NREMT EMT Practice Exam.
Free practice test — 124 quality-checked questions, instant feedback.

1. A candidate budgets for two separate exam application attempts, each charged the standard application fee. Using only the documented fee, what is the total cost of two applications?

• A. $260
• B. $104
• C. $208
• D. $156

2. A candidate budgeted exactly $100 for the application. Based on the published fee, is that amount sufficient, and by what margin is it short or over?

• A. Sufficient, with $4 to spare
• B. Short by $14
• C. Exactly enough, no margin
• D. Short by $4

3. A patient who was just told about a new terminal diagnosis insists there must be a mistake and demands the test be re-run. Which stage of grief does this response best reflect?

• A. Depression
• B. Bargaining
• C. Acceptance
• D. Denial

4. An EMT is asked to describe the difference between primary and secondary prevention while teaching a community class. Which pairing correctly matches the concept to an example category?

• A. Primary prevention only occurs in hospitals; secondary prevention only occurs at home
• B. Primary prevention stops a problem before it starts; secondary prevention detects and limits a problem already beginning
• C. Both terms mean exactly the same thing
• D. Primary prevention happens after an injury; secondary prevention happens before any risk exists

5. When counseling a patient's family about calling for help early rather than delaying, an EMT emphasizes prevention as a core public-health value. Which principle best reflects the purpose of health promotion in emergency care?

• A. Discouraging patients from seeking future care
• B. Prioritizing paperwork over patient education
• C. Reducing the likelihood and severity of illness or injury before it worsens
• D. Withholding information until a physician arrives

6. During a wellness talk, an EMT wants to explain why patient education is part of an EMT's role even when no emergency is active. Which rationale is most consistent with health-promotion goals?

• A. Education is never part of the EMT scope
• B. Educating patients can reduce future emergencies and improve outcomes
• C. Prevention efforts have no effect on outcomes
• D. Patients should not be told how to stay safe

7. A community health advocate reminds EMTs that promoting safe behaviors is a shared responsibility. Which action best exemplifies an EMT contributing to health promotion during routine community contact?

• A. Encouraging safety measures and connecting people to appropriate resources
• B. Telling patients that prevention is pointless
• C. Ignoring preventable risks observed on scene
• D. Refusing to discuss prevention with the public

8. A patient becomes acutely agitated and begins pacing and clenching their fists during an interview. Which is the MOST appropriate initial provider action to promote safety and de-escalation?

• A. Maintain a calm tone, keep a non-threatening distance, and ensure a clear exit path
• B. Raise your voice to establish authority and control
• C. Move closer and place a hand on the patient's shoulder to reassure them
• D. Turn your back and leave without explanation

9. During an assessment a patient discloses that a family member controls all of their money and prevents them from leaving the house alone. This is BEST recognized as a sign of:

• A. Possible abuse or neglect warranting further evaluation
• B. A cultural preference that should not be questioned
• C. Normal family caregiving
• D. A medication side effect

10. A patient states, "Sometimes I feel like everyone would be better off without me." What is the provider's MOST appropriate response?

• A. Change the subject to avoid making the patient uncomfortable
• B. Directly and calmly ask whether the patient is thinking about harming or killing themselves
• C. Reassure the patient that they are overreacting
• D. Document the comment and take no further action

11. A patient with alcohol use disorder repeatedly denies any problem despite clear consequences to work and family. This defense mechanism is BEST described as:

• A. Regression
• B. Denial
• C. Compensation
• D. Sublimation

12. A patient in the emergency setting is crying and unable to focus on questions after witnessing a traumatic event. The provider's therapeutic communication should FIRST focus on:

• A. Providing a calm presence and acknowledging the patient's feelings
• B. Collecting a full insurance and billing history
• C. Telling the patient to stop crying so the interview can proceed
• D. Explaining the long-term statistics of their condition in detail

13. A provider notices they feel increasingly exhausted, cynical, and detached from patients after months of heavy caseloads. This is BEST described as:

• A. A normal and healthy response requiring no attention
• B. An indication the patients are at fault
• C. Provider burnout, which can affect care quality and warrants self-care and support
• D. A sign the provider should never work in the field

14. A patient experiencing a panic-level anxiety episode reports a racing heart and a feeling of impending doom. Which communication strategy is MOST therapeutic?

• A. Use short, clear, reassuring statements and help the patient focus on slow breathing
• B. Leave the patient alone until the episode passes
• C. Tell the patient there is nothing to worry about and walk away
• D. Provide a long, detailed explanation of the physiology of anxiety

15. A patient from a culture unfamiliar to the provider declines a recommended treatment for reasons tied to their beliefs. The MOST culturally competent approach is to:

• A. Discharge the patient immediately for non-compliance
• B. Assume the refusal is due to a lack of intelligence
• C. Explore the patient's beliefs respectfully and seek a mutually acceptable plan
• D. Insist the patient comply because the provider knows best

16. Which finding during a mental status assessment MOST strongly suggests acute disorientation requiring further evaluation?

• A. The patient prefers to answer questions slowly
• B. The patient can state their name but not the current location or approximate time
• C. The patient asks the provider to repeat a question once
• D. The patient expresses sadness about a recent loss

17. A candidate is budgeting for the EMT cognitive certification. According to the official handbook, what is the application fee?

