NREMT Advanced Emergency Medical Technician (AEMT) Cognitive Exam — Questions and Answers

Question 1: Which finding in a pregnant trauma patient is MOST concerning for significant internal hemorrhage?

Mild nausea and vomiting
Tachycardia exceeding 100 bpm with hypotension (Correct answer)
Blood pressure of 118/76 mmHg
Fetal movement reported by the mother

Correct answer: Tachycardia exceeding 100 bpm with hypotension

Tachycardia with hypotension in a pregnant trauma patient signals significant hemorrhage; compensatory mechanisms can mask shock until 30–40% of blood volume is lost.

Question 2: A pregnant patient at 32 weeks gestation is found unresponsive after a syncopal episode. You should position her:

Supine with legs elevated 12 inches
Sitting upright at 90 degrees
Left lateral recumbent or with a wedge under her right hip to tilt the uterus left (Correct answer)
Prone to protect the fetus

Correct answer: Left lateral recumbent or with a wedge under her right hip to tilt the uterus left

Positioning the pregnant patient with left lateral tilt relieves aortocaval compression by the gravid uterus, improving venous return and cardiac output.

Question 3: For a responsive, stable medical patient during transport, how frequently should vital signs be reassessed?

Every 10 minutes
Every 20 minutes
Every 5 minutes
Every 15 minutes (Correct answer)

Correct answer: Every 15 minutes

Standard protocol requires vital signs to be reassessed every 15 minutes for stable medical patients during transport.

Question 4: Acute Coronary Syndrome (ACS) is defined as patients with angina, shortness of breath, chest, epigastric, arm, or jaw pain or discomfort and may be associated with diaphoresis, nausea, shortness of breath or difficulty breathing.

FALSE
TRUE (Correct answer)

Correct answer: TRUE

Acute Coronary Syndrome (ACS) is a broad term encompassing conditions caused by sudden, reduced blood flow to the heart. Its presentation is indeed characterized by symptoms like angina (chest pain), shortness of breath, and referred pain to the epigastrium, arms, or jaw. These symptoms are often accompanied by diaphoresis (sweating), nausea, and difficulty breathing, making the given definition accurate.

Question 5: The Glasgow Coma Scale (GCS) score consists of three components. What are they?

Orientation, memory, concentration
Pupils, pain response, posture
Respirations, blood pressure, pulse
Eye opening, verbal response, motor response (Correct answer)

Correct answer: Eye opening, verbal response, motor response

The GCS assesses Eye opening (1–4), Verbal response (1–5), and Motor response (1–6), with a maximum score of 15.

Question 6: Which set of vital signs would MOST concern an AEMT assessing an adult patient?

BP 118/76 mmHg, HR 72/min, RR 16/min, SpO2 98%
BP 90/60 mmHg, HR 124/min, RR 26/min, SpO2 91% (Correct answer)
BP 132/84 mmHg, HR 88/min, RR 18/min, SpO2 96%
BP 142/90 mmHg, HR 80/min, RR 20/min, SpO2 95%

Correct answer: BP 90/60 mmHg, HR 124/min, RR 26/min, SpO2 91%

Hypotension, tachycardia, tachypnea, and hypoxia together suggest a patient in decompensating shock requiring immediate aggressive intervention.

Question 7: What is the entry of drugs into the plasma?

Absorption (Correct answer)
Metabolism
Elimination
Distribution

Correct answer: Absorption

Absorption is the process by which a drug moves from its site of administration into the systemic circulation, specifically into the plasma. This step is critical because it determines how much of the drug will actually reach its target tissues and exert its effects. Factors like the drug's formulation, route of administration, and physiological conditions can significantly influence the rate and extent of absorption.

Question 8: A 20-gauge IV catheter is inserted and the patient is to receive a fluid bolus. What does increasing the IV bag height accomplish?

It reduces the risk of air embolism
It has no effect on flow rate
It increases flow rate by increasing hydrostatic pressure (Correct answer)
It decreases flow rate by reducing back pressure

Correct answer: It increases flow rate by increasing hydrostatic pressure

Raising the IV bag increases hydrostatic pressure in the tubing, which increases the flow rate of the infusing fluid.

