62 Patient Treatment & Transport Practice Questions & Answers

1. 1. A 58-year-old is found unresponsive with snoring respirations at 8 breaths per minute and shallow chest rise. No trauma is suspected. What is the MOST appropriate immediate action?

   • A.Insert a nasopharyngeal airway and transport
   • B.Apply oxygen by non-rebreather at 15 L/min
   • C.Head-tilt/chin-lift, then ventilate with a BVM✓ Answer
   • D.Place the patient in the recovery position

   Snoring indicates the tongue is occluding the airway, and a rate of 8/min with shallow rise is inadequate breathing. You must first open the airway manually (head-tilt/chin-lift, no trauma) and then provide positive-pressure ventilation with a BVM. A non-rebreather does not correct inadequate ventilation.

   Source: National EMS Education Standards — Airway Management; AHA BLS: inadequate breathing requires positive-pressure ventilationReport a problem with this question

2. 2. A patient with a suspected cervical spine injury after a diving accident is unresponsive with an obstructed airway. Which maneuver should you use FIRST to open the airway?

   • A.Jaw-thrust maneuver✓ Answer
   • B.Log-roll to the side
   • C.Head-tilt/chin-lift
   • D.Nasal airway insertion

   When spinal trauma is suspected, the jaw-thrust maneuver opens the airway without extending the neck, minimizing movement of the cervical spine. The head-tilt/chin-lift moves the neck and is reserved for patients with no suspected trauma.

   Source: National EMS Education Standards — Airway; AHA guidelines: jaw-thrust for suspected spinal injuryReport a problem with this question

3. 3. A 4-year-old child with a pulse is in respiratory arrest. According to current AHA guidance, how often should you deliver ventilations with a BVM?

   • A.1 breath every 10 seconds
   • B.1 breath every 2-3 seconds✓ Answer
   • C.1 breath every 5-6 seconds
   • D.1 breath every 8-10 seconds

   The 2020 AHA update raised the rescue-breathing rate for infants and children with a pulse to 20-30 breaths per minute, which is 1 breath every 2-3 seconds. This is faster than the adult rate because children have higher metabolic oxygen demand.

   Source: AHA/AAP 2025 Guidelines Part 6 (Pediatric BLS) — rescue breathing with a pulse: 20-30 breaths/min (1 breath every 2-3 seconds)Report a problem with this question

4. 4. An oropharyngeal airway (OPA) is contraindicated in which of the following patients?

   • A.An apneic patient ventilated with a BVM
   • B.An unresponsive patient with no gag reflex
   • C.A responsive patient with a gag reflex✓ Answer
   • D.An overdose patient with no gag reflex

   An OPA is only used in patients with no gag reflex. In a patient with an intact gag reflex it can trigger vomiting, aspiration, or laryngospasm, so it is contraindicated; a nasopharyngeal airway is used instead.

   Source: National EMS Education Standards — Airway adjuncts: OPA requires absent gag reflexReport a problem with this question

5. 5. How is a nasopharyngeal airway (NPA) correctly sized before insertion?

   • A.From the chin down to the sternal notch
   • B.From the corner of the mouth to the earlobe
   • C.From the tip of the nose to the earlobe✓ Answer
   • D.From the nose down to the xiphoid process

   An NPA is measured from the tip of the nose to the earlobe for length, and its diameter should match the patient's nostril (roughly the patient's little finger). Correct sizing ensures the tip sits in the posterior pharynx without being too long or too short.

   Source: National EMS Education Standards — NPA sizing: nose-tip to earlobeReport a problem with this question

6. 6. An NPA is specifically contraindicated in a patient with which finding?

   • A.An intact gag reflex
   • B.A history of asthma
   • C.Snoring respirations
   • D.Basilar skull fracture✓ Answer

   An NPA is contraindicated in suspected basilar skull fracture or significant facial trauma because the catheter can be inadvertently passed through the fracture into the cranial vault. An intact gag reflex is actually an indication for an NPA, not a contraindication.

   Source: National EMS Education Standards — NPA contraindication: basilar skull fractureReport a problem with this question

7. 7. You hear loud gurgling as you prepare to ventilate an unresponsive patient. What should you do NEXT?

   • A.Insert an OPA and ventilate at once
   • B.Apply a nasal cannula at 6 L/min
   • C.Suction the airway, then ventilate✓ Answer
   • D.Ventilate faster to clear the fluid

   Gurgling means there is fluid (secretions, blood, or vomit) in the airway. You must suction before ventilating or inserting an adjunct, otherwise positive-pressure ventilation would drive the fluid into the lungs and cause aspiration.

   Source: National EMS Education Standards — Suctioning indicated before ventilation when fluid presentReport a problem with this question

8. 8. What is the maximum time you should apply suction during a single pass in an adult patient?

   • A.30 seconds
   • B.5 seconds
   • C.10 seconds
   • D.15 seconds✓ Answer

   In an adult, suction for a maximum of 15 seconds per pass (child 10 seconds, infant 5 seconds). Suctioning removes oxygen along with secretions, so prolonged suctioning can worsen hypoxia; pre-oxygenate before and ventilate after.