• A. $104
• B. $150
• C. $85
• D. $120

18. On the scaled scoring model used for the EMT cognitive exam, which value marks the passing point?

• A. 900
• B. 950
• C. 1000
• D. 800

19. A test-taker has been working through items for exactly one hour. Based on the exam's total time limit, how much time remains?

• A. 90 minutes
• B. 60 minutes
• C. 45 minutes
• D. 30 minutes

20. An applicant completed a state-approved EMT course that meets the National EMS Education Standards, but finished it 3 years ago and never applied for certification. When applying now, which statement about the course's eligibility is accurate?

• A. The course qualifies as long as the applicant schedules the exam appointment before the end of the current year
• B. The course does not qualify, because applicants must complete their course in the same year they apply
• C. The course qualifies, because any state-approved course meeting the National EMS Education Standards is acceptable regardless of completion date
• D. The course does not satisfy the requirement, because the course must have been completed within the past 2 years

21. A candidate is confirming the requirements to become eligible for EMT certification. Which statement correctly describes the education requirement?

• A. The candidate must complete a state-approved EMT course that meets or exceeds the National EMS Education Standards.
• B. The candidate must complete 40 hours of continuing education before the first attempt.
• C. The candidate must complete any first-aid course offered nationwide, regardless of state approval.
• D. The candidate must hold one of the six certification levels before enrolling in a course.

22. An EMT is interviewing a patient in the back of the ambulance when the patient suddenly stands up, begins pacing, clenches their fists, and raises their voice. Which is the MOST appropriate INITIAL provider action to promote safety and de-escalation?

• A. Maintain a calm tone, keep a safe distance with a clear exit path, and acknowledge the patient's feelings
• B. Move close to the patient and place a reassuring hand on their shoulder to show support
• C. Ignore the behavior and continue asking the assessment questions to avoid escalating the situation
• D. Firmly warn the patient that they will be restrained if they do not sit down immediately

23. An EMT responds to a patient who reports a suddenly racing heart, chest tightness, shortness of breath, and an overwhelming feeling of impending doom, but has no signs of a physical cardiac emergency after assessment. The patient appears to be experiencing a panic-level anxiety episode. Which communication strategy is MOST therapeutic?

• A. Speak in short, calm, reassuring statements, orient the patient to their surroundings, and coach slow breathing
• B. Leave the patient alone in a quiet space until the episode passes on its own
• C. Tell the patient there is nothing physically wrong and that they simply need to relax
• D. Provide a detailed explanation of the physiology of the sympathetic nervous system to reassure them

24. An EMT is caring for an alert, oriented adult patient on a long transport who says they are cold and asks for a blanket, and also asks to keep their head slightly elevated because lying flat is uncomfortable. There is no suspected spinal injury and vital signs are stable. Which provider action BEST addresses the patient's basic comfort needs?

• A. Deny the blanket and keep the patient flat, because comfort measures are not part of prehospital care
• B. Withhold both measures until arrival at the hospital so staff there can decide
• C. Restrain the patient's movement to prevent any repositioning during transport
• D. Provide the blanket for warmth and position the patient with the head elevated as requested, since there is no contraindication and it improves comfort

25. An EMT recertifying through the continuing-education pathway wants to confirm that the three NCCP components sum to the full recertification requirement. Adding the national component, the state/local component, and the individual component together, what total number of continuing-education hours results?

• A. 40 hours
• B. 20 hours
• C. 30 hours
• D. 50 hours

26. A candidate who failed an attempt must wait the required interval between attempts and is limited to the maximum number of total attempts. If a candidate takes exactly two attempts and waits the minimum required time between them, what is the shortest possible number of days from the first attempt to the second attempt, and are further attempts still permitted afterward?

• A. 40 days, and further attempts are still permitted
• B. 15 days, and no further attempts are permitted
• C. 15 days, and further attempts are still permitted
• D. 6 days, and no further attempts are permitted

27. An EMT recertifying by continuing education has completed the national and state/local NCCP components in full but has not started the individual component. What fraction of the total 40-hour recertification requirement remains, and how many hours does that represent?

• A. Three quarters — 30 hours
• B. One quarter — 20 hours
• C. One half — 20 hours
• D. One quarter — 10 hours

28. An applicant asks how recently their state-approved EMT course must have been completed to remain eligible when applying for certification. Which statement is accurate?

• A. There is no time limit on when the course was completed
• B. The course must have been completed within the past 5 years
• C. The course must have been completed within the past 6 months
• D. The course must have been completed within the past 2 years

29. An EMT recertifying through the continuing-education pathway maps out the NCCP model. After completing the full 20-hour national component and the full 10-hour individual component, how many hours must still come from the state or local component to satisfy that portion of the requirement?

• A. 5 hours
• B. 10 hours
• C. 40 hours
• D. 20 hours

30. An EMT studying the NCCP model wants to describe the national component both as a share of the total recertification requirement and as an hour figure. Which statement is accurate?

• A. The national component is 100% of the requirement, equal to 20 hours
• B. The national component is 50% of the requirement, equal to 20 hours
• C. The national component is 25% of the requirement, equal to 10 hours
• D. The national component is 50% of the requirement, equal to 40 hours

31. During assessment of a patient who has just been told they have a terminal illness, the patient becomes tearful and repeatedly states, "If I just take better care of myself and follow every instruction, maybe this will go away." Which stage of the grieving process does this response BEST reflect?