Question 9: Which of the following would be considered a means to overcome pain management barriers?

Start an IV in children immediately
Less medical oversight
Offline protocols (Correct answer)
Training on medication administering

Correct answer: Offline protocols

Offline protocols empower AEMTs to administer pain medications based on pre-approved guidelines without needing direct medical control contact for every case. This streamlines care, reduces delays, and allows for more timely pain relief in the field. Such protocols enhance the efficiency and effectiveness of prehospital pain management by providing clear, standing orders.

Question 10: Sellick's maneuver (cricoid pressure) is applied to:

Open the airway by lifting the thyroid cartilage
Compress the cricoid ring posteriorly to occlude the esophagus and reduce aspiration risk (Correct answer)
Improve mask seal during BVM ventilation
Relieve a complete foreign-body airway obstruction

Correct answer: Compress the cricoid ring posteriorly to occlude the esophagus and reduce aspiration risk

Cricoid pressure compresses the cricoid cartilage against the esophagus, reducing the risk of regurgitation and aspiration during ventilation.

Question 11: If a patient can not be delivered to a Cardiac Intervention Center within 45 minutes, a Fibrinolytic Therapy Checklist should be completed for STEMI and the patient should be transported to the nearest ED.

FALSE
TRUE (Correct answer)

Correct answer: TRUE

If a patient with STEMI cannot be transported to a Cardiac Intervention Center for primary percutaneous coronary intervention (PCI) within the recommended timeframe (e.g., 45 minutes greater than transport to the nearest ED), then fibrinolytic therapy becomes the preferred reperfusion strategy. In such cases, a Fibrinolytic Therapy Checklist is completed to assess eligibility and contraindications, and the patient is transported to the nearest ED for administration.

Question 12: At what rate should you deliver ventilations to an adult patient who is not breathing but has a pulse?

12–20 breaths/min
8–10 breaths/min
10–12 breaths/min (Correct answer)
20–24 breaths/min

Correct answer: 10–12 breaths/min

For an apneic adult with a pulse, AEMT protocols call for rescue breathing at 10–12 breaths per minute (one breath every 5–6 seconds).

Question 13: When performing a focused exam on a patient with isolated extremity trauma, the AEMT should assess for all of the following EXCEPT:

Distal pulses
Distal sensation and motor function
Skin color and capillary refill distal to injury
Pedal edema bilaterally (Correct answer)

Correct answer: Pedal edema bilaterally

Pedal edema is a systemic finding associated with conditions like congestive heart failure, not acute localized extremity trauma; neurovascular status distal to the injury is the focus.

Question 14: A patient is found unresponsive at the bottom of a staircase. Which mechanism of injury consideration is MOST important?

Determining the patient's insurance status before transporting
Checking for carbon monoxide exposure
Estimating the exact number of stairs the patient fell
Spinal precautions due to potential mechanism for cervical or thoracic injury (Correct answer)

Correct answer: Spinal precautions due to potential mechanism for cervical or thoracic injury

Falls down stairs represent a significant mechanism for spinal injury; cervical spine precautions should be implemented until injury is ruled out.

Question 15: In the SAMPLE history mnemonic, the letter 'A' stands for:

Activity prior to onset
Allergies (Correct answer)
Assessment findings
Associated symptoms

Correct answer: Allergies

The 'A' in SAMPLE stands for Allergies, particularly to medications, foods, or environmental agents relevant to treatment.

Question 16: The mnemonic AVPU is used to rapidly assess which patient parameter?

Pupillary response
Level of consciousness (Correct answer)
Airway patency
Peripheral circulation

Correct answer: Level of consciousness

AVPU (Alert, Verbal, Painful, Unresponsive) is a quick tool to classify the patient's level of consciousness.

Question 17: Which of the following is considered a barrier to pain management in the prehospital environment?

