an opioid overdose, the patient begins gasping with very slow breaths. What is the next step?
• Which scenario would most strongly raise concern for non-accidental trauma in an infant?
• A 48-year-old female with fatigue and shortness of breath who is in sickle cell crisis presents with clear lungs. What is the most likely diagnosis?
• An elderly patient with signs of chronic liver disease including scleral icterus and edema has dysfunction of which organ?
• In a pregnant patient who has been given supplemental oxygen, what is the next priority if signs of shock are present?
• Which of the following will irritate the peritoneum the quickest?
• Which statement best describes breathing management for an obese patient during transport?
• If a violently acting patient is restrained and becomes calm during transport, what is the most appropriate next step?
• If a 2-month-old experiences a second generalized seizure, what is the most appropriate first action?
• A 55-year-old female bitten by a snake five hours ago reports generalized weakness. The snake had bands of color and is not poisonous. She reports blurred vision; pupils are four millimeters and reactive. What type of snake should you suspect?
• A 40-year-old female is 38 weeks pregnant with severe abdominal pain and dark red vaginal bleeding. After administering oxygen, what is the next action?
• An unresponsive 18-year-old female is obviously in her third trimester of pregnancy. Bystanders called when they saw her collapse and begin to have a seizure. She is no longer seizing, but she is postictal. Her face, hands, ankles, and feet appear swollen. Her abdomen is relaxed and soft to palpation. Her vital signs are P 98, R 16, BP 168/104, and SpO2 is 93% on room air. You should:
• In transporting a 76-year-old morbidly obese female with chest pain and dyspnea, which action should you ensure?
• An unresponsive 10-year-old female collapsed after being found at the playground. Bystanders report confusion before collapse. Skin is pale and moist; she localizes to painful stimuli. What is the most likely cause?
• Before applying a splint to an 8-year-old child with autism who has a lower leg fracture, which approach best respects the child’s needs?
• A confused 60-year-old female complains of generalized weakness after working outside on a hot, humid day. Her skin is hot and moist. After moving her to your air-conditioned ambulance, what should you do next?
• Which patient scenario best supports a diagnosis of gastroenteritis given the abdominal symptoms described?
• A 32-year-old female has a single episode of tonic-clonic seizure activity. She quit drinking yesterday. Which should you suspect?
• Why would the fontanel of an 8-month-old female who has meningitis bulge?
• A 16-year-old female who was raped presents with vaginal bleeding and bright red blood running down her leg. Which action is appropriate?
• An 85-year-old female with renal failure on hemodialysis has an AV fistula in the left arm. When measuring blood pressure, where should you place the cuff?
• Which medication reverses benzodiazepine effects?
• Which pupil finding is most consistent with opioid overdose?
• A 30-year-old female complains of epigastric pain radiating to the right shoulder after vomiting French fries. Pain worsens with deep inspiration. Suspect:
• Which condition is most consistent with sudden, severe flank pain that may radiate to the groin and is often accompanied by nausea?
• A 76-year-old male with vomiting and diarrhea has pale, dry conjunctivae and cannot keep down fluids for two days. What is the most appropriate action?
• In a child with sickle cell disease who presents with chest pain during crisis, the pain is most likely due to occlusion of which vascular bed?
• An unresponsive 74-year-old male with pinpoint pupils, cyanotic skin, and slow respirations is found unresponsive after taking prescribed pain medications. You should suspect a(n):
• In anaphylaxis, after initial treatment, if symptoms persist after several minutes, what is the most appropriate next action on the scene?
• A 95-year-old female hospice patient with a hip fracture refuses hospital transport. What is the best course of action?
• Maroon-colored stool is most consistent with which type of GI bleeding?
• A febrile 49-year-old male with HIV/AIDS presents with three days of diarrhea, pale dry mucous membranes, and tachycardia. Which action is most appropriate for initial management?
• A 70-year-old female with frequent urination and burning on urination; what is the most likely diagnosis?
