EMT PRACTICE

EMT EXAM
POWER PRACTICE

The content in this book has been reviewed
and updated by the LearningExpress
Team in 2020.

Copyright © 2015 LearningExpress
All rights reserved under International and Pan-American Copyright Conventions.
Published in the United States by LearningExpress, New York.
Library of Congress Cataloging-in-Publication Data On File
Printed in the United States of America
ISBN 978-1-61103-028-0

CONTENTS

CONTRIBUTORS iv
1
CHAPTER 1 The EMT Exam 5
33
CHAPTER 2 EMT Practice Exam 1 57
85
CHAPTER 3 EMT Practice Exam 2 113
CHAPTER 4 EMT Practice Exam 3 133
CHAPTER 5 EMT Practice Exam 4 152
CHAPTER 6 EMT Practice Exam 5 172
CHAPTER 7 EMT Practice Exam 6 192
CHAPTER 8 EMT Practice Exam 7 211
CHAPTER 9 EMT Practice Exam 8 241
CHAPTER 10 EMT Practice Exam 9
CHAPTER 11 EMT Practice Exam 10 iii
CHAPTER 12 EMT Practical Skills Exam Resources

CONTRIBUTORS

Mike Clumpner is a co-founder and senior partner with Nimshi International, a Charlotte, North Carolina
consulting firm. Mike is also a full-time fire captain and paramedic for the Charlotte Fire Department where he
is currently assigned to the Special Operations Division. Mike is a decorated 18-year veteran of the fire service,
with 16 years of experience as a firefighter and paramedic serving on busy inner-city fire companies. He is a
Federal Emergency Management Agency (FEMA) Medical Task Force Leader assigned to North Carolina Urban
Search and Rescue Task Force 3 (NCTF-3) and has worked since 2004 as a helicopter flight paramedic with
Regional One Air Medical Service in Spartanburg, South Carolina. Mike is also clinical faculty at the University
of Maryland at Baltimore County where he teaches a variety of classes and assists with program development
and is also a sworn civilian law enforcement officer with a large metropolitan law enforcement agency where he
is currently assigned to the Special Response Team as a SWAT officer and tactical paramedic.

Clumpner has three undergraduate degrees, an MBA, and is now completing a PhD in homeland security
policy. He has published numerous articles in peer-reviewed journals and has authored and co-authored mul-
tiple books on a variety of subjects. Clumpner has lectured extensively throughout North America, Latin Amer-
ica, Europe, Australia, New Zealand, and the Caribbean presenting at more than 250 major congresses and
symposiums on a variety of subjects.

Meredith C. White, CCEMT-P, EMT-P, CCT has been working in health care and EMS for 12 years, including
working as a helicopter flight paramedic for the last four years. She obtained her paramedic certificate in 1998
and received her critical care training at the Medical College of Georgia in Augusta, Georgia. In addition to her
EMS career, she has also been employed with Southeastern Tissue Alliance as a tissue procurement technician
and is also a certified cardiographic technician (CCT) with a nuclear medicine lab in Atlanta, Georgia. White
lives in New Orleans, Louisiana and is employed as a consultant at Nimshi International, where she is actively
involved in the development of various critical care education programs.

iv

–CONTRIBUTORS–
Malcolm D. Devine, NREMT-Paramedic worked as a paramedic in the New York City 911 system following
graduation from the State University of New York (SUNY) at Stony Brook EMT-Paramedic Program. Devine
currently holds the position of clinical coordinator–paramedic instructor at SUNY Stony Brook and is an active
paramedic with the Setauket fire district in Setauket, New York.
Gregory R. Sharpe MPA, Paramedic is a Battalion Chief with the Charlotte, North Carolina Fire Department.
He has been with the fire department for 18 years and has been a paramedic for 17 of those years. He began his
EMS career as a volunteer for the St. Michael’s College Fire and Rescue Department in February 1986. Sharpe
has served with various law enforcement agencies as a law enforcement officer, for the Mecklenburg EMS
Agency as a Paramedic Crew Chief, and has been an EMS Instructor for the past 14 years. He earned his MPA
from the University of North Carolina at Charlotte in December 2009.

v

CHAPTER1 THE EMT
EXAM

CHAPTER SUMMARY

This chapter tells you how to become certified as an Emergency
Medical Technician (EMT). It outlines the certification require-
ments of the National Registry of Emergency Medical Technicians
and tells you how to use this book to study for the written exam.

The National Registry of Emergency Medical Technicians (NREMT) was established in 1970 in response
to a suggestion of the U.S. Committee on Highway Safety. Today, the NREMT is an independent, not-
for-profit agency that certifies that EMTs have the knowledge and skills to do their job—to save lives
and preserve health. By setting uniform national standards for training, testing, and continuing education, the
NREMT helps ensure patient safety throughout the United States.

In some states, the NREMT certification process is the only licensure process for EMTs. Other states have
their own testing procedures. (A list of specific certification requirements for all 50 states, Washington, D.C.,
Puerto Rico, and the U.S. Virgin Islands appears in Chapter 14.) Nearly all states and U.S. territories base their
curriculums and tests on the National EMS Educational Standards. The NREMT exam uses the same curriculum
to guide the construction of exam questions. Therefore, whether you will be taking a state test or the NREMT
test, you will be learning and studying similar material. This book is based on the NREMT cognitive examination.

