EMT Basic Examination

The National Registry of Emergency Medical Technicians (NREMT) offers the EMT-Basic Examination for certification purposes. NREMT offers the test with the main goal of ensuring that EMS workers are able to give capable medical care to people during times of great need. An EMS professional is in a position of trust and must be able to proficiently manage patients outside of a hospital environment.

For the cognitive EMT basic test, the six main areas covered include:

  • 18% Airway & Breathing
  • 17.3% Cardiology
  • 16.7% Trauma
  • 15.3% Medical
  • 16% Obstetrics and Pediatrics
  • 16.7% Operations

For the practical exam, candidates need to master these skill areas:

  • Patient Assessment/Management – Trauma
  • Patient Assessment/Management – Medical
  • Cardiac Arrest Management/AED
  • Spinal Immobilization (Seated Patient)
  • Spinal Immobilization (Supine Patient)
  • Bag-Valve-Mask Apneic Patient with a Pulse
  • Long Bone Fracture Immobilization
  • Joint Dislocation Immobilization
  • Traction Splinting
  • Bleeding Control/Shock Management
  • Upper Airway Adjuncts and Suction
  • Mouth-to-Mask with Supplemental Oxygen
  • Supplemental Oxygen Administration

Each candidate will pass or fail based on whether or not he or she has met the least level of proficiency. The exams are computer adaptive tests (CAT), meaning that as the student works through the questions, the test is adjusted according to how the candidate is doing. As a candidate gets items in a series correct, the next series will be given at a higher level. This continues to occur until the candidate gets to a level that is the highest for him or her. At some point, every candidate reaches the highest level he or she can achieve and the test will be over. The computer will be able to tell whether the candidate meets the standard for entry-level competency for the content areas tested. Due to the nature of a CAT test, the length of time required to finish the assessment will vary. In the same way, the number of questions is different for each candidate, depending on the level of competency. For anyone, the test questions will cover the six main areas. If a candidate does not pass the exam, the results will indicate what areas to study for taking it again. The results will also indicate if a candidate is above, near or below the competency level needed for each content area.

EMT Basic Practice Test

    1. The medical terminology for breathing too fast and shallow is
      1. Bradypnea
      2. Dyspnea
      3. Tachypnea
      4. Bronchiectasis
    1. An important anatomical landmark when performing the Sellick maneuver is the
      1. Trachea
      2. Esophagus
      3. Cricoid ring
      4. Diaphragmatic ring
    1. Which of the following is a correct statement about circulation?
      1. Oxygen-poor blood flows into the left atrium, then the left ventricle through the pulmonary arteries to the lungs to receive oxygen, then into the pulmonary veins to the right atrium into the right ventricle, and then it is pumped to the rest of the body
      2. Oxygen-poor blood flows into the right ventricle, then the right atrium through the pulmonary arteries to the lungs to receive oxygen, then into the pulmonary veins to the left ventricle into the left atrium, and then it is pumped to the rest of the body
      3. Oxygen-poor blood flows into the right atrium, then the right ventricle through the pulmonary arteries to the lungs to receive oxygen, then into the pulmonary veins to the left atrium into the left ventricle, and then it is pumped to the rest of the body
      4. Oxygen-poor blood flows into the right atrium, then the right ventricle through the pulmonary veins to the lungs to receive oxygen, then into the pulmonary arteries to the left ventricle into the left atrium, and then it is pumped to the rest of the body
    1. In which of the following conditions would the use of an AED be most effective?
      1. Atrial fibrillation
      2. Asystole
      3. Ventricular tachycardia with a pulse
      4. Ventricular fibrillation
    1. You have been called to the home of a patient who was found unconscious. On first observation, you notice the patient has vomited what appears to be vomit mixed with dark brown liquid that looks like coffee grounds. This could possibly be indicative of which of the following?
      1. Blood that was swallowed from a wound in the mouth
      2. Bleeding that is originating from an internal bleed in the stomach
      3. Blood that has been in the stomach for a while and has been partially digested
      4. Blood that is originating from a lower gastrointestinal bleed
    1. You are assessing a pregnant patient who appears to be close to term. She is having regular contractions, and upon examination, you decide she is in the second stage of labor. What would be the BEST indication of this?
      1. Regular contractions 10 minutes apart
      2. Evidence of bloody show
      3. Crowning is evident
      4. The cervix is dilated almost to 10 cm
    1. As you are assessing an infant’s APGAR scores, you realize that the infant’s heart rate is 78 beats per minute. What should you do next?
      1. Provide artificial ventilations at a rate of 15 liters per minute then reassess after 30 seconds
      2. Provide positive pressure ventilations at a rate of 30 to 60 per minute then reassess after 30 seconds
      3. Start chest compressions according to newborn standards, and reassess in 1 minute. If the heart rate is above 100 beats per minute, stop the compressions and administer high-flow oxygen via a nonrebreather mask
      4. Start chest compressions according to newborn standards, and reassess after 30 seconds. If the heart rate is above 100 beats per minute, stop the compressions and administer free-flow oxygen
    1. The proper order for securing the straps on the KED is
      1. Head, top, middle, bottom, legs
      2. Head, legs, top, middle, bottom
      3. Legs, head, top, bottom, middle
      4. Middle, bottom, legs, head, top
    1. You are responding to a 911 call at the scene of a car accident. There appears to be two people in the car, and they are not able to get out. Which of the following is NOT an indication for rapid extrication?
      1. You smell gasoline around the car
      2. One of the passengers appears to be in severe pain
      3. The patient closest to you needs to be moved quickly in order to reach the second patient, who appears to be critically injured
      4. The patient appears to be in cardiac arrest
    1. You have arrived onto the scene to respond to a 911 call for a child in respiratory distress. When you arrive, you discover that the parents are divorced, are arguing about providing care, and the father is blocking your access. What is the best course of action for you to take?
      1. Treat the child in the way that you see fit
      2. Physically remove the child from the situation, and try to treat in another area away from the parents
      3. Try to reason with the parents and explain the urgency of the situation
      4. Call the police for assistance

