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L e a r n i n g E x p r e s
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COMPLETE TEST PREPARATION
EMT- BASIC EXAM The Most EMT Practice Tests Available!
n TWELVE complete practice tests based on the official national registry exa
n Updated review lessons covering current U.S. DOT/NHTSA curriculum
n Written by an expert team of EMS educators and practitioners
n Proven test-taking strategies to help reduce anxiety 5th
Edition
revised
completely
and updated!
Practice Exam
NREMT AND EMT-PARAMEDIC
BASIC EXAM PRACTICE TESTS
TWELVE complete practice tests based on the official national registry exam Updated review lessons covering current U.S. DOT/NHTSA curriculum Written by an expert team of EMS educators and practitioners Proven test-taking strategies to help reduce anxiety Contents Contributors Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Chapter 8 Chapter 9 Chapter 10 Chapter 11 Chapter 12
- Contents– Chapter 13 EMT-Basic Practical Skills Exam 273 Chapter 14 State Certification Requirements 309 Additional Online Practice 313
c h a p t e r
The EMT-Basic Exam
Chapter Summary
This chapter tells you how to become certified as an Emergency Medical Technician-Basic (EMT-B). It outlines the certification requirements of the National Registry of Emergency Medical Technicians and tells you how to use this book to study for the written exam.
T he National Registry of Emergency Medical Technicians (NREMT) was established in 1970 in response
to a suggestion of the U.S. Committee on Highway Safety. Today, the NREMT is an independent, not-for-profit agency whose job is to certify that EMTs have the knowledge and skills to do their job—to save lives and preserve health. By setting uniform national standards for training, testing, and continuing educa- tion, the NREMT helps ensure patient safety throughout the United States. In some states, the NREMT certification process is the only licensure process for EMTs. Other states have their own testing procedures. (A list of specific certification requirements for all 50 states, Washington, D.C., Puerto Rico, and the U.S. Virgin Islands appears in Chapter 14.) Nearly all states and U.S. territories base their curriculum and tests on the U.S. Department of Transportation’s National Standard Curriculum for EMT-Basics. The NREMT exam uses the same curriculum to guide the construction of exam questions. Therefore, whether you will be taking a state test or the NREMT test, you will be learning and studying similar material. This book is based on the NREMT cognitive examination.
- the emt-basic exam– The exam consists of six content areas: Percent of Category overall test Airway and Breathing 18.0% Cardiology 17.3% Trauma 16.7% Operations 16.7% Pediatrics and Obstetrics/Gynecology 16.0% Medical 15.3% TOTAL 100% For more information on the EMT-Basic cognitive exam, visit http://www.nremt.org. The EMT-Basic Practical Exam When you apply for National Registry EMT-Basic reg- istration, you will fill out an application that consists of several sections. The application requires verification of your credentials. The verification may be in the form of your program director’s electronic signature attest- ing to competency in the following skills: 1. Patient Assessment/Management—Trauma 2. Patient Assessment/Management—Medical 3. Cardiac Arrest Management/AED 4. Spinal Immobilization (Seated Patient) 5. Spinal Immobilization (Supine Patient) 6. Bag-Valve-Mask Apneic Patient with a Pulse 7. Long Bone Fracture Immobilization 8. Joint Dislocation Immobilization 9. Traction Splinting Bleeding Control/Shock Management Upper Airway Adjuncts and Suction Mouth-to-Mask with Supplemental Oxygen Supplemental Oxygen Administration The National Registry EMT-Basic application also requires proof that you have successfully completed state-approved practical examination within a 12-month period. At a minimum, the exam must evalu-ate your performance in the following skills. To pass the practical exam, you must meet or exceed the NREMT’s criteria in the following six areas: Station #1: Patient Assessment/Management— Trauma Station #2: Patient Assessment/Management— Medical Station #3: Cardiac Arrest Management/AED Station #4: Spinal Immobilization (seated or supine patient) Station #5: Bag-Valve-Mask Apneic Patient with a Pulse Station #6: Random Skill Station. This will con- sist of one of the following skills: Long bone fracture immobilization Joint dislocation immobilization Traction splinting Bleeding control/shock management Upper airway adjuncts and suction Mouth-to-mask with supplemental oxygen Supplemental oxygen administration Chapter 13 contains more detailed information about the NREMT practical exam. Using This Book to Prepare The bulk of this book consists of 10 practice tests, each containing 120–150 questions similar to those on the National Registry EMT-Basic cognitive examination. All practice tests represent content from the NREMT-Basic examination. The first step in using this book to prepare for the EMT-Basic cognitive examination is to read Chap-ter 2, which presents the nine-step LearningExpress Test Preparation System. Chapter 2 introduces essen-tial test-taking strategies that you can practice as you take the exams in this book.
