NREMT EMT - Emergency Medical Technicians Exam

Comprehensive and Detailed Explanation (Based on NREMT standards):

NREMT defines secondary prevention as actions taken to reduce the impact of a disease or injury after it has occurred, focusing on early intervention and harm reduction.

Option D is correct because educating the public on naloxone use does not prevent opioid addiction but reduces morbidity and mortality by reversing overdoses when they occur.

Option A and C are examples of primary prevention, which aim to prevent disease before it happens.

Option B is an operational task, not prevention.

NREMT emphasizes prevention roles as part of community paramedicine and public health integration.

Comprehensive and Detailed Explanation From Exact Extract:

The patient’s complaint of difficulty breathing is an airway/breathing issue and takes precedence over a controlled extremity bleed. The first action is to administer oxygen and evaluate respiratory effort.

Though reassessing the wound is important, oxygenation is the priority when airway compromise or respiratory distress is present. Tourniquets are for uncontrolled bleeding, which is not the case here.

The diaphragm is innervated by the phrenic nerve, which originates from spinal nerve roots C3–C5. NREMT teaching highlights the phrase: “C3, 4, and 5 keep the diaphragm alive.”

Option A (C4) is correct because an injury at or above this level can paralyze the diaphragm, resulting in apnea and immediate respiratory failure.

Option B (T1) and C (T3) affect intercostal muscles but not the diaphragm.

Option D (L4) affects lower extremity function only.

NREMT emphasizes that high cervical spine injuries are immediately life-threatening due to loss of ventilatory control.

Comprehensive and Detailed Explanation From Exact Extract:

Albuterol, a common beta-2 adrenergic agonist used in inhalers, stimulates bronchial smooth muscle relaxation. However, stimulation of beta receptors can also produce systemic effects such as:

Tachycardia (due to beta-1 cross-reactivity)

Nervousness (from central stimulation)

Coughing (a local airway response)

Confusion and drowsiness are not typical side effects of beta-agonists. Hypotension is rare unless severe overdose occurs.

Comprehensive and Detailed Explanation From Exact Extract:

If a choking patient becomes unresponsive, EMTs should:

Check for a pulse

Begin chest compressions if no pulse is foundChest compressions can help dislodge the object. After compressions, the airway should be opened and inspected. Back blows are not appropriate for unconscious patients.

Ventilation is attempted after clearing the airway or if no object is seen. Do not withhold compressions waiting for object removal.

Comprehensive and Detailed Explanation From Exact Extract:

Mechanism of Injury (MOI) assessment is a cornerstone of trauma care. It helps providers determine:

Extent of injury: High-speed collisions, falls from height, or penetrating trauma suggest internal injuries even if external signs are limited.

Need for additional resources: MOI may indicate the necessity of ALS backup, air transport, or technical rescue.

MOI cannot determine a patient’s medical history or guarantee survival predictions. The destination facility depends on multiple factors including triage protocols, vital signs, and local trauma system regulations.

This patient is experiencing anaphylactic shock, evidenced by hypotension, respiratory distress, hypoxia, and altered mental status. After epinephrine administration, NREMT priorities focus on aggressive oxygenation and airway support.

Option D is correct because a non-rebreather mask at high flow delivers the highest concentration of oxygen to a spontaneously breathing patient and is indicated with SpOâ‚‚ of 86%.

Option C would be indicated only if respirations were inadequate or absent.

Option B is insufficient for severe hypoxia.

Option A delays definitive supportive care.

NREMT emphasizes epinephrine first, followed immediately by high-flow oxygen and rapid transport.

Comprehensive and Detailed Explanation From Exact Extract:

The legal concept of tort negligence in EMS requires the plaintiff to establish four elements:

Duty to act

Breach of that duty

Damages (harm caused)

Causation — a direct link between the EMT’s action/inaction and the harm caused

Causation (often termed “proximate cause”) is the essential element that connects the EMT’s breach to the patient's injury or outcome. Abandonment, assault, and false imprisonment are other intentional torts, but not core elements of proving negligence.

Comprehensive and Detailed Explanation (Based on NREMT standards):

Continuous Positive Airway Pressure (CPAP) is used in patients with moderate to severe respiratory distress who are conscious and able to maintain their airway. NREMT guidelines identify specific respiratory conditions where CPAP improves oxygenation and ventilation.

Option A (Chronic bronchitis) is correct because CPAP helps overcome airway collapse and improves gas exchange in COPD patients.

Option B (Pulmonary edema) is correct because CPAP reduces preload and afterload while forcing fluid out of alveoli, improving oxygenation.

Option C (Acute bronchospasms) is correct because CPAP helps splint open airways and reduce work of breathing.

Option D is incorrect because CPAP is not used for isolated myocardial infarction without respiratory failure.

Option E is contraindicated because positive pressure can worsen a pneumothorax.

Option F is contraindicated due to airway burns and potential inhalation injury.

NREMT stresses proper patient selection to prevent CPAP-related complications.

Comprehensive and Detailed Explanation From Exact Extract:

The patient’s symptoms are consistent with acute coronary syndrome (ACS). The first-line treatments are:

Aspirin (160–325 mg): inhibits platelet aggregation, reducing clot progression.

Oxygen: administered when SpOâ‚‚ <94% or signs of hypoxia/distress are present.

CPAP is for pulmonary edema or respiratory failure. Nitroglycerin requires BP >90 systolic and medical direction approval. Laying the patient supine may increase myocardial workload and is inappropriate unless hypotension occurs.