Free NREMT Practice Questions
Shock and Resuscitation
Perfusion failure and arrest priorities. Recognize decompensation windows and act in order.
What you'll master
- ✓Shock identification and early actions
- ✓CPR/AED sequencing
- ✓Reversible causes mindset
- ✓Team communication under time
Common misses
- –Late CPR/AED
- –Missing shock signs
- –Poor reassessment cadence
Sample questions.
25 free shock and resuscitation 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
At a farm driveway, a 71-year-old male trauma patient has weak radial pulses and restlessness after blunt abdominal injury. What should you suspect?
Why:Correct. Restlessness and weak pulses after abdominal trauma suggest shock from internal bleeding.
Question 2
You respond to a 44-year-old male who was in a industrial accident and had a large metal press trap his abdomen and chest for approximately 25 minutes before rescue. He is now free and conscious but his abdomen is massively distended. HR 138, BP 88/56, SpO2 91%. He has no external abdominal wounds. What specific injury pattern occurs when the chest and abdomen are compressed simultaneously under high force?
Why:Correct. Traumatic diaphragmatic rupture from compressive force allows abdominal organs to herniate into the thoracic cavity. This can present with absent or bowel sounds heard in the left chest, respiratory distress, and hemodynamic compromise. High-flow oxygen, Priority 1 surgical transport. Auscultate both chest fields carefully.
Question 3
You respond to a 44-year-old male who was a restrained driver in a frontal collision at moderate speed. He is conscious with GCS 14. HR 118, BP 96/72. He has diffuse left upper quadrant tenderness. No external signs of hemorrhage. His seatbelt sign is visible — a linear bruise across his left upper abdomen from the lap belt. What specific abdominal injury pattern is associated with a seatbelt sign across the upper abdomen?
Why:Correct. Seatbelt sign abdominal pattern: the compressive force of the lap belt over the abdomen during deceleration causes predictable injuries — splenic/hepatic laceration, mesenteric tear, bowel injury, and the Chance fracture (flexion-distraction lumbar spine fracture from the fulcrum effect). Left UQ seatbelt sign with hemodynamic instability = splenic injury until proven otherwise. Priority 1 trauma center.
Question 4
You respond to a 29-year-old female who is 20 weeks pregnant and is in cardiac arrest. Two bystanders have been performing CPR. You arrive and take over. You note the patient is supine on the floor. Your partner is preparing the AED. What specific CPR modification is required for a pregnant patient at 20 weeks gestation?
Why:Correct. Pregnant CPR modification: at 20 weeks gestation manual left uterine displacement (LUD) or 15-30 degree right hip tilt is required to relieve aortocaval compression from the gravid uterus. Aortocaval compression reduces venous return and CPR effectiveness. LUD is performed continuously during compressions by a dedicated rescuer. Standard compression rate, depth, and technique otherwise.
Question 5
You respond to a 19-year-old female who was stung by multiple bees. She has diffuse urticaria, tongue angioedema, and audible stridor. SpO2 is 88%, HR is 158, BP is 68/44. You administer 0.3 mg epinephrine IM. Two minutes later SpO2 has improved to 93%, BP is 88/64, and the stridor has lessened but not resolved. She asks if you should wait to see if the first dose continues to work. What is the correct response?
Why:Correct. Second epinephrine dose for incomplete response: ongoing stridor with BP 88/64 and SpO2 93% indicates inadequate response to the first dose. A second 0.3 mg IM dose is indicated at 5-15 minutes for partial or inadequate response. Persistent stridor = ongoing airway risk. Do not wait. ALS urgently for IV epinephrine and fluid support for refractory anaphylaxis.
Question 6
A 19-year-old MVC patient has HR 126, BP 88/60 with no visible injuries and a rigid tender abdomen. Reassessed 8 minutes later: HR 136, BP 80/52. What does this vital sign trend indicate?
Why:Correct. Progressive tachycardia plus declining BP indicates ongoing hemorrhage exceeding compensatory capacity. The rate of deterioration (HR up 10, BP down 8 in 8 minutes) predicts continued deterioration. Pre-notify the trauma center immediately with the vital sign trend and ETA. The OR is the only treatment.
Question 7
A pulseless adult has CPR in progress. The AED says shock advised. What should you do?