1

–TH E E M T- B A S IC E X AM–

Minimum Requirements www.nremt.org. From there, you will click on the
link “Apply for your NREMT Exam” to create an
To apply for national registration as an EMT with the account, fill out your application, pay your $80 fee,
and ensure you are approved to take the exam. After
NREMT, you must: you finish these introductory steps, you will be able
to apply for the computerized exam by calling your
■ be at least 18 years old. state testing center.
■ have successfully completed a state-approved
The EMT Cognitive Exam
National Standard EMT training program within
the last two years. The National Registry’s EMT cognitive examination
■ provide documentation of 24 hours of state- ranges from 70 to 120 items, and the maximum time
approved EMT continuing education within the allotted to take the exam is two hours from the time
past two years if you currently hold a valid EMT it begins. The exam is administered using a com-
certification; this can also be CAPCE approved puter adaptive test (CAT). With the CAT method,
education. each question is modified to fit your abilities. For
■ obtain official documentation of your current example, if you answer a question correctly, the fol-
state EMT certification if your state does not lowing question will be somewhat more
require national EMT registration. challenging. If you answer a question incorrectly,
■ have successfully completed all sections of a state- the following question will be a bit easier. The more
approved EMT practical exam within the past 12 questions you answer correctly, the more likely you
months (24 months if the course was completed are to end the exam early. Once you complete each
after November 1, 2018). This exam must meet or section of ques-tions, the CAT will reevaluate your
exceed all the criteria established by the National ability, and as the exam continues, the program will
Registry. adapt to match your skill level.
■ complete the felony statement on the application
and submit the required documentation. submit The purpose of the CAT-administered cogni-
■ current cardiopulmonary resuscitation (CPR) tive exam is to find your highest ability level. The
credentials. exam is pass/fail, and in order to pass, you must meet
■ submit an acceptable application attesting to the sat- entry-level competency. Entry-level competency is
isfaction of the previous requirements. the NREMT’s criteria for an EMT candidate, which
■ send a $80 nonrefundable/nontransferable includes being able to practice carefully and
application fee (money order only). All fees must capably.
be made payable to the National Registry of
Emergency Medical Technicians and submitted
with the application to cover processing of the
application.
■ successfully complete the National Registry EMT
cognitive and state-approved psychomotor
examinations.

How to Apply

When you have met all the requirements and are
ready to take the exam, visit the NREMT website at

2

–T H E E M T- B AS IC E X A M–

The exam consists of five content areas: The National Registry EMT application
also requires proof that you have successfully
CATEGORY PERCENT OF completed a state-approved practical examination
OVERALL TEST within a 24-month period. At a minimum, the
exam must evaluate your performance in the
Airway, Respiration and Ventilations 18 - 22% following skills. To pass the practical exam, you
must meet or exceed the NREMT’s criteria in the
Medical, Obstetrics and Gynecology 27 - 31% following areas:

Cardiology and Resuscitation 20 - 24% ■ Station #1: Patient Assessment/Management—
Trauma
EMS Operations 10 - 14%
■ Station #2: Patient Assessment/Management—
Trauma 14 - 18% Medical

TOTAL 100% ■ Station #3: Bag-Valve-Mask Ventilation of an
Apneic Adult Patient
For more information on the EMT cognitive exam,
visit http://www.nremt.org. ■ Station #4: Oxygen Administration by Non-
rebreather Mask
The EMT Practical Exam
■ Station #5: Cardiac Arrest Management/AED
When you apply for National Registry EMT registra- ■ Station #6: Spinal Immobilization—Supine
tion, you will fill out an application that consists of sev-
eral sections. The application requires verification of Patient
your credentials. The verification may be in the form of ■ Station #7: Random Skill
your program director’s electronic signature attesting
to competency in the following skills: ■ Spinal Immobilization—Seated Patient
■ Bleeding Control/Shock Management
 Patient Assessment/Management ■ Long Bone Immobilization
—Trauma ■ Joint Immobilization

 Patient Assessment/Management Chapter 12 contains more detailed information
—Medical about the NREMT practical exam.

 Bag-Valve-Mask Ventilation of an Apneic Using This Book to Prepare
Adult Patient
The bulk of this book consists of ten
 Oxygen Administration by Non-rebreather practice tests, each containing 120 to 150 questions
Mask similar to those on the National Registry’s EMT
cognitive examination. All practice tests represent
 Cardiac Arrest Management/AED content from the NREMT examination.
 Bleeding Control/Shock Management
 Long Bone Immobilization First, take one complete practice test and
 Joint Immobilization score your answers using the answer key. Complete
 Note: Spinal immobilization is no longer

required by the NREMT but may still be a
required skills of the respective states.

3

–TH E E M T- B A S IC E X AM–

explanations for the answers are included. Even printed materials from your EMS course. Then take a
though the EMT cognitive exam is pass/fail, second practice test and check your total score and
LearningExpress recommends scoring at least a 70% content area breakdown again. Chances are that your
on the practice tests in order to achieve the best total will have improved.
results on your final EMT exam.
In the time leading up to the EMT cognitive
If you score more than 70% on your first exam, use the remaining practice tests to further pin-
practice exam, congratulations! However, even if you point areas of weakness and to find areas to review.
do very well on the practice test, don’t become For example, suppose that after additional study ses-
overconfident and simply assume that you’ll pass the sions, you take the third practice test. You now do well
actual test easily—the items on that test will be on all the questions about circulation except the ones
different from those on the practice test. You’ll still that ask you to recognize signs and symptoms of
need to do some test preparation. No matter what shock. This information tells you which specific pages
your initial score, follow the suggestions in the next of your textbook you should review.
paragraphs.
Once you have worked on and improved your
If you score less than 70% on your first practice areas of weakness, use the final days before the test to
test, don’t panic, but do put in some concentrated do some general reviewing. Devote a short period of
study time. Begin your studying by determining time each day to reviewing one or two chapters of
your major areas of weakness. For example, perhaps your textbook. Then use the fourth and tenth practice
you answered 40 items on the practice test tests to rehearse free-response testing. Although this
incorrectly, giving you a score of 80, or method is not included on the official exam, it pro-
approximately 67%. Upon rereading the questions vides an alternative form of evaluation, and the chal-
you missed, try to determine the content area in lenge will help you achieve greater understanding of
which they belong: Airway, Respirations & the concepts.
Ventilations, Medical, Obstetrics and Gynecology,
Cardiology and Resuscitation, EMS Operations, or After reading and studying this book, you’ll be
Trauma. well on your way to obtaining certification as an EMT.
Good luck as you enter this rewarding and worthwhile
This analysis tells you where you need to career!
concentrate your studying. Try putting in one or two
concentrated evenings of study on each area. Review
all the material on these topics in the textbook
and

4

CHAPTER 2 EMT
PRACTICE EXAM 1

CHAPTER SUMMARY

This is the first of ten practice exams in this book based on the
National Registry’s EMT cognitive exam.

