# NREMT Basic, in reality



## EMT91 (Jun 7, 2012)

I would like to have a thread about what to REALLY expect on the NREMT basic test. Perhaps we could have this thread stickied? My questions are as follows, and I would love a realistic answer:

1. Just how basic is the basic exam? Do some textbooks go above and beyond the standards?

2. Is the idea of "when in doubt, ABC out" really a good method?

3. What would be the hardest/most difficult question that might be thrown at you? In each area, I mean.

4. I have JBlearning, just got it today, so I have one week. Is it a fairly good way to know how you will do?

5. What tips/tricks are there? 

I know there are TONS of threads, but I was hoping we could make a sticky thread with all the info we need to know, with realistic replies from those who have actually taken it.


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## Ewok Jerky (Jun 7, 2012)

Just about everyone here has taken the NREMT, and the info on all the other threads is accurate.

The test is not that hard, read your book, pay attention in class and you will be fine. JB Learning is a good study aid.


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## Veneficus (Jun 7, 2012)

It has been 2 decades since I took the basic exam.

But from the educator point of view, I would like to remind you that with the recent curriculum change, if your book was written under the old curriculum, it will not be adequete.

Just keep that in mind.


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## AnthonyM83 (Jun 7, 2012)

There are a range of questions on it. After a few questions, the computer will start matching you with ones it's algorithm thinks will be difficult (but appropriate) for you. The test bank has super easy recall questions and some really really hard questions that most EMT books wouldn't prepare you for. Most of the questions are addressed by recent textbooks just fine, though. If you did well in EMT class and the program has a decent pass rate, you should do well.

There are some order of operations questions. You will need to know your ABC priorities. But also make sure they're appropriate for the situation. Review your AHA BLS book. You're expected to know all of that. Not everyone gets oxygen...remember CAB...etc.

Just read the questions carefully. Try to answer the question in your head before you look at the answers. Each wrong answer is wrong. It's EXTREMELY unlikely that there are two equally good answers. They're usually one little tiny bit of information in the question that will make each of the other choices wrong answers. Occasionally, there are other choices are might be right, but it's the not best choice.

There are a lot of questions like "What is most likely wrong with the patient" or "What would be the best action to take" or "What should you FIRST do for this patient".

Don't be stressed on time. Rare to fail for that. Read carefully. If it comes down to it, use common sense. That IS taken into account by the test writers.

If you get stopped at 70ish questions, you were either doing really well or horribly, so you'll know if you passed or not (thought you won't admit it to yourself).


Relax the night before. Let yourself chill out. Do your normal morning routine.


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## EMT91 (Jun 7, 2012)

I was taught ABCs...anywho, I understand that one should review and use common sense. One  thing I wonder though, is this: JBlearning said that if a trauma patients airway cannot be opened with a jaw thrust, you use the head tilt chin lift. My book (which is current, its Prehospital Care 9th by Mistovicach) says that you would re try it and use an airway adjunct. Which is NREMT correct?


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## Amberlamps916 (Jun 7, 2012)

Easier than you would believe.


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## EMT91 (Jun 7, 2012)

Addrobo87 said:


> Easier than you would believe.



In what way? What am I to judge it against? is the JBlearning site harder?


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## Amberlamps916 (Jun 7, 2012)

Jb learning helps. It's usually on par with your final, atleast from my experience.


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## EMT91 (Jun 7, 2012)

Addrobo87 said:


> Jb learning helps. It's usually on par with your final, atleast from my experience.



Is jblearning easier, on par, or harder than the nremt?


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## AnthonyM83 (Jun 8, 2012)

EMT91 said:


> I was taught ABCs...anywho, I understand that one should review and use common sense. One  thing I wonder though, is this: JBlearning said that if a trauma patients airway cannot be opened with a jaw thrust, you use the head tilt chin lift. My book (which is current, its Prehospital Care 9th by Mistovicach) says that you would re try it and use an airway adjunct. Which is NREMT correct?