   Source: National EMS Education Standards — Suction time limits: adult 15s / child 10s / infant 5sReport a problem with this question

9. 9. A conscious patient with mild shortness of breath has an SpO2 of 92% and cannot tolerate a mask. Which oxygen delivery device and flow rate is MOST appropriate?

   • A.Bag-valve-mask at 15 L/min
   • B.Nasal cannula at 1-6 L/min✓ Answer
   • C.Non-rebreather mask at 15 L/min
   • D.Simple face mask at 4 L/min

   A nasal cannula at 1-6 L/min delivers roughly 24-44% oxygen and is appropriate for mild distress or a patient who cannot tolerate a mask. The patient is breathing adequately with only mild hypoxia, so a BVM (for inadequate breathing) is not indicated.

   Source: National EMS Education Standards — Oxygen devices: nasal cannula 1-6 L/min ~24-44%Report a problem with this question

10. 10. A non-rebreather mask is the appropriate choice for which patient?

    • A.An apneic patient with no respirations
    • B.A patient with slow, shallow breathing
    • C.A patient breathing adequately but hypoxic✓ Answer
    • D.A fully alert patient with an SpO2 of 99%

    A non-rebreather at 10-15 L/min delivers 80-90+% oxygen and is used for a patient who is breathing adequately (moving enough air on their own) but has signs of hypoxia. A patient breathing inadequately or apneic needs positive-pressure ventilation with a BVM, not a non-rebreather.

    Source: National EMS Education Standards — Non-rebreather for adequate breathing with hypoxiaReport a problem with this question

11. 11. You are ventilating an adult with a BVM but the chest is not rising. What should you do FIRST?

    • A.Immediately begin chest compressions
    • B.Switch to a non-rebreather mask
    • C.Reposition the head; check the seal✓ Answer
    • D.Squeeze the bag harder and faster

    If the chest does not rise, the most common causes are an improper head position or a poor mask seal. Reposition the airway and re-establish the seal first, then check for an obstruction and suction if needed. Squeezing harder and faster causes gastric distension without fixing the problem.

    Source: AHA BLS — troubleshooting BVM: reposition airway and check mask sealReport a problem with this question

12. 12. A patient in severe respiratory distress from asthma is wheezing loudly. Within EMT scope, what medication assistance is appropriate?

    • A.Give chewable aspirin by mouth
    • B.Administer a diuretic by mouth
    • C.Help with his albuterol inhaler✓ Answer
    • D.Administer intravenous epinephrine

    Wheezing indicates lower-airway constriction. Within EMT scope, you can assist the patient in using their own prescribed albuterol metered-dose inhaler or nebulizer, a beta-2 agonist that relaxes bronchial smooth muscle. IV medications are outside EMT scope.

    Source: National EMS Scope of Practice — EMT may assist with prescribed MDI/nebulizer (albuterol)Report a problem with this question

13. 13. A 70-year-old with CHF is anxious, sitting upright, and has crackles in both lungs with an SpO2 of 85% but is alert and breathing on his own. Which intervention is a key EMT tool for this patient?

    • A.Continuous positive airway pressure✓ Answer
    • B.Withhold oxygen because of his age
    • C.Insert an oropharyngeal airway (OPA)
    • D.Immediate bag-valve-mask ventilation

    Continuous positive airway pressure (CPAP) is a key EMT tool for an alert, cooperative, spontaneously breathing patient in moderate-to-severe distress from CHF/pulmonary edema. It improves oxygenation and reduces the need for intubation. The patient is alert and breathing on his own, so BVM is not yet indicated.

    Source: National EMS Education Standards — CPAP indications: alert, spontaneously breathing CHF/pulmonary edemaReport a problem with this question

14. 14. CPAP is contraindicated in which of the following situations?

    • A.An alert patient with pulmonary edema
    • B.An anxious patient who follows commands
    • C.A cooperative COPD patient in distress
    • D.A hypotensive patient who is confused✓ Answer

    CPAP requires an alert, cooperative patient who is breathing on their own and can protect their airway. It is contraindicated in hypotension/shock, altered mental status, respiratory arrest, or vomiting. A hypotensive patient with altered mental status meets those contraindications.

    Source: National EMS Education Standards — CPAP contraindications: hypotension, altered mental status, arrest, vomitingReport a problem with this question

15. 15. A conscious 6-month-old infant has a sudden, severe airway obstruction and cannot cry or breathe. What is the correct technique?

    • A.A blind finger sweep of the mouth
    • B.Abdominal thrusts (the Heimlich)
    • C.5 back slaps, then 5 chest thrusts✓ Answer
    • D.Chest compressions at 100/min

    For a responsive infant with a severe obstruction, deliver 5 back slaps followed by 5 chest thrusts, repeating until the object is expelled or the infant becomes unresponsive. Abdominal thrusts are not used in infants because of the risk of internal organ injury.

    Source: AHA BLS — infant severe FBAO: 5 back slaps + 5 chest thrustsReport a problem with this question

16. 16. When positioning a young child's airway for ventilation, why should you avoid hyperextending the neck?

