Free NREMT EMT Practice Exam with Questions & Answers | Set: 9

The correct answers are B. Positional asphyxia and E. Sudden cardiac arrest.

This question refers to patients with severe agitation or delirium, often described in EMS as excited delirium syndrome or severe behavioral emergencies.

Why B is correct (Positional asphyxia):

Agitated patients who are restrained improperly (especially in prone positions) are at high risk of:

Restricted chest wall movement

Impaired ventilation

Hypoxia

NREMT-aligned guidance emphasizes:

“Improper restraint positioning can lead to positional asphyxia.”

This is a major cause of morbidity and death in agitated or restrained patients.

Why E is correct (Sudden cardiac arrest):

Severely agitated or delirious patients are at risk of:

Extreme catecholamine surge

Metabolic acidosis

Cardiac dysrhythmias

These can rapidly lead to sudden cardiac arrest.

NREMT materials highlight:

“Patients with severe agitation are at risk for sudden cardiac arrest.”

“Excited delirium may result in sudden death if not properly managed.”

Why the other options are incorrect:

A. Seizure activity: Not a primary or common morbidity risk directly associated with agitation.

C. Hypovolemic shock: Not typically related to agitation unless trauma or bleeding is present.

D. Hemorrhagic stroke: Not a typical complication of agitation/delirium in EMS context.

Exact Extracts:

“Improper restraint can result in positional asphyxia.”

“Excited delirium is associated with sudden cardiac arrest.”

“Agitated patients require careful monitoring due to risk of sudden death.”

The START (Simple Triage and Rapid Treatment) system classifies patients based on ability to walk, respirations, perfusion, and mental status. A patient with an open fracture who can breathe adequately, has a pulse, and follows commands is categorized as “Delayed”.

Immediate (Red) is reserved for those who cannot walk and have life-threatening conditions, such as compromised airway or severe bleeding.

The correct answers are A and B because standard EMT care for epistaxis (nosebleed) includes having the patient lean forward and applying direct pressure by pinching the nostrils .

Leaning forward prevents blood from draining into the airway or stomach, reducing the risk of aspiration or vomiting. Pinching the nostrils provides direct pressure to control bleeding , which is the primary intervention emphasized in NREMT-aligned bleeding control guidelines.

Send the next question.

The correct answer is C. Bradycardia.

In pediatric patients, it is critical to distinguish between respiratory distress and respiratory failure.

Respiratory distress includes early compensatory signs such as:

Intercostal retractions

Audible wheezes

Tachypnea

These findings indicate that the child is still attempting to compensate and maintain adequate oxygenation.

Respiratory failure, however, represents a late and life-threatening stage where the child can no longer maintain adequate oxygenation and ventilation.

Bradycardia is a key late sign of respiratory failure in infants and children and indicates severe hypoxia and impending cardiac arrest.

According to NREMT-aligned educational material:

“Bradycardia in pediatric patients is often the result of hypoxia.”

“Late signs of respiratory failure include decreased mental status and bradycardia.”

Why the other options are incorrect:

A. Intercostal retractions: Early sign of respiratory distress (increased work of breathing)

B. Audible wheezes: Indicates airway narrowing, typically seen in distress

D. Tachypnea: Early compensatory mechanism to improve oxygenation

NREMT guidance emphasizes:

“Increased work of breathing and abnormal breath sounds are signs of respiratory distress, not failure.”

Exact Extracts:

“Bradycardia in pediatric patients is usually caused by hypoxia.”

“Late signs of respiratory failure include bradycardia and decreased mental status.”

“Retractions and tachypnea are signs of respiratory distress.”