After you read an NREMT test item, you may be very tempted to look at the answers and choose the one that seems correct. This strategy may work in many cases, but it can also work against you, if more than one answer appears correct. Many of the NREMT exam items are challenging for exactly this reason.
A stem should be written well enough so that you should be able to answer it without looking at the responses. Doing so gets you to slow down and consider exactly what the question is asking. You may have to draw certain conclusions about the patient’s status or condition, based on the information provided in the stem, before answering the question.
After you have the answer in your head, compare it to the four choices that are presented. If you’re spot on, the best answer should immediately be apparent. If none of the choices appear to match what you thought the answer should be, move to the next step.
Take a look at the following example. First, read the stem and tell yourself what you think the answer is.
A 62-year-old female is experiencing chest pain that began at rest. She describes the pain as “sharp,” and points to the right side of her chest when you ask her to locate where the discomfort is. Her heart rate is 90, her blood pressure is 130/70, and her respiratory rate is 16 and nonlabored. Her oxygen saturation level is 97 percent. You should
(A)administer high-flow oxygen using a nonrebreather mask.
(B)transport immediately.
(C)question her further about the chief complaint.
(D)place her in a supine position.
Based only on the information provided — before you even look at answer choices — you should understand that the patient is not in a serious or critical state that requires a major intervention to airway, breathing, or circulation. Given that her oxygen saturation level is normal, supplemental oxygen isn’t indicated either. Although you can say that the discomfort doesn’t appear to be cardiac in nature, you still need to investigate further.
With this information in mind, you’re ready to consider the answer choices. Choice (A) isn’t indicated because her saturation level is normal and she’s not in respiratory distress. Choice (B) is not correct; none of the information given indicates that she needs to be rushed to an emergency department.
Her blood pressure is normal and there are no signs of shock, making Choice (D) incorrect. The leaves Choice (C) as the best answer; you want to know more about the chief complaint.
NREMT exam items rarely test you on simple “recall” performance. The test assumes that you possess basic knowledge contained within the EMT curriculum. The questions build upon your knowledge and test your ability to use it in a scenario or to deduce certain conclusions about a patient.