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質問 # 13
A patient has facial drooping, left side paralysis, and slurred speech. The vital signs are BP 160/100, P
100, R 20, and SpO2 96% on room air. Which of the following interventions is appropriate for this patient?

• A. Place the patient in a supine position
• B. Avoid asking the patient questions due to dysphasia
• C. Administer oxygen at 12 LPM
• D. Protect the left arm during transport

正解：D

解説：
Comprehensive and Detailed Explanation From Exact Extract:
The patient's symptoms are consistent with astroke (CVA). Proper prehospital care focuses on maintaining airway, breathing, circulation, and protecting the affected limbs.Positioning the patient with head elevated (not supine) reduces intracranial pressure and aspiration risk.
Protecting theparalyzed side (e.g., left arm)from injury during transport is critical. EMS should still communicate with the patient - even if speech is impaired - and perform a stroke assessment using tools likeCincinnati Prehospital Stroke Scale (CPSS)orFAST.
References:
NREMT Medical Emergencies: Neurological Conditions
AHA Stroke Guidelines - Prehospital Management
National EMS Education Standards - Stroke Assessment Protocols

質問 # 14
A 3-year-old female choked while eating a hot dog and then became unresponsive. You should first

• A. Begin chest compressions
• B. Deliver two rescue breaths
• C. Perform a head tilt-chin lift maneuver
• D. Check her carotid pulse

正解：A

解説：
Comprehensive and Detailed Explanation From Exact Extract:
According toPediatric Basic Life Support (PBLS) guidelinesby theAmerican Heart Association (AHA), when a child becomes unresponsive due to foreign body airway obstruction (FBAO), the immediate next step is to beginchest compressions. This is donebefore checking the airway or giving breathsbecause the airway is presumed obstructed. The compressions may dislodge the object.
After 30 compressions, open the airway and check for visible objects. If none are seen, attempt rescue breaths.
This protocol reflects the high risk of complete airway blockage in children with sudden collapse following a choking episode.
References:
AHA PALS and BLS Provider Manual (2020), Pediatric FBAO Algorithm
NREMT Cognitive Exam Blueprint - Pediatric Airway Obstruction
National EMS Education Standards (2011) - Pediatric Emergencies

質問 # 15
Which of the following is the most reliable indicator of effective respiration in a patient?

• A. Respiratory rate
• B. Mental status
• C. Skin color
• D. Pulse oximetry reading

正解：B

解説：
Comprehensive and Detailed Explanation From Exact Extract:
Mental statusreflects perfusion and oxygen delivery to thebrain, which is highly sensitive to hypoxia and hypercapnia. Even if respiratory rate and SpO# are normal, altered mental status suggests ineffective gas exchange or hypoperfusion.
Pulse oximetry may be falsely normal in CO poisoning or poor perfusion. Skin color is subjective and not as sensitive or specific as neurological status.
References:
NREMT Assessment Standards - Airway & Neurological Assessment
AHA BLS Manual - Recognition of Effective Ventilation
Brady Emergency Care (13th ed.) - Patient Assessment and Respiratory Emergencies

質問 # 16
A 70-year-old patient has a sudden onset of difficulty breathing with throat and chest tightness after working outside. The EMT auscultates bilateral wheezes. The vital signs are BP 60/44, P 128, R 28, and SpO# 90% on room air. Which of the following treatments should the EMT administer?