• A. Acceptance
• B. Depression
• C. Denial
• D. Bargaining

32. An instructor tells a cohort that a large majority of EMT candidates pass the cognitive certification exam nationally, then reinforces that maintaining certification is a career-long process requiring renewal on a fixed cycle. Using the reported figures, which statement pairs the national EMT passing percentage with the renewal cycle correctly?

• A. 80% pass nationally, and certification must be renewed every 2 years.
• B. 50% pass nationally, and certification must be renewed every 2 years.
• C. 80% pass nationally, and certification must be renewed every 4 years.
• D. 95% pass nationally, and certification must be renewed every 6 years.

33. An EMT instructor is teaching a unit on end-of-life care and describes a patient who has recently received a terminal diagnosis. The patient tells the crew, "I'm just so furious — why is this happening to me and not someone else?" and lashes out at staff. Which stage of the grieving process does this response BEST reflect?

• A. Bargaining
• B. Acceptance
• C. Denial
• D. Anger

34. An instructor is building a slide that pairs two facts about the credential: the number of distinct certification levels the National Registry offers and how often certification must be renewed. Which pairing is correct?

• A. Four certification levels; renew every 4 years
• B. Two certification levels; renew every 4 years
• C. Six certification levels; renew every 2 years
• D. Four certification levels; renew every 2 years

35. While gathering a history, an EMT hears a patient say, "Lately I feel like everyone would honestly be better off if I weren't around." What is the provider's MOST appropriate response?

• A. Note the comment in the report and continue with the physical assessment without addressing it
• B. Reassure the patient that everything will be fine and that they have a lot to live for
• C. Ask the patient directly and calmly whether they are thinking about harming or killing themselves
• D. Change the subject to keep the patient calm and avoid putting the idea of self-harm in their mind

36. A candidate is comparing the cost of two exam-related processes: the standard application fee for the cognitive exam versus the fee to request a rescore of a completed examination. Based on the documented fees, how much MORE expensive is a rescore request than a single application?

• A. $46 more
• B. $104 more
• C. $150 more
• D. They cost the same

37. An EMT nearing the end of a certification cycle does not want to sit for the cognitive exam again and prefers to accumulate continuing-education hours instead. Under the recertification options, is this permissible, and how many total continuing-education hours would this pathway require?

• A. Yes — continuing education is a permitted pathway, requiring a total of 40 hours of continuing education
• B. Yes — continuing education is permitted, but it requires only 20 total hours
• C. No — the only way to recertify is by retaking the cognitive examination
• D. Yes — but continuing education may only be used after failing a retake of the cognitive exam

38. An unresponsive adult with suspected cervical spine injury requires airway management. Which maneuver should the EMT use to open the airway?

• A. Hyperextension of the neck to maximize the opening
• B. The jaw-thrust maneuver, which opens the airway without extending the neck
• C. No airway maneuver until spinal immobilization is complete
• D. The head-tilt chin-lift maneuver

39. How is an oropharyngeal airway correctly sized before insertion?

• A. From the chin to the thyroid cartilage
• B. From the corner of the mouth to the angle of the jaw or the earlobe
• C. Any available size may be used
• D. From the tip of the nose to the sternal notch

40. An oropharyngeal airway is inserted into a patient who begins to gag. What should the EMT do?

• A. Remove the airway and be prepared to suction, since an intact gag reflex contraindicates its use
• B. Insert it further to bypass the gag reflex
• C. Leave it in place until the gagging subsides
• D. Replace it with a larger oropharyngeal airway

41. What is the maximum recommended duration for a single suctioning attempt in an adult?

• A. About 15 seconds
• B. About 60 seconds
• C. There is no time limit
• D. About 5 minutes

42. A patient requires high-concentration oxygen. Which device and flow rate are appropriate?

• A. A nasal cannula at 2 liters per minute
• B. A non-rebreather mask at 4 liters per minute
• C. A non-rebreather mask at 10 to 15 liters per minute
• D. A nasal cannula at 15 liters per minute

43. An EMT is ventilating an apneic adult with a bag-valve mask. What indicates adequate ventilation?

• A. Visible chest rise with each breath and improving color and oxygen saturation
• B. A ventilation rate of 30 breaths per minute
• C. Gastric distention developing during ventilation
• D. The bag emptying as rapidly as possible with each squeeze

44. An adult patient in cardiac arrest is being resuscitated by two EMTs without an advanced airway. What compression-to-ventilation ratio applies?

• A. 15 compressions to 2 ventilations
• B. 5 compressions to 1 ventilation
• C. 30 compressions to 2 ventilations
• D. Continuous compressions with no ventilations

45. What are the recommended rate and depth for adult chest compressions?

• A. 60 to 80 per minute at a depth of 1 inch
• B. 100 to 120 per minute at a depth of at least 2 inches but not more than 2.4 inches
• C. 140 to 160 per minute at a depth of 3 inches
• D. As fast and as deep as possible

46. An automated external defibrillator advises a shock during an adult cardiac arrest. What should the EMT do immediately after the shock is delivered?

• A. Resume chest compressions immediately without pausing to check a pulse
• B. Check for a pulse for a full minute before resuming
• C. Deliver three stacked shocks before resuming compressions
• D. Wait for the AED to reanalyze before touching the patient

47. A conscious adult with suspected acute coronary syndrome has no allergy and no active bleeding. What medication may an EMT typically administer per protocol?