EMT Basic Practice Test Answers and Explanations

  1. C: Tachypnea is the medical term used for shallow, fast breathing. A normal respiratory rate is somewhere around 12 to 20 breaths per minute for an adult. Breathing faster than 24 breaths per minute is considered tachypnea. Tachypnea can be caused by many different illnesses, including pneumonia, asthma, chronic obstructive pulmonary disease (COPD), chest pain, or pulmonary embolism. Patients who are breathing rapidly should be administered oxygen at a rate of 15 liters/minute. A nonrebreather mask can be used, or in some cases, a nasal cannula may be substituted. Patients who have a history of asthma or COPD may need to use their inhaler as well to help open up the airway.
  2. C: The Sellick maneuver is a method of establishing an airway that helps decrease the risk of regurgitation and can be performed on patients without a gag reflex. This procedure helps to reduce the amount of air that enters the stomach, thus reducing gastric distention. The cricoid ring is located just below the Adam’s apple. When this area is depressed, the resultant bump is the cricoid ring. When the cricoid ring is depressed posteriorly, the esophagus will collapse without causing harm to the airway. Three EMTs are required to perform this procedure. Two EMTs are needed to operate the bag mask ventilation (BMV), and the third is needed to hold pressure on the cricoid ring. This pressure needs to be maintained until an endotracheal tube is placed.
  3. C: There are four main chambers of the heart. The upper chambers of the heart are the right and left atria, and the lower chambers of the heart are the right and left ventricles. Oxygen-poor blood enters the right atrium and then is pumped into the right ventricle. From here, the blood enters into the pulmonary arteries into the lungs to become oxygenated. The blood is then pumped through the pulmonary veins into the left atrium and then into the left ventricle. From here, the oxygen-rich blood is pumped through the aorta to the rest of the body to deliver oxygen. There are many valves located within the heart to prevent blood from backing up. These valves include the tricuspid, bicuspid, aortic, and pulmonary valves. Arteries carry blood away from the heart, and veins carry blood back to the heart.
  4. D: An automated external defibrillator (AED) is most useful in a patient in sudden cardiac arrest (SCA) who is experiencing ventricular fibrillation. This occurs when the ventricles, or lower chambers of the heart, are beating abnormally fast and in an irregular pattern. By using the AED, the delivery of a shock can help regulate the heart’s rhythm. An AED can be used on a patient with ventricular tachycardia without a pulse, but if the patient has a pulse, it can cause irreparable damage, such as asystole. Asystole is a lack of heart rhythm that cannot be shocked into a normal rhythm. AEDs are now found in a wide variety of places, including airports, schools, places of business, and hotels. If an SCA occurs, early intervention is critical in achieving survival. AEDs are relatively easy to use and are computerized to provide detailed but simple instructions to ensure proper use.
  5. C: Blood that is related to a gastrointestinal bleed can provide a lot of information based just on appearance. Blood that appears to be oozing from the mouth, vagina, or rectum may be indicative of internal bleeding and should not be ignored. If the blood is originating from the GI tract, the color, smell, amount of blood, and any other distinguishing characteristics can provide a clue to the source of the bleed. Bright red blood mixed with vomit may be indicative of a new bleeding site. If the vomit is mixed with what appears to be a brownish liquid that looks like coffee grounds, it may be indicative of an older bleed that has been partially digested. This would contain digestive juices as well as the by-products of blood. If there is bleeding occurring lower in the GI tract, such as the small or large intestine, it will appear as black, tarry-looking stools. The blood has gone through the digestive process.
