NREMT EMTリアル試験問題テストエンジン問題集トレーニングには128問あります
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質問 # 48
A 55-year-old patient has ROSC and is trying to push the BVM away. Which of the following actions should the EMT take next?
- A. Switch to supplemental oxygen and check for a pulse.
- B. Restrain the patient and remove the AED.
- C. Switch to supplemental oxygen and remove the AED.
- D. Restrain the patient and continue ventilation.
正解：A
解説：
Return of spontaneous circulation (ROSC) indicates that the patient has regained a perfusing rhythm. If the patient is pushing away the BVM, this suggests improving mental status and spontaneous respirations.
Option D is correct because NREMT post-resuscitation care requires EMTs to reassess airway, breathing, and circulation, including confirming a pulse, and transition from assisted ventilations to supplemental oxygen if the patient is breathing adequately.
Options A and B are inappropriate because restraining a post-ROSC patient is rarely indicated and may worsen agitation.
Option C omits reassessment of circulation, which is critical after ROSC.
NREMT stresses frequent reassessment and supportive care following successful resuscitation.
質問 # 49
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. Brain herniation
- B. Commotio cordis
- 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 # 50
When treating a patient suspected of having tuberculosis, you should
- A. Wear a surgical mask before treating the patient
- B. Place a surgical mask on the patient
- C. Place a HEPA respirator on 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 # 51
Which of the following techniques are appropriate for examining a patient with an acute abdomen?
Select the two correct options.
- A. Press softly if the abdomen has a pulsating mass
- B. Palpate the abdomen prior to auscultation
- C. Visualize the abdomen before palpation
- D. Lie the patient supine with legs flexed
- E. Begin palpation with the most painful quadrant
正解：C、D
解説：
Comprehensive and Detailed Explanation From Exact Extract:
In patients with acute abdominal pain, you mustfirst inspect (visualize)for distension, discoloration, or masses beforetouching. Palpation always beginsaway fromthe most painful area. The patient should be in asupine position with knees flexedto relax the abdominal muscles and ease the exam.
Palpating a pulsating masscould rupture an abdominal aortic aneurysm and is contraindicated.
References:
NREMT Cognitive Exam Blueprint - Medical Emergencies
Emergency Care and Transportation of the Sick and Injured (AAOS, 11th ed.) - Chapter: Abdominal and GI Emergencies EMT-B National Standard Curriculum, Module: Medical Emergencies
質問 # 52
Heat exhaustion is most frequently associated with
- A. Altered mental status
- B. Bradycardia
- C. Hypertension
- D. Hypovolemia
正解：D
解説：
Comprehensive and Detailed Explanation From Exact Extract:
Heat exhaustionresults from prolonged exposure to elevated temperatures, leading tofluid and electrolyte loss(especially sodium and water), causinghypovolemia. This can result in:
* Tachycardia
* Weakness
* Dizziness
* Profuse sweating
Unlikeheat stroke, mental status is typically preserved in heat exhaustion. Hypertension and bradycardia are not characteristic.
References:
NREMT Environmental Emergencies Module
National EMS Education Standards - Heat-Related Illnesses
AAOS Emergency Care (11th ed.), Chapter: Environmental Emergencies
質問 # 53
What finding indicates that a mild airway obstruction has become a severe obstruction?
- A. Vomiting
- B. Ineffective cough
- C. Patient is able to speak
- D. Central cyanosis
正解：B
解説：
NREMT distinguishes mild versus severe airway obstruction primarily by the patient's ability to move air. In a mild obstruction, the patient can cough forcefully, speak, and exchange air. A severe obstruction occurs when airflow is critically impaired.
Option A (Ineffective cough) is the key indicator that a mild obstruction has progressed to a severe one. An ineffective or silent cough means the patient can no longer generate enough airflow to clear the obstruction, placing them at imminent risk of hypoxia and cardiac arrest.
Option B is a late sign of hypoxia but does not define severity of obstruction.
Option C is not specific to airway obstruction severity.
Option D indicates a mild obstruction, not severe.
NREMT teaches that once a cough becomes ineffective, immediate airway intervention is required.