- the emt-basic exam– Next, take one complete practice test and score your answers using the answer key. Complete explana-tions for the answers are included. Even though the EMT-Basic cognitive exam is pass/fail, LearningExpress recommends scoring at least a 70% on the practice tests in order to achieve the best results on your final EMT-Basic exam. If you score over 70% on your first practice exam, congratulations! However, even if you do very well on the practice test, don’t become overconfident and sim-ply assume that you’ll pass the actual test easily—the items on that test will be different from those on the practice test. You’ll still need to do some test prepara-tion. No matter what your initial score, follow the suggestions in the next paragraphs. If you score below 70% on your first practice test, don’t panic, but do put in some concentrated study time. Begin your studying by determinining your major areas of weakness. For example, perhaps you answered 40 items on the practice test incorrectly, giving you a score of 80, or approximately 67%. Upon rereading the questions you missed, try to determine the content area in which they belong: Cardiology; Airway and Breathing; Trauma; Medical; Pediatrics and Obstetrics/Gynecology; or Opera-tions, for example. This analysis tells you where you need to concen- trate your studying. Try putting in one or two con- centrated evenings of study on each area. Review all the material on these topics in the textbook and printed materials from your EMS course. Then take a second practice test and check your total score and content area breakdown again. Chances are that your total will have improved. In the time leading up to the EMT-Basic cogni- tive exam, use the remaining practice tests to further pinpoint areas of weakness and to find areas to review. For example, suppose that after additional study ses- sions, you take the third practice test. You now do well on all the questions about circulation except the ones that ask you to recognize signs and symptoms of shock. This information tells you which specific pages of your textbook you should review. Once you have worked on and improved your areas of weakness, use the final days before the test to do some general reviewing. Devote a short period of time each day to reviewing one or two chapters of your textbook. Then use the fourth and tenth practice tests to rehearse free-response testing. Although this method is not included on the official exam, it pro- vides an alternative form of evaluation, and the chal- lenge will help you achieve greater understanding of the concepts. After reading and studying this book, you’ll be well on your way to obtaining certification as an EMT-Basic. Good luck as you enter this rewarding and worthwhile career!
- the learningexpress test preparation system– What’s the common denominator in all these test-taking pitfalls? One thing: control. Who’s in con-trol, you or the exam? Now the good news: The LearningExpress Test Preparation System puts you in control. In just nine easy-to-follow steps, you will learn everything you need to know to ensure that you are in charge of your preparation and your performance on the exam. Other test takers may let the test get the better of them; other test takers may be unprepared or out of shape, but not you. You will have taken all the steps you need to get a high score on the EMT-Basic exam. Here’s how the LearningExpress Test Preparation System works: Nine easy steps lead you through every- thing you need to know and do to get ready to master your exam. Each of the following steps includes both reading about the step and one or more activities. It’s important that you do the activities along with the reading, or you won’t get the full benefits of the sys- tem. Each step tells you approximately how much time that step will take you to complete. Step 1. Get Information 50 minutes Step 2. Conquer Test Anxiety 20 minutes Step 3. Make a Plan 30 minutes Step 4. Learn to Manage Your Time 10 minutes Step 5. Learn to Use the Process 20 minutes of Elimination Step 6. Know When to Guess 20 minutes Step 7. Reach Your Peak 10 minutes Performance Zone Step 8. Get Your Act Together 10 minutes Step 9. Do It! 10 minutes Total 3 hours We estimate that working through the entire system will take you approximately three hours, though it’s perfectly okay if you work more quickly or slowly than the time estimates assume. If you have a whole afternoon or evening free, you can work through the whole LearningExpress Test Preparation System in one sitting. Otherwise, you can break it up and do just one or two steps a day for the next several days. It’s up to you—remember, you’re in control. Step 1: Get Information Time to complete: 50 minutes Activities: Read Chapter 1, “The EMT-Basic Exam” and Chapter 14, “State - Certification Requirements” Knowledge is power. The first step in the Learning Express Test Preparation System is finding out every-thing you can about the EMT-Basic exam. Once you have your information, the next steps in the Learning Express Test Preparation System will show you what to do about it.
