NREMT EMT Actual Questions

In infants, improper insertion of an OPA (oropharyngeal airway) can stimulate the vagus nerve, leading to bradycardia or even complete airway obstruction. If cyanosis and bradycardia develop after OPA insertion, immediate removal and resumption of ventilations with a bag-valve mask is critical.

The OPA must be properly sized and inserted only in patients without a gag reflex. Ventilations alone often reverse vagally induced bradycardia.

The correct answer is D. Apply humidified oxygen.

This patient presentation is highly suggestive of epiglottitis, a life-threatening upper airway infection commonly seen in pediatric patients.

Key findings:

Drooling → inability to swallow secretions

Stridor → upper airway obstruction

Fever (102.4°F) → infection

Anxiety and tachycardia → respiratory distress

Why D is correct:

The priority is to maintain airway patency without agitating the child.

Humidified oxygen helps improve oxygenation while minimizing airway irritation.

It is the safest initial intervention in suspected epiglottitis.

Why the other options are incorrect:

A. Visualize the airway → Can trigger complete airway obstruction due to swelling

B. Suction posterior pharynx → May stimulate gag reflex and worsen obstruction

C. Insert oropharyngeal airway → Contraindicated in conscious or semi-conscious patients and may cause airway collapse

Exact Extracts:

“Do not attempt to visualize the airway in suspected epiglottitis.”

“Avoid any procedure that may agitate the child and cause airway obstruction.”

“Provide humidified oxygen and transport promptly.”

Albuterol, a common beta-2 adrenergic agonist used in inhalers, stimulates bronchial smooth muscle relaxation. However, stimulation of beta receptors can also produce systemic effects such as:

Tachycardia (due to beta-1 cross-reactivity)

Nervousness (from central stimulation)

Coughing (a local airway response)

Confusion and drowsiness are not typical side effects of beta-agonists. Hypotension is rare unless severe overdose occurs.

The correct answer is B. Health Insurance Portability and Accountability Act.

HIPAA is a federal law that establishes national standards to protect patients’ medical records and other personal health information. It is a critical component of EMS operations, particularly regarding patient confidentiality and privacy.

Why B is correct:

HIPAA officially stands for Health Insurance Portability and Accountability Act.

It governs how healthcare providers, including EMTs, handle protected health information (PHI).

NREMT-aligned EMS guidelines emphasize:

“EMTs must maintain patient confidentiality in compliance with HIPAA regulations.”

“Protected health information must not be disclosed without proper authorization.”

Why the other options are incorrect:

A. Privacy and Administration Act: Incorrect wording; not the official name.

C. Payable and Accountability Act: Incorrect terminology.

D. Privacy and Accountability Act: Missing the term “Portability,” which is essential to the law’s name.

Exact Extracts:

“HIPAA (Health Insurance Portability and Accountability Act) protects patient privacy.”

“EMS providers are required to safeguard protected health information.”

“Unauthorized disclosure of patient information is a violation of federal law.”