NREMT Updated EMT Exam Questions and Answers by ozzy

Comprehensive and Detailed Explanation (Based on NREMT standards):

Neurogenic shock results from damage to the spinal cord, most commonly at or above the thoracic level. NREMT education emphasizes that this injury disrupts the sympathetic nervous system, which normally maintains vascular tone.

Option C is correct because loss of sympathetic tone leads to widespread vasodilation, causing hypotension and often bradycardia, distinguishing neurogenic shock from other shock types.

Option A is incorrect because acetylcholine inhibition is not the mechanism.

Option B describes cardiogenic shock.

Option D describes septic (distributive) shock.

NREMT highlights that recognizing neurogenic shock is critical, as treatment priorities differ from hypovolemic shock.

The correct answer is A. Remove the airway and ventilate him.

In pediatric patients, improper placement or incorrect sizing of an oropharyngeal airway (OPA) can cause:

Airway obstruction instead of opening

Worsening hypoxia

Leading to cyanosis and bradycardia

The patient’s cyanosis (low oxygen) and bradycardia (late hypoxia sign) indicate that the airway intervention has failed or worsened the situation.

Immediate action is to:

Remove the OPA

Provide effective ventilations with BVM

B. Continue ventilation with the airway in place → Incorrect because the airway is likely malpositioned or obstructing airflow

C. Increase ventilation rate to 40–60 → Excessive and inappropriate; does not correct obstruction

D. Start CPR if HR < 100 → In pediatrics, CPR begins if HR < 60 with poor perfusion, not < 100

“If an airway adjunct worsens ventilation, it should be removed immediately.”

“Bradycardia in infants is a sign of hypoxia.”

“Ensure adequate ventilation before initiating compressions.”

The correct answers are A. Mechanisms of injury, B. If entrapment occurred, and D. Total number of patients.

During the scene size-up, the EMT performs an initial overview to ensure safety and gather critical information before patient contact. NREMT guidelines emphasize specific elements that must be identified early.

Key components of scene size-up include:

1. Mechanism of Injury (MOI) (A):

Helps predict potential injuries based on how the incident occurred

Essential for determining severity and treatment priorities

2. Entrapment (B):

Determines whether patients are physically trapped

Helps anticipate need for extrication resources and delays in care

3. Number of Patients (D):

Critical for determining if additional resources are needed

Helps identify potential mass-casualty incidents (MCI)

NREMT-aligned references state:

“Scene size-up includes determining the mechanism of injury.”

“Identify the number of patients and need for additional resources.”

“Determine if extrication or special rescue is required.”

Why the other options are incorrect:

C. Severity of the patientsThis is determined during the primary assessment, not initial scene size-up

E. Which patients have diedNot part of initial size-up priorities

F. Site for loading injured patientsThis is part of incident management/transport decisions, not initial size-up

Exact Extracts (NREMT-aligned EMT educational references):

“Determine the mechanism of injury or nature of illness.”

“Determine the number of patients.”

“Assess the need for additional resources and extrication.”

Clinical Priority Summary:

Scene size-up focuses on environmental awareness and resource needs, specifically MOI, patient count, and entrapment, making A, B, and D correct.

Use the Glasgow Coma Scale (GCS) to calculate:

Eye Opening (E): Opens to speech = 3

Verbal Response (V): Confused but appropriate words = 4

Motor Response (M): Obeys commands = 6Total = 3 + 4 + 6 = 13

However, the question states he opens eyes to voice, knows name (orientation to person), and follows commands — this would mean:

Eye = 3

Verbal = 5 (Oriented to person, but disoriented to place/time)

Motor = 6

Correct Total: 14