Why:Correct. The AED interprets the rhythm. Clear the patient, deliver the shock, and resume CPR as directed.
Question 8
A stabbing patient has uncontrolled bleeding from the upper arm. Direct pressure is ineffective. What should you do?
Why:Correct. Life-threatening extremity bleeding that is not controlled by direct pressure requires tourniquet placement.
Question 9
At a dialysis center, a 67-year-old male trauma patient has weak radial pulses and restlessness after blunt abdominal injury. What should you suspect?
Why:Correct. Restlessness and weak pulses after abdominal trauma suggest shock from internal bleeding.
Question 10
At a restaurant, a 32-year-old male trauma patient has weak radial pulses and restlessness after blunt abdominal injury. What should you suspect?
Why:Correct. Restlessness and weak pulses after abdominal trauma suggest shock from internal bleeding.
Question 11
You respond to a 42-year-old female with a known history of hereditary angioedema who is experiencing a flare. She has massive tongue and lip swelling, is drooling, and is beginning to have difficulty swallowing. SpO2 is 94%, HR 108, BP 128/82. She states she has an epinephrine auto-injector prescribed. She says epinephrine does not work for her hereditary angioedema. What is your management priority?
Why:Correct. Hereditary angioedema is caused by C1-esterase inhibitor deficiency (not IgE-mediated allergy). Epinephrine, antihistamines, and steroids do not work for hereditary angioedema. The only treatments are specific HAE medications (C1-INH concentrate, icatibant — hospital medications). The EMT-B priority is airway monitoring and ALS intercept before the airway closes.
Question 12
You respond to a 31-year-old female in anaphylaxis from a wasp sting. Her BP is 62/40, HR 154, SpO2 88%, and she has stridor. She received 0.3 mg epinephrine IM from a bystander nurse approximately 4 minutes ago using the patient's own EpiPen. You assess the patient — she has improved slightly (BP 78/52) but stridor persists. You have a second EpiPen available. She weighs 65 kg. What is the dose and site for the second injection?
Why:Correct. Second epinephrine dose: 0.3 mg IM anterolateral thigh (adult weight over 30 kg). Anterolateral thigh provides the fastest and most reliable IM absorption — superior to the deltoid or arm. Persistent stridor 4 minutes after the first dose indicates inadequate response — second dose is clearly indicated. ALS urgently for IV epinephrine infusion for refractory anaphylaxis.
Question 13
At a parking garage, a 74-year-old female has uncontrolled arterial bleeding from the leg after a saw injury. Direct pressure fails. What is next?
Why:Correct. Life-threatening extremity bleeding not controlled by pressure requires a tourniquet.
Question 14
At a clinic waiting room, a 61-year-old male pulseless patient has an AED analyzing. What should rescuers do?
Why:Correct. Clear the patient during analysis so the AED can work accurately.
Question 15
At a fitness center, a 23-year-old female in shock is shivering during trauma care. Why cover the patient?
Why:Correct. Hypothermia worsens trauma outcomes and shock physiology. Keep the patient warm.
Question 16
You respond to a 37-year-old female with a known bleeding disorder (hemophilia A) who cut her thigh on broken glass. The laceration is approximately 8 cm and is bleeding moderately but steadily. Standard direct pressure has been applied for 10 minutes with minimal effect. HR 108, BP 96/68. What does hemophilia A specifically lack and why does standard pressure have reduced effectiveness?
Why:Correct. Hemophilia A: Factor VIII deficiency — the platelet plug forms normally (primary hemostasis intact) but the secondary coagulation cascade cannot complete without Factor VIII to activate Factor X. The fibrin clot needed to stabilize the platelet plug cannot form. Prolonged bleeding despite normal primary hemostasis. Direct pressure plus tourniquet if needed. Factor VIII concentrate is the definitive treatment (hospital).
Question 17
You respond to a 45-year-old female in anaphylaxis. After 0.3 mg epinephrine IM, her BP improves from 62/38 to 104/72 and her urticaria significantly reduces. She is transported to the hospital. At the hospital she is discharged after 4 hours of observation. Two days later she calls 911 with the same symptoms returning — same urticaria pattern, throat tightness, BP 74/50. She has not re-exposed to the allergen. Is this anaphylaxis?
