Primary Assessment makes up about 39–43% of the NREMT EMT exam. Here are 8 to work
through. When you open an answer, you'll see why it's right and why the other options aren't.
Question 1NRP reviewed
A rapid trauma assessment is performed before a detailed examination because
Ait finds the injuries that will kill in the next few minutes
Bdetailed examination is performed by the receiving facility
Cit takes less time to document than a full examination
Dpatients tolerate a rapid assessment better than a slow one
Show the answer
Correct answer: A. it finds the injuries that will kill in the next few minutes
The sequence exists to separate what must be found now from what can be found later. A tension pneumothorax discovered during a systematic head-to-toe is discovered too late.
A. The rapid assessment targets immediately life-threatening injuries.
B. Detailed examination is performed by both, at different times.
C. Documentation is not what determines the sequence.
D. Patient tolerance is not the clinical rationale.
Question 2NRP reviewed
A patient presenting with pinpoint pupils with salivation, lacrimation, bronchorrhea and incontinence is showing signs of
AA sedative-hypnotic toxidrome
BA sympathomimetic toxidrome
CAn anticholinergic toxidrome
DA cholinergic toxidrome
Show the answer
Correct answer: D. A cholinergic toxidrome
Pinpoint pupils with salivation, lacrimation, bronchorrhea and incontinence together define a cholinergic toxidrome. Recognizing a toxidrome lets you treat a poisoning correctly even when the substance is unknown, which is the usual situation in the field.
A. A sedative-hypnotic toxidrome instead presents with depressed mentation and respiratory depression with normal or slightly small pupils.
B. A sympathomimetic toxidrome instead presents with dilated pupils with hypertension, tachycardia, hyperthermia and diaphoresis.
C. An anticholinergic toxidrome instead presents with dilated pupils with hot dry flushed skin, delirium and urinary retention.
D. These findings together define a cholinergic toxidrome.
Question 3NRP reviewed
A patient presenting with dilated pupils with hypertension, tachycardia, hyperthermia and diaphoresis is showing signs of
AAn opioid toxidrome
BA sympathomimetic toxidrome
CA cholinergic toxidrome
DA sedative-hypnotic toxidrome
Show the answer
Correct answer: B. A sympathomimetic toxidrome
Dilated pupils with hypertension, tachycardia, hyperthermia and diaphoresis together define a sympathomimetic toxidrome. Recognizing a toxidrome lets you treat a poisoning correctly even when the substance is unknown, which is the usual situation in the field.
A. An opioid toxidrome instead presents with pinpoint pupils with respiratory depression and depressed mentation.
B. These findings together define a sympathomimetic toxidrome.
C. A cholinergic toxidrome instead presents with pinpoint pupils with salivation, lacrimation, bronchorrhea and incontinence.
D. A sedative-hypnotic toxidrome instead presents with depressed mentation and respiratory depression with normal or slightly small pupils.
Question 4NRP reviewed
A patient presenting with depressed mentation and respiratory depression with normal or slightly small pupils is showing signs of
AA sedative-hypnotic toxidrome
BA sympathomimetic toxidrome
CA cholinergic toxidrome
DAn opioid toxidrome
Show the answer
Correct answer: A. A sedative-hypnotic toxidrome
Depressed mentation and respiratory depression with normal or slightly small pupils together define a sedative-hypnotic toxidrome. Recognizing a toxidrome lets you treat a poisoning correctly even when the substance is unknown, which is the usual situation in the field.
A. These findings together define a sedative-hypnotic toxidrome.
B. A sympathomimetic toxidrome instead presents with dilated pupils with hypertension, tachycardia, hyperthermia and diaphoresis.
C. A cholinergic toxidrome instead presents with pinpoint pupils with salivation, lacrimation, bronchorrhea and incontinence.
