21 Choking Response Practice Questions & Answers

1. 1. An adult suddenly grabs their throat during a meal but is coughing forcefully and can still make gasping sounds. What is the correct action?

   • A.Start chest compressions immediately
   • B.Give 5 back blows between the shoulders
   • C.Begin abdominal thrusts immediately
   • D.Encourage more coughing and stay close✓ Answer

   Forceful coughing and audible sounds indicate a mild (partial) airway obstruction, meaning air is still moving. Coughing is the most effective way to expel the object, so a rescuer should not interfere and should only intervene if the obstruction becomes severe.

   Source: 2025 AHA Guidelines for CPR & ECC — Choking (mild vs. severe airway obstruction)Report a problem with this question

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

   • A.Loud forceful coughing and clear speech
   • B.Noisy wheezing but normal talking
   • C.No speech, no cough, no air movement✓ Answer
   • D.Mild throat tickle with easy breathing

   A severe obstruction means air cannot move, so the victim cannot speak, cough, or breathe and may show cyanosis or clutch the throat (the universal choking sign). These signs are the trigger to begin back blows and thrusts immediately.

   Source: 2025 AHA Guidelines for CPR & ECC — Recognition of severe airway obstructionReport a problem with this question

3. 3. Under the 2025 AHA guidelines, what is the recommended technique for a conscious, choking adult with a severe obstruction?

   • A.Alternate 5 back blows and 5 abdominal thrusts✓ Answer
   • B.A blind finger sweep followed by rescue breaths
   • C.Only abdominal thrusts, never back blows
   • D.Only back blows, never abdominal thrusts

   The 2025 AHA guidelines added formal conscious-adult guidance for the first time: alternate 5 back blows with 5 abdominal thrusts, repeating the cycle until the object is expelled or the person becomes unresponsive. Combining both maneuvers increases the chance of dislodging the object.

   Source: 2025 AHA Guidelines for CPR & ECC — Conscious adult choking reliefReport a problem with this question

4. 4. Where should you position your fist when giving abdominal thrusts to a choking adult?

   • A.Below the navel, near the pelvic bone
   • B.Over the lower ribs on the left side
   • C.Above the navel, below the breastbone✓ Answer
   • D.On the breastbone, between the nipples

   The fist is placed in the midline just above the navel and well below the xiphoid process, then thrust inward and upward in a J-shape. This location transmits pressure to the diaphragm to force air upward without injuring the ribs or xiphoid.

   Source: 2025 AHA Guidelines for CPR & ECC — Abdominal thrust hand placementReport a problem with this question

5. 5. What direction should each abdominal thrust be delivered to a choking adult?

   • A.A quick inward and upward J-shaped thrust✓ Answer
   • B.A straight backward push against the spine
   • C.A straight downward push toward the feet
   • D.A slow steady squeeze held for seconds

   Each thrust is a quick, distinct inward-and-upward J-shaped motion. The upward component raises the diaphragm and creates a burst of pressure beneath the obstruction to expel it, which a slow squeeze or downward push would not achieve.

   Source: 2025 AHA Guidelines for CPR & ECC — Abdominal thrust techniqueReport a problem with this question

6. 6. How should back blows be delivered to a choking adult?

   • A.Heel-of-hand blows between the shoulder blades✓ Answer
   • B.Heel-of-hand blows to the center of the chest
   • C.Light fingertip taps over the lower back
   • D.Heel-of-hand blows to the back of the neck

   Back blows are delivered firmly between the shoulder blades with the heel of the hand. This location and force create vibration and pressure that can help dislodge the object without striking vulnerable areas like the neck or chest.

   Source: 2025 AHA Guidelines for CPR & ECC — Back blow techniqueReport a problem with this question

7. 7. A conscious 4-year-old child has a severe airway obstruction. How does the relief technique compare to that for an adult?

   • A.Same as an adult: 5 back blows, 5 abdominal thrusts✓ Answer
   • B.Abdominal thrusts are forbidden for anyone under age 8
   • C.Only chest thrusts are allowed for young children
   • D.You must start CPR immediately without back blows

   For a child older than 1 year, the choking-relief sequence is the same as for an adult: alternate 5 back blows and 5 abdominal thrusts. Abdominal thrusts are only excluded for infants under 1 year, not for older children.

   Source: 2025 AHA Guidelines for CPR & ECC — Child (over 1 year) choking reliefReport a problem with this question

8. 8. What is the correct choking-relief sequence for a conscious infant under 1 year old?