質問 # 54
Which of the following actions are appropriate management for two-rescuer pediatric basic life support? Select the three correct options.
- A. Perform compressions at a ratio of 15:2
- B. Use the two-thumb-encircling-hands technique for infants
- C. Perform rescue breathing at a rate of 20 per minute
- D. Compress at a rate of 180 per minute
- E. Start CPR if the pulse rate is 72
- F. Compress the chest one-half the diameter of the chest
正解：A、B、F
解説：
Comprehensive and Detailed Explanation From Exact Extract:
Forpediatric BLS with two rescuers, currentAHA Guidelines (2020)recommend:
* Two-thumb encircling hands technique: Most effective for infants; provides consistent depth and control.
* Compression ratio of 15:2: Enhances ventilation without compromising perfusion.
* Compression depth: 1/3 of chest or approximatelyone-half the chest's depth.
CPR begins ifpulse <60 bpm with signs of poor perfusion, not at 72 bpm. Rate of180/minis excessive; ideal rate is100-120/min.
References:
AHA BLS Provider Manual (2020) - Pediatric BLS Section
NREMT Cardiology & Resuscitation Module
Pediatric Advanced Life Support (PALS) Guidelines
質問 # 55
A 27-year-old patient reports trouble breathing after being struck by a car. Which of the following findings are indicative of a possible chest wall injury? Select the three answer options that are correct.
- A. Subcutaneous emphysema
- B. Unequal rise and fall
- C. Clavicle deformity
- D. Jugular vein distention
- E. Occipital depression
- F. Epigastric distension
正解：A、B、C
解説：
Comprehensive and Detailed Explanation From Exact Extract:
Clavicle deformity suggests potential rib or thoracic trauma. Unequal chest rise may indicate a flail segment, pneumothorax, or hemothorax. Subcutaneous emphysema, the presence of air under the skin, is a classic finding in pneumothorax or tracheobronchial injury.
Occipital depression is not chest related; epigastric distension is a GI symptom; and jugular vein distention would suggest tension pneumothorax or cardiac tamponade, which are more advanced complications.
References:
NREMT Trauma Assessment Guidelines
National EMS Education Standards - Chest Injuries
AAOS Emergency Care and Transportation (11th ed.), Chapter: Chest and Abdominal Trauma
質問 # 56
A 15-year-old patient is unresponsive following an assault. The patient has a stab wound on the chest, which is gurgling. The vital signs are BP 76/48 mmHg, P 146/min, R 26/min, and SpO# 90% on room air.
Which of the following types of shock is the most likely cause of the patient's presentation?
- A. Distributive
- B. Cardiogenic
- C. Hypovolemic
- D. Obstructive
正解：D
解説：
Comprehensive and Detailed Explanation (Based on NREMT standards):
This patient has signs of penetrating chest trauma, severe hypotension, tachycardia, and respiratory distress.
A gurgling chest wound suggests an open pneumothorax, which can progress to tension pneumothorax.
Option C (Obstructive shock) is correct because air trapped in the chest can compress the heart and great vessels, preventing adequate cardiac output.
Option A is less likely because although blood loss may be present, the chest injury suggests impaired circulation due to pressure.
Option B involves pump failure, not trauma-related compression.
Option D involves abnormal vessel dilation, not mechanical obstruction.
NREMT emphasizes rapid recognition of obstructive shock and immediate intervention with occlusive dressings and rapid transport.
質問 # 57
A 78-year-old female tripped and fell while walking. Her left leg is rotated externally and shorter than her right leg. You should suspect
- A. Colles' fracture
- B. Posterior hip dislocation
- C. Proximal femur fracture
- D. Pelvic fracture
正解：C
解説：
Comprehensive and Detailed Explanation From Exact Extract:
Anexternally rotated, shortened legis a classic sign of aproximal femur fracture, specifically afemoral neck or intertrochanteric fracture, commonly seen in elderly fall patients. This presentation reflectsmuscle pulland fracture displacement.
* Posterior hip dislocationscauseinternal rotation.
* Pelvic fracturesmay cause instability but not specific leg rotation/shortening.
* Colles' fractureis a distal radius (wrist) injury, unrelated to leg trauma.
