EMT Intermediate/85 Examination

The National Registry of Emergency Medical Technicians (NREMT) offers the EMT Intermediate/85 Examination for certification purposes. NREMT offers the test with the main goal of ensuring that EMS workers are able to give capable medical care to people during times of great need. An EMS professional is in a position of trust and must be able to proficiently manage patients outside of a hospital environment. This test is taken as part of an EMT-Intermediate/85 registration.

The content of the cognitive test includes the following categories:

18% Airway & Breathing
17.3% Cardiology
16.7% Trauma
15.3% Medical
16% Obstetrics and Pediatrics
16.7% Operations

Candidates are allowed to attempt this examination three times. If after three attempts a candidate is still unsuccessful, the candidate will have to provide records regarding having taken 36 hours of remedial education before being allowed to try again up to three more times. If a candidate is unsuccessful after six tries, the candidate must complete an entire state-approved EMT-Intermediate/85 program. After a candidate passes the exam, he or she will receive information about national EMS certification. If a candidate does not pass, an account of which categories were near or below the requirements for passing will be provided.

The content of the practical test for EMT-Intermediate/85 covers four main skill competencies:

Patient assessment and management
Managing ventilation
Intravenous therapy
Random basic skills

Candidates must pass all four competencies, since this assessment is all-or-none. Not passing just one part means a candidate does not pass the whole test. If a candidate fails one or two skills, the candidate can take just the skills tests that were failed, or the candidate may be able to retest on one area on the same day. If unsuccessful on the second try, the candidate will need to provide documentation of remedial education. If unsuccessful after three tries, the candidate must participate in another EMT-Intermediate/85 education program before testing again.

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EMT Intermediate/85 Practice Test

1. Which of the following statements regarding PPE is FALSE?
  1. Prescription glasses with side shields are acceptable eye protection
  2. Surgical masks protect against TB
  3. Coveralls are preferable to gowns as protection against body fluid exposure
  4. Vinyl gloves should never be reused

1. Treatment of a severely injured patient who is under arrest would be permissible according to
  1. Implied consent
  2. Involuntary consent
  3. Informed consent
  4. Expressed consent

1. The most common neurotransmitter in the sympathetic nervous system is
  1. Acetylcholine
  2. Norepinephrine
  3. Adrenalin
  4. Epinephrine

1. Guaifenesin is classified as a ______ drug.
  1. Schedule I
  2. Schedule V
  3. Schedule IV
  4. Schedule II

1. All of the following can be administered in drug form except
  1. Edrophonium
  2. Pilocarpine
  3. Acetylcholine
  4. Atropine

1. Which of the following can be administered with blood products?
  1. Lactated Ringer’s solution
  2. Sodium chloride 0.9%
  3. Five percent dextrose in water
  4. Glucose

1. Large-bore catheters should be used for all of the following except
  1. Administration of 50% dextrose
  2. Administration of blood
  3. Shock patients
  4. Elderly patients

1. Which of the following IM injections sites is not recommended for young children?
  1. Dorsogluteal muscle
  2. Vastus lateralis muscle
  3. Ventrogluteal muscle
  4. Deltoid muscle

1. Pulse oximetry is reliable in monitoring arterial oxygen saturation in
  1. Patients in stable condition
  2. Patients in cardiac arrest
  3. Patients with anemia
  4. Patients with hypotension

1. Which of the following is symptomatic of subcutaneous emphysema?
  1. Neck vein distention
  2. Battle’s sign
  3. Crackling below the skin
  4. Ecchymosis

EMT Intermediate/85 Practice Test Answers and Explanations

B: Surgical masks do not provide adequate protection against some airborne pathogens, such as those causing tuberculosis (TB). Although goggles provide the best protection against bloodborne pathogens, prescription glasses with side shields are acceptable. Because coveralls are closer-fitting than gowns, overall-type coveralls with approved barrier shielding are preferable to gowns as protection against exposure to body fluids. Latex or rubber gloves should never be reused.
B: Involuntary consent involves treatment of a patient granted under authority of law whether or not the patient agrees to treatment, This may apply to a patient held for mental health evaluation or a patient who is under arrest; implied consent involves treatment of a patient who is severely ill or injured under the assumption that the patient would want care if able to respond. In the case of expressed consent, the patient gives verbal or written permission to be treated; in the case of informed consent, the patient gives consent to be treated only after receiving all information needed to understand his or her condition.
B: Norepinephrine is the most common neurotransmitter in the sympathetic nervous system; norepinephrine is related to epinephrine or adrenaline, which also functions as a sympathetic neurotransmitter. Acetylcholine is the most common neurotransmitter in the parasympathetic nervous system.
B: Guaifenesin, an ingredient in many cough medicines, is classified as a Schedule V drug, with the lowest potential for abuse; Schedule I drugs have the highest otential for abuse and include heroin, LSD, and mescaline.
C: Acetylcholine cannot be administered as a drug because it is broken down by cholinesterase in the blood and synapses before it can occupy receptors; however, some drugs, such as pilocarpine, which is used to treat glaucoma, mimic the action of acetylcholine. Edrophonium is a cholinesterase inhibitor; atropine is used to treat cardiovascular conditions.
B: Sodium chloride 0.9% is the only IV solution that can be given with blood products.
D: Large-bore, or 14- to 16-guage catheters, may be used for administration of viscous fluids, such as blood or blood components, or viscous medications, such as 50% dextrose. Large-bore catheters should be used for patients in shock, cardiac arrest, or other life-threatening conditions; however, they are not indicated for patients with small or fragile veins, such as infants and children or the elderly.
A: The dorsogluteal injection site is not recommended for children under the age of 3 years because the muscle is not yet developed and injection at this site may result in penetration of the sciatic nerve. The vastus lateralis muscle is the preferred site for injection in children less than 3 years of age; the ventrogluteal and deltoid muscles may be used for young children.
A: Pulse oximetry is unreliable in unstable patients, such as those with hypotension or hypothermia, anemia, or severe vascular disease, and in patients in cardiac arrest.
C: Subcutaneous emphysema is caused by air entering the subcutaneous tissue through a hole in the trachea; patients often complain of a crackling or crunching sensation below the skin. Neck vein distention may be indicative of congestive heart failure or cardiac tamponade; ecchymosis may signify neck trauma and subsequent airway obstruction. Battle’s sign is a discoloration of the area behind the ear and may indicate skull fracture.