   • A.Give abdominal thrusts only, with no back blows
   • B.Alternate 5 back blows and 5 abdominal thrusts
   • C.Perform a blind finger sweep and give breaths
   • D.Alternate 5 back blows and 5 chest thrusts✓ Answer

   For an infant, rescuers alternate 5 back blows and 5 chest thrusts until the object is expelled or the infant becomes unresponsive. Abdominal thrusts are never used on infants because of the risk of injuring their delicate internal organs.

   Source: 2025 AHA Guidelines for CPR & ECC — Infant choking reliefReport a problem with this question

9. 9. Why are abdominal thrusts (the Heimlich maneuver) never performed on a choking infant?

   • A.They cannot generate enough force in infants
   • B.They can injure the infant's abdominal organs✓ Answer
   • C.Infants rarely choke on anything but liquids
   • D.They almost always cause the infant to vomit

   An infant's liver and other abdominal organs are large relative to the body and poorly protected, so abdominal thrusts can cause serious internal injury. Chest thrusts safely generate the needed pressure instead.

   Source: 2025 AHA Guidelines for CPR & ECC — Rationale for excluding abdominal thrusts in infantsReport a problem with this question

10. 10. How should you position a choking infant to deliver back blows?

    • A.Face-up along your forearm, head above chest
    • B.Face-down on your forearm, head above chest
    • C.Sitting upright on your lap with head tilted back
    • D.Face-down along your forearm, head below chest✓ Answer

    The infant is placed face-down along the forearm with the head lower than the chest, while the rescuer supports the jaw and head. Gravity assists the back blows in moving the object toward the mouth while keeping the airway supported.

    Source: 2025 AHA Guidelines for CPR & ECC — Infant back blow positioningReport a problem with this question

11. 11. Approximately how deep should each chest thrust be on a choking infant?

    • A.About 1.5 inches (4 cm)✓ Answer
    • B.About 2 inches (5 cm)
    • C.About 3 inches (7.5 cm)
    • D.About 0.5 inches (1 cm)

    Infant chest thrusts, like infant compressions, are about 1.5 inches (4 cm) deep — roughly one-third the depth of the chest. This is enough to generate expelling pressure while remaining safe for an infant's small body.

    Source: 2025 AHA Guidelines for CPR & ECC — Infant chest thrust depth (~1.5 in / 4 cm)Report a problem with this question

12. 12. You are helping a choking adult when they suddenly go limp and unresponsive. What should you do first?

    • A.Do a blind finger sweep before anything else
    • B.Lower them to a firm flat surface and start CPR✓ Answer
    • C.Keep giving standing abdominal thrusts regardless
    • D.Give 2 rescue breaths and then wait for EMS

    When a choking victim becomes unresponsive, lower them to a firm flat surface, activate EMS and get an AED, then begin CPR starting with chest compressions. The compressions themselves also help build pressure that can expel the object.

    Source: 2025 AHA Guidelines for CPR & ECC — Choking victim who becomes unresponsiveReport a problem with this question

13. 13. During CPR on a choking victim, what should you do each time you open the airway to give breaths?

    • A.Do a blind finger sweep before each breath set
    • B.Look in the mouth; remove the object if visible✓ Answer
    • C.Skip the breaths and give compressions only
    • D.Roll the victim onto their side to drain it

    In choking-modified CPR, each time you open the airway you look for the object and remove it only if it is visible. A blind finger sweep is never done because it can push the object deeper into the airway.

    Source: 2025 AHA Guidelines for CPR & ECC — Check for visible object before breaths; no blind finger sweepReport a problem with this question

14. 14. Why is a blind finger sweep NOT recommended when managing a choking victim?

    • A.It is allowed only for trained clinicians
    • B.It usually knocks out the victim's front teeth
    • C.A finger cannot reach far enough to help
    • D.It can push the object deeper into the airway✓ Answer

    A blind finger sweep is done without seeing the object, so it risks pushing a lodged item further down and turning a partial obstruction into a complete one. Objects should be removed only when they can actually be seen.

    Source: 2025 AHA Guidelines for CPR & ECC — Rationale against blind finger sweepsReport a problem with this question

15. 15. What is the correct compression-to-breath ratio for single-rescuer CPR on an unresponsive adult choking victim?

