Pharmacology

Sample questions.

8 free pharmacology 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.

1. Question 1

   You respond to a 61-year-old male with an acute asthma exacerbation. His albuterol MDI is available. Before assisting with the MDI, you observe him shake the inhaler once and immediately actuate it without exhaling first. What two technique errors must you correct before assisting with the next dose?

   • A.Two errors: (1) insufficient shakingCorrect
   • B.Both technique errors are acceptable
   • C.Only the exhale technique matters — shaking is optional
   • D.Only shaking matters

   Why:Correct. MDI technique errors: (1) Shaking: 10-15 vigorous shakes before each actuation resuspends the drug particles in the propellant — one shake is insufficient. (2) Exhale fully before actuating: complete exhalation maximizes inspiratory volume available to carry drug particles into the lower airways. Both errors significantly reduce drug deposition in the bronchioles. Correct both before the next dose.

2. Question 2

   You respond to a 49-year-old female with severe chest pain. BP 136/84. No PDE5 inhibitor use. After one NTG 0.4 mg SL, pain is still 8 out of 10 four minutes later. BP is now 124/78. Can you administer a second dose?

   • A.only one nitroglycerin dose is ever permitted at EMT-B level
   • B.give all three doses simultaneously to save time
   • C.the blood pressure must return to the original
   • D.standard protocol allows up to three nitroglycerinCorrect

   Why:Correct. Standard NTG protocol allows up to three doses 3-5 minutes apart provided SBP remains above 90 mmHg and pain persists. BP 124/78 clears the threshold. Document dose number, time, pre-dose BP, post-dose BP, and pain score for each administration.

3. Question 3

   A poison-control order allows activated charcoal. What must be true before giving it?

   • A.Chest pain is present
   • B.Patient is unconscious
   • C.Any overdose qualifies
   • D.Patient can protect airwayCorrect

   Why:Correct. Activated charcoal requires medical direction or protocol and a patient able to protect the airway.

4. Question 4

   A 53-year-old female has acute asthma and left her spacer at home. You have a paper cup available. What is the clinical priority regarding improvised spacers?

   • A.No spacer is equivalent to a spacer — technique compensates
   • B.Only commercially approved spacers should be used
   • C.Any improvised spacer is better than no spacerCorrect
   • D.Spacers only help patients with poor MDI technique

   Why:Correct. Improvised spacers are better than no spacer: any enclosed container that slows aerosol velocity and allows inhalation from it significantly improves lower airway drug deposition. Use the improvised paper cup. Document the device used.

5. Question 5

   You respond to a 33-year-old female in anaphylaxis. You administer epinephrine 0.3 mg IM to her right anterolateral thigh. She improves significantly over 4 minutes. Five minutes after the injection she reports her heart is pounding and she has a severe headache. Her HR is 168 and BP is 182/118. Are these expected findings and do they change your management?

   • A.These are dangerous side effects — administer a reversal agent
   • B.Tachycardia and hypertension are expected and transientCorrect
   • C.She is having a hypertensive stroke — stop the epinephrine
   • D.Administer nitroglycerin for the hypertension

   Why:Correct. Tachycardia and hypertension are expected pharmacological effects of epinephrine. These effects are transient and significantly less harmful than the anaphylaxis that was treated. In true anaphylaxis there are no absolute contraindications to epinephrine. Reassure the patient, monitor continuously, and transport. NTG is contraindicated because her anaphylactic state is still evolving.

6. Question 6

   At a clinic waiting room, a 63-year-old male took aspirin before EMS arrival. What should you document?

   • A.Dose and timeCorrect
   • B.Only brand color
   • C.Nothing if taken
   • D.Shoe size

   Why:Correct. Document medication taken before EMS, including dose, time, and response if known.

7. Question 7

   At a train platform, a 38-year-old female EMT-B medication decision varies by state protocol. What should you follow?

   • A.Local medical directionCorrect
   • B.Social media advice
   • C.Another state's rule
   • D.Patient demand

   Why:Correct. EMT-B medication authorization depends on state and local medical direction.

8. Question 8

   You respond to a 61-year-old male with severe chest pain consistent with ACS. You have administered aspirin 324 mg chewed and are preparing his prescribed nitroglycerin. Before his first dose you check his blood pressure: 136/84. Before his second dose 5 minutes later you check again: 108/68. Before his third dose 5 minutes later you check: 88/56. What do you do?

   • A.Administer the third dose since 88/56 is above zero
   • B.Check the blood pressure again in 2 minutes before deciding
   • C.Administer the third dose since two doses
   • D.Withhold the third dose and all further NTGCorrect

   Why:Correct. Sequential NTG-induced hypotension: SBP dropped to 88 mmHg which is below the absolute threshold of 90 mmHg. Withhold all further NTG. The trend (136 to 108 to 88) shows progressive hypotension — a third dose would likely cause severe hemodynamic compromise. Position supine with legs elevated. Notify receiving facility of NTG-induced hypotension.