    • A.Hyperextension is only a concern in adults
    • B.It prevents the OPA from being inserted
    • C.The soft trachea can kink the airway shut✓ Answer
    • D.Children have a smaller tongue than adults

    Young children have a proportionally large occiput and a soft, flexible trachea. Hyperextending the neck can kink and collapse the airway, so a neutral or slight sniffing position is used, often with padding under the shoulders. Children actually have a larger tongue relative to the mouth, not smaller.

    Source: National EMS Education Standards — Pediatric airway: avoid hyperextension, neutral/sniffing positionReport a problem with this question

17. 17. A patient found unresponsive has a respiratory rate of 6/min with pinpoint pupils after a suspected opioid overdose. What should you do FIRST?

    • A.Give naloxone and wait for a response
    • B.Ventilate with a BVM, then naloxone✓ Answer
    • C.Roll him into the recovery position
    • D.Apply a non-rebreather mask at 15 L/min

    The immediate life threat in opioid overdose is respiratory depression. A rate of 6/min is inadequate, so support ventilations with a BVM first to correct hypoxia, then administer naloxone. Oxygenation and ventilation always take priority over the antidote.

    Source: National EMS Scope of Practice — opioid overdose: ventilate first, then naloxoneReport a problem with this question

18. 18. A patient with COPD is severely hypoxic with an SpO2 of 84% and increasing confusion. What is the correct oxygen approach?

    • A.Give high-flow oxygen and assist ventilation✓ Answer
    • B.Limit oxygen to 1 L/min regardless of SpO2
    • C.Withhold oxygen to keep his hypoxic drive
    • D.Give no oxygen and transport him quickly

    The old 'hypoxic drive' teaching that oxygen should be withheld from COPD patients is outdated. You must never withhold oxygen from a hypoxic patient; give high-flow oxygen to correct the hypoxia and support ventilation if breathing becomes inadequate, while monitoring the patient.

    Source: Current AHA/EMS guidance — never withhold oxygen from a hypoxic patient (hypoxic drive myth)Report a problem with this question

19. 19. Two EMTs are performing CPR on an adult in cardiac arrest without an advanced airway. What compression-to-ventilation ratio should they use?

    • A.10:2
    • B.30:1
    • C.15:2
    • D.30:2✓ Answer

    For adults the ratio stays 30:2 whether one or two rescuers are present; only children and infants change to 15:2 when two rescuers are working, a commonly tested trap.

    Source: AHA BLS Guidelines — Adult compression-to-ventilation ratio remains 30:2 with 1 or 2 rescuersReport a problem with this question

20. 20. After confirming an adult is unresponsive, pulseless, and apneic, which action should you perform first?

    • A.Give two rescue breaths
    • B.Begin chest compressions✓ Answer
    • C.Do a head-tilt/chin-lift
    • D.Sweep the mouth for objects

    Current guidelines use the C-A-B sequence — Compressions, Airway, Breathing. At the moment of arrest the blood still carries residual oxygen, so circulation is the limiting factor: every second before the first compression lowers coronary and cerebral perfusion pressure. Airway and ventilation follow the first set of 30 compressions.

    Source: AHA BLS Guidelines — C-A-B sequence (compressions before airway/breathing)Report a problem with this question

21. 21. Where should you place your hands to perform chest compressions on an adult?

    • A.Directly over the xiphoid process
    • B.Over the left nipple, on the apex
    • C.Center of the chest, lower sternum✓ Answer
    • D.Upper third of the sternum, midline

    Hands are placed on the center of the chest over the lower half of the sternum; compressing over the xiphoid can cause injury, and compressing too high is ineffective.

    Source: AHA BLS Guidelines — Adult hand placement: lower half of the sternumReport a problem with this question

22. 22. What is the correct chest compression depth for a child (1 year to puberty) during CPR?

    • A.About 2.4 inches (6 cm)
    • B.About 1.5 inches (4 cm)
    • C.About 1 inch (2.5 cm)
    • D.About 2 inches (5 cm)✓ Answer

    For a child, compress about one-third of the anterior-posterior chest diameter, which is roughly 2 inches (5 cm) — deeper than the 1.5 in (4 cm) used for an infant, but not the 2.4 in (6 cm) that marks the adult upper limit.

    Source: AHA BLS Guidelines — Child compression depth ~1/3 AP diameter (~2 in/5 cm)Report a problem with this question

23. 23. Two rescuers are performing CPR on an infant. Which compression technique is preferred?

    • A.Two hands, as used for an adult
    • B.Two thumbs, hands encircling chest✓ Answer
    • C.Two fingers on the lower sternum
    • D.Two thumbs on the xiphoid process

    With two rescuers, the two-thumb encircling-hands technique is preferred for infants because it produces better coronary perfusion and more consistent depth than the two-finger method, which current guidelines no longer recommend. Either way the thumbs sit on the lower half of the sternum, just below the nipple line — never on the xiphoid, which risks liver injury.

    Source: AHA BLS Guidelines — Infant two-rescuer technique: two-thumb encircling handsReport a problem with this question

24. 24. The AED analyzes an adult in cardiac arrest and states 'No shock advised.' What should you do?