Like the other tests in this book, this test is based on the National Registry’s cognitive exam for EMTs. See
Chapter 1 for a complete description of this exam.
Take this first exam in as relaxed a manner as you can, and don’t worry about timing. You can time
yourself on the other nine exams. You should, however, allow sufficient time to take the entire exam at one
sitting, at least two hours. Find a quiet place where you can work without being interrupted.
The correct answers, each fully explained, come after the exam. Once you have read and understood the
answer explanations, turn to Chapter 1 for an explanation of how to assess your score.

5

Blank Page

–THE EMT PRACTICE EXAM 1–

EMT Practice Exam 1 4. Which of the following is the highest priority
patient?
1. EMTs should wear high-efficiency particulate a. 57-year-old male with chest pain and systolic
air (HEPA) respirators when they are in contact blood pressure of 80
with patients who have which of the following? b. 40-year-old female with moderate pain from
a. HIV (human immunodeficiency virus) or a leg injury
AIDS (acquired immune deficiency c. 75-year-old male who appears confused but
syndrome) responds to commands
b. tuberculosis (TB) d. 25-year-old female in labor with
c. open wounds contractions six minutes apart
d. hepatitis B
5. Of the following, which has the most potential
2. You are called to assist a 60-year-old female to transmit blood-borne diseases?
who complains of a severe headache. Upon a. cerebral spinal fluid
entering the home, you smell a strong odor of b. vomitus
natural gas. What is your first action? c. epistaxis
a. Check the patient’s airway, breathing, and d. feces
circulation.
b. Insert a nasopharyngeal airway and assess 6. Your patient is an 11-month-old female. How
vital signs. can you determine if she has a decreased
c. Remove the patient from the house to your mental status and is responsive to verbal
ambulance. stimuli?
d. Open all windows and determine the source a. She will be upset when you take her from her
of the gas leak. mother’s arms.
b. She will be unable to tell you how old she is
3. The most common electrical rhythm if you ask her.
disturbance that results in sudden cardiac c. She will attempt to locate her parents’ voices
arrest is called when they speak.
a. pulseless electrical activity. d. She will try to pull away from a painful
b. ventricular fibrillation. stimulus on her toe.
c. ventricular tachycardia.
d. asystole. 7. What is the best method to assess circulation in
an infant?
a. Palpate the carotid pulse.
b. Palpate the brachial pulse.
c. Palpate the radial pulse.
d. Observe capillary refill time.

7

–THE EMT PRACTICE EXAM 1–

8. A 45-year-old male is experiencing chest 12. To assess the motor function in the lower
discomfort. After placing him in his position of extremities of a responsive patient, you would
comfort, your next action should be to a. ask the patient to bend his knees.
a. ventilate the patient with a nonrebreather b. ask the patient to wiggle his toes.
mask at 15 L/min. c. carefully move the patient’s leg.
b. ventilate the patient with the bag-valve mask d. touch the skin of the patient’s foot.
at 15 L/min.
c. administer oxygen by nonrebreather mask at 13. Which patient can safely receive only a focused
15 L/min. physical examination rather than a rapid
d. administer oxygen if the patient's pulse trauma assessment?
oximetry falls below 94%. a. 10-year-old male with a deformed right
lower leg who is unresponsive after falling
9. Which patient should receive a rapid trauma off his bicycle
survey to determine hidden injuries? b. 20-year-old female who complains of severe
a. alert 2-year-old child in a car seat who was in pain in her ankle after stepping off a curb
a medium-speed crash c. 70-year-old male who complains of neck
b. alert 20-year-old male who fell ten feet and is pain after a medium-speed car collision
complaining of leg pain d. 30-year-old male who is unresponsive but
c. alert 65-year-old female who fell in the has only minor cuts on the extremities
bathtub and is complaining of wrist pain
d. alert 11-year-old female who tripped while 14. You are using the OPQRST acronym to assess a
roller-skating and fell down three steps responsive medical patient. What question
would you ask to assess the P component?
10. Which of the following is a sign of increased a. What were you doing when the pain started?
pressure in the circulatory system? b. Can you describe the character of the pain
a. flat neck veins for me?
b. palpable carotid pulse c. What makes the pain feel worse or better?
c. distended jugular veins d. On a scale of 1 to 10, how would you rank
d. decreased radial pulse the pain?

11. An automated external defibrillator (AED) will 15. What is the first step in the physical assessment
shock which of the following rhythms? of an unresponsive medical patient?
a. sinus rhythm a. Perform the initial assessment.
b. asystole b. Assess a complete set of vital signs.
c. ventricular fibrillation c. Position the patient to protect the airway.
d. pulseless electrical activity d. Obtain SAMPLE history from a family
member.

