21 Choking Response Practice Questions & Answers

1. 1. What is the universal sign that a person is choking?

   • A.Pointing at their stomach
   • B.Waving both arms overhead
   • C.Covering their eyes
   • D.Clutching or grabbing the throat with one or both hands✓ Answer

   The recognized universal choking sign is clutching the throat with the hands, which signals that the airway is obstructed and the person cannot speak. Rescuers are taught to recognize this so they can act immediately.

   Source: AHA/ARC First Aid Guidelines — universal choking signReport a problem with this question

2. 2. An adult is coughing forcefully after food goes down the wrong way but can still cough loudly. What should you do?

   • A.Give 5 back blows right away
   • B.Encourage them to keep coughing and stay close to monitor them✓ Answer
   • C.Immediately begin abdominal thrusts
   • D.Perform a blind finger sweep of the mouth

   A forceful cough moves more air than any thrust, so with a mild (partial) obstruction the best action is to encourage continued coughing and monitor. Intervening with thrusts on someone who can still cough effectively may push the object deeper.

   Source: AHA/ARC — mild vs. severe airway obstruction managementReport a problem with this question

3. 3. Which set of signs indicates SEVERE airway obstruction requiring immediate intervention?

   • A.Sneezing repeatedly with a runny nose
   • B.Unable to speak, cough weakly or silently, poor air exchange, may clutch the throat✓ Answer
   • C.Talking normally while eating
   • D.Loud forceful coughing and able to say a few words

   Severe obstruction is defined by poor air exchange: the victim cannot speak, has a weak or silent cough, and may make no sound or clutch the throat. These signs mean the airway is blocked enough that thrusts are needed immediately.

   Source: AHA/ARC — recognition of severe airway obstructionReport a problem with this question

4. 4. For a responsive adult with severe choking, what is the recommended intervention?

   • A.Chest compressions on the floor
   • B.A large drink of water
   • C.Two rescue breaths
   • D.Abdominal thrusts (Heimlich maneuver)✓ Answer

   For a responsive choking adult, abdominal thrusts create a burst of upward pressure below the diaphragm that forces air out of the lungs to expel the object. This is the standard Heimlich maneuver for severe obstruction.

   Source: AHA/ARC — abdominal thrusts for responsive adultReport a problem with this question

5. 5. Where do you place your hands to perform abdominal thrusts on a responsive choking adult?

   • A.A fist just above the navel and well below the breastbone, grasped with the other hand✓ Answer
   • B.On the lower ribs on each side
   • C.Around the neck below the jaw
   • D.Directly over the breastbone (sternum)

   Place the thumb side of a fist against the abdomen slightly above the navel and below the breastbone, then grasp it with the other hand and thrust inward and upward. This position directs force under the diaphragm without pressing on the ribs or sternum.

   Source: AHA/ARC — hand placement for abdominal thrustsReport a problem with this question

6. 6. How long should you continue abdominal thrusts on a responsive choking adult?

   • A.For no more than 10 seconds total
   • B.Until the person coughs once
   • C.Until the object is expelled or the person becomes unresponsive✓ Answer
   • D.Exactly five thrusts, then stop regardless

   You repeat abdominal thrusts in quick succession until the object is forced out or the victim becomes unresponsive. If they become unresponsive, the care changes to CPR, so thrusts are not stopped arbitrarily before then.

   Source: AHA/ARC — duration of thrusts until relief or unresponsivenessReport a problem with this question

7. 7. A responsive choking victim suddenly becomes unresponsive and you are alone with a phone. What should you do first?

   • A.Give five more abdominal thrusts while they lie down
   • B.Give two rescue breaths and wait
   • C.Leave to find help before doing anything
   • D.Call 9-1-1 (or have it dialed), lower the victim to the ground, and begin CPR✓ Answer

   When a choking victim becomes unresponsive, activate EMS, carefully lower them to the ground, and start CPR. Chest compressions generate pressure that may help dislodge the object, and CPR is the appropriate care for an unresponsive person.

   Source: AHA/ARC — choking victim who becomes unresponsiveReport a problem with this question

8. 8. While giving CPR to a choking victim who became unresponsive, what should you do each time you open the airway to give breaths?