D. An opioid toxidrome instead presents with pinpoint pupils with respiratory depression and depressed mentation.
Question 5NRP reviewed
SCENE — 55-year-old with epigastric discomfort he attributes to indigestion. HR 96, BP 138/84, RR 18, SpO2 97%, skin cool and damp, and he is a smoker with diabetes.
The finding that should change your working impression is
Athe blood pressure of 138/84 on your assessment
Bhis history of smoking and diabetes
Cthe epigastric location of the discomfort he describes
Dcool damp skin, which does not accompany simple indigestion
Show the answer
Correct answer: D. cool damp skin, which does not accompany simple indigestion
Indigestion does not make someone sweat at rest. Cool damp skin is a sympathetic response, and in a diabetic smoker with epigastric discomfort it points at infarction presenting atypically rather than at the stomach.
A. This blood pressure is unremarkable.
B. Risk factors raise suspicion but the skin finding changes the impression.
C. Epigastric pain is exactly how atypical infarction presents.
D. Diaphoresis with cool skin is a sympathetic response inconsistent with indigestion.
Question 6
SCENE — 33-year-old with a painful swollen leg and severe pain that seems out of proportion to the appearance. HR 122, temperature 101.8°F, BP 94/58, and the skin over the area is dusky with a small blister.
The combination of pain out of proportion with systemic upset suggests
Aa muscle tear in the calf from recent hard exercise
Ba simple cellulitis that will settle over the next few days
Ca clot in the deep veins of the calf and the thigh
Dinfection spreading fast through the deep tissue planes
Show the answer
Correct answer: D. infection spreading fast through the deep tissue planes
Pain way beyond what the skin shows, plus fever and a falling pressure, is infection destroying tissue below the surface faster than it shows above. This is a surgical emergency measured in hours. Don't let the skin fool you.
A. A muscle injury doesn't cause fever and hypotension.
B. Simple cellulitis doesn't cause hypotension and duskiness.
C. A clot causes swelling and pain without this much systemic upset.
D. Pain out of proportion with systemic upset points to deep infection spreading fast.
Question 7
SCENE — 15-month-old, drowsy after being found with an open bottle of a grandparent's tablets. HR 52, RR 16, BP 74/40.
The combination of a slow pulse and a low pressure in a toddler suggests
Aa substance affecting heart rate and vascular tone
Ba head injury from an unwitnessed fall down the stairs
Chypoglycemia from meals missed earlier in the day
Da normal sleeping state for a toddler of this age
Show the answer
Correct answer: A. a substance affecting heart rate and vascular tone
Kids compensate by raising the rate. So why is this one slow with a low pressure? Because something is actively suppressing that response, not just compensation running out. A grandparent's cardiac meds do exactly this, and a single tablet can be enough.
A. Bradycardia with hypotension in a toddler means a substance is actively suppressing the response.
B. A head injury with raised pressure causes hypertension, not hypotension.
C. Hypoglycemia causes tachycardia, not bradycardia.
D. A sleeping toddler keeps a normal rate and pressure.
Question 8
SCENE — 2-year-old with a barking cough. RR 36 with stridor at rest, SpO2 94%, sitting on a parent's lap, becomes distressed when you approach with a mask.
The most appropriate immediate action is
Aapply the mask despite the distress
Bstop, and let the child stay settled on the parent
Clay the child flat to examine the throat
Dseparate the child from the parent for assessment
Show the answer
Correct answer: B. stop, and let the child stay settled on the parent
Crying increases turbulent flow through a narrowed airway and makes the obstruction worse. So if the mask is distressing a child with stridor, the intervention is doing harm. Backing off is the treatment.
A. Forcing the mask on increases the work of breathing more than the oxygen helps.
B. Distress makes turbulent flow through the narrowed airway worse.
C. Lying flat worsens a compromised airway, and examining the throat risks obstruction.
D. Separating them adds distress to a child who needs to stay calm.
There are 449 EMT Primary Assessment questions in EMS Registry Ready. Try 15
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