• A. Epinephrine auto-injector
• B. Patient's metered-dose inhaler
• C. Positive pressure ventilations
• D. Sublingual nitroglycerin

正解：A

解説：
Comprehensive and Detailed Explanation From Exact Extract:
The symptoms and vital signs (wheezing, hypotension, high pulse rate, respiratory distress) are strongly indicative ofanaphylaxis, which is alife-threatening allergic reaction. Bilateral wheezing and hypotension further confirm systemic involvement. Thefirst-line treatment is intramuscular epinephrine, which:
* Reverses bronchospasm (via beta-2 adrenergic effects)
* Raises blood pressure (via alpha-1 vasoconstriction)
* Improves airway tone and reduces mucosal edema
A metered-dose inhaler may help in mild bronchospasm but is insufficient duringanaphylactic shock.
Positive pressure ventilations are a secondary measure if respiratory failure occurs. Nitroglycerin is contraindicated due to low BP.
References:
NREMT Medical/Obstetrics/Gynecology Guidelines - Allergic Reactions
AHA ACLS Provider Manual (2020), Section on Anaphylaxis
National EMS Education Standards - Immune System Emergencies

質問 # 17
Which of the following components can be determined by assessing the mechanism of injury? Select the two correct options.

• A. Extent of injury
• B. Destination facility
• C. Chances of survival
• D. Need for additional resources
• E. Patient's medical history

正解：A、D

解説：
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 ofALS backup,air transport, or technical rescue.
MOI cannot determine a patient'smedical historyor guarantee survival predictions. Thedestination facility depends on multiple factors including triage protocols, vital signs, and local trauma system regulations.
References:
NREMT Trauma Assessment Skills Sheet
National EMS Education Standards - Trauma Module
AAOS Emergency Care and Transportation (11th ed.), Chapter: Mechanism of Injury and Trauma Assessment

質問 # 18
While responding to an emergency, a car is tailgating the ambulance. Which of the following actions should the EMT take?

• A. Slow down
• B. Pull over
• C. Tap the brakes
• D. Speed up

正解：C

解説：
Comprehensive and Detailed Explanation From Exact Extract:
In situations where a vehicle is tailgating an emergency unit, tapping the brakes briefly is a standard defensive driving maneuver to alert the driver behind to increase distance. It is less risky than slowing dramatically or pulling over, which could endanger crew or delay response.
Speeding up could reduce your reaction window or increase accident risk. EMS operators must follow safe driving practices per NFPA 1002 and DOT Emergency Vehicle Operation Guidelines.
References:
NREMT Operations Section - Driving and Scene Safety
NFPA 1002: Standard for Fire Apparatus Driver/Operator Professional Qualifications
U.S. DOT: Emergency Vehicle Operator Course (EVOC)

質問 # 19
A 24-year-old patient was involved in an MVC. The EMT is completing the patient care report. Which of the following statements indicate pertinent negatives? Select the two correct options.

• A. "The patient reported abdominal tenderness."
• B. "The patient denied neck or back pain."
• C. "The patient initially refused assessment."
• D. "The patient reported no loss of consciousness."
• E. "The patient was disruptive and non-compliant with EMS."

正解：B、D

解説：
Comprehensive and Detailed Explanation From Exact Extract:
Pertinent negativesare findings that arenot present, butwould be clinically relevant if they were. For example:
* "No neck or back pain"helps rule out spinal injury
* "No loss of consciousness"informs head trauma assessment
Statements about behavior or initial refusal (B, E) may be documented under patient behavior or refusal, but they are not pertinent negatives. Positive findings like abdominal tenderness arepertinent positives.
References:
NREMT Documentation Standards
National EMS Education Standards - Communication and Documentation
Brady Emergency Care (13th ed.) - Patient Care Reporting

質問 # 20
In order for a plaintiff to recover damages in a lawsuit against an EMT, there must be a duty to perform, breach of duty, damage, and

• A. Proximate causation
• B. Malfeasance
• C. Contributory neglect
• D. Abandonment

正解：A

解説：
Comprehensive and Detailed Explanation From Exact Extract:
To establishnegligence, four legal elements must be proven:
* Duty to act- a legal obligation to provide care.
* Breach of duty- failing to meet the standard of care.
* Damages- harm occurred.
* Proximate causation- the breach directly caused the damage.
"Proximate causation" means the EMT's action or inaction is closely linked to the harm suffered by the patient.
References:
NREMT Candidate Handbook - Legal and Ethical Guidelines
"Emergency Care" (13th ed., Limmer & O'Keefe) - Chapter: Medical, Legal, and Ethical Issues National EMS Education Standards - Professionalism and Ethics

質問 # 21
A 9-year-old patient who was injured in an MCI is brought to the treatment area with a delayed triage tag. Which of the following signs or symptoms would the EMT expect to find? Select the three correct options.