  6. C: Labor consists of three stages. The first stage starts with contractions that help to propel the baby closer to the birth canal. Initially, the contractions can be abnormal and far apart, but as labor progresses, the contractions will be closer together. The cervix dilates and is measured in centimeters to gauge how far along the first stage of labor is. Contractions help to prepare the cervix, and the presence of bloody show can be seen during this phase. Ten centimeters is the dilation needed to attain in order for the baby’s head to fit through the birth canal. A woman enters the second stage of labor as the baby’s head enters the birth canal and can be seen through the vaginal opening. This is known as crowning. When this is observed, it is an indication that the baby will be born very quickly and on the scene. The third stage of labor is the afterbirth where the placenta is delivered.
  7. D: Newborn infants should begin breathing on their own within a few seconds after birth. If the infant does not immediately begin to breathe, the infant should be gently rubbed in a circular motion on the back to stimulate breathing. Alternately, you can rub or gently tap on the bottom of the infant’s feet. If neither of these tactics works, the next step is to provide positive pressure ventilations at a rate of 30 to 60 per minute. When assessing the heart rate, if it is less than 100 beats per minute, ventilations should be given at a rate of 60 per minute. If the heart rate is less than 80, this indicates a need for chest compressions. There are special standards for conducting CPR on a newborn, and these guidelines should be followed. The infant should be reassessed in 30 seconds. Once the heart rate is above 100, free-flow oxygen should be administered by holding the oxygen mask close to the baby’s mouth but not placing it directly on the face.
  8. D: Manufacturer’s instructions should be verified on strap use, but EMTs are taught the following basic procedure. Straps are color coded on the KED for simplifying use. There are two head straps, two leg straps, and three chest straps. First, the chest straps are applied in the order of middle and bottom. The thigh or leg straps are secured next. The head is secured, followed by tightening of the top strap. Ensure that the patient is able to breathe properly and that the strap is not too tight. There are a couple of mnemonics that are used: “My Baby Looks Hot Tonight” or “Money Buys Lots of Hot Toys,” in which the first letter of each word helps you to remember the order. The main point to remember is that the head should be secured after the middle to prevent additional injuries from occurring.
  9. B: Rapid extrication is the quick removal of a patient. There are certain situations that warrant rapid extrication. These include an unsafe scene where there may be danger of a fire or explosion. Another indication would be that the patient is in the way of accessing another patient who is more seriously injured. Rapid extrication should occur if the patient’s medical status indicates the need to immediate care, such as cardiac arrest, possible shock, or difficulty breathing. The decision to make a rapid extrication should be based on the urgency of care or safety but not on the preference of the responder. The disadvantages of rapid extrication include the inability to adequately stabilize the spine in case of spinal injury.
  10. D: Most parents will willingly provide legal consent for treatment for their child. In very rare and unusual situations, consent may not be provided. Sometimes this is not an issue if the injury is not a threat to the child’s life. In other circumstances, quick action must be taken. The best course of action in a life-threatening situation would be to summon the help of the police. The officer would be able to take the child into protective custody, and then treatment can begin without issue. Physically removing a child from the situation could be dangerous for the child, the adults involved in the situation, as well as the EMT responding.

 

Last Updated: June 4, 2019