References:
NREMT Trauma Module - Musculoskeletal Injuries
National EMS Education Standards - Geriatric Trauma
AAOS Emergency Care (11th ed.), Chapter: Orthopedic Injuries
質問 # 58
A 17-year-old patient was stung by a bee and is now confused and short of breath. The vital signs are BP 78
/60 mmHg, P 140/min, R 26 and shallow, and SpO# 86% on room air. After administering epinephrine, what should the EMT do next?
- A. Assist ventilations with a BVM.
- B. Administer oxygen by non-rebreather mask.
- C. Administer oxygen by nasal cannula.
- D. Closely monitor the SpO#.
正解：B
解説：
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 SpO# 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.
質問 # 59
What are possible complications of using continuous positive airway pressure (CPAP)? Select the two correct options.
- A. Myocardial infarction
- B. Pulmonary edema
- C. Bronchospasms
- D. Feeling of suffocation
- E. Hypotension
正解：D、E
解説：
Comprehensive and Detailed Explanation From Exact Extract:
CPAPworks by delivering continuous positive pressure to keep alveoli open and improve oxygenation.
However, complications include:
* Hypotension: Due to reduced venous return and cardiac preload
* Feeling of suffocation: Common psychological reaction to a tight-fitting mask and forced airflow It isused to treat, not cause, pulmonary edema. It doesnot induce bronchospasmor myocardial infarction.
References:
NREMT Airway & Ventilation Guidelines
National EMS Education Standards - Noninvasive Positive Pressure Ventilation AAOS EMT Textbook (11th ed.), CPAP and Respiratory Distress Management
質問 # 60
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. Patient's metered-dose inhaler
- B. Epinephrine auto-injector
- C. Positive pressure ventilations
- D. Sublingual nitroglycerin
正解：B
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 # 61
A 43-year-old patient is experiencing a sudden onset of coughing, nausea, and shortness of breath. The patient has a history of alcohol use disorder and major depressive disorder. The patient spent the day cleaning. The kitchen has food in various forms of decay. The patient's condition improves slightly once oxygen has been administered. Which of the following environmental factors is the most likely cause of the patient's presentation?
- A. Mold exposure
- B. Chemical inhalation
- C. Alcohol intoxication
- D. Food poisoning
正解：B
解説：
Comprehensive and Detailed Explanation (Based on NREMT standards):
Sudden respiratory symptoms following prolonged cleaning strongly suggest chemical inhalation, particularly from cleaning agents such as ammonia or bleach. Mixing chemicals or using them in poorly ventilated areas can release toxic gases that cause coughing, nausea, and dyspnea.
Option D is correct because inhaled chemical irritants commonly cause acute respiratory distress that improves with oxygen therapy.
Option A typically causes chronic symptoms, not sudden onset.
Option B does not cause respiratory distress.
Option C does not explain the environmental exposure or oxygen response.
NREMT emphasizes recognizing environmental hazards and removing patients from the source while providing supportive care.
質問 # 62
Which of the following elements proves tort negligence in a court of law?
- A. False imprisonment
- B. Abandonment
- C. Causation
- D. Assault and battery
正解：C
解説：
Comprehensive and Detailed Explanation From Exact Extract:
The legal concept oftort negligencein 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 otherintentional torts, but not core elements of proving negligence.
References:
NREMT Ethics & Legal Module
Brady Emergency Care (13th ed.), Chapter: Legal and Ethical Issues
EMS Legal Primer - National EMS Management Association (NEMSMA)
質問 # 63
Which of the following is categorized as a personal injury prevention supply?
- A. Disinfectant cleaning solution
- B. N95 respirator
- C. Biohazard bag
- D. Pair of leather gloves
正解：D
解説：
Personal injury prevention supplies are designed to protect EMS providers from physical injuries, rather than infection.
Option C (Pair of leather gloves) is correct because leather gloves protect against cuts, abrasions, and puncture injuries during rescue operations such as vehicle extrication.
Option D (N95 respirator) is personal protective equipment (PPE) for infection control, not injury prevention.
Option A and B are related to biohazard handling and decontamination.
NREMT differentiates PPE from injury-prevention equipment to ensure proper risk management.