    • A.Get a replacement AED; this one has failed
    • B.Immediately resume high-quality CPR for 2 minutes✓ Answer
    • C.Stop CPR and monitor; the rhythm is normal
    • D.Re-analyze the rhythm before resuming CPR

    'No shock advised' means only that the rhythm is non-shockable — usually asystole or PEA — not that the patient has recovered. Those rhythms are treated with chest compressions, which build the coronary perfusion pressure that makes any later shock work, so resume CPR at once and let the AED re-analyze after about 2 minutes.

    Source: AHA BLS/AED operation — 'No shock advised' → resume CPR immediatelyReport a problem with this question

25. 25. You are about to use an AED on a patient just pulled from a swimming pool. The chest is wet. What should you do first?

    • A.Pour saline on the chest for contact
    • B.Apply pads now; water conducts well
    • C.Do not use an AED on a wet patient
    • D.Move off the water and dry the chest✓ Answer

    Water on the chest or standing water under the patient conducts the shock across the skin surface or into rescuers instead of through the heart, so move the patient off wet ground and towel the chest dry before applying pads. A quick dry-off costs seconds; it does not mean withholding defibrillation.

    Source: AHA AED special situations — remove from water and dry chest before useReport a problem with this question

26. 26. While placing AED pads on a patient's chest, you find a medication patch where a pad must go. What should you do?

    • A.Cancel AED use; the drug interferes
    • B.Remove the patch, then wipe the area✓ Answer
    • C.Leave the patch; shift the pad aside
    • D.Place the pad directly over the patch

    A transdermal medication patch can block energy delivery and cause burns, so remove it — with a gloved hand to avoid absorbing the drug — wipe the area, then apply the pad.

    Source: AHA AED special situations — remove transdermal medication patch before pad placementReport a problem with this question

27. 27. You notice a hard lump under the skin of a cardiac-arrest patient's upper chest, consistent with an implanted pacemaker. How should you place the AED pad?

    • A.The opposite side of the chest only
    • B.Do not use the AED on this patient
    • C.Over the device, to reset the device
    • D.At least 1 inch (2.5 cm) to the side✓ Answer

    Current flows between the two pads, so a pad sitting on the generator lets the device shunt or absorb the energy instead of it reaching the myocardium, and the pacemaker or ICD itself can be damaged. Offsetting the pad by at least 1 inch (2.5 cm) keeps the shock path across the heart; an implanted device is never a reason to withhold defibrillation.

    Source: AHA AED special situations — place pad ≥1 in (2.5 cm) from implanted pacemaker/ICDReport a problem with this question

28. 28. You have only pediatric AED pads with a dose attenuator available for an adult in cardiac arrest. What should you do?

    • A.Use pediatric pads; the dose is safer
    • B.Place pediatric pads front and back
    • C.Use adult pads, not the pediatric pads✓ Answer
    • D.Withhold defibrillation altogether

    Pediatric pads and dose attenuators deliver too little energy for an adult and may fail to defibrillate, so adults require adult pads — whereas adult pads may be used on a child if pediatric pads are unavailable. Changing where the pads sit does not change the energy they deliver.

    Source: AHA AED pad rules — pediatric pads/attenuator must not be used on an adultReport a problem with this question

29. 29. For which cardiac rhythm is an AED designed to deliver a defibrillation shock?

    • A.Asystole (a flat-line rhythm)
    • B.Normal sinus rhythm at 70 bpm
    • C.Ventricular fibrillation (VF)✓ Answer
    • D.Pulseless electrical activity

    Ventricular fibrillation — a disorganized, quivering rhythm — and pulseless ventricular tachycardia are the shockable rhythms a defibrillator can reorganize; asystole and PEA are non-shockable and treated with CPR.

    Source: AHA ECC — shockable rhythms: ventricular fibrillation and pulseless VTReport a problem with this question

30. 30. A 58-year-old man with chest pain asks you to help him take his prescribed nitroglycerin. He mentions he took sildenafil (Viagra) about 6 hours ago. What should you do?

    • A.Give a double dose instead
    • B.Give the nitroglycerin as usual
    • C.Withhold the nitroglycerin✓ Answer
    • D.Give it only if he lies flat

    Nitroglycerin combined with a PDE-5 inhibitor (sildenafil within 24 h, tadalafil within 48 h) can cause profound, life-threatening hypotension that no position change or dose adjustment prevents, so it must be withheld.

    Source: Nitroglycerin contraindication — PDE-5 inhibitors (sildenafil <24 h, tadalafil <48 h)Report a problem with this question

31. 31. Before assisting a chest-pain patient with nitroglycerin, you find the blood pressure is 84/50 mmHg. What is the appropriate action?

    • A.Withhold the nitroglycerin✓ Answer
    • B.Give half the usual dosage
    • C.Give it; it will relieve pain
    • D.Give it, then recheck the BP

    Nitroglycerin is a vasodilator that lowers blood pressure, so it is contraindicated when the systolic pressure is below about 90–100 mmHg; halving the dose or checking the pressure afterward does not remove the risk of dangerous hypotension.