    • A.Compressions only, never any breaths
    • B.15 compressions to 2 rescue breaths
    • C.5 compressions to 1 rescue breath
    • D.30 compressions to 2 rescue breaths✓ Answer

    Single-rescuer adult CPR uses a ratio of 30 compressions to 2 breaths. This same cycle applies to a choking victim who has become unresponsive, with the added step of looking for a visible object before each set of breaths.

    Source: 2025 AHA Guidelines for CPR & ECC — Adult single-rescuer CPR ratio 30:2Report a problem with this question

16. 16. For an unresponsive choking victim, at what depth and rate should chest compressions be performed on an adult?

    • A.1 inch deep, 60–70 compressions per minute
    • B.3 inches deep, 80–90 compressions per minute
    • C.4–5 inches deep, 140–150 compressions per minute
    • D.2 inches deep, 100–120 compressions per minute✓ Answer

    Adult chest compressions should be at least 2 inches (5 cm) deep at a rate of 100–120 per minute, pushing hard and fast with full recoil. Adequate depth and rate maintain blood flow and help build the pressure that can expel the object.

    Source: 2025 AHA Guidelines for CPR & ECC — Adult compression depth (~2 in) and rate (100–120/min)Report a problem with this question

17. 17. A visibly pregnant woman in her third trimester is choking and you cannot get your arms around her abdomen. What technique should you use?

    • A.Standard abdominal thrusts around the waist
    • B.Forceful thrusts over the pregnant belly
    • C.Chest thrusts on the lower half of the sternum✓ Answer
    • D.Wait for EMS rather than risk the fetus

    When you cannot encircle the abdomen — as with late-term pregnancy or obesity — you give chest thrusts with hands on the lower half of the breastbone, the same placement as CPR compressions. This avoids pressure on the abdomen and the fetus while still generating expelling force.

    Source: 2025 AHA Guidelines for CPR & ECC — Choking in pregnancy/obesity: chest thrustsReport a problem with this question

18. 18. For a choking victim who is very obese and whose abdomen you cannot encircle, where do your hands go for chest thrusts?

    • A.On the soft belly below the navel
    • B.On the upper belly, above the navel
    • C.On the lower half of the breastbone✓ Answer
    • D.On the very top of the breastbone

    Chest thrusts for a person you cannot reach around use the same landmark as CPR: the lower half of the sternum. This lets the rescuer generate the necessary intrathoracic pressure when abdominal thrusts are not feasible.

    Source: 2025 AHA Guidelines for CPR & ECC — Chest thrust hand placement (lower sternum)Report a problem with this question

19. 19. You are choking and completely alone with no one to help. What is an appropriate self-treatment?

    • A.Press your upper abdomen hard over a chair back✓ Answer
    • B.Lie down flat and wait for the object to pass
    • C.Swallow water quickly to wash the object down
    • D.Slap your own back between the shoulder blades

    When alone, you can perform self-abdominal thrusts by pressing your own fist inward and upward above the navel, or by thrusting your upper abdomen against a firm edge such as a chair back or counter. This substitutes for a rescuer's hands to create expelling pressure.

    Source: 2025 AHA Guidelines for CPR & ECC — Self-treatment for chokingReport a problem with this question

20. 20. After successfully relieving a choking episode with abdominal thrusts, what follow-up is recommended?

    • A.Have them eat something to test the airway
    • B.Give a week of antibiotics as a precaution
    • C.No follow-up is needed once the object is out
    • D.Have a medical professional evaluate them✓ Answer

    Abdominal thrusts can cause internal injury, and a retained foreign body may remain. Anyone who received thrusts or has a persistent cough, trouble breathing or swallowing, or a sensation of a stuck object should be evaluated by a medical professional.

    Source: 2025 AHA Guidelines for CPR & ECC — Post-choking medical evaluationReport a problem with this question

21. 21. A notable structural change in the 2025 AHA guidelines is the introduction of what?

    • A.One unified Chain of Survival for all arrests✓ Answer
    • B.The removal of chest compressions from CPR
    • C.A separate Chain of Survival for each age group
    • D.A ban on bystander CPR without certification

    The 2025 guidelines replaced the previously separate adult and pediatric, in-hospital and out-of-hospital chains with a single unified Chain of Survival for all cardiac arrest. This simplifies the response framework across all settings and ages.

    Source: 2025 AHA Guidelines for CPR & ECC — Single unified Chain of SurvivalReport 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 →