質問 # 64
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 mmHg, P 126/min, and R 0. Which of the following conditions should the EMT most suspect?
- A. Brain herniation
- B. Commotio cordis
- C. Spine injury
- D. Open pneumothorax
正解：A
解説：
This patient presents with severe head trauma, unresponsiveness, hypotension, tachycardia, and apnea (R =
0). NREMT education stresses that apnea following head injury is a critical red flag for increased intracranial pressure (ICP) and potential brain herniation.
Option B is correct because brain herniation occurs when swelling or bleeding within the skull forces brain tissue downward, compressing the brainstem. Compression of the brainstem can result in loss of respiratory drive, explaining the absence of respirations. Elderly patients are at increased risk due to cerebral atrophy and fragile bridging veins.
Option A is possible but does not directly explain apnea.
Option C is associated with sudden cardiac arrest after chest impact, not head trauma.
Option D would present with respiratory compromise but not directly from a forehead injury.
NREMT emphasizes rapid airway management, ventilation, spinal precautions, and immediate transport for suspected brain herniation.
質問 # 65
You are called to a small hotel where it is reported by the manager that several persons, in separate rooms, are unresponsive. Your first actions should be to
- A. rescue the victims.
- B. establish command.
- C. announce there is poisonous gas in the building.
- D. determine the size of the incident.
正解：D
解説：
This scenario suggests a potential multiple-casualty incident with a possible environmental hazard, such as carbon monoxide or another toxic gas. NREMT places strong emphasis on scene size-up as the first and most critical step in EMS operations.
Option B is correct because determining the size and scope of the incident allows the EMT to assess scene safety, identify hazards, estimate the number of patients, and determine the need for additional resources.
Entering the scene without this assessment could result in responder injury or death.
Option A is incorrect because establishing command typically follows an initial size-up. Command cannot be effectively established without understanding the nature of the incident.
Option C is incorrect because announcing the presence of poisonous gas without confirmation may cause panic and is not an appropriate first action.
Option D is incorrect because attempting rescue before confirming scene safety violates NREMT's core principle that rescuer safety comes first.
NREMT standards clearly state that EMTs must never enter a potentially hazardous scene until it has been properly assessed and deemed safe or appropriate resources are requested.
質問 # 66
A 12-year-old male suffered helmet-to-helmet contact while playing football. A bystander states, "He passed out for several seconds, then walked off the field under his own power." He is now unresponsive, and his vital signs are BP 180/110, P 90, and R 6. You should suspect
- A. Subdural hemorrhage
- B. Epidural hematoma
- C. Subarachnoid hemorrhage
- D. Intracerebral hematoma
正解：B
解説：
Comprehensive and Detailed Explanation From Exact Extract:
Anepidural hematomaclassically presents with a"lucid interval"- a brief period of regained consciousness following head trauma, followed by rapid deterioration. This is due to arterial bleeding, often from themiddle meningeal artery, leading to increasing intracranial pressure.
Signs include:
* High blood pressure
* Decreasing respiratory rate
* Altered LOC or unresponsiveness
Subdural hemorrhages are slower venous bleeds, common in elderly patients. Subarachnoid hemorrhage often presents with "worst headache of life." Intracerebral bleeds are less commonly linked to lucid intervals.
References:
NREMT Trauma Module - Head Injuries
AAOS Emergency Care Textbook (11th ed.), Chapter: Head and Spine Trauma Emergency Neurological Life Support (ENLS) Guidelines - Traumatic Brain Injury
質問 # 67
Reassessment of a patient begins with repeating the
- A. Secondary assessment
- B. Scene size-up
- 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 # 68
Ice crystals are found in several medications during a daily check. What should the EMT do next?
- A. Discard the medications.
- B. Check to see if the medications are expired.
- C. Reserve the medications for restock.
- D. Warm the medications prior to administration.
正解：A
解説：
NREMT medication management standards require EMTs to ensure that all medications are stored properly and are safe for administration. The presence of ice crystals indicates that a medication has frozen, which can alter its chemical stability, concentration, and effectiveness.
Option C is correct because medications that have frozen must be discarded and replaced, even if they later thaw. Freezing can cause separation of active ingredients or damage to the medication vial or syringe.