    Source: Nitroglycerin contraindication — systolic BP <90–100 mmHg (hypotension)Report a problem with this question

32. 32. You are giving aspirin to a conscious patient with suspected acute coronary syndrome. How should the patient take it?

    • A.Take it together with an antacid
    • B.Swallow it whole with some water
    • C.Chew the tablets, then swallow them✓ Answer
    • D.Let it dissolve under the tongue

    Aspirin works by irreversibly blocking platelet cyclo-oxygenase, which shuts down thromboxane A2 and keeps the clot in the coronary artery from growing. Chewing 162–324 mg of non-enteric aspirin gets it absorbed within minutes instead of waiting on gastric dissolution, so platelet inhibition starts far sooner.

    Source: EMT protocol — aspirin 162–324 mg chewable, chewed for faster antiplatelet effectReport a problem with this question

33. 33. Which finding is a contraindication to giving aspirin to a patient with chest pain?

    • A.Being older than 65 years of age
    • B.Active gastrointestinal bleeding✓ Answer
    • C.A previous heart attack or stent
    • D.A history of high blood pressure

    Aspirin impairs platelet function and can worsen bleeding, so active gastrointestinal bleeding — along with aspirin allergy or inability to swallow — is a contraindication. Age, hypertension, and a prior MI or stent are not; those patients are usually the ones who benefit most.

    Source: Aspirin contraindications — active GI bleeding/ulcer, allergy, inability to swallowReport a problem with this question

34. 34. For a patient in ventricular fibrillation, what is the single most important treatment that improves survival, along with early high-quality CPR?

    • A.Sublingual nitroglycerin
    • B.High-flow oxygen alone
    • C.Early defibrillation✓ Answer
    • D.An IV bolus of fluid

    For VF and pulseless VT, early defibrillation is the single most effective treatment; survival falls roughly 7–10% for each minute defibrillation is delayed when no CPR is given, so nothing — including vascular access — may push the first shock later.

    Source: Chain of Survival — early defibrillation is the most effective treatment for VF/pulseless VTReport a problem with this question

35. 35. A 30-year-old has spurting bright red blood from a deep forearm laceration. You apply firm direct pressure but bleeding continues to soak through. What is the MOST appropriate next action?

    • A.Apply a tourniquet distal to the wound over the laceration
    • B.Loosen pressure briefly to check whether bleeding has slowed
    • C.Elevate the arm and wait several minutes before reassessing
    • D.Apply a tourniquet proximal to the wound and note the time✓ Answer

    When direct pressure fails to rapidly control life-threatening extremity hemorrhage, a tourniquet is applied proximal (toward the torso) to the wound and tightened until bleeding and the distal pulse stop; the time is noted and it is not loosened, because arterial inflow must be occluded above the injury.

    Source: National EMS Education Standards — Trauma; TCCC/committee external hemorrhage control guidelinesReport a problem with this question

36. 36. You are managing a patient in hemorrhagic shock after controlling external bleeding. In addition to high-flow oxygen and supine positioning, which intervention is MOST important?

    • A.Give oral fluids to replace the lost volume
    • B.Keep the patient warm and transport promptly✓ Answer
    • C.Actively cool the patient to cut oxygen use
    • D.Delay transport until vital signs normalize

    Hypothermia worsens coagulopathy and outcomes in hemorrhagic shock, so keeping the patient warm and transporting rapidly to definitive care is critical; the underlying blood loss cannot be fixed in the field, so on-scene time must be minimized.

    Source: National EMS Education Standards — Shock; PHTLS trauma triad of deathReport a problem with this question

37. 37. A patient struck in the neck has severe bleeding at the base of the neck (a junctional area) where a tourniquet cannot be placed. Direct pressure alone is not controlling it. What is the BEST option?

    • A.Apply a tourniquet around the neck wound
    • B.Pack the wound with a hemostatic dressing✓ Answer
    • C.Elevate the stretcher head to slow bleeding
    • D.Cover with loose gauze and apply no pressure

    Junctional wounds (neck, groin, axilla) cannot be tourniqueted, so a hemostatic dressing packed into the wound plus sustained direct pressure is the recommended method; a tourniquet around the neck would occlude the airway and cerebral circulation and is never done.

    Source: National EMS Education Standards — Hemorrhage control; hemostatic dressing / wound packing guidelinesReport a problem with this question

38. 38. You applied a three-sided occlusive dressing to an open chest wound. The patient now shows rising respiratory distress, JVD, and falling blood pressure. What should you do FIRST?

    • A.Seal all four sides of the dressing
    • B.Start chest compressions immediately
    • C.Remove the dressing and pack the wound
    • D.Lift the dressing to release trapped air✓ Answer

    These signs indicate a tension pneumothorax forming under the seal; briefly lifting one edge of the occlusive dressing lets the trapped pressurized air escape, decompressing the chest, after which the dressing is replaced and the patient reassessed.

    Source: National EMS Education Standards — Open chest wound / vented occlusive dressing managementReport a problem with this question

39. 39. What is the current recommended EMT management of a flail chest segment?