Immediate transport
Difficult vascular access (Correct answer)
Ability to assess pain
High pain score

Correct answer: Difficult vascular access

In the pre-hospital environment, several factors can hinder effective pain management. Difficult vascular access, particularly in pediatric patients or those with trauma, can delay or prevent the administration of intravenous pain medications, which are often the most effective route for rapid relief. Other options like ability to assess pain or high pain scores are reasons to manage pain, not barriers, and immediate transport doesn't inherently prevent pain management.

Question 18: Intraosseous (IO) access delivers medications and fluids to which anatomical structure?

The cortical bone where nutrients diffuse slowly
The medullary cavity of the bone, which connects to the venous circulation (Correct answer)
The periosteal space around the bone
The subcutaneous fat layer adjacent to the bone

Correct answer: The medullary cavity of the bone, which connects to the venous circulation

IO needles enter the medullary cavity, which contains a non-collapsible venous network that rapidly delivers fluids and drugs into central circulation.

Question 19: What percentage of patients in the pre-hospital environment complain of pain?

100%
80%
50%
20% (Correct answer)

Correct answer: 20%

Studies and clinical observations in the pre-hospital environment indicate that a significant, but not overwhelming, portion of patients complain of pain. While pain is a common complaint, 20% is often cited as a more accurate representation of patients actively seeking or requiring pain management interventions in the field, rather than a majority or all patients.

Question 20: A patient is found unresponsive with absent breathing and no detectable pulse. After recognizing cardiac arrest, the AEMT's FIRST action should be:

Begin high-quality CPR (Correct answer)
Obtain a 12-lead ECG
Establish IV access for medication administration
Apply and analyze the AED immediately

Correct answer: Begin high-quality CPR

High-quality CPR must be initiated immediately upon recognition of cardiac arrest to maintain circulation until defibrillation can be performed.

Question 21: What is the maximum amount of time you should suction an adult's airway in a single pass?

60 seconds
15 seconds (Correct answer)
30 seconds
5 seconds

Correct answer: 15 seconds

Suction should not exceed 15 seconds per attempt in adults to minimize hypoxia caused by interrupting ventilation.

Question 22: The transport decision made during the primary assessment is used to determine:

The definitive diagnosis of the patient's condition
Which hospital-specific treatment protocols to follow
Whether to activate the ALS intercept protocol
The priority and mode of patient transport (Correct answer)

Correct answer: The priority and mode of patient transport

The transport decision establishes whether the patient requires emergent priority transport or can be transported non-urgently to the appropriate facility.

Question 23: Which of the following is considered an immediate benefit of pain control and additionally provides a calming effect?

Patient’s vital signs remain the same
Improvement in the patient’s respiratory effort (Correct answer)
Administering the pain medication immediately
Doing a patient assessment quickly

Correct answer: Improvement in the patient’s respiratory effort

Effective pain control, particularly with certain analgesics, can lead to a calming effect and reduce the physiological stress response. This often translates to an improvement in the patient's respiratory effort, as pain and anxiety can cause shallow, rapid breathing. Alleviating pain can help normalize breathing patterns, which is an immediate and beneficial physiological response.

Question 24: The START triage system classifies patients into four categories. Which color tag indicates immediate life-threatening injuries that are survivable with rapid intervention?

Red (Immediate) (Correct answer)
Yellow (Delayed)
Green (Minor)
Black (Expectant/Deceased)

Correct answer: Red (Immediate)

Red tags in START triage identify patients with critical but survivable injuries who require immediate treatment to prevent death.

Question 25: What is the exclusion criteria that a patient must meet for the Fibrinolytic Therapy Checklist for STEMI?

Known bleeding disorder
Within 3 months of intracranial surgery, serious head trauma, or stroke
Active internal bleeding within the last 21 days
All of the above (Correct answer)

Correct answer: All of the above

Fibrinolytic therapy carries a significant risk of bleeding, so strict exclusion criteria are in place to prevent severe complications. Active internal bleeding, known bleeding disorders, and recent intracranial surgery, serious head trauma, or stroke are all major contraindications due to the high risk of intracranial hemorrhage or exacerbating existing bleeding. Therefore, all the listed items are critical exclusion criteria.