8

–THE EMT PRACTICE EXAM 1–

16. Which patient needs a detailed physical 20. Which of the following is a contraindication
examination? for the administration of patient-assisted
a. 48-year-old male with a history of heart nitroglycerin?
disease who is complaining of chest pain a. The patient has epistaxis.
b. 35-year-old female who has been in a single- b. The medication is prescribed for the patient.
car collision and who briefly lost c. The patient’s blood pressure is greater than
consciousness 100 mmHg.
c. 28-year-old full-term pregnant female whose d. The patient has taken Viagra or other erectile
water has broken and who is having dysfunction medication within the past 24
contractions every two minutes hours.
d. 53-year-old female with a history of
smoking who is distressed and short of 21. In which of the following situations should you
breath call for immediate assistance?
a. You must care for two critical patients with
17. The purpose of the ongoing assessment is to gunshot wounds.
re-evaluate the patient’s condition and to b. Your patient is a 26-year-old female in active
a. find any injuries missed during the initial labor.
assessment. c. Your patient is a child with fever who has
b. reassure the patient that you are still caring had a brief seizure.
for him or her. d. Your partner is needed to stabilize the
c. check the adequacy of each intervention cervical spine.
performed.
d. protect the EMT against liability from 22. What is the structure that prevents food and
malpractice. liquid from entering the trachea during
swallowing?
18. Immediately after delivering a shock with an a. larynx
AED to a patient in cardiac arrest, you should b. cricoid cartilage
a. check for a pulse. c. epiglottis
b. check breathing and provide rescue breaths d. diaphragm
as necessary.
c. analyze with the AED and shock again if 23. The air sacs in the lungs where oxygen–carbon
indicated. dioxide exchange occurs are the
d. do CPR. a. bronchioles.
b. bronchi.
19. You should apply an AED to c. epiglottis.
a. adult patients experiencing chest discomfort. d. alveoli.
b. adult patients with significant traumatic
injuries.
c. adult patients without respirations or a
pulse.
d. adult patients with low blood pressure.

9

–THE EMT PRACTICE EXAM 1–

24. Pink or bloody sputum is often seen in patients 28. A gurgling sound heard with artificial
with ventilation is a sign that
a. pulmonary edema. a. the patient must be suctioned immediately.
b. anaphylaxis. b. supplemental oxygen should be added to
c. allergic reaction. the bag-valve mask.
d. flu. c. the airway is most likely open, patent,
and clear.
25. Which occurs during capillary–cellular d. the patient is trying to communicate with
exchange? you.
a. Oxygen enters the capillaries as carbon
dioxide enters the alveoli. 29. You are assisting a patient’s ventilations with an
b. Oxygen-poor blood from the capillaries Automatic Transport Ventilator (ATV). What
passes into the alveoli. indicates that you have set the ventilator on the
c. Body cells give up carbon dioxide and correct tidal volume?
capillaries give up oxygen. a. The alarm stops sounding
d. Body cells give up carbon monoxide and b. Capnography reading < 20 mmHg
capillaries give up oxygen. c. Adequate chest rise and fall
d. Proper wave form on the screen
26. Which of the following is a sign of inadequate
breathing? 30. You take a report from a first responder who
a. warm, dry skin describes a patient as postictal; based on this
b. no audible sounds report, you would expect to find the patient
c. equal chest expansion a. alert and oriented.
d. accessory muscle use b. confused.
c. unresponsive.
27. A patient complaining of facial paralysis on d. hallucinating.
one side of his face with tearing, localized pain,
and sensitivity may be suffering from the most 31. When suctioning a patient, how far should you
common form of facial paralysis called insert a soft suction catheter?
a. dystonia. a. as far as you can see
b. muscular dystrophy. b. as far as the base of the tongue
c. amyotrophic lateral sclerosis (ALS). c. until resistance is encountered
d. Bell’s palsy. d. past the vocal cords

10

–THE EMT PRACTICE EXAM 1–

32. What is the correct procedure for a patient who 36. When providing mouth-to-mask ventilation
has secretions or emesis that suctioning cannot with supplementary oxygen, what is the first
easily remove? step after sealing the mask to the patient’s face?
a. Insert an oropharyngeal or nasopharyngeal a. Follow body substance precautions before
airway immediately. touching the patient.
b. Suction for 15 seconds, ventilate for two b. Connect the one-way valve and filter (if
minutes, and then repeat. available) to the mask.
c. Logroll the patient and clear the oropharynx c. Exhale slowly over the ventilation port for
and nasopharynx. one and a half to two seconds.
d. Hyperventilate the patient with a bag-valve- d. Attach oxygen tubing to the mask and set
mask unit. the flow rate at 15–30 L/min.

33. What is the purpose of the head-tilt/chin-lift 37. The correct rate of artificial ventilations for an
technique? adult patient is
a. to position the patient for insertion of an a. three ventilations per minute.
airway adjunct b. five ventilations per minute.
b. to remove foreign bodies from the upper c. ten ventilations per minute.
airway d. twelve ventilations per minute.
c. to help the rescuer better visualize the larynx
and vocal cords 38. When using the two-person bag-valve-mask
d. to lift the tongue and epiglottis out of their procedure, one EMT ventilates the patient
obstructing position while the other
a. suctions the patient and administers CPR.
34. After opening the airway, the next step in b. administers mouth-to-mask ventilation.
patient management is to c. inserts the oral or nasopharyngeal airway.
a. insert an endotracheal tube. d. maintains the mask seal and monitors
b. assess adequacy of respirations. chest rise.
c. begin mouth-to-mouth ventilation.
d. apply bag-valve-mask ventilation. 39. Where is the cricoid cartilage located?
a. inferior to the larynx
35. A patient should receive high-flow oxygen if he b. superior to the epiglottis
or she exhibits c. at the carina
a. fever. d. in the oropharynx
b. anxiety.
c. dehydration. 40. Your patient is awake, confused, and
d. cyanosis. disoriented. How would you grade her using
the AVPU scale?
a. A
b. V
c. P
d. U