   • A.Turn the victim onto their side each time
   • B.Skip the breaths entirely and only do compressions
   • C.Look in the mouth and remove the object only if you can see it✓ Answer
   • D.Always do a deep blind finger sweep first

   Before giving breaths, open the mouth and look for the object; remove it only if it is visible. Blind finger sweeps are not recommended because they can push the object deeper or cause injury.

   Source: AHA/ARC — look for object before breaths; no blind finger sweepReport a problem with this question

9. 9. For a responsive choking infant (under 1 year), what is the correct technique?

   • A.Alternate 5 back blows and 5 chest thrusts✓ Answer
   • B.Shake the infant upside down
   • C.One hard back blow only
   • D.Abdominal thrusts (Heimlich maneuver)

   For a choking infant you alternate 5 back blows and 5 chest thrusts. Abdominal thrusts are not used on infants because their organs are more easily injured and the technique is not appropriate for their anatomy.

   Source: AHA/ARC — infant choking: 5 back blows and 5 chest thrustsReport a problem with this question

10. 10. When delivering back blows to a choking infant, how should the infant be positioned?

    • A.Sitting upright on your knee
    • B.Face-down along your forearm with the head lower than the chest, supporting the jaw/head✓ Answer
    • C.Lying flat on their back on a table
    • D.Held vertically by the ankles

    Support the infant face-down along your forearm with the head lower than the chest and the jaw supported, so gravity assists the back blows in dislodging the object. This positioning also protects the infant's head and neck.

    Source: AHA/ARC — infant back-blow positioningReport a problem with this question

11. 11. What is the recommended technique for a responsive choking victim who is pregnant or too large for you to reach around the abdomen?

    • A.Harder abdominal thrusts low on the belly
    • B.Chest thrusts instead of abdominal thrusts✓ Answer
    • C.Lay them down immediately and start compressions
    • D.Back blows only, no thrusts

    For a pregnant person (or anyone too large to encircle), use chest thrusts instead of abdominal thrusts. Abdominal thrusts could injure the fetus or fail to reach around a large abdomen, so hand placement moves to the center of the breastbone.

    Source: AHA/ARC — chest thrusts for pregnant or large victimsReport a problem with this question

12. 12. For a choking victim who is pregnant or very large, where should chest thrusts be placed?

    • A.On the center of the breastbone, the same spot used for chest compressions✓ Answer
    • B.On the upper abdomen above the navel
    • C.On the left side over the heart
    • D.On the lower ribs

    Chest thrusts are placed on the center of the breastbone, the same landmark as CPR chest compressions. This avoids the abdomen (protecting a fetus) while still creating pressure to expel the object.

    Source: AHA/ARC — chest-thrust hand placementReport a problem with this question

13. 13. You are alone and start choking with no one around. What self-treatment does the Red Cross/AHA describe?

    • A.Give yourself abdominal thrusts with your hands or press your abdomen over a firm object like a chair back✓ Answer
    • B.Drink a large glass of water quickly
    • C.Lie flat and wait for the object to pass
    • D.Slap your own back repeatedly

    If alone, you can perform abdominal thrusts on yourself with your own hands, or lean over and press your upper abdomen against a firm object such as the back of a chair. Both create the upward pressure needed to expel the object when no rescuer is present.

    Source: AHA/ARC — self-administered abdominal thrustsReport a problem with this question

14. 14. When should EMS (9-1-1) be called for a choking adult who cannot breathe, speak, or cough?

    • A.Only if the person loses consciousness first
    • B.Never, unless the person asks
    • C.Only after 10 minutes of failed thrusts
    • D.Right away — have someone call 9-1-1 while you begin thrusts✓ Answer

    Severe choking is a life-threatening emergency, so EMS should be activated immediately — ideally by a bystander while you start thrusts. Early activation ensures advanced help arrives quickly if your efforts do not clear the airway.

    Source: AHA/ARC — activate EMS for severe obstructionReport a problem with this question

15. 15. Why are abdominal thrusts NOT used on a choking infant under 1 year old?