• You are assessing an unresponsive infant who was found next to a bottle of an opioid analgesic. The observed cyanosis and gasping respirations most strongly suggest which cause?
• A 6-month-old female is cyanotic and slow to respond after an empty balloon is found in her mouth. After you begin to ventilate her, you should:
• Painless vaginal bleeding in the late third trimester is most classically associated with which condition?
• If a loop of the umbilical cord is observed around the neonate's neck or at the vaginal opening during delivery, what is the recommended initial action?
• A 26-year-old male complains of difficulty breathing and has SpO2 94% on room air. What is the most appropriate initial action?
• An 91-year-old female with dyspnea has fine crackles in the lower lungs and large areas of dry, crusted skin on the legs. After giving oxygen, what is the next best action?
• A patient with fever and unilateral dermatomal rash along an intercostal space is most consistent with which diagnosis?
• A 78-year-old male is having difficulty breathing. He has a history of dementia and COPD. His daughter tells you his breathing gets worse when he walks up the steps. He tells you that he is fine and doesn't want to go to the hospital. He is dyspneic and unable to identify his daughter. You should:
• In an elderly patient with dyspnea and leg ulcers, what is the most appropriate action after starting oxygen?
• A 21-year-old male complains of abdominal pain. His abdomen is soft to palpation, and the pain is greatest in the left upper quadrant. He reports maroon stools for the past two days. Which is most likely suspected?
• An unresponsive 28-year-old female presents with hot, clammy skin and foul-smelling vaginal discharge. Her blood pressure is 86/58 and SpO2 is 92% on room air. What should you do?
• Which finding is classic for a hip fracture?
• A 66-year-old female complains of burning pain on the right side of her back. She tells you the pain began two days ago, and she can no longer tolerate it. You observe a red rash along the eighth intercostal space on the right side of her back. You should next:
• A 67-year-old female complains of crampy abdominal pain with diarrhea and mucus in stool. Which action should you take?
• Which action is the priority during treatment of a patient with breathing difficulty and wheezing who is not yet severely hypoxic?
• In a patient with fever and petechial rash suggestive of meningococcemia, responders should wear which PPE on arrival?
• When a patient with psychosis reports hallucinations but appears otherwise calm and cooperative, the best response is to:
• A 23-year-old female complains of shortness of breath. She has a history of lupus. You observe a rash across both cheeks and the bridge of her nose. Her lungs are clear to auscultation. Her vital signs are P 88, R 20, BP 126/76, and SpO2 is 95% on room air. You should:
• A 55-year-old female jumped out of a second-story window and injured her right leg. She tells you she is depressed and that there is no hope for her. She recently lost her job, and her husband left her. You should suspect that she is:
• What is the first step in resuscitating a newborn who is crying at birth but shows signs requiring attention?
• Which of the following is the mode of transmission for hepatitis C?
• During delivery, if a loop of the umbilical cord is seen protruding at the vaginal opening, what should you do first?
• In a patient with suspected meningitis who is unresponsive and photophobic, which symptom is most characteristic of meningitis?
• A healthy 32-year-old female just delivered a full-term neonate. After delivery of the placenta, she continues to have significant bleeding. You feel a grapefruit-sized mass in her lower abdomen that is painful when palpated. You should suspect the mass is:
• A 95-year-old male with chronic renal failure misses dialysis; which condition should you expect his symptoms to mimic?
• A 36-year-old female is 39 weeks pregnant with contractions and bleeding. During transport, what is the priority given pale and diaphoretic skin?
• A 72-year-old man with dementia and back pain has ecchymotic stripes on his back; his daughter says the marks are shingles. What is the most appropriate action?
• In the hospice hip fracture scenario, what is the most appropriate approach when the patient directs you not to go to the hospital?
• A 1-month-old male has bilateral circumferential superficial burns from mid-calf to toes after being placed in a tub with hot water. What is the most likely cause?
• A 41-year-old female with shortness of breath and fatigue has a history of Hodgkin's lymphoma and asthma. Lungs are clear on exam. Which action is appropriate?