• A. Mottled skin
• B. Ability to ambulate
• C. Breathing only after opening the airway
• D. Follows simple commands
• E. Respiratory rate of 16
• F. Palpable pulses being present

正解：B、D、F

解説：
Comprehensive and Detailed Explanation From Exact Extract:
In pediatric START orJumpSTARTtriage, a "delayed" status is appropriate if the child is breathing adequately, has palpable pulses, and follows commands. The respiratory rate of 16 is normal for a 9-year-old, and being able to walk also supports the "delayed" tag.
"Mottled skin" and "breathing only after airway opening" would more likely lead to "immediate" or even
"expectant" categories depending on associated symptoms.
References:
JumpSTART Pediatric MCI Triage Algorithm
National EMS Education Standards - Triage
PALS Provider Manual (American Heart Association)

質問 # 22
What components are necessary to maintain adequate perfusion? Select the three correct options.

• A. Sufficient blood volume
• B. High alveolar pressure
• C. Intact microcirculation
• D. Hypoxic drive
• E. Patent airway
• F. Low ventilation-perfusion ratio

正解：A、C、E

解説：
Comprehensive and Detailed Explanation From Exact Extract:
Perfusionrefers to delivery of oxygen and nutrients to tissues. It depends on three essential components:
* Patent airway: Ensures oxygen reaches lungs
* Intact microcirculation: Capillary-level exchange must function
* Sufficient blood volume: Maintains blood pressure and oxygen transport Hypoxic drive relates toCOPD physiology, not perfusion.High alveolar pressure(like from CPAP) may impede venous return, and alow ventilation-perfusion ratiomeans poor oxygenation efficiency, which negatively affects perfusion.
References:
NREMT Cardiovascular and Shock Guidelines
National EMS Education Standards - Perfusion and Circulatory Assessment AHA ACLS Provider Manual - Systemic Perfusion Concepts

質問 # 23
A 65-year-old patient with a history of angina reports chest pain and shortness of breath after playing golf. The patient stated the pain began one hour ago and has not stopped with rest. The vital signs are BP 86/64, P 112, R 22, and SpO# 89% on room air. Which of the following actions should the EMT do next?

• A. Administer CPAP
• B. Give nitroglycerin
• C. Obtain a 12-lead ECG
• D. Provide nebulized albuterol

正解：C

解説：
Comprehensive and Detailed Explanation From Exact Extract:
This is ahigh-risk cardiac eventdue to unstable angina or possiblemyocardial infarction. The EMT should:
* Administer oxygenif SpO# is <94%
* Avoid nitroglycerinif systolic BP is <90 mmHg
* Obtain a 12-lead ECGto identify ST-elevation MI (STEMI) and transmit it if trained and authorized CPAP is indicated forpulmonary edema, and albuterol is forbronchospasm, neither of which applies here.
References:
AHA ACLS and BLS Guidelines - ACS Management
NREMT Cardiology Guidelines - Chest Pain/MI
National EMS Education Standards - Cardiovascular Emergencies and ECG Recognition

質問 # 24
A 3-year-old patient ingested laundry detergent. The patient is drowsy and has crackles in all lung fields. What should most concern the EMT at this time? Select the three answer options that are correct.