    • A.Encourage shallow breathing to reduce motion
    • B.Support oxygenation and assist ventilation✓ Answer
    • C.Have the patient lie on the uninjured side to splint the flail
    • D.Tape a bulky dressing tightly over the segment

    Current practice treats flail chest by supporting oxygenation and ventilation — including positive-pressure ventilation when respiratory compromise develops — because the injury impairs the mechanics of breathing; taping bulky dressings to splint the segment is no longer recommended as it restricts chest expansion.

    Source: National EMS Education Standards — Flail chest management (updated practice)Report a problem with this question

40. 40. For a patient with a suspected traumatic brain injury, which principle MOST reduces secondary brain injury?

    • A.Maintain oxygenation and avoid hypotension✓ Answer
    • B.Withhold oxygen to keep intracranial pressure low
    • C.Keep the patient hypotensive to limit bleeding
    • D.Hyperventilate every TBI patient to lower CO2

    Hypoxia and hypotension are the two biggest drivers of secondary brain injury, so maintaining oxygenation and adequate blood pressure while ventilating at a normal rate is essential; routine hyperventilation causes cerebral vasoconstriction and is reserved only for active herniation signs.

    Source: National EMS Education Standards — TBI management; Brain Trauma Foundation prehospital guidelinesReport a problem with this question

41. 41. A patient with suspected spinal injury needs an airway opened. Which technique is preferred?

    • A.Turning the head aside to open the airway
    • B.Jaw-thrust maneuver with in-line stabilization✓ Answer
    • C.Head-tilt/chin-lift to fully extend the neck
    • D.Hyperextending the neck to align the airway

    The jaw-thrust opens the airway without moving the cervical spine, so it is preferred when spinal injury is suspected; the head-tilt/chin-lift extends the neck and risks worsening a cord injury.

    Source: National EMS Education Standards — Airway with suspected spinal injuryReport a problem with this question

42. 42. Which approach reflects current best practice for a patient with a possible spinal injury?

    • A.Spinal motion restriction with a cervical collar✓ Answer
    • B.Routine long-backboard use for every trauma patient
    • C.No cervical collar because the patient can walk
    • D.Forcing the head into neutral alignment despite pain

    Modern practice favors spinal motion restriction — a cervical collar plus securing the patient to the stretcher — over routine long-backboard immobilization, because prolonged backboard use causes harm and offers little benefit; the head is never forced into alignment if it causes pain or resistance.

    Source: National EMS Education Standards — Spinal motion restriction (updated practice)Report a problem with this question

43. 43. A knife is impaled in a patient's thigh and is still in place. There is no airway involvement. What is the correct management?

    • A.Push the knife deeper to prevent movement
    • B.Remove the knife only if bleeding is minor
    • C.Stabilize the knife in place and dress around it✓ Answer
    • D.Remove the knife and pack the wound tightly

    Impaled objects are stabilized in place and bleeding is controlled around them, because removal can trigger uncontrolled hemorrhage and further tissue damage; exceptions are objects in the cheek causing airway obstruction or those interfering with CPR.

    Source: National EMS Education Standards — Soft-tissue trauma / impaled objectsReport a problem with this question

44. 44. A patient's finger has been completely amputated. How should the amputated part be cared for during transport?

    • A.Wrap it in dry gauze and keep it warm
    • B.Bag it in moist gauze and keep it cool✓ Answer
    • C.Place it directly on ice to freeze it
    • D.Submerge it in a container of cool water

    An amputated part is wrapped in moist sterile gauze, sealed in a bag, and kept cool on ice (not directly on ice or submerged in water), because direct ice contact freezes tissue and water soaking macerates it, both destroying the part's viability for reimplantation.

    Source: National EMS Education Standards — Amputation careReport a problem with this question

45. 45. A patient has an abdominal evisceration with a loop of bowel protruding. What is the correct EMT care?

    • A.Cover with moist gauze, then an occlusive dressing✓ Answer
    • B.Gently push the bowel back in, then bandage it
    • C.Leave the bowel exposed and transport without covering
    • D.Cover with dry gauze and apply firm pressure to it

    An evisceration is covered with a moist sterile dressing and then an occlusive dressing to keep the organs moist and protected; the organs are never pushed back in, as doing so risks contamination and further injury.

    Source: National EMS Education Standards — Abdominal trauma / eviscerationReport a problem with this question

46. 46. You are splinting a patient's angulated forearm fracture. When should you assess pulse, motor function, and sensation (PMS) distal to the injury?

    • A.Only after the splint has been applied
    • B.Before and after applying the splint✓ Answer
    • C.Only before the splint is applied
    • D.Only if the patient reports numbness

    PMS (pulse, motor, sensation) distal to the injury must be checked before and after splinting, because splinting can compromise circulation or nerve function, and comparing the two assessments confirms the limb was not made worse.

    Source: National EMS Education Standards — Musculoskeletal trauma / splinting principlesReport a problem with this question

47. 47. A 72-year-old woman has sudden facial droop and slurred speech, and the Cincinnati Prehospital Stroke Scale is positive. Besides rapid transport to a stroke center, which action is MOST important?