Part A: Straight Talk about the
EMT-Basic Exam
Why do you have to take this exam anyway? Simply put, because lives depend on your performance in the field. The EMT-Basic cognitive exam is just one part of a whole series of evaluations you have to go through to show that you can be trusted with the health and safety of the people you serve. The cognitive exam attempts to measure your knowledge of your trade. The practical skills exam attempts to measure your ability to apply what you know. It’s important for you to remember that your score on the EMT-Basic cognitive exam does not determine how smart you are or even whether you will make a good EMT. There are all kinds of things an
- the learningexpress test preparation system– exam like this can’t test: whether you are likely to fre-quently show up late or call in sick, whether you can keep your cool under the stress of trying to revive a victim of cardiac arrest, whether you can be trusted with confidential information about people’s health, etc. Those kinds of things are hard to evaluate, while whether you can click on the right answer on a com-puter is easy to evaluate. This is not to say that clicking on the right answer is not important. The knowledge tested on the cogni-tive exam is knowledge you will need to do your job. Furthermore, your ability to enter the profession you’ve trained for depends on your passing this exam. And that’s why you’re here—using the LearningExpress Test Preparation System to achieve control over the exam.
Part B: What’s on the Test
If you haven’t already done so, stop here and read Chapter 1 of this book, which gives you an overview of EMT-Basic cognitive exams in general and the National Registry of Emergency Medical Technicians (NREMT) exam in particular. Many states use the NREMT exam, but others do not. Turn to Chapter 14 for a state-by-state overview of certification requirements. If you haven’t already gotten the full rundown on certification procedures as part of your training program, you can contact your state’s EMT agency listed in Chapter 14 for details. Step 2: Conquer Test Anxiety Time to complete: 20 minutes Activity: Take the Test Stress Exam Having complete information about the exam is the first step in getting control of it. Next, you have to overcome one of the biggest obstacles to test success: anxiety. Test anxiety can not only impair your perfor- mance on the exam itself, it can even keep you from preparing! In Step 2, you’ll learn stress-management techniques that will help you succeed on your exam. Learn these strategies now, and practice them as you work through the exams in this book so they’ll be second nature to you by exam day.
Combating Test Anxiety
The first thing you need to know is that a little test anxiety is a good thing. Everyone gets nervous before a big exam—and if that nervousness motivates you to prepare thoroughly, so much the better. It’s said that Sir Laurence Olivier, one of the foremost British actors of the twentieth century, felt sick before every performance. His stage fright didn’t impair his perfor- mance; in fact, it probably gave him a little extra edge —just the kind of edge you need to do well, whether on a stage or in an examination room. The Test Stress Exam is on page 9. Stop here and answer the questions on that page to find out whether your level of test anxiety is cause for worry.