• A. Hypoglycemia
• B. Vomiting
• C. Esophageal perforation
• D. Acid reflux
• E. Respiratory failure
• F. Seizure

正解：B、C、E

解説：
Comprehensive and Detailed Explanation From Exact Extract:
Laundry detergent ingestion - especially in the case ofliquid detergent pods- is associated withcaustic airway and gastrointestinal injuries. The presence ofcracklesanddrowsinessare signs of aspiration and possiblerespiratory failure. Vomiting increases the risk ofaspiration pneumonitis, andesophageal perforationis a life-threatening complication from corrosive ingestion.
While seizure and hypoglycemia are possible complications of toxic ingestion, they are not as immediately linked to the detergent profile as airway injury and aspiration risk.
References:
NREMT Pediatric Toxicology and Airway Emergencies
National Poison Data System (NPDS) Annual Report
AAOS Emergency Care Textbook (11th ed.) - Pediatric Poisoning and Toxin Exposure

質問 # 25
A 30-year-old patient has a stab wound to the left forearm that is bleeding profusely. Which of the following interventions should the EMT perform first?

• A. Place a tourniquet
• B. Determine severity of wound
• C. Assess the airway
• D. Apply direct pressure

正解：D

解説：
Comprehensive and Detailed Explanation From Exact Extract:
Thefirst step in hemorrhage controlfor external bleeding is alwaysdirect pressureusing gloved hands or dressing. Only if this fails or the bleeding issevere and life-threatening(especially from extremities) should a tourniquetbe applied.
Assessing the airway is critical in overall trauma care but not thefirst priorityin isolated extremity hemorrhage. Severity assessment is secondary tobleeding control.
References:
NREMT Trauma Skills: Bleeding Control/Shock
Tactical Combat Casualty Care (TCCC) Guidelines - Hemorrhage Management National EMS Education Standards - Soft Tissue Injuries

質問 # 26
When using the SALT method for triage, which of the following interventions should the EMT perform during the individual assessment step?

• A. Assessing respirations, administering two rescue breaths, and assessing patient mentation
• B. Insertion of airway adjuncts, bleeding control, and moving patients to the triage area
• C. Completing first responder scorecards to track patients
• D. Bleeding control, opening the airway, and administering two rescue breaths for pediatric patients

正解：A

解説：
Comprehensive and Detailed Explanation From Exact Extract:
SALT(Sort, Assess, Lifesaving interventions, Treatment/Transport) is a mass casualty triage method recommended by theCDC and the National Association of EMS Physicians (NAEMSP). During the
"Assess" step, responders:
* Checkrespirations
* Providelifesaving interventionssuch asrescue breathsif the patient is not breathing but has a pulse
* Evaluatementation(e.g., ability to follow commands)
Airway adjuncts and full transport do not happen at this stage. Scorecards and pediatric-specific modifications are addressed later in the protocol.
References:
NREMT EMS Operations - Mass Casualty and Triage Guidelines
CDC SALT Mass Casualty Triage Guidelines
National EMS Education Standards - Disaster Response

質問 # 27
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?

• A. The patient's blood sugar is most likely low.
• B. The patient's blood sugar cannot be inferred.
• C. The patient's blood sugar is most likely high.
• D. The patient's blood sugar is most likely normal.

正解：A

解説：
Comprehensive and Detailed Explanation From Exact Extract:
Altered mental status, combined withpale, cool, and clammy skin, is strongly suggestive ofhypoglycemia (low blood sugar). Hypoglycemia is especially dangerous in diabetics who take insulin or oral hypoglycemics.
The body'sadrenergic responsecauses the "cool and clammy" presentation.
Hyperglycemia typically presents withwarm, dry skinand develops more slowly. EMTs shouldadminister oral glucoseif 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

質問 # 28
A 58-year-old patient reports chest pain and difficulty breathing after missing their last three hemodialysis treatments. Which of the following signs and symptoms should the EMT suspect to find?