• A. Intravenous morphine
• B. Chewable aspirin
• C. Thrombolytic therapy
• D. Oral beta blockers

48. An EMT is preparing to assist a patient with their own prescribed nitroglycerin. Which finding is a contraindication?

• A. Recent use of an erectile dysfunction medication, or hypotension
• B. Chest pain rated 8 out of 10
• C. A blood pressure of 140/88
• D. A history of angina

49. A patient in cardiac arrest has an implanted pacemaker visible under the skin. How does this affect AED pad placement?

• A. Remove the device before applying pads
• B. Place the pad directly over the device for better conduction
• C. Place the pad at least about an inch away from the device rather than directly over it
• D. Do not use the AED at all

50. A patient exhibits facial droop, slurred speech and unilateral arm drift. What is the most important information for the receiving hospital?

• A. The time the patient was last known well
• B. The patient's preferred hospital
• C. The patient's usual blood pressure
• D. Whether the patient has eaten recently

51. A conscious diabetic patient with an altered mental status can still swallow and protect their airway. What may an EMT administer per protocol?

• A. Intravenous dextrose
• B. Oral glucose
• C. Nothing by mouth in any circumstance
• D. Subcutaneous insulin

52. A patient stung by a bee develops hives, facial swelling, wheezing and hypotension. What is the priority intervention?

• A. Administer oral antihistamine and monitor
• B. Apply ice to the sting site and reassess in ten minutes
• C. Administer or assist with epinephrine by auto-injector per protocol, with high-concentration oxygen
• D. Withhold treatment until arrival at the hospital

53. An unresponsive patient has pinpoint pupils, respiratory rate of 6, and a suspected opioid overdose. Beyond ventilatory support, what may an EMT administer under many protocols?

• A. Nitroglycerin
• B. Activated charcoal
• C. Oral glucose
• D. Naloxone

54. A patient is actively seizing on arrival. What is the EMT's priority?

• A. Restrain the extremities to stop the movement
• B. Attempt to give oral medication
• C. Protect the patient from injury, maintain the airway and note the seizure duration
• D. Place a bite block between the teeth

55. A woman in labor has crowning visible with contractions two minutes apart. What is the appropriate action?

• A. Ask the mother to resist the urge to push until arrival at the hospital
• B. Prepare for delivery on scene, since crowning indicates imminent birth
• C. Load and transport immediately with the mother's legs held together
• D. Apply firm pressure to delay delivery

56. During delivery the EMT finds the umbilical cord wrapped around the newborn's neck. What is the correct action?

• A. Gently slip the cord over the head; if it cannot be freed, clamp and cut it per protocol
• B. Delay delivery until the cord loosens on its own
• C. Ignore it and continue the delivery
• D. Pull firmly on the cord to release it

57. A newborn is delivered and is limp with weak respiratory effort. What is the first priority?

• A. Clamp and cut the cord before any other action
• B. Administer oral glucose
• C. Immediately begin chest compressions
• D. Dry, warm, position and stimulate the infant while assessing breathing and heart rate

58. A patient with a history of asthma is wheezing, speaking in short phrases and using accessory muscles. Which finding would most concern the EMT?

• A. Reported use of a rescue inhaler before EMS arrival
• B. Sudden absence of wheezing with continued severe distress
• C. Audible expiratory wheezing throughout the lung fields
• D. A respiratory rate of 24

59. A patient with severe external bleeding from an extremity does not respond to direct pressure. What is the next step?

• A. Remove the dressing to inspect the wound repeatedly
• B. Elevate the limb and wait ten minutes
• C. Apply ice directly to the wound
• D. Apply a tourniquet proximal to the wound and note the time of application

60. A trauma patient is pale, cool and diaphoretic with a rapid weak pulse and anxiety. What stage of shock does this suggest?

• A. Decompensated shock with a normal mental status
• B. Compensated shock, in which blood pressure may still be normal
• C. No shock, since blood pressure is maintained
• D. Irreversible shock requiring no intervention

61. An adult sustains partial-thickness burns to the entire anterior surface of one arm and the entire anterior trunk. Using the rule of nines, what percentage of body surface area is involved?

• A. About 13.5 percent
• B. About 22.5 percent
• C. About 18 percent
• D. About 27 percent

62. A patient has an open chest wound with air bubbling through it. What is the appropriate initial management?

• A. Apply an occlusive dressing and monitor for signs of tension pneumothorax
• B. Apply a dry gauze dressing taped on all four sides and leave it
• C. Pack the wound tightly with gauze
• D. Leave the wound open to the air

63. An object is impaled in a patient's abdomen. What is the correct field management?

• A. Stabilize the object in place with bulky dressings and transport
• B. Leave the object unsecured during transport
• C. Remove the object and control bleeding
• D. Push the object further in to prevent movement

64. An EMT arrives at a scene where a power line is down across the vehicle involved in a crash. What is the first priority?

• A. Ensure scene safety and keep everyone clear until the utility company confirms the line is de-energized
• B. Move the line with a wooden pole to clear access
• C. Instruct occupants to exit the vehicle immediately
• D. Immediately approach the vehicle to assess the patients

65. A conscious, alert adult with decision-making capacity refuses treatment and transport after a minor collision. What is the appropriate action?