This will occasionally happen. The test writers don't go to all the major EMT books on every single question they write, so sometimes it's based on the most common theory on it. AHA traditionally says to skip to head-tilt, chin-lift if jaw thrust isn't working. So, that's the answer I would choose, since everyone reads AHA (only a certain percentage read Mistovich). If it was a very educated group writing that question, someone might catch the conflict and thus not put OPA as an answer. What to do in a real life? Based on judgement you can do either or a combination of both. Welcome to medicine 

Also, the practice questions from that website aren't validated the same way NREMT's are. If most students who do very well on the NREMT are getting that question wrong, it would be thrown out. Some of the questions you'll get on the test will be "pilot" questions and won't affect your score.


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## Monkadelic (Jun 9, 2012)

none of the books and practice tests did any justice at all for the questions asked on the exam i took- and i spent about 60 bucks on books; all i can say is whatever is in the current brady book you have- that is what the test wants, all these books/sites are all off 2011 and earlier curriculum and its a whole new set of rates and stuff this year.  either you know it or you don't, or your just a damn good guesser because there are some questions on it you just have to bow down and just guess what "they" want to be correct.  mostly there are 2 blatantly wrong out the bat- a right answer, and a best answer.  that is the time you will spend between each question, but dont read to far into it tho. it cut me off at 70 and i was like oh sh-- i bombed it; but i passed; that test had me second guessing for 6 hours waiting for results rechecking some of them whack questions in the book to see if i got them right or not. they are whack because some of them dont give you any info on whats going on so it makes you ponder especially with trauma.


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## EMT91 (Jun 9, 2012)

I have prehospital care 9th ed


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## Veneficus (Jun 9, 2012)

EMT91 said:


> I was taught ABCs...anywho, I understand that one should review and use common sense. One  thing I wonder though, is this: JBlearning said that if a trauma patients airway cannot be opened with a jaw thrust, you use the head tilt chin lift. My book (which is current, its Prehospital Care 9th by Mistovicach) says that you would re try it and use an airway adjunct. Which is NREMT correct?



head tilt chin lift.

The idea is a patient with no airway will die no matter what other efforts are undertaken.


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## Martyn (Jun 9, 2012)

Jeez people...chill...it's only a test - one that is shrouded in mystery. As was said if you were good in class then passing it should be no problem. All these people publishing stuff 'Pass the NREMT' or 'Use this book, it's the ONLY one that will get you through the NREMT' etc are just profiteering off peoples fears...RELAX, IT'S NOT ROCKET SCIENCE!!!


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## EEMMTT (Jun 9, 2012)

JBL is a good study aid....I pretty much used that only to pass NREMT exam.   The NREMT - B actual questions are quite different and you may think you have no idea what they are asking but trust yourself you will know.    

Just do the study, make sure you are getting high marks 90%+ and you will pass.


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## EMT91 (Jun 9, 2012)

EEMMTT said:


> JBL is a good study aid....I pretty much used that only to pass NREMT exam.   The NREMT - B actual questions are quite different and you may think you have no idea what they are asking but trust yourself you will know.
> 
> Just do the study, make sure you are getting high marks 90%+ and you will pass.



Only jblearning only has like a hundred different cardiac questions etc.


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## blachatch (Jun 10, 2012)

My test had some of the exact questions from the JB learning site. The test seemed a bit easier than my tests in class. They do have a lot of tricky questions read the question over and over and pick the best answer, some will have all of the answers that seem right.


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## EpiEMS (Jun 10, 2012)

It's a fairly straightforward exam - follow the protocols from your textbook (assuming it's current). Don't go beyond your scope of practice and don't give everybody O2. Beyond that, remember your BCLS.


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## EMT91 (Jun 10, 2012)

COPD patients don't get o2 at times, correct?


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## rwik123 (Jun 10, 2012)

EMT91 said:


> COPD patients don't get o2 at times, correct?



The onset of oxygen toxicity is upwards of an hour. So technically prolonged O2 administration to COPDers is bad but idk if it's really pertinent in a prehospital setting unless it's a long transport.