• A. Crackles
• B. Bradycardia
• C. Fever
• D. Hypotension

正解：A

解説：
Comprehensive and Detailed Explanation From Exact Extract:
Missing dialysis leads tofluid overload, causing:
* Pulmonary edema, evident bycrackleson auscultation
* Dyspnea and chest discomfort
Bradycardia is less likely; patients more often present withtachycardiadue to volume stress. Fever would suggest infection (not stated here), and hypotension can occur later, but hypertension is more common in early fluid overload.
References:
NREMT Medical Emergencies - Renal and Dialysis Patients
National Kidney Foundation Guidelines - Missed Dialysis and Pulmonary Symptoms AAOS EMT Textbook - Urologic and Fluid Volume Imbalance

質問 # 29
When treating a patient suspected of having tuberculosis, you should

• A. Place a HEPA respirator on the patient
• B. Place a surgical mask on the patient
• C. Wear a surgical mask before treating the patient
• D. Notify the Centers for Disease Control

正解：B

解説：
Comprehensive and Detailed Explanation From Exact Extract:
Forsuspected or confirmed tuberculosis (TB), the EMT should place asurgical mask on the patient, not a HEPA respirator. Surgical masks are used tocontain droplets from the patientand reduce airborne transmission.
The EMTshould wear aN95 or HEPA respiratorto protect against inhaling airborne particles. Notification to the CDC is not the EMT's responsibility - that falls to public health officials.
References:
CDC Guidelines for TB Exposure in Prehospital Settings
NREMT Infectious Disease Control Protocols
National EMS Education Standards - Airborne Pathogens and PPE Use

質問 # 30
Which of the following sections are designated by command at an MCI? Select the three correct options.

• A. Finance
• B. Planning
• C. Catering
• D. Aviation
• E. Logistics
• F. Staging

正解：A、B、E

解説：
Comprehensive and Detailed Explanation From Exact Extract:
InIncident Command System (ICS)for Mass Casualty Incidents (MCI), the four major sections are:
* Planning: Collects data and develops response strategies
* Logistics: Supplies and personnel
* Finance/Administration: Cost tracking, contracts, compensation
Stagingis atactical location, not a management section.Catering and aviationare not command-level ICS designations unless part of specific tasks under logistics or operations.
References:
NIMS ICS Framework - FEMA (ICS-100/700)
NREMT EMS Operations - MCI Command Structure
National EMS Education Standards - Incident Management

質問 # 31
A patient is having an asthmatic attack. The EMT receives orders from medical control to assist with the patient's inhaler. What are the expected side effects of this medication? Select the three correct options.

• A. Nervousness
• B. Tachycardia
• C. Confusion
• D. Drowsiness
• E. Coughing
• F. Hypotension

正解：A、B、E

解説：
Comprehensive and Detailed Explanation From Exact Extract:
Albuterol, a commonbeta-2 adrenergic agonistused 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.
References:
NREMT Scope of Practice Model - Medication Administration
American Heart Association BLS and ACLS Drug List
"Emergency Care and Transportation of the Sick and Injured" (AAOS, 11th ed.), Chapter on Respiratory Emergencies

質問 # 32
An 83-year-old patient is unresponsive and lying on the floor. The patient has a large bruise and laceration on the forehead. The patient's vital signs are BP 90/60, P 126, and R 0. Which of the following conditions should the EMT most suspect?

• A. Commotio cordis
• B. Brain herniation
• C. Open pneumothorax
• D. Spine injury

正解：D

解説：
Comprehensive and Detailed Explanation From Exact Extract:
Givenfall with head traumaandabsent respirations, the most concerning cause isspinal injury, particularly acervical spine fracture. Ahigh cervical injury (C1-C4)canparalyze the diaphragm, leading toapnea despite a beating heart.
Brain herniation can also depress respirations but often presents withunequal pupils,posturing, andCushing' s triad(not described here).Commotio cordisis sudden cardiac arrest from blunt chest trauma (not head).
Open pneumothoraxaffects chest mechanics, not directly linked here.
References:
NREMT Trauma Skills - Spinal Assessment
Brady Emergency Care (13th ed.), Chapter: Spine Injuries
National EMS Education Standards - CNS Trauma and Spinal Immobilization

質問 # 33
Which of the following would potentially complicate patient care during a helicopter transport?

