Free NREMT EMT Practice Exam with Questions & Answers | Set: 2

SALT (Sort, Assess, Lifesaving interventions, Treatment/Transport) is a mass casualty triage method recommended by the CDC and the National Association of EMS Physicians (NAEMSP). During the " Assess " step, responders:

Check respirations

Provide lifesaving interventions such as rescue breaths if the patient is not breathing but has a pulse

Evaluate mentation (e.g., ability to follow commands)

Airway adjuncts and full transport do not happen at this stage. Scorecards and pediatric-specific modifications are addressed later in the protocol.

The cerebrum is the largest and most developed part of the human brain and is responsible for higher cognitive functions. According to NREMT anatomy and physiology education, the cerebrum controls thinking, reasoning, memory, judgment, voluntary movement, and sensory interpretation.

Option B is correct because conscious thought, problem-solving, and decision-making all originate in the cerebrum.

Option A (Pons) helps regulate breathing and sleep cycles.

Option C (Brain stem) controls vital functions such as heart rate, breathing, and blood pressure.

Option D (Cerebellum) coordinates balance, posture, and fine motor movement.

Understanding brain function helps EMTs correlate neurological findings with possible injuries or medical conditions.

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 .

The patient is in hypoperfusion (shock) from blood loss. In shock states, tissues are deprived of oxygen, leading to anaerobic metabolism, which produces lactic acid as a byproduct. This causes metabolic acidosis, which is a critical sign of systemic oxygen debt.

Carbon dioxide rises with respiratory failure, but lactic acid is a more specific indicator of cellular hypoxia.

Mental status reflects perfusion and oxygen delivery to the brain, which is highly sensitive to hypoxia and hypercapnia. Even if respiratory rate and SpO₂ are normal, altered mental status suggests ineffective gas exchange or hypoperfusion.

Pulse oximetry may be falsely normal in CO poisoning or poor perfusion. Skin color is subjective and not as sensitive or specific as neurological status.

Comprehensive and Detailed Explanation (Based on NREMT standards):

For a conscious adult with complete airway obstruction, abdominal thrusts are typically indicated. However, NREMT guidelines specify that chest thrusts should be used instead for patients who are morbidly obese or pregnant, because abdominal thrusts may be ineffective or unsafe.

Option D is correct because chest thrusts provide effective airway clearance while accommodating body habitus.

Options A and B are inappropriate for a conscious patient.

Option C is incorrect because abdominal thrusts may not be effective in morbidly obese patients.

NREMT stresses modifying airway obstruction techniques based on patient size and condition.

The correct answer is A. Fluid overload.

Missed dialysis → inability to remove excess fluid

Shortness of breath + crackles → fluid in the lungs (pulmonary edema)

Hypertension (188/90)

Tachycardia (120)

Low-normal SpO₂ (92%)

These findings strongly indicate fluid overload leading to pulmonary edema.

Patients who miss dialysis retain excess fluid

Fluid accumulates in the lungs → crackles and respiratory distress

Hypertension is common due to increased circulating volume

B. Bronchiolitis → Typically seen in infants/children, not adults

C. Pneumonia → May cause crackles, but does not explain missed dialysis + fluid retention + hypertension pattern

D. Ascites → Fluid in the abdomen, not primarily causing lung crackles or acute respiratory distress

“Patients with renal failure who miss dialysis may develop fluid overload.”

“Pulmonary edema presents with crackles and respiratory distress.”

“Hypertension is commonly associated with fluid overload states.”

The correct answers are A. Fever, D. Lethargy, and E. Bulging fontanelles.

Meningitis is an infection of the meninges (coverings of the brain and spinal cord) and presents differently in infants compared to adults.

Common signs of meningitis in infants include:

Fever (A)

Lethargy or decreased level of consciousness (D)

Bulging fontanelles (E) → due to increased intracranial pressure

Irritability

Poor feeding

Seizures

NREMT-aligned references state:

“Infants with meningitis may present with fever and lethargy.”

“A bulging fontanelle is a key sign of increased intracranial pressure in infants.”

Why the other options are incorrect:

B. Drooling → More associated with epiglottitis or airway obstruction, not meningitis

C. Pale skin → Nonspecific finding, not characteristic of meningitis

F. Inability to stay still → More commonly associated with pain, anxiety, or stimulant conditions, not a classic meningitis sign

Exact Extracts (NREMT-aligned EMT educational references):

“Signs of meningitis in infants include fever, lethargy, and bulging fontanelles.”

“Increased intracranial pressure may cause bulging of the fontanelle.”

“Altered mental status is common in CNS infections.”

Clinical Priority Summary:

In infants, meningitis typically presents with fever, decreased responsiveness, and bulging fontanelles, making A, D, and E the correct answers.

If a patient is responsive, they must have adequate cerebral perfusion, meaning a pulse is present—even if it is difficult to palpate. NREMT guidelines emphasize that EMTs should not assume cardiac arrest based solely on an inability to feel a pulse.

Option C is correct because the EMT should continue the primary assessment, reassessing airway, breathing, and circulation using additional indicators such as skin condition, mental status, and breathing quality.

Option A is incorrect because CPR is only initiated in unresponsive, pulseless patients.

Option B is incorrect because AED use is indicated only for unresponsive, pulseless patients.

Option D may be appropriate later for shock but does not address the assessment discrepancy.

NREMT teaches that patient responsiveness is a reliable indicator of circulation and that EMTs must avoid unnecessary resuscitative interventions.

The correct answer is B. Administer epinephrine.

This patient is experiencing anaphylactic shock, a life-threatening allergic reaction.

Key findings indicating anaphylaxis:

Sudden onset respiratory distress (wheezing)

Urticaria (hives) → hallmark allergic reaction

Hypotension (BP 82/48) → indicates shock

Hypoxia (SpO₂ 91%)

Why B is correct:

Epinephrine is the first-line, life-saving treatment for anaphylaxis.

It works by:

Bronchodilation (improves wheezing)

Vasoconstriction (raises blood pressure)

Reduces airway swelling

It must be given immediately when anaphylaxis is suspected.

Why the other options are incorrect:

A. Nebulized albuterol → Helps wheezing but does not treat shock or airway swelling

C. High-flow oxygen → Important, but not definitive treatment; epinephrine takes priority

D. Immediate transport → Necessary, but life-saving intervention must occur first

Exact Extracts:

“Epinephrine is the first-line treatment for anaphylaxis.”

“Anaphylaxis presents with respiratory distress, hypotension, and hives.”

“Immediate administration of epinephrine is critical.”