• A. Ask a bystander to authorize transport
• B. Leave the scene without documentation
• C. Transport the patient against their wishes for safety
• D. Explain the risks, attempt to persuade, and document the informed refusal with a signature and witness

66. An unresponsive adult is found alone with no family present. Under what principle may the EMT provide care?

• A. Expressed consent given verbally
• B. Implied consent, which presumes a reasonable person would consent to lifesaving care
• C. No care may be provided without a signature
• D. Informed refusal

67. During a multiple-casualty incident using START triage, a patient walks toward the EMT when asked to move to a designated area. How is this patient categorized?

• A. Delayed, or yellow, regardless of ability to walk
• B. Deceased, or black
• C. Minor, or green, because ambulatory patients are triaged to the lowest priority group first
• D. Immediate, or red, because they approached the responder

68. An EMT documents a patient care report. Which entry is appropriate?

• A. The EMT's opinion that the patient was intoxicated without supporting observations
• B. Objective findings and the patient's own statements in quotation marks
• C. A diagnosis of the patient's underlying condition
• D. Speculation about how the patient's family contributed to the incident

69. What distinguishes online medical direction from offline medical direction?

• A. Online direction is real-time contact with a physician; offline direction is standing orders and protocols issued in advance
• B. Online direction refers to internet-based training modules
• C. Offline direction means no physician oversight exists
• D. The two terms are interchangeable

70. An EMT is exposed to a patient's blood through a break in the skin. What is the correct immediate action?

• A. Wash the area, report the exposure immediately, and follow the agency's exposure control plan
• B. Finish the call and report at the end of the shift
• C. Take no action unless the patient is known to be infectious
• D. Apply an antiseptic and consider the matter closed

71. An EMT approaching the end of a certification cycle asks what pathways exist to recertify. Which response is accurate?

• A. The EMT must complete a new EMT course to recertify
• B. Recertification is only possible by completing continuing education
• C. Recertification is only possible by retaking the cognitive examination
• D. The EMT may recertify either by retaking the cognitive examination or by completing continuing education

72. A candidate has failed the cognitive exam four times and asks how many attempts remain under the attempt policy. What is the correct answer?

• A. 2
• B. 3
• C. 1
• D. 0 — the candidate has already reached the maximum

73. A candidate ready to schedule the cognitive exam asks who administers it and in which formats it can be taken. Which statement is correct?

• A. Pearson VUE administers it, but only in person at physical testing centers
• B. The state EMS office administers it as an online-only examination
• C. The National Registry administers it directly using paper-based test sites
• D. Pearson VUE administers it, at testing centers and via OnVUE online proctored delivery

74. A newly certified EMT asks their instructor how often National Registry certification must be renewed. Which renewal cycle is correct?

• A. Every 2 years
• B. Every 3 years
• C. Every 4 years
• D. Every year

75. A candidate receives a failing result on the cognitive exam and asks to schedule the next attempt right away. Under the retake policy, what must happen before the candidate can test again?

• A. Nothing — the candidate may retest as soon as an appointment is available
• B. The candidate must wait 30 days between attempts
• C. The candidate must wait 15 days between attempts
• D. The candidate must wait until the next certification cycle begins

76. After receiving a failing result on the cognitive exam, a candidate wants to formally request that the examination be rescored. According to the exam handbook, what fee applies to this request?

• A. No fee — rescoring is free on the first request
• B. $75
• C. $104
• D. $150

77. An EMT recertifying through continuing education has completed the entire 20-hour national component and the entire 10-hour state/local component of the NCCP model. How many additional hours from the individual component are needed to reach the total recertification requirement?

• A. 0 hours — the total requirement is already met
• B. 20 hours
• C. 10 hours
• D. 5 hours

78. An EMT is applying AED pads to a patient in cardiac arrest and notices the chest is covered in dense hair, preventing good pad contact. What should the EMT do?

• A. Apply water to the chest to help the pads stick
• B. Apply the pads over the hair and proceed immediately
• C. Skip defibrillation and continue compressions only
• D. Rapidly shave or otherwise remove hair from the pad placement sites before reapplying pads

79. An EMT is ventilating a patient with severe facial trauma using a bag-valve mask and cannot obtain an adequate mask seal with one hand. What technique should the EMT use?

• A. Apply more downward pressure with one hand until the seal improves
• B. Ventilate with the mask reversed to better fit the facial contours
• C. Abandon bag-valve-mask ventilation and wait for advanced airway equipment
• D. Use a two-person technique, with one provider maintaining the seal with both hands while the other squeezes the bag

80. After a shock is delivered and CPR is resumed, the patient begins to move, open their eyes, and breathe spontaneously. What does this most likely indicate?

• A. Muscle artifact unrelated to circulation
• B. A false rhythm reading by the AED
• C. An agonal breathing pattern that still requires compressions
• D. Return of spontaneous circulation

81. At a multi-vehicle collision with twelve patients and limited resources, the EMT is applying START triage. A patient is breathing 36 times per minute with a delayed capillary refill and cannot follow commands. How should this patient be categorized?

• A. Minor
• B. Deceased/expectant
• C. Immediate
• D. Delayed

82. A pediatric patient presents with a muffled voice, drooling, high fever, and stridor, sitting upright and leaning forward. Which action should the EMT avoid?

• A. Preparing for the possibility of rapid transport
• B. Allowing the patient to remain in a position of comfort
• C. Administering high-flow oxygen in a non-threatening manner
• D. Attempting to visualize the posterior oropharynx with a tongue depressor

83. An EMT ventilating an unresponsive patient with a bag-valve mask notices the chest is not rising despite squeezing the bag. What is the FIRST action to correct this?