Question 26: Which of the following correctly describes the 'pediatric chain of survival' priority for preventing cardiac arrest?

Early defibrillation above all other interventions
Immediate cardiac catheterization
Rapid administration of epinephrine before CPR
Prevention of respiratory failure, since most pediatric arrests are respiratory in origin (Correct answer)

Correct answer: Prevention of respiratory failure, since most pediatric arrests are respiratory in origin

Because most pediatric cardiac arrests are secondary to respiratory failure, preventing and treating respiratory problems is the highest-priority link in the pediatric chain of survival.

Question 27: You are ventilating an apneic adult at 12 breaths/min with a BVM. After 2 minutes, EtCO2 climbs to 55 mmHg. You should:

Reduce rate to 6 breaths/min
Increase rate slightly or improve tidal volume to enhance CO2 clearance (Correct answer)
Administer sodium bicarbonate IV
Switch to a non-rebreather mask

Correct answer: Increase rate slightly or improve tidal volume to enhance CO2 clearance

A rising EtCO2 above 45 mmHg indicates hypoventilation; increasing rate or tidal volume will improve CO2 elimination.

Question 28: When assessing pupils, the finding 'PERRL' indicates:

Pupils Elevated, Round, and Reactive to Light
Pupils Equal, Round, and Restricted Laterally
Pupils Equal, Round, and Reactive to Light (Correct answer)
Pupils Elevated, Rigid, and Reactive to Light

Correct answer: Pupils Equal, Round, and Reactive to Light

PERRL stands for Pupils Equal, Round, and Reactive to Light, which is the normal expected finding during neurological assessment.

Question 29: During a normal delivery, once the baby's head is delivered, you should immediately:

Deliver the placenta before suctioning
Clamp and cut the umbilical cord
Administer oxytocin to the mother
Check for a nuchal cord and suction the airway if needed (Correct answer)

Correct answer: Check for a nuchal cord and suction the airway if needed

After head delivery, check for a nuchal cord (cord around the neck) and suction the mouth and nose to clear the airway before full delivery.

Question 30: What is the criteria that a patient must meet for the Fibrinolytic Therapy Checklist for STEMI?

18 years or older
Sign and symptoms of STEMI
All of the above (Correct answer)
45 minutes

Correct answer: All of the above

The Fibrinolytic Therapy Checklist for STEMI includes specific inclusion criteria to ensure the therapy is appropriate and safe. These typically include the patient being 18 years or older, presenting with signs and symptoms consistent with STEMI, and being within a specific time window from symptom onset (often related to the 45-minute transport threshold for PCI). Therefore, all listed options are generally part of the inclusion criteria.

Question 31: What describes the action of a drug on the body?

Pharmacokinetics
Pharmacodynamics (Correct answer)
Physiology
Microbiology

Correct answer: Pharmacodynamics

Pharmacodynamics is the study of what the drug does to the body. It focuses on the biochemical and physiological effects of drugs and their mechanisms of action, including how drugs interact with receptors, enzymes, or other targets to produce their therapeutic or adverse effects. Understanding pharmacodynamics is essential for predicting a drug's efficacy and potential side effects.

NREMT Advanced Emergency Medical Technician (AEMT) Cognitive Exam

The NREMT AEMT cognitive exam certifies candidates to provide advanced pre-hospital emergency care, including IV therapy, advanced airway management, and medication administration beyond the EMT level. It covers clinical judgment, medical emergencies, trauma, airway management, and EMS operations.

Questions

35 min

Time Limit

70%

To Pass

Checking for saved progress...

Exam Rules

You can skip questions and return to them later
Flag questions for review before submitting
No feedback shown until you submit the entire exam
Unanswered questions count as wrong — answer everything
10 pretest questions are mixed in and don't affect your score
Timer auto-submits when time runs out
Your progress is auto-saved every 30 seconds