• Which symptom is typical in alcohol withdrawal?
• A 78-year-old female with dyspnea, chronic renal failure and asthma missed dialysis; crackles in bases; SpO2 89%: Which action is indicated?
• When delivering a newborn, which action is the correct initial step in a basic newborn assessment?
• An unresponsive 18-year-old male with fever and headache who prefers dark rooms due to light sensitivity. What is the most likely diagnosis?
• Which lung sound was observed in the elderly patient with tuberculosis and left lower-lobe rhonchi?
• A 32-year-old female who is 39 weeks gravid is in active labor. You observe the baby's head as it begins to deliver. You should:
• A confused 30-year-old male with flushed dry skin and fever after taking 500 mg diphenhydramine; pupils dilated; glucose 73 mg/dL. What should you do?
• A 29-year-old male with severe left flank pain; vitals stable; what is the recommended EMS action?
• A 5-year-old child presents with vomiting and escalating abdominal pain that localizes to the right lower quadrant. What is the most likely diagnosis?
• A febrile 17-year-old female complains of a headache and sensitivity to light. You observe a petechial rash on her exposed legs. You should first:
• Which presentation is most consistent with a hip fracture?
• During the delivery of a term infant, which action is most appropriate to protect the newborn's airway?
• In suspected sickle cell crisis, which action is most appropriate?
• In a cyanotic infant with pinpoint pupils who has just begun ventilation, what is the most appropriate immediate action?
• A 36-year-old female complains of palpitations. She tells you that she has a hyperactive thyroid gland. Her skin is warm and moist. Her vital signs are P 108 and irregular, R 18, BP 126/80, and SpO2 is 97% on room air. You should:
• What is the most common cause of seizures in an adult?
• A 21-year-old female complains of severe nausea and vomiting. She tells you she is six weeks pregnant, and she has been vomiting four times a day. Her conjunctivae are pale and dry. Her vital signs are P 110, R 18, BP 104/86, and SpO2 is 93% on room air. Her blood glucose level is 72 mg/dL. You should administer oxygen and:
• An 11-year-old with autism and breathing difficulty shows intercostal retractions but can answer questions. Which approach is appropriate?
• A 32-year-old female complains of crampy abdominal pain. She tells you she is 20 weeks pregnant. She has moderate vaginal bleeding. You should suspect:
• An unresponsive 23-year-old male with type 2 diabetes has warm, dry skin and stable vital signs. Which condition should you suspect?
• Which finding best supports gastroenteritis over peritonitis in a patient with crampy abdominal pain and diarrhea and a soft abdomen?
• Why can a patient who is having an anaphylactic reaction have angioedema?
• In a third-trimester patient with heavy vaginal bleeding and signs of poor perfusion, what is the priority during transport after ensuring oxygenation?
• A 10-month-old infant has a two-inch soft bulge under the umbilicus that appeared after coughing. The infant does not cry when you palpate it. What is the most likely diagnosis?
• A 27-year-old female aspirin overdose; diaphoretic and hot; vitals; which source provides most up-to-date information on how to manage her condition?
• What document should you request before transporting a patient exposed to a hazardous chemical?
• A 38-year-old male complains of nausea and vomiting. He has a history of alcoholism. His abdomen is distended, and he has left upper quadrant tenderness on palpation. His vital signs are P 112, R 18, BP 116/88, and SpO2 is 95% on room air. You should:
• An unresponsive 58-year-old female who had a seizure and has a brief tonic phase followed by clonic activity should be managed next by:
• After moving a patient with heat-related illness to an air-conditioned environment, which is the next best step?
• A 37-year-old pregnant woman with identical twins is in labor. The second neonate's buttock is delivering. What is the appropriate action?
• How do the kidneys assist in buffering the pH of the blood?
• In a patient with obesity presenting with chest pain, which action is not appropriate?
• Which step is appropriate first in managing a patient with breathing difficulty and wheezing?