11

–4THE EMT PRACTICE EXAM 1–

41. A bulb syringe is used to suction infants up to 45. Your patient is a 62-year-old male with a
the age of history of heart disease. He is experiencing
a. one month. chest pain. Your first action should be to
b. three to four months. a. place the pads for the AED on his chest.
c. six to eight months. b. begin CPR while preparing the AED.
d. one year. c. ask him if he has taken his nitroglycerin,
and if not, offer to assist him.
42. You are on the scene of a 6-year-old patient in d. place him in a comfortable position and
cardiac arrest. CPR is being performed by administer oxygen if needed.
EMRs and you are preparing the AED. The
pads should be placed 46. The EMT-Basic should request prehospital
a. to the right of the sternum and below the ACLS for the care of the cardiac arrest patient
right clavicle and on the left lower ribs in the because
anterior axillary line. a. ACLS intervention may improve survival.
b. on the lower left anterior chest and on the b. EMT-Basics must have prehospital ACLS
upper left posterior thorax. present to perform defibrillation.
c. nowhere, as children under eight do not c. only paramedics can transport cardiac arrest
defibrillate. patients.
d. on the lower right anterior chest and on the
lower left posterior thorax. d. the EMT-Basic is not adequately trained to
manage cardiac arrest.
43. The right ventricle pumps blood into the
a. body via the aorta. 47. Your patient is a 29-year-old male who has
b. lungs via the pulmonary vein. fallen off a ladder. He is bleeding profusely
c. lungs via the pulmonary artery. from a wound on his right forearm and has an
d. left atrium. obvious deformity of his left thigh. Which of
the following is an appropriate initial
44. A 56-year-old female patient complains of mild treatment for this patient?
chest discomfort. You should a. Perform a quick initial assessment to assess
a. decide what type of heart problem it might his ABCs.
be. b. Stop the bleeding by applying direct pressure
b. decide whether the patient has a heart to the wound with a dry sterile dressing.
problem. c. Maintain an open airway and ventilate the
c. maintain a high index of suspicion for patient with a bag-valve mask.
cardiac compromise.
d. apply the AED. d. Elevate the patient’s legs 20–30 cm to treat
him for shock.

12

–THE EMT PRACTICE EXAM 1–

48. Touching the patient when the semiautomatic 52. A bystander is performing CPR when you
external defibrillator (SAED) is analyzing the arrive. You evaluate the scene, practice body
rhythm substance isolation, and begin your initial
a. is acceptable with today’s modern assessment by having the bystander
defibrillators. a. verify pulselessness.
b. is indicated to maintain cardiac b. continue CPR.
compressions. c. stop CPR.
c. is indicated to maintain artificial ventilation. d. provide a history of cardiac arrest.
d. can cause the SAED to misinterpret a
rhythm. 53. Your patient is bleeding from a wound to the
forearm. The blood flows in a steady, dark-red
49. What should you do for the cardiac arrest stream. What type of bleeding should you
patient found in the rain? suspect?
a. Perform one rapid defibrillation, then move a. venous
the patient inside. b. arterial
b. Defibrillate three times, then move the c. capillary
patient inside. d. internal
c. Move the patient inside, away from the rain.
d. Perform one rapid defibrillation, then start 54. Your patient is restless, anxious, and
CPR if pulseless. complaining of thirst. She exhibits increased
heart rate and pale, clammy skin. You should
50. Your patient is bleeding profusely from a do all the following EXCEPT
wound on her right forearm. You have applied a. maintain an open airway and provide
direct pressure, which has failed to stop the oxygen.
bleeding. What is your next step? b. elevate her legs if not contraindicated.
a. Apply pressure to the brachial pressure c. cover the patient with a blanket to keep
point. her warm.
b. Apply a tourniquet proximal to the wound. d. give the patient small amounts of liquid
c. Add a bulky sterile dressing and apply a to drink.
tourniquet over it.
d. Apply a tourniquet distal to the wound. 55. If a person was hit by an object described in the
following, which would have the potential to
51. Kinetic energy is described as the cause the most damage?
a. energy an object has while in motion. a. one-pound object traveling at 10 mph
b. measure of matter. b. two-pound object traveling at 20 mph
c. capacity to do work. c. one-pound object traveling at 30 mph
d. tendency for an object to stay in motion. d. one-pound object traveling at 20 mph

13

–THE EMT PRACTICE EXAM 1–

56. You have responded to a call for a 63-year-old 60. You are transporting a patient who has been
female complaining of chest pain and shortness resuscitated but is still unresponsive. You
of breath. You arrive to find her sitting up. Your should check the patient’s pulse every
patient exam reveals clear and equal breath a. thirty seconds.
sounds, jugular vein distention, and bilateral b. minute.
pedal edema. The patient states she takes Lasix. c. five minutes.
What is the most likely cause of these d. ten minutes.
symptoms?
a. Left-sided heart failure 61. The medical direction physician orders you to
b. Secondary drowning deliver additional shocks to a patient in cardiac
c. Right-sided heart failure arrest while en route to the hospital. What is
d. Atherosclerosis the correct procedure to follow?
a. Wait for the arrival of the ACLS team.
57. Which heart rhythm often converts to b. Deliver the shocks without stopping CPR.
ventricular fibrillation? c. Stop the vehicle before reanalyzing the
a. asystole rhythm.
b. ventricular tachycardia d. Refuse to defibrillate the patient while en
c. atrial fibrillation route.
d. atrial tachycardia
62. What is the primary action of nitroglycerin?
58. What is the reason for stopping CPR while the a. lower the blood pressure
AED is analyzing? b. contract the heart muscles
a. To give the patient a chance to breathe on c. slow the heart rate down
his or her own d. dilate the coronary vessels
b. To allow the ACLS system to take over
patient care 63. Patients commonly describe heart attack pain
c. To minimize interference and allow the AED as which of the following characteristics?
to analyze the cardiac rhythm a. like pins and needles
d. To allow other rescuers to get out of the way b. crushing or squeezing
c. intermittent (comes and goes)
59. You have analyzed the cardiac rhythm with an d. less severe than indigestion
AED and it is indicating “no shock advised.”
What should your next action be?
a. Contact medical control for direction
b. Check the AED battery/power supply
c. Resume CPR
d. Discontinue CPR as the patient has a pulse

