NREMT Updated EMT Exam Questions and Answers by mahira

The correct answer is D. Apply CPAP.

This patient is experiencing respiratory distress following a drowning/submersion event, which strongly suggests aspiration and possible pulmonary edema. The key findings include:

Shallow respirations (R 28)

Persistent hypoxia (SpO₂ 92%) despite oxygen therapy

History of water exposure (lake rescue)

Why D is correct (CPAP):

CPAP provides positive pressure, helping to recruit alveoli and improve gas exchange.

It is especially effective in cases of noncardiogenic pulmonary edema, such as near-drowning.

Indicated when:

Patient is awake and breathing

Hypoxia persists despite oxygen therapy

Why the other options are incorrect:

A. 12-lead ECG → Not relevant to respiratory failure from drowning

B. Nitroglycerin → Used for cardiac chest pain/pulmonary edema of cardiac origin, not drowning

C. Rapid transport → Important, but does not address immediate respiratory failure; airway intervention takes priority

Exact Extracts:

“CPAP is indicated for patients with respiratory distress who do not improve with oxygen therapy.”

“Positive pressure ventilation helps improve oxygenation in patients with pulmonary edema.”

“Near-drowning patients may develop respiratory distress due to fluid in the lungs.”

For suspected or confirmed tuberculosis (TB), the EMT should place a surgical mask on the patient, not a HEPA respirator. Surgical masks are used to contain droplets from the patient and reduce airborne transmission.

The EMT should wear a N95 or HEPA respirator to protect against inhaling airborne particles. Notification to the CDC is not the EMT’s responsibility — that falls to public health officials.

The correct answer is A. Causation.

Key Concept: Elements of Negligence

To prove negligence in a court of law, four elements must be established:

Duty to act

Breach of duty

Causation

Damages

Why A is correct (Causation):

Causation is a required legal element of negligence

It establishes that the provider’s actions (or failure to act) directly caused harm to the patient

NREMT-aligned guidance states:

“Causation links the EMT’s actions to the patient’s injury.”

“All four elements must be proven to establish negligence.”

Why the other options are incorrect:

B. Abandonment❌ A type of negligence, not one of the four required elements

C. Assault and battery❌ Intentional torts, separate from negligence

D. False imprisonment❌ Also an intentional tort, not an element of negligence

Exact Extracts (NREMT-aligned EMT educational references):

“Negligence requires duty, breach, causation, and damages.”

“Causation must show that the provider’s actions caused harm.”

“Intentional torts differ from negligence.”

Clinical Priority Summary:

Among the options, only causation is one of the required legal elements used to prove negligence, making A the correct answer.

Comprehensive and Detailed Explanation (Based on NREMT standards):

NREMT trauma care guidelines clearly state that distal circulation, sensation, and motor function (CSM) must be assessed both before and after splinting any musculoskeletal injury.

Option C is correct because the pre-splint assessment establishes a baseline, while the post-splint assessment confirms that the splint has not compromised blood flow or nerve function.

Option A is incomplete and unsafe.

Option B misses baseline data.

Option D violates standard trauma care practices.

Proper documentation of distal neurological status is critical for patient safety and medico-legal protection.