• A. Reposition the head and re-establish an airway seal, then reattempt ventilation
• B. Increase the ventilation rate to compensate for reduced volume
• C. Insert an oropharyngeal airway without checking the mask seal
• D. Switch immediately to mouth-to-mask ventilation

84. A responsive adult with copious vomitus pooling in the oropharynx needs suctioning before effective ventilation is possible. Which technique is correct?

• A. Suction in short intervals no longer than about 15 seconds at a time, reoxygenating between attempts
• B. Insert the suction catheter only after placing an oropharyngeal airway
• C. Suction continuously for up to 60 seconds to ensure the airway is completely clear
• D. Use a rigid suction catheter inserted past the point of visualization

85. Before inserting a nasopharyngeal airway, an EMT should assess for which condition that makes this device inappropriate to use?

• A. Absent gag reflex
• B. Signs of significant facial or suspected basilar skull fracture
• C. Patient age older than 65
• D. History of asthma

86. An EMT manages a patient with known chronic obstructive pulmonary disease who is hypoxic and in significant respiratory distress, with a pulse oximetry reading of 84 percent. What is the appropriate oxygen approach?

• A. Administer oxygen at the lowest possible flow regardless of the oximetry reading
• B. Provide only room air and monitor closely
• C. Administer oxygen titrated to relieve hypoxia, since untreated hypoxia is the more immediate threat
• D. Withhold supplemental oxygen because it may suppress the patient's drive to breathe

87. A two-rescuer team is performing CPR on a child with an advanced airway already in place. How should compressions and ventilations be coordinated?

• A. Pause compressions for every two ventilations, delivered in a 15:2 ratio
• B. Switch to a 30:2 ratio identical to single-rescuer CPR
• C. Deliver ventilations only when the child shows signs of inadequate oxygenation
• D. Deliver continuous compressions without pausing, with ventilations given asynchronously at a set rate

88. An elderly patient reports feeling weak and lightheaded, with a heart rate of 38 beats per minute, pale skin, and a systolic blood pressure of 78 mmHg. Which term best describes this presentation?

• A. Hypertensive emergency
• B. Symptomatic bradycardia
• C. Compensated tachyarrhythmia
• D. Normal age-related vital sign variation

89. A patient recovering from a recent heart attack develops cool, clammy skin, a weak rapid pulse, confusion, and a falling blood pressure. What condition does this presentation most strongly suggest?

• A. Adequate compensation requiring no intervention
• B. Cardiogenic shock secondary to pump failure
• C. Anxiety related to hospital discharge
• D. A simple vasovagal episode

90. An EMT suspects a patient is having a stroke and performs a rapid assessment. Which combination of findings is included in a standard prehospital stroke screening tool?

• A. Chest pain, shortness of breath, and diaphoresis
• B. Joint swelling, warmth, and limited range of motion
• C. Abdominal pain, nausea, and rebound tenderness
• D. Facial droop, arm drift, and speech abnormality

91. A patient who just had a generalized seizure is now unresponsive to voice, breathing adequately, and has secretions in the mouth. What is the priority action during this postictal period?

• A. Position the patient to protect the airway, such as on their side, and monitor breathing
• B. Insert an oropharyngeal airway immediately regardless of gag reflex
• C. Restrain the patient's limbs to prevent injury during ongoing convulsions
• D. Administer oral glucose to reverse the postictal state

92. A patient develops hives, lip swelling, and a hoarse voice minutes after eating shellfish, then becomes hypotensive and short of breath. Beyond assisting with any prescribed epinephrine, what should the EMT prepare for?

• A. Withholding all treatment until advanced life support arrives
• B. Delaying oxygen administration until the hives resolve
• C. Rapid transport and continuous monitoring for airway compromise and worsening shock
• D. Applying a tourniquet above the site of the allergic trigger

93. A known diabetic patient is found confused and diaphoretic with cool, clammy skin, and is still able to swallow safely. What does this presentation most likely indicate?

• A. Hyperglycemia requiring immediate oral fluids only
• B. Diabetic ketoacidosis requiring insulin administration
• C. A stroke unrelated to blood glucose
• D. Hypoglycemia, for which oral glucose may be appropriate if the patient can protect their airway

94. A woman in her third trimester reports severe abdominal pain and vaginal bleeding after a minor motor vehicle collision, with a rigid, tender abdomen. What condition should the EMT suspect?

• A. Normal round ligament pain of pregnancy
• B. Placental abruption
• C. A urinary tract infection
• D. Braxton Hicks contractions

95. Immediately after delivering a newborn, the EMT finds the infant is limp, cyanotic, and has a weak, slow respiratory effort. What is the first priority in newborn care?

• A. Immediately begin chest compressions regardless of heart rate
• B. Dry, warm, and stimulate the newborn while positioning the airway
• C. Submerge the newborn briefly in cool water to stimulate breathing
• D. Delay any intervention until the umbilical cord is cut

96. A patient involved in a fall has an obvious flail segment on the chest wall, with paradoxical movement visible during breathing and worsening respiratory distress. What is the appropriate management?

• A. Instruct the patient to take shallow breaths to minimize chest wall movement
• B. Apply a tight circumferential bandage around the entire chest to stabilize the segment
• C. Support ventilation as needed and consider gentle stabilization of the segment while monitoring for respiratory failure
• D. Withhold oxygen until the segment is surgically repaired

97. A construction worker's arm is severed above the elbow in a machinery accident. Bleeding is controlled and the amputated part is recovered. How should the amputated part be prepared for transport?