Stress Management before the Test
If you feel your level of anxiety is getting the best of you in the weeks before the test, here is what you need to do to bring the level down again: Get prepared. There’s nothing like knowing what to expect and being prepared for it to put you in control of test anxiety. That’s why you’re reading this book. Use it faithfully, and remind yourself that you’re better prepared than most of the peo-ple taking the test. Practice self-confidence. A positive attitude is a great way to combat test anxiety. This is no time to be humble or shy. Stand in front of the mirror and say to your reflection, “I’m prepared. I’m full of self-confidence. I’m going to ace this test. I know I can do it.” Record it and play it back once a day. If you hear it often enough, you’ll believe it. Fight negative messages. Every time someone starts telling you how hard the exam is or how it’s almost impossible to get a high score, start telling them your self-confidence messages. If that someone with the negative messages is you telling yourself you don’t do well on exams, you just can’t
this book. UseTestitfaihfully,StressandremindExamyourself that You need to worry about test anxiety only if it is extreme enough to impair your performance. The following questionnaire will diagnose your level of test anxiety. In the blank before each statement, write the number that most accurately describes your experience. 0 = Never 1 = Once or twice 2 = Sometimes 3 = Often _____ I have gotten so nervous before an exam that I simply put down the books and didn’t study for it. _____ I have experienced disabling physical symptoms such as vomiting and severe headaches because I was nervous about an exam. _____ I have simply not shown up for an exam because I was scared to take it. _____ I have experienced dizziness and disorientation while taking an exam (^). _____ I have had trouble filling in the little circles because my hands were shaking too hard. _____ I have failed an exam because I was too nervous to complete it. _____ Total: Add up the numbers in the blanks above.
Your Test Stress Score
Here are the steps you should take, depending on your score. If you scored: ■ Below 3, your level of test anxiety is nothing to worry about; it’s probably just enough to give you that little extra edge. ■ Between 3 and 6, your test anxiety may be enough to impair your performance, and you should practice the stress-management techniques listed in this section to try to bring your test anxiety down to manageable levels. ■ Above 6, your level of test anxiety is a serious concern. In addition to practicing the stress-management tech-niques listed in this section, you may want to seek additional personal help. Call your local high school or com-munity college and ask for the academic counselor. Tell the counselor that you have a level of test anxiety that sometimes keeps you from being able to take the exam. The counselor may be willing to help you or may suggest someone else with whom you should talk. Step 3: Make a Plan Time to complete: 30 minutes Activity: Construct a study plan Maybe the most important thing you can do to get control of yourself and your exam is to make a study plan. Too many people fail to prepare simply because they fail to plan. Spending hours the day before the exam poring over sample test questions not only raises your level of test anxiety, it also is simply no substitute for careful preparation and practice over time. Don’t fall into the cram trap. Take control of your preparation time by mapping out a study sched-ule. On the following pages are two sample schedules based on the amount of time you have before you take the EMT- Basic cognitive exam. If you’re the kind of person who needs deadlines and assignments to moti-vate you for a project, here they are. If you’re the kind of person who doesn’t like to follow other people’s plans, you can use the following suggested schedules to construct your own. Even more important than making a plan is making a commitment. You can’t review everything you learned in your EMT course in one night. You
- the learningexpress test preparation system– have to set aside some time every day for study and practice. Try for at least 20 minutes a day. Twenty min-utes daily will do you much more good than two hours on Saturday. Don’t put off your studying until the day before the exam. Start now. A few minutes a day, with half an hour or more on weekends, can make a big difference in your score.