• A. Maintaining 98% oxygen saturation
• B. Position of the patient's head within the aircraft
• C. Increase in the atmospheric humidity
• D. Use of air splints to immobilize fractures

正解：B

解説：
Comprehensive and Detailed Explanation From Exact Extract:
Theposition of the patient's headwithin the aircraft affectsaccess to airway managementandcrew maneuverability. If the head is oriented away from providers or toward a non-accessible bulkhead, this can delay critical interventions(airway suctioning, ventilations).
Use of air splints, maintaining oxygen saturation, or environmental humidity are not major complications relative tophysical positioningandin-cabin access limitations.
References:
NREMT EMS Operations - Air Medical Transport
NAEMSP (National Association of EMS Physicians): Air Medical Guidelines EMS Helicopter Safety Protocols - FAA Advisory Circulars

質問 # 34
Reassessment of a patient begins with repeating the

• A. Scene size-up
• B. Secondary assessment
• C. Vital signs
• D. Primary survey

正解：D

解説：
Comprehensive and Detailed Explanation From Exact Extract:
Thereassessment phasein the EMT patient assessment model starts with repeating theprimary survey(also called the primary assessment), which includes:
* Airway
* Breathing
* Circulation
* Disability (mental status)
* Exposure/environment
The purpose is to identify any changes or deterioration in the patient'slife-threatening conditions, especially in dynamic or unstable patients. Only after this do EMTs check vitals and reevaluate secondary complaints.
References:
NREMT Assessment Guidelines - Patient Reassessment
Brady Emergency Care (13th ed.), Chapter: Assessment in EMS
National EMS Education Standards - Patient Assessment

質問 # 35
A mountain climber tells you that he came down from a hike because he was coughing up blood. You should suspect

• A. Pulmonary embolism
• B. Neoplasm
• C. Pulmonary edema
• D. Spontaneous pneumothorax

正解：A

解説：
Comprehensive and Detailed Explanation From Exact Extract:
Hemoptysis (coughing up blood)in a physically active person, such as a mountain climber, strongly suggests apulmonary embolism (PE), particularly due to:
* Dehydration
* Prolonged exertion or immobility
* High altitude increasing clot risk
Symptoms may include:
* Shortness of breath
* Chest pain
* Tachypnea
* Hemoptysis
Pulmonary edemagenerally causes pink frothy sputum and is more associated with heart failure.Neoplasm (lung cancer)is possible but much less acute in onset.Spontaneous pneumothoraxcauses dyspnea and pleuritic chest pain but not typically hemoptysis.
References:
NREMT Medical Assessment - Pulmonary and Hematologic Emergencies
AAOS EMT Textbook - Chapter: Respiratory Emergencies
CDC Guidelines - High-Risk Conditions for Pulmonary Embolism

質問 # 36
Which of the following signs and symptoms indicate dehydration in an infant? Select the three correct options.

• A. Sunken fontanelles
• B. Hypoglycemia
• C. Hypertension
• D. Delayed capillary refill
• E. Flushed, dry skin
• F. Poor skin turgor

正解：A、D、F

解説：
Comprehensive and Detailed Explanation From Exact Extract:
Dehydration signs in infantsinclude:
* Poor skin turgor(elasticity)
* Sunken fontanelles(indicative of fluid loss)
* Delayed capillary refill(>2 seconds)
Flushed skin is more common infever or heat illness, not dehydration.Hypotension, not hypertension, is associated with dehydration in late stages.
References:
NREMT Pediatric Assessment and Fluid Emergencies
PALS Provider Manual - Dehydration in Infants
AAOS Emergency Care (11th ed.) - Pediatric Emergency Chapter

質問 # 37
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