Free NREMT Practice Questions
Patient Treatment and Transport
Treat, reassess, move. Pick destination and pace based on patient status and evolving risk.
What you'll master
- ✓Scene time decisions vs rapid transport
- ✓Destination and escalation triggers
- ✓Reassessment loops during transport
- ✓Clear handoff structure
Common misses
- –Transport delays
- –No reassessment after interventions
- –Unclear handoff priorities
Sample questions.
25 free patient treatment and transport questions with answers and explanations. MedRelay's full question bank covers every NREMT domain, plus live scenarios that grade the decision, not just the answer.
Question 1
A 74-year-old female with a suspected hip fracture asks if her living will means you cannot treat her. How do you respond?
Why:Correct. A living will addresses end-of-life care in terminal or permanently unconscious states — it does not restrict fracture treatment, pain management, or transport for a conscious patient. Treat and transport her fracture appropriately. Document the living will and explain the distinction.
Question 2
You respond to a 62-year-old male with severe abdominal pain. While packaging him for transport his wife asks if you can turn on the heat in the ambulance because he is shivering from cold. The ambulance is already at 21 degrees C (70 degrees F). Is there any clinical concern with patient shivering during transport for abdominal pain?
Why:Correct. Shivering at comfortable ambient temperature may indicate fever or sepsis: the hypothalamus raises the body's temperature setpoint in response to infection, triggering the shivering reflex to generate heat to reach the new setpoint. Shivering at 21 degrees C without cold exposure is a clinical sign of possible systemic infection. Combined with abdominal pain, this suggests possible sepsis. Temperature assessment and notification of the receiving team are appropriate.
Question 3
You are transporting a 58-year-old male in hemorrhagic shock following a high-speed MVC. You have controlled external bleeding with a tourniquet. En route to the hospital he becomes more confused and his BP drops from 88/60 to 72/44. His HR increases from 118 to 138. What is the CORRECT interpretation and action?
Why:Correct. Falling BP and rising HR in a trauma patient indicates decompensating hemorrhagic shock — the body's compensatory mechanisms are failing. This patient needs definitive hemorrhage control in the OR. Notify the receiving facility immediately and transport Priority 1. The window for survival is closing.
Question 4
You respond to a 24-year-old male with a penetrating wound to the right upper chest from a nail gun. The nail has been removed before your arrival. There is a 1 cm wound that makes a sucking sound with inspiration. The patient is conscious with SpO2 91%, HR 128, BP 96/72. You apply a vented occlusive chest seal. As you prepare to transport your partner says the seal is not necessary since the wound is small. Why is a chest seal indicated even for a small sucking wound?
Why:Correct. Any thoracic wound with a sucking sound (confirming pleural communication) requires an occlusive chest seal regardless of wound size. The size criterion is irrelevant — what matters is whether the wound communicates with the pleural space. A sucking sound confirms this. A small unsealed wound can progressively accumulate air with each inspiration.
Question 5
You respond to a 44-year-old male with chest pain. His wife tells you he had a heart attack 2 years ago and received a coronary artery stent. He now reports crushing substernal chest pain identical to his prior MI. He takes aspirin, clopidogrel, metoprolol, and rosuvastatin. You are preparing to assist with his prescribed nitroglycerin when you notice he already has a nitroglycerin patch on his upper left chest. What should you know about the patch before giving sublingual NTG?
Why:Correct. Nitroglycerin transdermal patch and sublingual NTG: the patch provides a very low basal dose. One additional sublingual NTG for acute chest pain is generally acceptable — the cumulative dose is within normal therapeutic range. However remove the patch before defibrillation if needed (arching current risk). The patch is not a contraindication to sublingual NTG for acute pain.
Question 6
At a grocery store, a 35-year-old female is stable but needs specialty burn care. What should guide destination?
Why:Correct. Specialty-center criteria should guide destination decisions when protocol applies.
