NREMT Updated EMT Exam Questions and Answers by ameerah

The correct answer is B. Ventricular tachycardia only.

Key Concept: Shockable Rhythms and Pulse Presence

The two primary shockable rhythms are:

Ventricular fibrillation (VF)

Ventricular tachycardia (VT)

Ventricular Fibrillation (VF):

Chaotic, disorganized electrical activity

No effective cardiac output

Always pulseless

NREMT-aligned reference:

“Ventricular fibrillation results in no pulse due to ineffective quivering of the ventricles.”

Ventricular Tachycardia (VT):

Rapid, organized ventricular rhythm

May be:

Pulseless VT (cardiac arrest)

Perfusing VT (with a pulse)

NREMT-aligned reference:

“Ventricular tachycardia may present with or without a pulse.”

Why B is correct:

Only ventricular tachycardia can sometimes produce a pulse

VF never produces a pulse

Why the other options are incorrect:

A. VF only → Incorrect; VF is always pulseless

C. Both → Incorrect; VF cannot produce a pulse

D. Neither → Incorrect; VT can produce a pulse

Exact Extracts (NREMT/AHA-aligned references):

“Shockable rhythms include ventricular fibrillation and pulseless ventricular tachycardia.”

“Ventricular tachycardia may be with or without a pulse.”

“Ventricular fibrillation produces no cardiac output.”

Clinical Priority Summary:

Among shockable rhythms, only ventricular tachycardia can still produce a pulse, making B the correct answer.

This is the kind of patient where EMTs should think beyond the absence of chest pain. In women, a myocardial infarction can present with less classic symptoms such as shortness of breath, dizziness/lightheadedness, and unusual weakness or fatigue . The American Heart Association specifically notes that women may have heart attack symptoms including shortness of breath and unusual tiredness and weakness , and the American Diabetes Association also lists shortness of breath and dizziness or lightheadedness among symptoms of heart disease that people with diabetes should recognize. ( www.heart.org )

So from an NREMT-style assessment standpoint, a 56-year-old woman with diabetes and a sudden onset of these symptoms should be treated with a high index of suspicion for acute myocardial infarction until proven otherwise. ( www.heart.org )

The correct answer is A because Lyme disease is transmitted through the bite of infected ticks , specifically the Ixodes (deer tick) species. In EMS and NREMT-aligned infectious disease education, Lyme disease is classified as a tick-borne illness , not spread by mosquitoes, bats, or dogs.

The causative organism, Borrelia burgdorferi , is transmitted to humans when an infected tick feeds on the host and transfers the bacteria through its bite. This is a standard concept in EMT training under environmental and infectious disease awareness .

NREMT distinguishes mild versus severe airway obstruction primarily by the patient’s ability to move air. In a mild obstruction, the patient can cough forcefully, speak, and exchange air. A severe obstruction occurs when airflow is critically impaired.

Option A (Ineffective cough) is the key indicator that a mild obstruction has progressed to a severe one. An ineffective or silent cough means the patient can no longer generate enough airflow to clear the obstruction, placing them at imminent risk of hypoxia and cardiac arrest.

Option B is a late sign of hypoxia but does not define severity of obstruction.

Option C is not specific to airway obstruction severity.

Option D indicates a mild obstruction, not severe.

NREMT teaches that once a cough becomes ineffective, immediate airway intervention is required.