Option A is insufficient because expiration status does not address medication integrity.
Option B is incorrect because frozen medications are unsafe and should not be reused.
Option D is dangerous and explicitly prohibited, as warming does not restore medication safety.
NREMT emphasizes strict medication safety checks to prevent patient harm and ensure effective treatment.
質問 # 69
Which of the following is spread through the fecal-oral route?
- A. Hepatitis D
- B. Hepatitis A
- C. Hepatitis C
- D. Hepatitis B
正解：B
解説：
Comprehensive and Detailed Explanation (Based on NREMT standards):
Hepatitis A is a viral liver infection transmitted primarily through the fecal-oral route, often due to contaminated food, water, or poor hand hygiene. NREMT education highlights hepatitis transmission routes as part of infection control and standard precautions.
Option A is correct because hepatitis A spreads when microscopic amounts of fecal matter are ingested, commonly in environments with inadequate sanitation.
Options B, C, and D are incorrect because these forms of hepatitis are transmitted primarily through blood and body fluids, such as needlestick injuries, sexual contact, or shared needles.
Understanding transmission routes allows EMTs to apply proper protective measures and reduce occupational exposure risks, a core component of NREMT infection-control training.
質問 # 70
A 67-year-old patient is sitting in the tripod position. What general impression should the EMT most strongly suspect from this patient's position?
- A. The patient is in cardiac arrest
- B. The patient has abdominal pain
- C. The patient has trouble breathing
- D. The patient is having a seizure
正解：C
解説：
Comprehensive and Detailed Explanation From Exact Extract:
Thetripod position- sitting upright, leaning forward, supporting the upper body with arms on knees - is a classic sign ofrespiratory distress. This position:
* Maximizes diaphragmatic movement
* Engages accessory muscles of respiration
* Improves air exchange in patients with obstructive airway diseases (e.g., COPD, asthma) It is rarely used by patients with abdominal pain or seizures and is not associated with cardiac arrest (where unconsciousness is expected).
References:
NREMT Medical Assessment Flowchart - General Impression
AAOS EMT Textbook (11th ed.), Chapter: Respiratory Emergencies
AHA BLS: Identifying Signs of Respiratory Distress
質問 # 71
An Emergency Medical Responder is ventilating an apneic adult using a BVM. He is forcefully delivering each ventilation in less than 1 second. You should
- A. Assure the patient's airway has been opened.
- B. Tell the Emergency Medical Responder to stop ventilations and perform compressions.
- C. Have the Emergency Medical Responder squeeze the bag slower.
- D. Tell the Emergency Medical Responder to switch to a non-rebreather mask.
正解：C
解説：
NREMT guidelines specify that adult ventilations with a BVM should be delivered over approximately 1 second, just enough to see visible chest rise. Forceful, rapid ventilations increase the risk of gastric inflation, aspiration, barotrauma, and hypotension.
Option B is correct because slowing the rate and reducing force improves ventilation effectiveness and patient safety.
Option A may be important, but the primary error described is ventilation speed.
Option C is inappropriate for an apneic patient.
Option D is only indicated if the patient is pulseless.
NREMT emphasizes controlled, gentle ventilations to minimize complications.
質問 # 72
A 26-year-old male is choking. He is awake and has no air movement. He has a history of morbid obesity.
You should
- A. Perform abdominal thrusts while he is standing.
- B. Perform chest thrusts while he is standing.
- C. Lay him down and perform back slaps.
- D. Lay him down and perform abdominal thrusts.
正解：B
解説：
Comprehensive and Detailed Explanation (Based on NREMT standards):
For a conscious adult with complete airway obstruction, abdominal thrusts are typically indicated. However, NREMT guidelines specify that chest thrusts should be used instead for patients who are morbidly obese or pregnant, because abdominal thrusts may be ineffective or unsafe.
Option D is correct because chest thrusts provide effective airway clearance while accommodating body habitus.
Options A and B are inappropriate for a conscious patient.
Option C is incorrect because abdominal thrusts may not be effective in morbidly obese patients.
NREMT stresses modifying airway obstruction techniques based on patient size and condition.
質問 # 73
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