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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Scene Size-Up and Safety | 15–19% | - Hazard recognition and management - Scene assessment and safety protocols - Mechanism of injury / nature of illness |
| Topic 2: Primary Assessment | 39–43% | - General patient impression and priority determination - Airway, breathing, and circulation management - Initial patient assessment - Identification and management of life-threatening conditions |
| Topic 3: Secondary Assessment | 5–9% | - Symptom assessment and history taking - Focused history and physical exam - Vital signs and monitoring |
| Topic 4: EMS Operations | 10–14% | - Documentation and legal aspects - Incident command and multiple-casualty situations - Emergency vehicle operations and safety - EMS system roles and responsibilities |
| Topic 5: Patient Treatment and Transport | 20–24% | - Medical and trauma care interventions - Communication with receiving facilities - Patient packaging and transport procedures - Medication administration and protocols |
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질문 # 168
A 26-year-old patient has an altered mental status. Family advises that the patient has diabetes. The patient ' s skin is pale, cool, and clammy. What, if anything, can the EMT infer about the patient ' s glucose level based on the patient ' s presentation?
정답：C
설명：
Altered mental status, combined with pale, cool, and clammy skin, is strongly suggestive of hypoglycemia (low blood sugar). Hypoglycemia is especially dangerous in diabetics who take insulin or oral hypoglycemics.
The body ' s adrenergic response causes the " cool and clammy " presentation.
Hyperglycemia typically presents with warm, dry skin and develops more slowly. EMTs should administer oral glucose if the patient can swallow.
References:
NREMT Medical Guidelines - Endocrine Emergencies
AAOS EMT Textbook (11th ed.), Chapter: Endocrine and Metabolic Emergencies National EMS Education Standards - Diabetic Emergencies
질문 # 169
A 12-year-old patient has uncontrollable jerking movement of the left arm. The patient answers the EMT ' s questions appropriately. What type of seizure is the patient most likely experiencing?
정답：A
설명：
The correct answer is B. Focal.
This question is testing recognition of seizure types based on motor activity and level of consciousness.
A focal (partial) seizure originates in a specific area of the brain and typically affects one part of the body, such as a single limb. Importantly, the patient may remain conscious and responsive, which is exactly what is described in this scenario.
The patient has:
* Uncontrollable jerking of one arm (localized motor activity)
* Ability to answer questions appropriately (preserved mental status)
These findings directly indicate a focal seizure.
According to standard NREMT EMT educational content:
* Focal seizures may present with "jerking of one extremity"
* The patient may "remain conscious and aware"
These features distinguish focal seizures from generalized seizures.
Why the other options are incorrect:
* A. Tonic: Characterized by sudden muscle stiffening, usually involving the whole body, often with impaired consciousness.
* C. Atonic: Involves sudden loss of muscle tone, leading to collapse ("drop attack"), not jerking.
* D. Absence: Characterized by brief loss of awareness, staring spells, and unresponsiveness-not motor jerking of a limb.
Exact Extracts:
* "Focal seizures affect a specific part of the brain and may produce localized motor activity."
* "The patient may remain conscious during a focal seizure."
* "Generalized seizures typically involve loss of consciousness."
References:
NREMT EMT Education Standards - Neurology / Seizures section
NREMT National Continued Competency Program (NCCP) - Medical Emergencies Standard EMT Text (aligned with NREMT): Neurologic Emergencies and Seizure Types
질문 # 170
A drowsy 72-year-old female complains of difficulty breathing. Her respiratory rate is 50, and her SpO# is 89% on room air. You should suspect
정답：C
설명：
Comprehensive and Detailed Explanation From Exact Extract:
The patient'sexcessively high respiratory rate (RR 50),hypoxia (SpO# 89%), anddecreased mental status (drowsiness) indicaterespiratory failure, which is theinability to maintain oxygenation or ventilation.
* Respiratory distress: Increased effort but adequate compensation
* Respiratory arrest: Complete absence of breathing
* Respiratory alkalosis: Possible early finding, but not a condition diagnosis This patient is tiring and losing the ability to ventilate effectively - a hallmark of failure.
References:
NREMT Airway and Ventilation Guidelines
AHA BLS Manual - Recognition of Respiratory Failure
AAOS EMT Textbook - Chapter: Airway Emergencies
질문 # 171
While assisting an ALS unit, you observe a contaminated needle has been stuck into the mattress. You should
정답：A
설명：
NREMT standards emphasize scene safety, infection control, and proper sharps handling to reduce the risk of occupational exposure. A contaminated needle left in a mattress presents a serious needlestick hazard to EMS providers, hospital staff, and patients.
Option B is correct because the appropriate action is to carefully remove the needle and immediately dispose of it in an approved sharps container. This follows OSHA and NREMT infection-control principles, which state that sharps must be disposed of promptly in puncture-resistant containers without unnecessary handling.
Option A is incorrect because recapping needles is strictly prohibited under standard precautions. Recapping significantly increases the risk of accidental needlestick injuries and violates established safety guidelines.
Option C is incorrect because confronting a paramedic in front of a patient is unprofessional and undermines team dynamics. Any concerns regarding unsafe practices should be addressed privately and through appropriate supervisory channels.
Option D is incorrect because ignoring an exposed sharp creates an ongoing safety hazard and fails the EMT's responsibility to maintain a safe environment.
In summary, NREMT expects EMTs to act proactively to reduce hazards, follow standard precautions, and safely dispose of sharps without recapping or delay. Removing the needle carefully and placing it in a sharps container is the safest and most appropriate response.
질문 # 172
Following insertion of an oropharyngeal airway in an unresponsive 1-year-old male, he develops cyanosis and bradycardia. You should
정답：B
설명：
Comprehensive and Detailed Explanation From Exact Extract:
In infants, improper insertion of an OPA (oropharyngeal airway) can stimulate the vagus nerve, leading to bradycardia or even complete airway obstruction. If cyanosis and bradycardia develop after OPA insertion, immediate removal and resumption of ventilations with a bag-valve mask is critical.
The OPA must be properly sized and inserted only in patients without a gag reflex. Ventilations alone often reverse vagally induced bradycardia.
References:
NREMT Psychomotor Skills - Pediatric Airway
American Heart Association PALS Provider Manual (2020)
Brady Emergency Care (13th ed.) - Pediatric Airway Management
질문 # 173
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