NREMT-I85 Exam Guide: Intermediate EMT Certification Preparation
                     Healthcare
NREMT-I85
ExamName: EMT Intermediate 85 (NREMT-I85)
Exam Version: 6.0
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Question 1. (Single Select)
Cancer-causing agents are known as which of the following?
A: cardiotoxins
B: hemotoxins
C: carcinogens
D: corrosives
Answer: C
Explanation:
Cancer-causing agents are known as carcinogens. These substances are involved in causing cancer by
altering cellular metabolism or damaging DNA in our cells, which interferes with biological processes and
induces uncontrolled, malignant growth. Carcinogens can be found in a variety of substances, including
certain chemicals, industrial compounds, and some natural products.
Carcinogens can be classified into different categories based on their origin and nature. Chemical
carcinogens include substances such as asbestos, tobacco smoke, arsenic, and certain dioxins. Physical
carcinogens involve ultraviolet rays and radioactive materials. Biological carcinogens include certain
viruses, bacteria, and parasites.
The mechanism of action of carcinogens can vary. Some directly damage DNA, causing mutations that can
lead to cancer. Others may increase the rate of cell division, which can indirectly lead to cancer if it results
in increased opportunities for mutation. Additionally, some carcinogens can cause changes to the cellular
environment that promote growth of cancerous cells or impair the function of DNA repair mechanisms.
It is important to note that not all exposure to carcinogens will lead to cancer. The likelihood of developing
cancer depends on several factors, including the type and amount of the carcinogen, the duration of
exposure, and an individual’s genetic background. Some people may be more susceptible to the effects of
carcinogens due to genetic predispositions or other health factors.
In summary, carcinogens are a diverse group of cancer-causing agents that include chemicals, physical
agents, and biological organisms. Understanding the sources and mechanisms of carcinogens helps in
developing preventive measures and treatment strategies for various types of cancer.
Question 2. (Single Select)
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The gas that remains in the lungs after forced expiration is known as which of the following?
A: expiratory reserve volume
B: inspiratory reserve volume
C: residual volume
D: tidal volume
Answer: C
Explanation:
Residual volume refers to the amount of air that remains in the lungs after a person has exhaled as
forcefully as possible. This volume of air cannot be voluntarily expelled from the lungs because it is
required to keep the alveoli (the tiny air sacs in the lungs) open and prevent lung collapse. Maintaining
these air sacs in an open state is critical for ongoing gas exchange between the lungs and the bloodstream,
even between breaths.
The typical range of residual volume is between 1000 to 1200 milliliters (mL) in a healthy adult, though this
can vary based on factors such as age, sex, and body size. For instance, it tends to be lower in children
and higher in adults, and can be influenced by the overall health and lung capacity of an individual.
It's important to differentiate residual volume from other lung volumes and capacities. For example,
expiratory reserve volume is the additional air that can be forcibly exhaled after the end of a normal tidal
exhalation. Inspiratory reserve volume, on the other hand, is the extra amount of air that can be inhaled
with maximum effort after a normal inhalation. Tidal volume is the amount of air inhaled or exhaled during
normal breathing without any extra effort. Each of these volumes plays a crucial role in overall lung function
and respiratory health, but residual volume is specifically key to preventing lung collapse and ensuring that
gas exchange continues efficiently at all times.
Question 3. (Single Select)
Which of the following types of seizure is caused by an elevated body temperature that is not associated
with a central nervous system infection?
A: febrile seizure
B: absence seizure
C: atonic seizure
D: clonic seizure
Answer: A
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Explanation:
A febrile seizure, also known as a fever-induced seizure or febrile convulsion, is a convulsive event in
young children triggered by a spike in body temperature, often from an infection outside the central nervous
system (CNS). These episodes are not caused by an infection of the CNS, such as meningitis or
encephalitis, but are rather a response to a rapid increase in temperature, typically above 38°C (100.4°F).
Febrile seizures are most common in children between the ages of 6 months and 5 years, with the peak
incidence occurring in toddlers around 18-24 months of age. The risk of experiencing these seizures starts
to decline after the age of 5. It is important to note that these seizures are relatively common, affecting 2%
to 5% of children in the U.S. and Europe. Boys are slightly more prone to febrile seizures than girls.
The exact mechanism behind febrile seizures is not fully understood, but it is believed to involve the
immature brain's response to fever. Young children have a lower seizure threshold compared to adults,
which means their brains are more susceptible to seizures in the presence of fever. Genetic factors also
play a role, as having a family history of febrile seizures increases a child's risk of experiencing them.
Clinically, febrile seizures are classified into two types: simple and complex. A simple febrile seizure is
short, generally lasting less than 15 minutes, and does not recur within a 24-hour period. It involves
convulsions that are generalized and affect both sides of the body. On the other hand, a complex febrile
seizure may last longer than 15 minutes, occur more than once within 24 hours, or be focal, affecting only
one part of the body.