Question 7
While caring for a suspected opioid overdose patient, an EMT notices powder on the patient's clothing. What is the most appropriate EMT-B action?
Why:Correct. EMT-B care is scene safety, appropriate PPE such as nitrile gloves and a mask if powder may become airborne, avoiding unnecessary disturbance of powder, decontamination for skin contact, and airway/ventilation support for the patient. Naloxone is used for symptomatic opioid toxicity per protocol.
Question 8
At a assisted-living room, a 69-year-old male with isolated ankle pain is stable. What transport decision should be based on?
Why:Correct. Destination and transport decisions should follow local protocol and patient condition.
Question 9
At a office lobby, a 58-year-old female elderly fall patient is on blood thinners but feels fine. What should you recommend?
Why:Correct. Anticoagulant use after head strike increases bleeding risk even when symptoms seem mild.
Question 10
You respond to a 62-year-old female with a hip fracture. She is conscious with GCS 15. She lives alone and says she does not want to go to the hospital because she cannot afford it. Her pain is 8/10 and she cannot bear weight. She appears competent. Her daughter calls you and asks you to transport her mother against her will. What is the correct action?
Why:Correct. Adult autonomy overrides family preference: a competent adult's right to refuse treatment is fundamental. The daughter cannot override her mother's decision regardless of family relationship. Provide thorough risk counseling, offer alternatives, document everything including the specific risks explained and the patient's stated understanding, and have her sign the refusal form. The refusal belongs to the patient, not the family.
Question 11
You respond to a 29-year-old male who attempted to hang himself. He was found by his roommate and cut down approximately 4 minutes ago. He is conscious with GCS 13. He has ligature marks on his neck and is hoarse. HR is 104, BP is 118/76. SpO2 is 94%. He says he is fine now and refuses to go to the hospital. What specific risk makes this a high-priority refusal requiring intensive counseling?
Why:Correct. Hanging airway injury — delayed edema: neck compression injuries cause laryngeal and tracheal edema that progresses over hours. SpO2 94% now does not mean the airway will remain patent. Complete airway obstruction from progressive edema can occur 2-8 hours after the injury. This specific medical risk (beyond psychiatric) must be explained as part of the refusal counseling. Priority 1 ALS transport urgently.
Question 12
A severe anaphylaxis patient improves after epinephrine. What remains important?
Why:Correct. Symptoms can recur and the patient still needs transport, reassessment, and ALS involvement when available.
Question 13
A possible stroke patient is within a known time window. Which destination is most appropriate?
Why:Correct. Stroke patients need rapid transport to a stroke-capable receiving facility when available by protocol.
Question 14
At a dialysis center, a 66-year-old male respiratory patient needs CPAP but your service does not allow it. What should you do?
Why:Correct. Provide oxygen, positioning, BVM if needed, ALS intercept, and transport within local protocol.
Question 15
A chest pain patient receives aspirin and remains pale and diaphoretic. What should you add?
Why:Correct. Ongoing suspected ACS needs rapid transport, reassessment, and early hospital notification.
Question 16
You respond to a call where a 35-year-old female patient needs to be carried down a narrow staircase in a carry chair. She is conscious with a suspected hip fracture from a fall. As you prepare to lift, your partner says your combined lift weight for two people with the chair should not exceed 350 pounds. The patient weighs approximately 300 pounds. Is this lift safe?
Why:Correct. Safe lift limits and additional resource requests: exceeding safe lift limits on a staircase puts both the patient and providers at serious risk. Dropping a patient on stairs can cause fatal injuries. Request additional resources — a 4-person carry with mechanical advantage distributes weight safely. Never attempt lifts that exceed safe weight limits for the number of providers. This is a safety decision, not a patient care decision.
Question 17
You respond to a 67-year-old female with a suspected hip fracture. She is in significant pain. During transport she tells you that she is afraid of hospitals and becomes increasingly anxious, hyperventilating at RR 38. SpO2 is 99%. She reports perioral tingling and her hands are going into a spastic position. What is causing her symptoms and what is the treatment?
