Free NREMT EMT Practice Exam with Questions & Answers | Set: 4

Comprehensive and Detailed Explanation (Based on NREMT standards):

The healthcare provider is ultimately responsible for maintaining certification, licensure, and continuing education requirements. While agencies, supervisors, and training officers may assist or provide opportunities, NREMT clearly states that responsibility rests with the individual EMT.

Option C is correct because failure to meet certification requirements can result in expiration or revocation regardless of employer involvement.

Options A, B, and D are incorrect because these roles may support education but are not legally responsible for an individual provider’s compliance.

NREMT emphasizes professional accountability as a core expectation of EMS practice.

Hypovolemic shock results from acute blood loss, commonly seen with penetrating trauma such as gunshot wounds. NREMT identifies several key indicators that reflect reduced circulating volume and inadequate tissue perfusion.

Option A (Heart rate) is a strong indicator. Tachycardia (P 140) reflects the body’s attempt to compensate for reduced blood volume and maintain cardiac output.

Option B (Lung sounds) are significant in this case because absent sounds suggest associated chest trauma that may contribute to blood loss and impaired oxygenation, worsening shock.

Option C (Mental status) is a critical indicator. Unconsciousness reflects inadequate cerebral perfusion, a late and serious sign of shock.

Additional supportive findings include pale, cool skin and borderline hypotension. NREMT emphasizes early recognition of shock and rapid control of bleeding, oxygenation, and transport to definitive care.

Comprehensive and Detailed Explanation From Exact Extract:

The patient's symptoms are consistent with a stroke (CVA). Proper prehospital care focuses on maintaining airway, breathing, circulation, and protecting the affected limbs. Positioning the patient with head elevated (not supine) reduces intracranial pressure and aspiration risk.

Protecting the paralyzed side (e.g., left arm) from injury during transport is critical. EMS should still communicate with the patient — even if speech is impaired — and perform a stroke assessment using tools like Cincinnati Prehospital Stroke Scale (CPSS) or FAST.

Comprehensive and Detailed Explanation From Exact Extract:

In any unresponsive patient, the first step is to assess and open the airway to determine patency and identify obstruction or inadequate breathing.

Gasping respirations (agonal) are not effective; they require BVM ventilation support. The airway must be open before checking for a pulse or performing auscultation. A secondary assessment is performed only after primary survey and stabilization.

NREMT guidelines emphasize that patient refusal is only valid if the patient has decision-making capacity. This patient has a severe headache with critically elevated blood pressure, which raises concern for conditions such as hypertensive emergency, intracranial hemorrhage, or stroke—all of which can impair cognition.

Option D is correct because the EMT must first determine whether the patient is alert, oriented, understands the risks, and can communicate a rational decision. Without capacity, a refusal is not legally or ethically valid.

Option A is incorrect because a refusal form should only be signed after capacity is confirmed.

Option B does not address the legal and ethical priority.

Option C is unnecessary unless the patient lacks capacity and poses a danger to themselves or others.

NREMT stresses that EMTs must protect patient autonomy while ensuring informed refusal, especially in high-risk presentations.

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.

Comprehensive and Detailed Explanation From Exact Extract:

Under HIPAA (Health Insurance Portability and Accountability Act), only designated personnel are authorized to handle inquiries regarding a patient’s Protected Health Information (PHI). The Privacy Officer is responsible for enforcing compliance with privacy regulations and addressing PHI access requests.

Shift supervisors or hospitals do not have the legal authority to release PHI unless specifically designated.