    • A.Administer aspirin for the stroke
    • B.Lay her flat with legs elevated
    • C.Give oral glucose empirically
    • D.Check her blood glucose level✓ Answer

    Hypoglycemia is the classic stroke mimic, so blood glucose must always be checked; oral glucose is given only if hypoglycemia is confirmed and the patient can protect the airway, and aspirin is not indicated for an undifferentiated stroke.

    Source: AHA/ASA prehospital stroke care; Cincinnati Prehospital Stroke Scale protocol (mandatory glucose check)Report a problem with this question

48. 48. You witness a patient having a generalized tonic-clonic seizure. What is the MOST appropriate action?

    • A.Protect the patient from injury✓ Answer
    • B.Restrain the patient supine firmly
    • C.Place a bite block in the mouth
    • D.Hold the limbs to stop shaking

    During a seizure you protect the patient from injury and never restrain them or place anything in the mouth, which risks injury and aspiration; afterward you position for airway and suction and manage the postictal phase.

    Source: National EMS Education Standards — Neurologic emergencies (seizure management)Report a problem with this question

49. 49. A known diabetic is unresponsive and cannot follow commands or swallow. Family hands you an oral glucose tube. What should you do?

    • A.Put gel between cheek and gum
    • B.Give the full tube of glucose
    • C.Withhold the oral glucose✓ Answer
    • D.Mix the glucose into water

    Oral glucose is contraindicated in a patient who is unresponsive or unable to swallow because of the aspiration risk; it may be given only to a patient who is awake and able to protect the airway.

    Source: National EMS Education Standards — oral glucose administration (contraindication: cannot protect airway)Report a problem with this question

50. 50. An adult in anaphylaxis has stridor and hypotension, and you are assisting with an epinephrine auto-injector. What is the correct adult dose and injection site?

    • A.0.3 mg IM in the lateral thigh✓ Answer
    • B.0.5 mg SC in the abdominal wall
    • C.0.15 mg IM in the deltoid muscle
    • D.1 mg IM in the gluteal muscle

    The adult epinephrine auto-injector dose is 0.3 mg intramuscularly into the lateral (mid-outer) thigh (pediatric dose is 0.15 mg); epinephrine reverses anaphylaxis by causing vasoconstriction and bronchodilation.

    Source: National EMS Education Standards — anaphylaxis / epinephrine auto-injector (adult 0.3 mg IM lateral thigh)Report a problem with this question

51. 51. Which patient is the BEST candidate for an epinephrine auto-injector?

    • A.Sneezing and watery eyes each spring
    • B.Localized redness at a bee-sting site
    • C.Hives on one arm with normal vital signs
    • D.Airway swelling, wheezing, hypotension✓ Answer

    Epinephrine is indicated for anaphylaxis — a multi-system reaction with airway swelling/wheezing and hypotension, such as after eating shellfish — and not for a mild, localized allergic reaction without airway or circulatory compromise.

    Source: National EMS Education Standards — allergic reaction vs anaphylaxis (epinephrine indication)Report a problem with this question

52. 52. An unresponsive patient has a respiratory rate of 4/min and pinpoint pupils, and naloxone is available. What is your FIRST priority?

    • A.Apply the cardiac monitor first
    • B.Perform a rapid full-body exam now
    • C.Administer naloxone immediately
    • D.Assist ventilations with bag-mask✓ Answer

    The immediate life threat in opioid overdose is respiratory depression, so ventilations are supported with a bag-valve mask first; naloxone is then given per protocol, with awareness of possible re-sedation or combativeness.

    Source: National EMS Education Standards — Toxicology (opioid overdose: ventilate first, then naloxone)Report a problem with this question

53. 53. A patient in respiratory distress now has a rate of 6/min, shallow tidal volume, and a declining mental status. What is the MOST appropriate action?

    • A.Assist ventilations with a bag-mask✓ Answer
    • B.Coach the patient to breathe slower
    • C.Apply a nasal cannula at 4 L/min
    • D.Assist with his metered-dose inhaler

    Inadequate breathing — signaled by a low rate, poor tidal volume, and falling mental status — requires positive-pressure ventilation with a bag-valve mask connected to supplemental oxygen; a cannula or inhaler cannot correct inadequate ventilation.

    Source: National EMS Education Standards — Respiratory (adequate vs inadequate breathing; BVM)Report a problem with this question

54. 54. Which patient with pulmonary edema is the BEST candidate for CPAP where it is authorized?

    • A.Unresponsive, agonal respirations
    • B.Awake, follows commands, has crackles✓ Answer
    • C.Systolic blood pressure of 70 mmHg
    • D.Vomiting, cannot protect the airway

    CPAP is used for CHF/pulmonary edema in patients who are awake, follow commands, and have an adequate blood pressure; it is contraindicated in patients who are unresponsive, hypotensive, or unable to protect their airway.

    Source: National EMS Education Standards — CPAP indications/contraindicationsReport a problem with this question

55. 55. A 58-year-old with crushing chest pressure and diaphoresis has no aspirin allergy or other contraindication. What aspirin dose is appropriate?