Why:Correct. Hyperventilation syndrome: RR 38 blows off CO2, causing hypocapnia and respiratory alkalosis. Alkalosis causes increased neuromuscular excitability producing perioral tingling, hand tingling, and carpal-pedal spasm (Trousseau's sign). SpO2 99% confirms adequate oxygenation — this is ventilation not oxygenation excess. Coaching to slow breathing rate corrects the CO2. Reassurance addresses the anxiety trigger.
Question 18
You respond to a 58-year-old male who was electrocuted while working on power lines. He is unconscious at the base of the utility pole. Power company has confirmed the line is de-energized. He has entry and exit burns. He is pulseless and apneic. Your partner begins CPR while you set up the AED. What additional injuries must you consider that make electrocution patients unique?
Why:Correct. Electrocution causes: cardiac arrhythmias (the immediate life threat), internal burns along the current pathway, rhabdomyolysis (muscle destruction causing renal failure), spinal injury from muscle tetany or fall, and compartment syndrome from massive muscle necrosis. Entry and exit burns dramatically underestimate internal injury extent. Treat as multisystem trauma.
Question 19
You are on scene with a 66-year-old female who fell at home. She is conscious, GCS 15, with a suspected right hip fracture (shortened externally rotated right leg, severe pain with any movement). Vital signs are stable. She refuses to go to the hospital. She states she has fallen before and just wants to rest. What is your responsibility?
Why:Correct. An alert oriented adult has the legal right to refuse medical care. Your responsibility is to ensure she has decision-making capacity explain the risks and consequences clearly in terms she understands and document everything. Medical control consultation is appropriate. A signed informed refusal is required. Family cannot override a competent adult's decision.
Question 20
At a fitness center, a 24-year-old female severe asthma patient is tiring and ALS is 20 minutes away. What should EMT-B care emphasize?
Why:Correct. Basic airway and breathing support plus rapid transport should not wait for delayed ALS.
Question 21
You respond to a 24-year-old male who is in a state of severe alcohol intoxication. GCS is 10. He refuses transport and is saying 'leave me alone.' His friends say he has been drinking heavily for 4 hours. He cannot stand without assistance. Can he make a valid informed refusal?
Why:Correct. Decision-making capacity requires: understanding the nature of the illness, understanding the proposed treatment, understanding the risks of refusal, and the ability to make a reasoned decision. GCS 10 from acute alcohol intoxication impairs all of these. Implied consent applies when a patient lacks capacity for a potentially life-threatening condition. Document the clinical basis for impaired capacity.
Question 22
At a clinic waiting room, a 62-year-old male with isolated ankle pain is stable. What transport decision should be based on?
Why:Correct. Destination and transport decisions should follow local protocol and patient condition.
Question 23
At a parking garage, a 74-year-old female with anaphylaxis improves after epinephrine. What is the safest transport recommendation?
Why:Correct. Anaphylaxis can recur after initial improvement, so transport and reassessment remain important.
Question 24
At a college dorm, a 21-year-old female elderly fall patient is on blood thinners but feels fine. What should you recommend?
Why:Correct. Anticoagulant use after head strike increases bleeding risk even when symptoms seem mild.
Question 25
You are treating an 88-year-old male with a hip fracture from a ground-level fall. He is on aspirin, metoprolol, and apixaban (Eliquis). His vitals are stable. During packaging you notice his right leg appears shorter and externally rotated. Pain is severe at 9 out of 10. He tells you he has a DNR but does not have the document with him. His son says do not resuscitate. What do you do regarding the DNR?
Why:Correct. A DNR requires a valid written document — verbal statements from family members are not legally binding. Without the document provide full appropriate treatment for the current complaint (hip fracture). A DNR also typically addresses cardiac arrest management — it does not mean withhold all treatment for other injuries. Treat the hip fracture.
Keep going
The exam mixes domains. So should your practice.
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