Schedule A: The 30-Day Plan
If you have at least a month before you take the EMT-Basic exam, you have plenty of time to prepare—as long as you don’t waste it! If you have less than a month, turn to Schedule B. Time Preparation Days 1–3 Skim over the written materials from your training program, particularly noting 1) areas you expect to be emphasized on the exam and 2) areas you don’t remember well. On Day 3, concentrate on those areas. Day 4 Take the first and second practice exams in Chapters 3 and 4. Day 5 Score the practice exams. Use the outline of skills in Chapter 1 to reveal your strongest and weakest areas. Identify two areas that you will concentrate on before you take the next practice exams. Days 6–9 Study the two areas you identified as your weak points. Don’t worry about the other areas. Day 10 Take the third and fourth practice exams in Chapters 5 and 6. Day 11 Score the practice exams. Identify one area to concentrate on before you take the next practice exams. Days 12–17 Study the one area you identified for review. In addition, review the practice exams you’ve already taken, with special attention to the answer explanations. Day 18 Take the fifth and sixth practice exams in Chapters 7 and 8. Day 19 Once again, identify one area to review, based on your score on the practice exams. Day 20 Study the one area you identified for review. Days 21–23 Take an overview of all your training materials, consolidating your strengths and improving on your weaknesses. Days 24–25 Review all the areas that have given you the most trouble in the practice exams you’ve already taken. Day 26 Take the seventh and eighth practice exams in Chapters 9 and 10 and score them. See how much you’ve improved! Day 27 Take the ninth and tenth practice exams in Chapters 11 and 12. Score and take note of any remaining areas that need improvement. Days 28–29 Review one or two weak areas. Day before Relax. Do something unrelated to the exam, and go to bed at a reasonable hour. the exam
- the learningexpress test preparation system– Pace yourself. Glance at your watch every few minutes, and compare the time to how far you’ve gotten in the test. When one-quarter of the time has elapsed, you should be one-quarter through the test, and so on. If you’re falling behind, pick up the pace a bit. Don’t rush. Though you should keep moving, rushing won’t help. Try to keep calm and work methodically and quickly. Step 5: Learn to Use the Process of Elimination Time to complete: 20 minutes Activity: Complete worksheet on Using the Process of Elimination After time management, the next most important tool for taking control of your exam is using the process of elimination wisely. It’s standard test-- taking wisdom that you should always read all the answer choices before choosing your answer. This helps you find the right answer by eliminating wrong answer choices. And, sure enough, that standard wisdom applies to your exam, too. Let’s say you’re facing a question that goes like this: Which of the following lists of signs and symptoms indicates cardiac compromise? headache, dizziness, nausea, confusion dull chest pain, sudden sweating, difficulty breathing wheezing, labored breathing, chest pain difficulty breathing, high fever, rapid pulse You should always use the process of elimination on a question like this, even if the right answer jumps out at you. Sometimes the answer that jumps out isn’t right after all. Let’s assume, for the purpose of this exercise, that you’re a little rusty on your signs and symptoms of cardiac compromise, so you need to use a little intuition to make up for what you don’t remember. Proceed through the answer choices in order. Start with answer a. This one is pretty easy to eliminate; none of these signs and symptoms is con- sistent with cardiac compromise. On a piece of scrap paper, mark an X next to choice a so you never have to look at it again. On to the next. “Dull chest pain” looks good, though if you’re not up on your cardiac signs and symptoms you might wonder if it should be “acute chest pain” instead. “Sudden sweating” and “difficulty breathing”? Check. And that’s what you write next to answer b on your scrap paper—a check mark, mean- ing, “Good answer, I might use this one.” Choice c is a possibility. Maybe you don’t really expect wheezing in cardiac compromise, but you know “chest pain” is right, and let’s say you’re not sure whether “labored breathing” is a sign of cardiac difficulty. Put a question mark next to c , meaning, “Well, maybe.” Choice d strikes you about the same; “difficulty breathing” is a good sign of cardiac compromise. But wait a minute. “High fever”? Not really. “Rapid pulse”? Well, maybe. This doesn’t really sound like cardiac compromise, and you’ve already got a better answer picked out in choice b. If you’re feeling sure of your-self, put an X next to this one. If you want to be care-ful, put a question mark. Now your notes on the question look like this: Which of the following lists of signs and symptoms indicates cardiac compromise? a. headache, dizziness, nausea, confusion ✔ b. dull chest pain, sudden sweating, difficulty breathing ? c. wheezing, labored breathing, chest pain ? d. difficulty breathing, high fever, rapid pulse
- the learningexpress test preparation system– You’ve got just one check mark for a good answer. It’s good to have a system for marking good, bad, and maybe answers. We’re recommending this one: X = bad ✔ = good? = maybe If you don’t like these marks, devise your own sys- tem. Just make sure you do it long before test day (while you’re working through the practice exams in this book) so you won’t have to worry about it during the test. Even when you think you’re absolutely clueless about a question, you can often use the process of elimination to get rid of one answer choice. If so, you’re better prepared to make an educated guess, as you’ll see in Step 6. More often, the process of elimina-tion helps you get down to only two possibly right answers. Then you’re in a strong position to guess. And sometimes, even though you don’t know the right answer, you find it simply by getting rid of the wrong ones, as you did in the previous example. Try using your powers of elimination on the questions in the worksheet Using the Process of Elim- ination beginning on the next page. The questions aren’t about EMT work; they’re just designed to show you how the process of elimination works. The answer explanations for this worksheet show one way you might use the process to arrive at the right answer. The process of elimination is your tool for the next step, which is knowing when to guess.