• A. Wrap the part in a warm, moist towel to keep tissue temperature elevated
• B. Leave the part uncovered and unpackaged for the trauma team to inspect
• C. Wrap the part in sterile dry or lightly moistened gauze, place it in a plastic bag, and keep it cool without direct ice contact
• D. Submerge the part directly in ice water to preserve tissue

98. A patient has an object impaled in the thigh after a fall onto a metal fence post. What is the correct field management of the impaled object?

• A. Remove the object to allow for direct pressure on the wound
• B. Stabilize the object in place with bulky dressings and do not attempt removal
• C. Apply a tourniquet directly over the impaled object
• D. Shorten the object by cutting it as close to the skin as possible

99. A patient with a suspected unstable pelvic fracture from a motorcycle collision is hypotensive and has bruising over the hips. Besides addressing airway and breathing, what should guide the EMT's management of the pelvis?

• A. Repeatedly rock the pelvis to confirm instability before treatment
• B. Allow the patient to ambulate briefly to assess pain response
• C. Minimize pelvic movement and consider a pelvic binder or wrap to reduce internal bleeding and stabilize the fracture
• D. Apply direct manual pressure to the iliac crests during transport in place of any stabilization device

100. A patient sustains a penetrating injury to the eye from a piece of flying debris, with the object still visible in the globe. How should the EMT manage this injury?

• A. Irrigate the eye copiously with saline before covering it
• B. Stabilize the object without applying pressure and cover both eyes to limit sympathetic eye movement
• C. Cover only the injured eye, leaving the uninjured eye uncovered
• D. Attempt to remove the debris to inspect the extent of injury

101. An EMT arrives first on scene at a report of a person down in a building with an unknown mechanism. What is the FIRST action before approaching the patient?

• A. Call for additional units before any scene evaluation
• B. Ask bystanders to move the patient to a safer location
• C. Begin patient assessment immediately to save time
• D. Perform a scene size-up to identify hazards and determine the need for standard precautions

102. An EMT crew arrives at a scene with visible spilled chemicals and a placard on an overturned truck. What is the appropriate initial action?

• A. Stage a safe distance away, uphill and upwind, and await hazardous materials resources
• B. Approach closely to read the placard identification numbers
• C. Begin patient extrication immediately since time is critical
• D. Use a handheld light to search for victims inside the spill area

103. A patient is trapped in a vehicle after a collision but is not in immediate danger and is breathing adequately with stable vital signs. What extrication approach is most appropriate?

• A. A controlled, methodical extrication that maintains spinal precautions
• B. Waiting for the patient to exit the vehicle unassisted once free
• C. Forcible removal through the nearest window
• D. Rapid extrication regardless of the patient's stability

104. An EMT crew transfers a critical patient to an emergency department team. What information is most important to include in the verbal handoff report?

• A. The patient's insurance and billing information
• B. Personal opinions about the patient's home living situation
• C. A detailed narrative of every radio transmission made during transport
• D. Chief complaint, pertinent history, treatment given, and changes in patient condition during transport

105. An EMT encounters an unusual clinical situation not clearly covered by standing protocols and needs guidance before proceeding with an intervention. What is the appropriate action?

• A. Refuse to provide any care until the situation resolves itself
• B. Proceed with the intervention based on personal judgment alone
• C. Contact online medical direction for real-time physician guidance
• D. Wait until returning to base to ask a supervisor

106. While writing a patient care report, an EMT wants to document findings objectively. Which entry best reflects objective documentation?

• A. Patient was clearly faking the injury for attention
• B. Patient rated pain as 8 out of 10 on the numeric pain scale
• C. Patient seemed to be exaggerating the pain level
• D. Patient was probably under the influence of alcohol

107. An EMT crew arrives at a scene with three patients from a motor vehicle collision, none of whom meet mass-casualty triage criteria. How should the crew prioritize care among these three patients?

• A. Wait for a supervisor to assign each patient before beginning any care
• B. Treat the patient who is loudest and most vocal about pain first
• C. Treat patients in the order they were encountered upon arrival
• D. Rapidly assess each patient's airway, breathing, and circulation to identify and treat the most critical needs first

108. A conscious, alert adult with no evidence of impaired decision-making capacity refuses further treatment after being informed of the risks of doing so. What must the EMT ensure before honoring this refusal?

• A. That a family member signs the refusal instead of the patient
• B. That the refusal is informed, the patient understands the risks, and the refusal is thoroughly documented
• C. That the crew simply leaves without any documentation
• D. That the patient is transported regardless of their stated wishes

109. A patient with a known history of asthma is wheezing and in mild to moderate respiratory distress, and has their own prescribed metered-dose inhaler. What is the EMT's role regarding this medication?

• A. Withhold the inhaler until advanced life support providers arrive
• B. Increase the prescribed dose beyond what is indicated on the inhaler
• C. Administer the inhaler using a different patient's prescription if available
• D. Assist the patient in self-administering their prescribed inhaler per protocol

110. An EMT is preparing to assist a patient with a history of chest pain in taking their prescribed nitroglycerin. Which finding would make this administration inappropriate?

