NREMT Scene Size-Up and Safety Practice Test (Free)

How much of the NREMT is scene size-up?

Up to about one question in five, and the principle behind it (scene first) decides questions in every other domain too.

Weight on the real exam (NREMT) and on our mocks
Scene Size-Up and Safety	15-19% of the EMT exam, about 11 to 23 questions across the 70 to 120 rangePublished by the ownerNREMT, EMT candidate handbook: about the examination
What it covers	Scene hazards, PPE, mechanism of injury or nature of illness, number of patients and the resources to callPublished by the ownerNREMT, "Emergency Medical Technician examination specifications" (test plan, PDF)
On our mocks	12 of 70 questions in every mock, mixed in with the other domainsLifeScore

What does scene size-up and safety cover?

Five things to decide in the first moments of a call.

Scene safety
Violence, traffic, fire, electricity, unstable structures and when to stage and wait for law enforcement or fire.
Standard precautions and PPE
Gloves, eye protection, masks and N95s, gowns; cleaning and exposure reporting.
Hazardous materials
Recognizing a hazmat scene, staying uphill and upwind, decontamination before treatment.
Mechanism of injury and nature of illness
Frontal, side, rear and rollover crashes, falls, penetrating trauma; clues in the room such as medications or oxygen.
Patients and resources
Counting patients, calling for more units, ALS, fire or a helicopter early.

What do scene size-up questions look like?

A scene with a problem and four actions; the right one keeps you and your crew safe. The first two are worked.

NREMT-style question 1 · Scene safety
You are dispatched to a crash and see a downed power line lying across the car. The driver is awake. What should you do?
1. AStay clear and wait for the power company to make it safe
2. BReach in to check the driver's pulse
3. CTell the driver to step out quickly
4. DMove the line with a dry wooden pole
Worked answer
A: Stay clear and wait for the power company to make it safe. A downed line can energize the car and the ground. Only the utility can make it safe; the driver should stay inside.
The trap: Wanting to rescue the patient right away.
NREMT-style question 2 · Hazardous materials
You arrive at a tanker spill with a placard and a strong smell. Where should you stage?
1. ARight next to the tanker
2. BDownwind so fumes blow away from the truck
3. CDownhill so you can see the spill
4. DUphill and upwind at a safe distance
Worked answer
D: Uphill and upwind at a safe distance. Gases and liquids travel downhill and downwind. Stage uphill and upwind and use the placard to identify the substance.
NREMT-style question 3 · PPE
A patient has a cough, fever and suspected tuberculosis. What respiratory protection should you wear?
1. AA surgical mask
2. BGloves only
3. CA fit-tested N95 respirator
4. DNo mask if you stay 3 feet away
Show the answer
C: A fit-tested N95 respirator. Tuberculosis is airborne; an N95 filters the particles a surgical mask does not.
NREMT-style question 4 · Mechanism of injury
An unrestrained driver hit a tree head-on and the windshield is starred. What injury should you suspect?
1. AHead and neck injury
2. BA foot injury only
3. CAn isolated wrist injury
4. DNo injury, since the airbag deployed
Show the answer
A: Head and neck injury. A starred windshield means the head struck it: suspect head and spine injury.

Written for this page as worked examples. None is a real exam question, and none is in any mock or drill.

Scene first, on every call and every question

Twelve questions show the gap. 4 more scene size-up drills and 8 full mocks close it.

The NREMT Pass Pack gives you 8 full mocks on the real clock, 20 drills of 12 questions for the sections that cost you points, and a predictor that turns your mocks into the odds of reaching your target. One payment, no subscription, and your free score stays free.

Prep courses for these tests usually cost $19 to $129. The NREMT Pass Pack is US$39 (£29), once.

See the NREMT Pass Pack How our questions are built and checked

8
timed mocks: 20
topic drills: 1
score predictor

Which injuries go with which mechanism?

The mechanism tells you what to look for before you find it.

Common mechanism-of-injury patterns taught in EMT courses
Mechanism	Suspect
Frontal crash, down-and-under	Knee, femur and hip injuries
Frontal crash, up-and-over	Head, neck, chest and abdomen
Side impact (T-bone)	Ribs, pelvis and neck on the struck side
Rear impact	Neck injury, especially with a low headrest
Rollover or ejection	Multiple and serious injuries; high suspicion
Fall over 20 feet in an adult	Significant mechanism; consider spine and internal injury
Penetrating trauma	Injury along the path; look for an exit wound

What rules win scene size-up questions?

Four rules.

Your safety first
Then your crew, then bystanders, then the patient. Never enter an unsafe scene.
PPE before contact
Choose it for what you expect to meet: gloves always, more for blood, airborne or splash risks.
Call early
If you will need more units, ALS or fire, call before you are busy with patients.
Let the mechanism guide you
A significant mechanism raises your suspicion even when the patient looks well.

What traps are set in scene size-up questions?

Brave-sounding answers.

Entering a violent scene before law enforcement secures it.
Approaching a hazmat scene downhill or downwind.
Treating a contaminated patient before decontamination.
Assuming an airbag means no injury.
Waiting to call for more units until you have assessed everyone.

How do I study scene size-up?

Three short sessions cover it.

Our plan, with minutes a day

Day 1
20 min
Free drill above; note the hazards you missed.
Day 2
20 min
PPE and hazmat: which protection, where to stage.
Day 3
20 min
Mechanism of injury patterns and when to call for resources.

Frequently asked questions

How many scene size-up questions are on the NREMT?

15-19% of the EMT exam, so roughly 11 to 23 questions depending on exam length.

What is the first step of every call?

Scene size-up: safety, PPE, mechanism or nature of illness, number of patients and resources.

Should an EMT enter a crime scene?

Only once law enforcement has made it safe; then preserve evidence while caring for the patient.

Do these questions follow my local protocols?

They follow national EMT education standards, which is what the exam tests. Your local protocols and medical direction govern real patient care.

Make scene safety automatic

20 topic drills (4 for scene size-up), 8 full mocks and a predictor, in one payment with no subscription.