this bookUsing.Useitfaithefully,Processandremindyourselfof thatElimination ( continued )
Answers
Here are the answers, as well as some suggestions on how you might have used the process of elimination to find them. d. You should have eliminated answer a right off the bat. Ilsa can’t be four years old if Meghan is going to be Ilsa’s age in five years. The best way to eliminate other answer choices is to try plugging them into the information given in the problem. For instance, for answer b , if Ilsa is 10, then Meghan must be 5. The difference in their ages is 5. The difference between Ed’s age, 29, and Meghan’s age, 5, is 24. Is 24 two times 5? No. Then answer b is wrong. You could eliminate answer c in the same way and be left with answer d. c. Note the word not in the question, and go through the answers one by one. Is the truck driver in choice a “operating a commercial vehi-cle”? Yes, idling counts as “operating,” so he needs to have a commercial driver’s license. Likewise, the bus operator in answer b is operat-ing a commercial vehicle; the question doesn’t say the operator must be on the street. The limo driver in d is operating a commercial vehicle, even if it doesn’t have a passenger in it. How-ever, the cabbie in answer c is not operating a commercial vehicle, but his own private car. a. You could eliminate answer b simply because of the presence of all. Such absolutes hardly ever appear in correct answer choices. Choice c looks attractive until you think a little about what you know—aren’t fewer people smoking these days, rather than more? So how could smoking be responsible for a higher mortality rate? (If you didn’t know that mortality rate means the rate at which people die, you might keep this choice as a possibility, but you’d still be able to eliminate two answers and have only two to choose from.) And choice d is plain silly, so you could eliminate that one, too. And you’re left with the correct choice, a. a. How you used the process of elimination here depends on which words you recognized as being spelled incorrectly. If you knew that the correct spellings were outrageous, domesti- cated, and understandable, then you were home free. Surely you knew that at least one of those words was wrong!
- the learningexpress test preparation system– Step 6: Know When to Guess Time to complete: 20 minutes Activity: Complete worksheet on Your - Guessing Ability Armed with the process of elimination, you’re ready to take control of one of the big questions in test taking: Should I guess? The first and main answer is “Yes.” Some exams have what’s called a “guessing penalty,” in which a fraction of your wrong answers is subtracted from your right answers—but EMT-Basic exams don’t often work that way. The number of questions you answer correctly yields your raw score, so you have nothing to lose and everything to gain by guessing. The more complicated answer to the question “Should I guess?” depends on you—your personality and your “guessing intuition.” There are two things you need to know about yourself before you go into the exam: Are you a risktaker? Are you a good guesser? You’ll have to decide about your risk-taking quotient on your own. To find out if you’re a good guesser, complete the worksheet Your Guessing Abil-ity that begins on page 17. Frankly, even if you’re a play-it-safe person with lousy intuition, you’re prob-ably still safe guessing every time. The best thing would be if you could overcome your anxieties and go ahead and mark an answer. But you may want to have a sense of how good your intuition is before you go into the exam.