Febrile seizures, although alarming for parents, are generally benign and do not lead to permanent brain
damage, developmental delays, or future neurological problems like epilepsy. Management primarily
focuses on treating the cause of the fever and providing safety measures during a seizure to prevent injury.
Regular use of antipyretics during illness to prevent fever spikes is common, although it does not
necessarily prevent a febrile seizure. In some cases, preventive medication may be recommended for
children with a high risk of recurrent febrile seizures.
Overall, febrile seizures are a relatively common pediatric condition linked with high fevers, not CNS
infections, and usually resolve without long-term effects. However, any first instance of a febrile seizure
should prompt a medical evaluation to rule out more serious conditions and to provide guidance on
managing future fevers.
Question 4. (Single Select)
A tear in the posterior rim of the capsule that encloses the gelatinous center of the spinal disk is known as
which of the following?
A: degenerative disk disease
B: spondylosis
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C: spinal cord tumor
D: herniated intervertebral disk
Answer: D
Explanation:
The correct answer to the question is a herniated intervertebral disk. This medical condition involves a tear
in the posterior rim of the capsule that encloses the gelatinous center, known as the nucleus pulposus, of a
spinal disk. The spinal disks are crucial structures located between the vertebrae (the bones of the spine)
that act as shock absorbers and allow flexibility in the spine.
The nucleus pulposus inside these disks is a soft, jelly-like center that distributes pressure across the disk
to reduce the impact on the spinal column during daily activities and movements. When there is a
herniation, the nucleus pulposus protrudes or leaks out through a tear in the tougher, outer ring of the disk,
known as the annulus fibrosus. This usually occurs in the posterior (back) side of the disk, which faces the
spinal canal.
The causes of a herniated intervertebral disk can vary but often include factors such as trauma to the
spine, degenerative disk disease, which is a condition that causes the disks to deteriorate with age, or
improper lifting techniques that place excessive strain on the spine. Symptoms of a herniated disk can
include pain, numbness, and weakness in the limbs, as well as back pain. In severe cases, it can affect
nerve function due to pressure on the spinal nerves or spinal cord.
Diagnosis of a herniated disk is typically achieved through imaging studies such as MRI or CT scans, which
provide detailed images of the body's internal structures, allowing healthcare providers to see the extent of
disk damage and displacement. Treatment options can vary depending on the severity of the herniation and
the specific symptoms experienced by the patient. Conservative treatments may include physical therapy,
medications to reduce pain and inflammation, and in some cases, corticosteroid injections. Surgical options
might be considered if conservative treatments fail to relieve symptoms or if there is significant nerve or
spinal cord compression.
Overall, understanding the nature of a herniated intervertebral disk is crucial for effective management and
treatment. This condition, while potentially painful and debilitating, often can be managed effectively with
the right combination of medical interventions and lifestyle adjustments.
Question 5. (Single Select)
The resistance against which the heart muscle must pump is called the:
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A: stroke volume
B: myocardial contractility
C: preload
D: afterload
Answer: D
Explanation:
The correct answer to the question regarding the resistance against which the heart muscle must pump is
"afterload."
Afterload is a critical concept in cardiovascular physiology, referring specifically to the resistance that the
left ventricle of the heart must overcome to circulate blood throughout the body. When the heart pumps, it
must force blood out into the aorta through the aortic valve. The pressure in the aorta and the peripheral
resistance the blood encounters as it flows through the circulatory system contribute to the afterload.
Essentially, afterload is the load that the heart must work against during systole, the phase of the heart
cycle when the heart contracts and pumps blood.
Stroke volume, another term mentioned in the question, is the volume of blood the heart ejects during each
contraction. It is influenced by several factors, one of which is afterload. Higher afterload increases the
workload on the heart and can reduce stroke volume if the heart muscle is unable to generate sufficient
force to overcome the increased vascular resistance. In contrast, a lower afterload makes it easier for the
heart to pump blood, potentially increasing stroke volume if other factors remain constant.
Myocardial contractility refers to the inherent capability of the heart muscle (myocardium) to contract. This
factor is independent of heart load conditions like preload and afterload. Enhanced contractility leads to a
more forceful contraction of the heart muscle, potentially increasing stroke volume by enabling the heart to
pump a greater volume of blood with each beat, even against a high afterload.
Preload, yet another factor influencing stroke volume, is the volume of blood in the ventricles at the end of
diastole (when the heart is filled). It represents the initial stretching of the cardiac myocytes prior to
contraction. Essentially, it is the load placed on the heart before it contracts, setting the stage for how
forcefully the heart needs to pump based on how much it is filled.
In summary, while preload sets the initial conditions of the heart's pump, and myocardial contractility
enhances its power, afterload is the resistance that must be overcome by this power. Understanding these
interrelationships is crucial for comprehending how the heart functions under various physiological and
pathological conditions.
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