Why:Correct. Biphasic anaphylaxis: recurrence of anaphylaxis symptoms 1-72 hours after the initial episode WITHOUT re-exposure to the allergen. Up to 20% of anaphylaxis cases have a biphasic component. The mechanism involves a secondary wave of inflammatory mediator release. Treatment is identical to the initial anaphylaxis episode — epinephrine 0.3 mg IM, high-flow oxygen, Priority 1 transport.
Question 18
You respond to a 27-year-old female bitten by a rattlesnake on the hand 45 minutes ago. Massive swelling with bluish discoloration spreading to the elbow. She tastes metal in her mouth. Her friend insists on cutting the wound and sucking out the venom. What is the correct response?
Why:Correct. Cut-and-suck removes less than 2% of venom while introducing infection risk and delaying transport. Metallic taste indicates systemic coagulopathy — a serious systemic sign. Immobilize, keep calm, remove rings and tight clothing, Priority 1 to an antivenom facility.
Question 19
At a apartment hallway, a 42-year-old male is being assessed. CPR is underway for an adult. What compression depth is appropriate?
Why:Correct. Adult compressions should be about 2 to 2.4 inches deep with full recoil.
Question 20
At a soccer field, a 29-year-old female has uncontrolled arterial bleeding from the leg after a saw injury. Direct pressure fails. What is next?
Why:Correct. Life-threatening extremity bleeding not controlled by pressure requires a tourniquet.
Question 21
At a college dorm, a 19-year-old female is pulseless and apneic. What is the first treatment sequence?
Why:Correct. Cardiac arrest care begins with CPR and AED use as soon as available.
Question 22
A trauma patient is pale, weak, and hypotensive after abdominal injury. What position is safest?
Why:Correct. Keep the patient supine if tolerated, manage ABCs, prevent heat loss, and transport rapidly.
Question 23
You respond to a 44-year-old male who was working under his car when the jack slipped. The car has been on his chest for approximately 20 minutes. His coworker jack up the car just as you arrive. He is conscious with GCS 14 but develops severe dyspnea, tachycardia, and hypotension over the next 3 minutes after the car is removed. What specific physiological event occurs when prolonged chest compression is suddenly released?
Why:Correct. Traumatic asphyxia and chest decompression: prolonged chest compression causes retrograde venous hypertension (classic presentation: facial and conjunctival petechiae, cyanosis). On release, sudden restoration of venous return causes right heart overload and potential arrhythmias. Crush syndrome (potassium, myoglobin release), rib fractures, pneumothorax, and pulmonary contusion also contribute. Priority 1 ALS transport.
Question 24
You respond to a 29-year-old male with a penetrating wound to the right thigh from a nail gun. The nail is still embedded. Bright red blood is pulsating from around the embedded nail. The nail appears to be approximately 8 cm long. Should you remove the nail to control the bleeding?
Why:Correct. Never remove embedded objects — they may be tamponading major vessel injury. The femoral artery and femoral vein are in the thigh — nail gun injury at this depth can involve major vessels. Removal risks uncontrolled hemorrhage. Apply a tourniquet 2-3 inches proximal to control the pulsatile bleeding. Stabilize the nail. Priority 1 transport to a trauma center.
Question 25
You respond to a 55-year-old male with a history of anaphylaxis to penicillin who is prescribed amoxicillin for a tooth infection and took his first dose 30 minutes ago. He now has diffuse hives, a swollen tongue, stridor, and HR 144. BP 72/44. SpO2 88%. He has not been prescribed an epinephrine auto-injector. You have epinephrine 1:1000 on your unit. What is the appropriate EMT-B action?
Why:Correct. Epinephrine for anaphylaxis is a standing order medication that EMT-Bs can administer from unit stock without a patient-specific prescription in most jurisdictions. Systemic anaphylaxis (stridor, hypotension, hives) clearly meets the threshold. The 0.3 mg IM anterolateral thigh dose applies. Antihistamines take 30-60 minutes — far too slow for airway compromise.
Keep going
The exam mixes domains. So should your practice.
Questions only get you so far.
Run a live shock and resuscitation scenario and get graded on decision order and timing, not just the right answer — plus the full 2025 question bank and PCR training in Student Pro.