14

–THE EMT PRACTICE EXAM 1–

64. In pedestrian versus automobile impacts, 67. Your patient is found lying on the ground after
which of the following statements is true? falling off a roof. He is unconscious and apneic.
a. Children often turn toward the impact and Which method should you use to open the
are often thrown down and under the patient’s airway?
vehicle. a. head-tilt/chin-lift
b. Adults tend to turn toward the vehicle before b. modified jaw thrust
impact. c. head-tilt only
c. Children often turn toward the impact and d. head-tilt/neck-lift
are often scooped and thrown over the
vehicle. 68. Following an explosion, a patient is trapped in a
d. There tends to be no difference in the way collapsed structure and suffers crush injuries to
adults and children respond in these both lower extremities. How would the injuries
situations. be classified based on the blast-injury phase?
a. primary blast injury
65. Your patient has profuse bleeding from a b. secondary blast injury
wound on her lower leg but no signs of skeletal c. tertiary blast injury
injury. The steps you should take to stop the d. Quaternary blast injury.
bleeding, in the correct order, are which of the
following? 69. When splinting an injured limb, you should
a. Direct pressure, elevation, pressure dressing, assess pulse, motor function, and sensation
and tourniquett distal to the injury
b. Pressure point, tourniquet, and concentrated a. after applying the splint.
or diffuse direct pressure b. before applying the splint.
c. Pneumatic anti-shock garments (PASG), c. while applying the splint.
lower extremity elevation, and diffuse direct d. before and after applying the splint.
pressure
d. Direct pressure, elevation, pressure point, 70. When performing the modified jaw-thrust
tourniquet, and pressure dressing maneuver to open your patient’s airway, which
of the following steps is NOT correct?
66. Where should you place your hands when a. Stabilize the patient’s cervical spine with
using the head-tilt/chin-lift maneuver to open your forearms.
an unconscious patient’s airway? b. Rest your elbows on the same surface as the
a. on the nose, with the fingertips pinching it patient.
closed, and under the neck c. Tilt the head by applying gentle pressure to
b. on the nose, with the fingertips pinching it the forehead.
closed, and on the forehead d. Use your index fingers to push the angles of
c. on the forehead, with the other hand under the lower jaw forward.
the neck
d. on the forehead, with the fingertips of the
other hand under the lower jaw

15

–THE EMT PRACTICE EXAM 1–

71. The golden hour in emergency medicine refers 75. Which of the following is true regarding using
to the first 60 minutes after the a pocket mask to ventilate a nonbreathing
a. arrival of EMS. patient?
b. occurrence of multisystem trauma. a. There is direct contact between the rescuer
c. arrival at the emergency room. and the patient’s mouth.
d. start of surgery. b. Oxygen cannot be connected to the mask.
c. A one-way valve prevents exhaled air from
72. Your unconscious patient has blood in his contacting the rescuer.
airway. You should d. Oxygen levels of 100% may be achieved.
a. use a suction unit to immediately clear the
airway. 76. To which patient should you administer oral
b. apply oxygen using a nonrebreather mask at glucose?
15 L/min. a. 60-year-old female behaving as if she is
c. use a bag-valve mask to clear the airway. intoxicated, and whose daughter informs
d. perform a finger sweep to remove the you that she takes insulin by injection
blockage. b. 45-year-old male with a history of diabetes
behaving erratically after falling and hitting
73. What are the three factors the EMT should his head in the bathtub
consider when evaluating the MOI of a patient c. 70-year-old male with a long history of
who has fallen? diabetes who is unconscious and cannot
a. Height of the fall, surface the patient landed swallow
on, and body part making first contact d. 52-year-old female who tells you that she is
b. Height of the fall, surface the patient landed feeling dizzy and has low blood sugar
on, and the weight of the patient
c. Weight of the patient, surface the patient 77. The focused history for patients with altered
landed on, and loss of consciousness mental status should include questions about a
d. Height of the fall, body part making first history of trauma, diabetes, seizures, and which
contact, and papillary response of the following?
a. heart disease
74. You should not suction a patient’s airway for b. pregnancy
more than 15 seconds because c. fever
a. the patient’s tongue may be injured. d. stress
b. the suction unit’s battery may drain too
quickly. 78. All of the following may be signs of allergic
c. the patient will become hypoxic during this reaction EXCEPT
time. a. headache and dizziness.
d. you may cause the patient to vomit. b. rapid, labored breathing.
c. decreased blood pressure.
d. decreased heart rate.