    • A.1000 mg swallowed with water
    • B.650 mg of chewable aspirin
    • C.81 mg enteric-coated, whole
    • D.162–324 mg chewable aspirin✓ Answer

    For suspected cardiac chest pain, 162–324 mg of chewable aspirin is given (absent allergy or contraindication) for its antiplatelet effect, and chewing speeds absorption.

    Source: AHA ACS guidelines; National EMS Education Standards — aspirin for suspected ACS (162–324 mg chewable)Report a problem with this question

56. 56. Before assisting a chest-pain patient with his prescribed nitroglycerin, which finding is a reason to WITHHOLD it?

    • A.His systolic blood pressure is 150
    • B.He has taken two of his own tablets
    • C.He rates his chest pain 8 out of 10
    • D.He took sildenafil 12 hours ago✓ Answer

    Nitroglycerin is contraindicated within 24–48 hours of an erectile-dysfunction drug (e.g., sildenafil, tadalafil) because the combination can cause severe, refractory hypotension; you also withhold it for low systolic BP and recheck BP after each dose.

    Source: National EMS Education Standards — nitroglycerin assist (ED-drug interaction and hypotension contraindications)Report a problem with this question

57. 57. A combative patient must be restrained per protocol. Which practice is correct to prevent positional asphyxia?

    • A.Restrain the patient prone, hobbled
    • B.Apply a spit mask and step away
    • C.Never restrain the patient face-down✓ Answer
    • D.Assume it is psychiatric, no vitals

    Patients must never be restrained prone or hobbled because of the positional-asphyxia and sudden-death risk (excited delirium); restrained patients need continuous airway and breathing monitoring and must never be left unattended, and organic causes must be ruled out.

    Source: National EMS Education Standards — Behavioral emergencies (restraint; positional asphyxia)Report a problem with this question

58. 58. A woman in labor has contractions 90 seconds apart, a strong urge to push, and crowning is visible. What is the BEST decision?

    • A.Place her supine to slow the labor
    • B.Have her cross her legs to delay it
    • C.Prepare to deliver the baby on scene✓ Answer
    • D.Load and transport rapidly, no pushing

    Crowning, contractions less than about 2 minutes apart, and an urge to push signal imminent delivery, so the EMT prepares to deliver on scene rather than transport, and attempts to delay delivery are unsafe.

    Source: National EMS Education Standards — Obstetrics (signs of imminent delivery)Report a problem with this question

59. 59. A newborn's heart rate remains 50/min despite 30 seconds of effective bag-valve-mask ventilation. What is the next step?

    • A.Continue ventilations, no compressions
    • B.Begin chest compressions at a 3:1 ratio✓ Answer
    • C.Score the APGAR before anything else
    • D.Give blow-by oxygen and rub the feet

    If a newborn's heart rate stays below 60/min despite adequate ventilation, chest compressions are started and coordinated with ventilations at a 3:1 compression-to-ventilation ratio; resuscitation is never delayed to assign an APGAR score.

    Source: Neonatal Resuscitation guidelines; National EMS Education Standards — newborn care (HR<60 → compressions, 3:1 ratio)Report a problem with this question

60. 60. During delivery you see the umbilical cord protruding from the vagina ahead of the baby. What is the correct action?

    • A.Clamp and cut the cord immediately
    • B.Lift the presenting part off the cord✓ Answer
    • C.Push the cord back into the vagina
    • D.Sit the mother up and have her push hard

    For a prolapsed cord you insert a gloved hand to push the presenting part off the cord (relieving compression), place the mother knee-chest or hips-elevated, keep the cord moist, give oxygen, and transport rapidly; the cord is never pushed back in.

    Source: National EMS Education Standards — Obstetric complications (prolapsed umbilical cord)Report a problem with this question

61. 61. After delivery the mother has continued heavy vaginal bleeding. Which intervention is MOST appropriate?

    • A.Sit her upright and withhold oxygen
    • B.Delay transport until bleeding stops
    • C.Massage the uterine fundus, treat shock✓ Answer
    • D.Pack the vagina with sterile gauze

    For postpartum hemorrhage, firm fundal (uterine) massage helps the uterus contract and slow bleeding, letting the newborn nurse also stimulates uterine contraction, and the patient is treated for shock; the vagina is never packed.

    Source: National EMS Education Standards — Postpartum hemorrhage managementReport a problem with this question

62. 62. A woman has heavy vaginal bleeding that is not related to childbirth. What is the correct EMT care?

    • A.Insert a tampon to absorb the blood
    • B.Do an internal exam to find the source
    • C.Place external pads, treat for shock✓ Answer
    • D.Pack the vagina with gauze to tamponade

    For gynecologic (non-obstetric) vaginal bleeding, EMTs use external sanitary pads, treat for shock, and transport; nothing is ever packed or inserted into the vagina, and internal exams are outside the EMT scope.

    Source: National EMS Education Standards — Gynecologic emergencies (vaginal bleeding; do not pack)Report a problem with this question

Practice questions modeled on the National EMS Education Standards and NREMT cognitive-exam content areas. Not medical advice and not affiliated with or endorsed by the National Registry of Emergency Medical Technicians (NREMT) or NHTSA. Always follow your instructor, medical director, and local protocols. Study the official materials at nremt.org. Official NREMT →