    • A.Infants never choke on solid objects
    • B.Their airways are too wide to block
    • C.Back blows are illegal on infants
    • D.Their abdominal organs (like the liver) are large and easily injured✓ Answer

    Infants have proportionally large, unprotected abdominal organs such as the liver, so abdominal thrusts risk serious internal injury. Back blows and chest thrusts safely generate expelling pressure without endangering those organs.

    Source: AHA/ARC — rationale for infant techniqueReport a problem with this question

16. 16. During abdominal thrusts on an adult, what direction should each thrust be directed?

    • A.Side to side across the belly
    • B.Inward and upward, like trying to lift the person✓ Answer
    • C.Outward away from the body
    • D.Straight downward toward the feet

    Each abdominal thrust is directed inward and upward, in a quick J-shaped motion. The upward component drives the diaphragm up to expel air from the lungs and pop the object out of the airway.

    Source: AHA/ARC — direction of abdominal thrustReport a problem with this question

17. 17. A choking child (age 1 to puberty) is responsive and cannot cough, speak, or breathe. What should you do?

    • A.Give abdominal thrusts, as you would for an adult but with less force✓ Answer
    • B.Use two-finger chest thrusts as for an infant
    • C.Give only back blows
    • D.Wait to see if it clears on its own

    For a responsive choking child over 1 year, use abdominal thrusts as for an adult, adjusting the force to the child's size. Children have the same anatomy that makes the Heimlich maneuver appropriate, unlike infants.

    Source: AHA/ARC — child choking uses abdominal thrustsReport a problem with this question

18. 18. Why can chest compressions help a choking victim who has become unresponsive, even before EMS arrives?

    • A.Compressions raise pressure in the chest that can help expel the airway object✓ Answer
    • B.They warm the body to relax the throat
    • C.They replace the need to check the mouth
    • D.Compressions dissolve the object chemically

    Chest compressions raise intrathoracic pressure much like a thrust, which can help move or expel the obstructing object, in addition to circulating blood. That is why CPR is the correct care once a choking victim is unresponsive.

    Source: AHA/ARC — compressions generate expelling pressureReport a problem with this question

19. 19. After abdominal thrusts successfully expel the object and the person recovers, what is the recommended follow-up?

    • A.Tell them to induce vomiting
    • B.No follow-up is ever needed
    • C.Advise them to be evaluated by a medical professional because thrusts can cause internal injury✓ Answer
    • D.Have them immediately eat to test the throat

    Even after a successful rescue, abdominal thrusts can cause internal injuries, so the person should be evaluated by a medical professional. Persistent cough, difficulty swallowing, or a sensation of something stuck also warrant medical assessment.

    Source: AHA/ARC — medical follow-up after abdominal thrustsReport a problem with this question

20. 20. A person who was eating suddenly cannot make any sound, looks panicked, and is clutching the throat. What does this most likely indicate?

    • A.A heart attack unrelated to the airway
    • B.A mild obstruction that will clear with coughing
    • C.Simple nervousness, no action needed
    • D.Severe airway obstruction requiring immediate thrusts✓ Answer

    Sudden inability to make any sound during eating, along with panic and the choking sign, indicates severe (complete) airway obstruction. No air is moving, so you must act immediately with abdominal thrusts and call for help.

    Source: AHA/ARC — recognizing complete airway obstructionReport a problem with this question

21. 21. What is the correct order of care for a responsive infant with severe choking, using back blows and chest thrusts?

    • A.5 back blows, then 5 chest thrusts, repeating the cycle until relief or unresponsiveness✓ Answer
    • B.1 back blow and 1 chest thrust alternating
    • C.10 back blows, then stop
    • D.5 chest thrusts only, repeated

    The infant sequence is 5 back blows followed by 5 chest thrusts, repeated in cycles until the object is expelled or the infant becomes unresponsive. If the infant becomes unresponsive, you begin infant CPR.

    Source: AHA/ARC — infant choking sequence 5+5 cycleReport a problem with this question

Practice questions based on the American Heart Association Guidelines for CPR & ECC and American Red Cross first-aid guidance. This is general education, not medical advice, and does not replace hands-on certification. To be certified in CPR/AED/First Aid you must complete an approved in-person course with a skills check. In a real emergency, call 911. Study official materials at cpr.heart.org or redcross.org. Official CPR guidelines →