16

–THE EMT PRACTICE EXAM 1–

79. Under medical direction, the EMT may 83. Two important principles in the emergency
administer epinephrine to a patient with treatment of local cold injuries are to remove
respiratory distress or hypoperfusion resulting the patient from the cold environment and to
from an allergic reaction if the a. rewarm the cold extremity quickly.
a. patient has no history of heart disease. b. warm the whole body as soon as possible.
b. patient is tachypneic with clear breath c. prevent further tissue damage.
sounds. d. prevent or treat pain.
c. medication has been prescribed for this
patient. 84. Which of the following indicates that a patient
d. medication has been stored in the with hyperthermia is in serious danger?
refrigerator. a. hot skin
b. moist skin
80. What is the pediatric dosage of epinephrine for c. muscle cramps
anaphylaxis? d. dizziness
a. 0.1 mg per kg
b. 0.15 mg 85. Your patient has been stung by a bee, and the
c. 1 ml per kg stinger is present in the wound. You should
d. 0.5 mg attempt to remove it by
a. grabbing it with sterile tweezers.
81. Your patient is a 25-year-old female who is b. cutting around it with a knife.
severely hypothermic after having plunged into c. scraping it away with a rigid object.
an icy river. Although she was rescued after d. grabbing it with your fingers.
only a few minutes in the water, she is showing
a diminished level of responsiveness. Your care 86. Patients exposed to a nerve agent or
should include organophosphate poisoning may show signs
a. encouraging the patient to walk in order to and syptoms that are described by the
improve her circulation. mnemonic SLUDGE. What does this
b. covering the patient in blankets and turning mnemonic stand for?.
up the heat in the ambulance. a. Swelling, Lacrimation, Urination,
c. giving her hot coffee or tea to drink and Decerebrate posturing, Gastric distress,
massaging her extremities. Emesis
d. beginning active rewarming measures under b. Salivation, Laceration, Urticaria, Defecation,
direct medical direction. Gastric distress, Elevated temperature
c. Salivation, Lacrimation, Urticaria, Dyspnea,
82. A sign of generalized cold emergency, or Gastric distress, Emesis
hypothermia, is cool skin on the d. Salivation, Lacrimation, Urination,
a. feet or hands. Defecation, Gastric distress, Emesis
b. ears.
c. face.
d. abdomen.

17

–THE EMT PRACTICE EXAM 1–

87. Which of the following are the signs of early 90. The head of a newborn infant has just
respiratory distress in children and infants? delivered. You should
a. breathing rate of less than ten per minute, a. suction the baby’s mouth and nostrils with a
limp muscle tone, slow or absent heart rate, bulb syringe.
weak or absent distal pulses b. push down on the baby’s upper shoulder to
b. increased rate of breathing, nasal flaring, facilitate the rest of the delivery.
intercostal or supraclavicular retractions, c. push up on the baby’s lower shoulder to
mottled skin color, abdominal muscle use facilitate the rest of the delivery.
c. altered mental status, respiratory rate of over d. ventilate the baby with a pediatric bag-valve
60 or under 20 breaths per minute, severe mask and high-flow oxygen.
retractions, severe use of accessory muscles
d. inability to cough, crying with tears but no 91. Emergency care for a responsive 7-year-old
sounds, cyanosis, abdominal or chest-wall child with a foreign-body airway obstruction
movements with absent breath sounds includes
a. holding the child on your knee and
88. Your patient is an 8-year-old female who had a performing back blows.
single, brief seizure at school. Her mother b. standing behind the child and performing
arrives at the same time you do and reports that sub-diaphragmatic thrusts.
her daughter has seizures often and is under c. placing the child supine on the floor and
medical treatment. What should you do? attempting to see the obstruction.
a. Request advanced life support (ALS) and law d. placing the child supine on the floor and
enforcement backup so you can transport performing abdominal thrusts.
the child.
b. Administer a dose of the child’s prescribed 92. A 2-year-old male is in respiratory failure when
seizure-control medication. he has
c. Maintain ABCs, monitor vital signs, and a. altered mental status and breathing rate of
transport the patient immediately. 68 per minute.
d. Ensure a patent airway and request medical b. limp muscle tone and weak or absent distal
direction regarding transport. pulses.
c. nasal flaring and mottled skin color.
89. All of the following are signs of possible child d. breathing rate of 0 per minute and heart rate
abuse EXCEPT of 50 per minute.
a. the presence of multiple bruises in various
stages of healing. 93. A sign or symptom of a predelivery emergency is
b. a single, severe traumatic event that occurred a. the mother’s skin is dry.
for no reason. b. profuse vaginal bleeding.
c. injuries inconsistent with the mechanism c. the presence of a bloody show.
described. d. a contraction every 20 minutes.
d. conflicting histories of the injury from the
guardians/parents.

18

–THE EMT PRACTICE EXAM 1–

94. Select the correct-size oral airway for a small 98. The presence of a bloody show during the first
child by measuring from the corner of the stage of labor is a sign that
patient’s mouth to what structure? a. the delivery of the infant is imminent.
a. central incisor b. the newborn is in danger of respiratory
b. angle of the jaw distress.
c. tip of the nose c. labor is progressing normally.
d. pinnea of the ear d. the second stage of labor has begun.

95. Vitreous humor is found 99. Your patient has experienced a spontaneous
a. behind the lens of the eye. abortion or miscarriage. You should
b. in the bone marrow of the upper arm. a. remove any tissues from the vagina.
c. in front of the lens of the eye. b. discard any expelled tissues.
d. in the joint lubrication of the upper arm. c. place a sanitary napkin in the vagina.
d. treat the patient for shock.
96. You are assisting with childbirth in the field. As
the infant’s head is delivered, you discover that 100. What is the first treatment when a mother bleeds
the umbilical cord is wrapped tightly around excessively from her vagina after delivery?
the neck. You should immediately a. Massage her abdomen gently.
a. place the mother on her side and transport b. Administer oxygen.
rapidly. c. Transport her immediately.
b. deliver the infant with the cord wrapped d. Treat her for shock.
around its neck.
c. clamp the cord in two places and cut it 101. Emergency care for an infant when meconium
between clamps. is present in the amniotic fluid includes
d. suction the infant’s mouth and nose to clear a. stimulating the infant to cough to expel
secretions. the meconium.
b. performing bag-valve-mask ventilation to
97. You have just assisted in delivering an infant improve lung compliance.
with a pink body, a pulse rate of 106 per c. performing back blows and chest thrusts to
minute, and good muscle tone. The infant is remove the meconium.
crying lustily. How should you care for this d. suctioning and notifying the hospital that
newborn? meconium was present.
a. Wrap the newborn in clean towels and give
her to the mother to hold during transport.
b. Provide positive pressure ventilations at the
rate of 60 per minute with a bag-valve mask.
c. Monitor the infant for one minute and
reassess vital signs to see if the heart rate
increases.
d. Administer free-flow oxygen by holding
an oxygen mask or tubing over the
newborn’s face.