• A. The patient has taken nitroglycerin for this type of pain before
• B. The chest pain has been present for less than thirty minutes
• C. The patient's blood pressure is within normal range
• D. The patient reports recently taking a medication for erectile dysfunction

111. An unresponsive adult with slow, shallow respirations, pinpoint pupils, and track marks on the arms is found by an EMT crew. After providing ventilatory support, what medication might be administered under many EMS protocols?

• A. Oral glucose
• B. Naloxone
• C. Aspirin
• D. Epinephrine via auto-injector

112. Before assisting a patient with any prescribed medication, an EMT should confirm several key details. Which of the following is essential to verify first?

• A. That the medication is prescribed to this patient, is the correct medication, and has not expired
• B. Whether the medication is the least expensive option available
• C. The color and brand of the medication packaging
• D. The patient's preference between brand-name and generic versions

113. An EMT is assessing a frightened young child who becomes more anxious when approached quickly and directly. Which approach is most likely to build trust during the assessment?

• A. Approach quickly to complete the assessment before the child becomes more upset
• B. Direct all questions to the child and exclude the caregiver from the interaction
• C. Get down to the child's eye level, speak calmly, and consider examining a stuffed animal or the child's hand first
• D. Use complex medical terminology so the caregiver understands the seriousness

114. An EMT responding to a call for an elderly patient notices unexplained bruising in various healing stages, poor hygiene despite an attentive-looking caregiver present, and the patient appears fearful when the caregiver speaks. What should the EMT do?

• A. Advise the patient to handle the situation independently without any report
• B. Confront the caregiver directly and accuse them of abuse
• C. Document objective findings carefully and report concerns through the appropriate reporting channel
• D. Ignore the findings since the caregiver appears attentive

115. While transporting a patient, a bystander who is not involved in the patient's care repeatedly asks the EMT to share details about the patient's condition and medical history. What is the appropriate response?

• A. Share only the diagnosis but withhold medications
• B. Decline to share the patient's information with anyone not directly involved in their care
• C. Share all details freely since the bystander seems concerned
• D. Ask the patient's family to decide later whether to share the details

116. An EMT arrives at a residence for a reported fall and notices a large dog barking aggressively near the front door. What is the appropriate first action?

• A. Attempt to pet the dog to calm it down
• B. Spray the dog with irritant to clear a path inside
• C. Request that the dog be secured in another room or that animal control assist before entering
• D. Enter quickly to reach the patient before the dog can react

117. An EMT is dispatched to a patient with an unknown respiratory illness and a reported cough and fever. Before patient contact, what level of personal protective equipment is most appropriate to consider?

• A. Full structural firefighting gear
• B. Protective equipment only if the patient specifically requests it
• C. A surgical or N95-type mask along with eye protection and gloves, based on suspected transmission route
• D. No additional precautions beyond routine gloves, since respiratory illnesses are rarely contagious

118. A patient with significant respiratory distress from pulmonary edema is anxious and struggling to breathe while lying flat. What positioning would best address the patient's comfort and respiratory status?

• A. Upright or semi-Fowler's position, allowing the patient to sit as comfortable as their condition allows
• B. Trendelenburg position with the head lowered
• C. Prone with the head turned to one side
• D. Fully supine with legs elevated

119. An EMT is splinting a suspected fracture of the forearm to provide comfort and prevent further injury before transport. What is a key principle of proper splinting technique?

• A. Apply the splint as tightly as possible to prevent any movement
• B. Remove all clothing and jewelry from the entire limb regardless of proximity to the injury
• C. Splint only the fracture site itself without including nearby joints
• D. Immobilize the joints above and below the injury site

120. An EMT is preparing to transport a patient on a stretcher down a steep ambulance ramp. What action best reduces the risk of a fall during this movement?

• A. Ensure all straps are secured, rails are up, and use a controlled, deliberate pace with adequate personnel
• B. Move quickly to minimize the time spent on the incline
• C. Rely on a single strap across the patient's waist only
• D. Leave the stretcher rails down for easier patient access

121. An unresponsive patient with adequate breathing and no suspected spinal injury needs to be prepared for transport. Which positioning best reduces the risk of aspiration?

• A. Fully supine with the head turned straight up
• B. Prone with the arms tucked underneath the body
• C. The recovery position, lying on one side
• D. Sitting fully upright without support

122. An EMT volunteers at a community safety fair and is asked to run a station on preventing pediatric injuries. Which activity best reflects the EMT's role in health promotion at this event?

• A. Distributing prescription-strength medications for common childhood illnesses
• B. Demonstrating proper child car-seat installation and teaching caregivers correct use
• C. Performing sports physicals for local youth athletes
• D. Diagnosing minor injuries brought to the booth by attendees

123. A patient with a minor laceration refuses transport after the wound is bandaged. As part of health maintenance guidance, what should the EMT emphasize before leaving?

• A. That no further care is ever needed once bleeding stops
• B. That the patient should avoid seeking care even if the wound worsens
• C. Signs of infection to watch for and the importance of following up with a physician if those signs appear
• D. That home remedies are preferable to any physician follow-up

124. An EMT rechecks a trauma patient's vital signs after initial treatment and finds the heart rate has risen from 88 to 124 while blood pressure has dropped from 118/76 to 96/60 over ten minutes. What does this trend most likely indicate?

• A. A normal physiological response to being placed on a stretcher
• B. Ongoing compensation for worsening internal blood loss
• C. The patient's condition is stable and improving
• D. An artifact of inconsistent measurement technique