Never deprive oxygen regardless of COPD diagnosis.


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## EMT91 (Jun 10, 2012)

That is what I thought. My book basically suggests o2 always.


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## TheGodfather (Jun 11, 2012)

rwik123 said:


> The onset of oxygen toxicity is upwards of an hour. So technically prolonged O2 administration to COPDers is bad but idk if it's really pertinent in a prehospital setting unless it's a long transport.
> 
> Never deprive oxygen regardless of COPD diagnosis.



The reason behind the low flow O2 concept with COPDer's isn't due to toxicity, but rather due to high flow o2's antagonizing effects on the COPD patient's normal hypoxic drive to breathe.

It would be a reasonable idea to consider the circumstances of the specific patient before jumping direct to high-flow o2 by NRB. Although this phenomenon is a rare finding in the prehospital environment, it still exists and the provider should still take caution.

If the patient is in distress, is it due to their oxygen saturations, or their work of breathing? 9 times out of 10, it's the ladder and that will not be fixed with a mask on high flow o2 alone.


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## EMT91 (Jun 11, 2012)

Its getting closer....June 14 near 6 PM...my NREMT


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## blachatch (Jun 11, 2012)

I was taught always give o2 it cant hurt anyone it can only help.


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## AnthonyM83 (Jun 12, 2012)

blachatch said:


> I was taught always give o2 it cant hurt anyone it can only help.



Read up on why that's not true....


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## EMT91 (Jun 13, 2012)

Tomorrow is the big day! Am I allowed to have a water bottle and a tissue for my nose in the test or is that a negative? Also its just one photo id and ame with your name and sig like a cpd card?


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## EMT91 (Jun 13, 2012)

In about 24 hours I will be taking the nremt


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## Amberlamps916 (Jun 13, 2012)

Oxygen toxicity can occur.


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## EMT91 (Jun 14, 2012)

So here are some questions from JBlearning, tell me if they are as hard or harder than the ones I might see on NREMT?

    Which of the following mechanisms of injury would necessitate performing a rapid trauma assessment? •A. Amputation of three toes from the patient’s left foot with controlled bleeding •B. An impaled object in the patient’s lower extremity with minimal venous bleeding •C. A 5 foot, 8 inch tall adult who fell 12 feet from a roof and landed on his side •D. A stable patient involved in a car crash, whose passenger was killed

2.A young male has an open abdominal wound through which a small loop of bowel is protruding. There is minimal bleeding. The BEST way to treat his injury is to: •A. Apply dry sterile gauze pads to the wound and then keep them continuously moist by pouring sterile saline or water on them throughout transport. •B. Cover the wound with a dry sterile trauma dressing and tightly secure it in place by circumferentially wrapping roller gauze around the abdomen. •C. Gently clean the exposed loop of bowel with warm sterile saline, carefully replace it back into the wound, and cover it with a dry sterile dressing. •D. Apply a sterile trauma dressing moistened with sterile saline directly to the wound and secure the moist dressing in place with a dry sterile dressing.

    If a passenger strikes his or her head on the windshield during a motor-vehicle crash: •A. You will always see a starburst fracture of the windshield at the location where the patient struck his or her head. •B. He or she will likely experience a hyperflexion injury, resulting in fractures of the vertebrae in the cervical spine. •C. The posterior portion of the brain will receive the initial impact, resulting in severe intracerebral hemorrhage. •D. The anterior portion of the brain sustains a compression injury, while the posterior portion sustains a stretching injury.


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## AnthonyM83 (Jun 14, 2012)

Stop studying and take the freaking test. I already told you, you'll be fine if you're doing well on those JB Questions. You have an adequate understanding of everything.

I can't answer whether the questions will be easier or harder. The difficulty of the questions depends on how well you do on the prior questions. You might get a medical student level question or you might get a middle school anatomy question. 

I will tell you, that they'll be better constructed than the sample ones you gave. Stuff like "always" and "never" will rarely be included in the answers, because it makes it too easy to psych the test out.


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