Patient Assessment practice test: free NREMT EMT questions

Sample Practice Questions for Patient Assessment

1. Question 1Ref: NREMT EMT Test Plan - Primary Assessment Domain

   You arrive on scene to find a 58-year-old man clutching his chest and diaphoretic. He is alert but anxious. What is your FIRST priority during the primary assessment?

   AAdminister aspirin immediatelyBObtain a full set of vital signsCAssess airway, breathing, and circulationDApply the cardiac monitor leads
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   C. Assess airway, breathing, and circulation

   The primary assessment always begins with evaluating the ABCs (airway, breathing, circulation) to identify and manage life threats. While vital signs, aspirin, and cardiac monitoring are important, they come after the initial assessment of ABCs. Jumping to treatment before completing the primary assessment is a critical error on the NREMT exam.

2. Question 2Ref: NREMT EMT Skill Sheet - Airway Management / BVM Ventilation

   During your primary assessment of an unresponsive trauma patient, you note the patient is breathing inadequately. What should you do FIRST?

   AInsert an OPA and reassess breathingBApply a cervical collarCCheck the patient's blood glucoseDProvide ventilations with a bag-valve-mask
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   D. Provide ventilations with a bag-valve-mask

   Inadequate breathing is an immediate life threat. The first action is to provide positive pressure ventilations with a bag-valve-mask (BVM) to ensure oxygenation. While an OPA may be inserted, ensuring adequate ventilations takes priority. Cervical collars and glucose checks are secondary interventions.

3. Question 3Ref: NREMT EMT Test Plan - Patient Treatment and Transport / Stroke Assessment

   A 72-year-old woman presents with slurred speech and left-sided weakness that began 45 minutes ago. Her blood glucose is 110 mg/dL. What is your MOST appropriate action?

   AAdminister oral glucose and transportBPosition the patient supine with legs elevatedCPerform a detailed secondary assessment on sceneDRapidly transport to a stroke center
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   D. Rapidly transport to a stroke center

   This patient's presentation of slurred speech, unilateral weakness, and normal glucose is highly suspicious for a stroke. Stroke patients require rapid transport to a stroke center where CT imaging and potential thrombolytic therapy within a 4.5-hour window can be initiated. Delaying transport for a detailed on-scene assessment wastes critical time.

4. Question 4Ref: NREMT EMT Test Plan - Primary Assessment / Circulation

   You are assessing a patient's pulse and note it is weak, thready, and rapid at 120 bpm. The patient's skin is cool and diaphoretic. These findings are MOST indicative of:

   AAnxiety attackBAnaphylaxisCHypovolemic shockDHeat exhaustion
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   C. Hypovolemic shock

   A weak, thready, rapid pulse combined with cool, diaphoretic skin are classic signs of hypovolemic shock, typically caused by blood or fluid loss. Anaphylaxis would also present with wheezing or urticaria. Anxiety typically causes a strong bounding pulse. Heat exhaustion usually presents with hot, flushed skin.

5. Question 5Ref: NREMT EMT Test Plan - Secondary Assessment / History Taking

   During your secondary assessment, you ask a patient with abdominal pain about onset, provocation, quality, region, severity, and timing. This assessment tool is known as:

   ASAMPLE historyBAVPU scaleCDCAP-BTLSDOPQRST
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   D. OPQRST

   OPQRST is a pain assessment mnemonic used to characterize a patient chief complaint: Onset, Provocation/Palliation, Quality, Region/Radiation, Severity, and Time. SAMPLE gathers Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, and Events leading up. AVPU assesses level of consciousness. DCAP-BTLS is a trauma physical exam framework used for head-to-toe assessment.

6. Question 6Ref: NREMT EMT Test Plan - Primary Assessment / Disability

   A patient responds to verbal stimuli by opening his eyes and mumbling incoherently. He withdraws from painful stimuli. What is his Glasgow Coma Scale score?

   A10B8C9D11
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   C. 9

   Eye opening to voice = 3, Verbal response of incomprehensible sounds = 2, Motor withdrawal = 4. Total GCS = 3 + 2 + 4 = 9. This indicates moderate brain injury. Patients with GCS of 9 or below may require advanced airway management.

7. Question 7Ref: NREMT EMT Test Plan - Scene Size-Up and Safety / Multiple Patients

   You arrive at a two-car MVC. The driver of the first car is entrapped and unresponsive. The second driver is ambulatory with neck pain. How should you manage this scene?

   ABegin with a detailed physical exam on both patientsBTreat the ambulatory patient firstCRequest additional resources and begin with the entrapped patientDTriage using START and assign both patients green
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   C. Request additional resources and begin with the entrapped patient

   The entrapped, unresponsive patient has the highest acuity and requires immediate attention. Additional resources for fire/rescue extrication should be requested. The ambulatory patient with neck pain should be stabilized and moved to a safe area. Triage principles prioritize the most critically injured first.

8. Question 8Ref: NREMT EMT Test Plan - Patient Treatment / Oral Glucose Contraindications

   A 45-year-old man with diabetes is found unresponsive at home. Blood glucose is 42 mg/dL. His airway is patent and he is breathing. What is your INITIAL treatment?

   AAdminister oral glucoseBEstablish an IV and give dextroseCPerform a full secondary assessmentDPosition him supine and apply oxygen
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   D. Position him supine and apply oxygen

   An unresponsive patient cannot safely swallow oral glucose due to aspiration risk. The initial treatment for hypoglycemia in an unresponsive patient is to position them supine, administer oxygen, and transport for IV dextrose or glucagon. Oral glucose is contraindicated in unconscious patients.

9. Question 9Ref: NREMT EMT Test Plan - Secondary Assessment / Reassessment

   During reassessment of a stable patient, you should evaluate vital signs and reassess the chief complaint at minimum every:

   A5 minutesB10 minutesC30 minutesD15 minutes
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   D. 15 minutes

   For stable patients, reassessment of vital signs and the chief complaint should occur at minimum every 15 minutes during transport. Unstable patients require reassessment every 5 minutes. This frequency allows early detection of changes in patient condition and ensures timely intervention if the patient deteriorates.

10. Question 10Ref: NREMT EMT Test Plan - Patient Treatment and Transport / Transport Priority

    A 30-year-old woman presents with sudden severe headache, nausea, and nuchal rigidity. She is alert and oriented. What is the MOST appropriate transport decision?

    ADelay transport to complete a full secondary assessmentBNon-urgent transport to the nearest hospitalCRapid transport to a facility with CT capabilitiesDTransport to a psychiatric facility
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    Correct Answer
    C. Rapid transport to a facility with CT capabilities

    Sudden severe headache with nuchal rigidity and nausea suggests possible subarachnoid hemorrhage or meningitis. These are life-threatening conditions requiring rapid transport to a facility with CT scanning capability. Delaying transport for a full secondary assessment would waste critical time. Every minute counts for these patients.