19

–THE EMT PRACTICE EXAM 1–

102. In addition to caring for injuries, emergency care 105. When arriving at the scene of a possible
for a rape victim should focus on which of the hazardous materials incident, you would
following? identify hazards by
a. performing a pelvic or rectal exam on the a. thoroughly investigating the scene yourself.
patient b. interviewing victims and bystanders.
b. collecting evidence of the rape and bagging c. scanning with binoculars from a safe distance.
it in plastic d. assisting law enforcement officers in the
c. allowing the patient to shower and change search.
clothes
d. preserving evidence in a paper bag and 106. Which of the following situations represents
reassuring the victim your abandonment of a patient?
a. You begin assessing a patient, but turn
103. The reason to position a pregnant woman on responsibility for that patient over to a first
her left side is to responder.
a. reduce the pressure of the fetus on maternal b. You begin CPR on a cardiac arrest patient,
circulation. but stop when the ALS team takes over care.
b. make labor proceed more slowly by slowing c. With the approval of medical direction, you
down contractions. do not transport a patient who feels fine
c. help turn a breech fetus in the birth canal to after having a seizure.
the vertex position. d. You refuse to help a patient administer
d. ensure that there is sufficient blood flow to nitroglycerin that has been prescribed for
the placenta. someone else.

104. The patient is a 29-year-old female pregnant 107. You are called to a store where a holdup has
with her second child. She is 39-weeks pregnant been committed. Police are already on the scene
and saw a bloody show approximately four searching for the gunman. Through the store
hours ago. Her contractions are two minutes window, you see the store manager, who has
apart and lasting 60 seconds. Transport time is been shot. You should
approximately 45 minutes. You should a. enter the store immediately to care for
a. protect the airway and monitor vital signs the manager.
while transporting. b. leave immediately and seek cover a
b. prepare for an imminent on-scene delivery. distance away.
c. position the mother on her left side and c. wait until the police tell you it is safe to enter
begin transport. the scene.
d. notify dispatch of the need for ALS d. request medical direction to determine if
assistance. you can enter.

20

–THE EMT PRACTICE EXAM 1–

108. What is the first thing you should do after 112. Bacterial meningitis has an incubation period of
receiving orders from the medical direction a. weeks to months, depending on the type.
physician? b. 11–21 days.
a. Carry out the orders immediately. c. 2–10 days.
b. Repeat the orders exactly as you heard them. d. 2–6 weeks.
c. Question anything you did not understand.
d. Document the orders in your report. 113. You can assess a pregnant woman’s uterine
contractions by placing your gloved hand on
109. Your pregnant patient is experiencing a. her abdomen, below the naval.
contractions. She feels like she needs to move b. her abdomen, above the naval.
her bowels. This may indicate that c. the right side of her abdomen.
a. birth is still some time away. d. the left side of her abdomen.
b. birth is imminent.
c. she is going into shock. 114. You are assessing a 24-year-old male patient
d. the baby is still very high in the birth canal. who is unresponsive with the following vital
signs: Pulse – 60; BP – 118/76; R – 8 and
110. Which statement about a patient’s right to shallow; Skin is warm and dry; Pupils are
refuse care is correct? pinpoint and nonreactive. There are needles
a. A child who is old enough to understand near the patient and what appear to be fresh
danger is old enough to refuse care and punctures in the patient’s arm. What is your
transport. primary focus for this patient?
b. An adult patient who is of sound mind and a. Administer 2 mg Narcan IV
understands the consequences can refuse b. Maintain a patent airway and assist
treatment. ventilations with a bag-valve mask.
c. No one can authorize treatment or transport c. Place the patient on oxygen at 4 lpm via
for any other individual, regardless of his or nasal cannula
her age. d. Remove the patient immediately to fresh air
d. EMTs should leave immediately whenever a
patient says that he or she will refuse care. 115. A 23-year-old pregnant female is bleeding
profusely from her vagina. All of the following
111. Which situation requires that an emergency actions are appropriate EXCEPT
patient be moved? a. providing high-concentration oxygen.
a. Your patient has undergone cardiac arrest b. placing a sanitary napkin in the vagina.
while seated in a chair. c. replacing pads as they become soaked.
b. Your patient is found on the ground, d. rapid transport to the hospital.
unresponsive, and alone.
c. Your patient is found in his bed,
displaying early symptoms of shock.
d. Your patient is showing signs of inadequate
breathing and shock.

21

–THE EMT PRACTICE EXAM 1–

116. In a multiple-casualty situation, which patient 119. Your patient, a 69-year-old male, is in cardiac
should be assigned the highest priority? arrest. His wife informs you that their physician
a. adequate breathing, responsive, venous has written a do not resuscitate order for the
bleeding patient, but she does not have the written order.
b. adequate breathing, responsive, suspected You should
spine injury a. provide all necessary care to save the
c. inadequate breathing, responsive, suspected patient’s life.
broken tibia b. obey the do not resuscitate order and leave
d. inadequate breathing, unresponsive, immediately.
suspected internal bleeding c. leave right after documenting the wife’s
statement.
117. Your patient is an 84-year-old female having d. call the patient’s doctor and try to confirm
difficulty breathing. Her daughter, age 45, is the order.
with her. When communicating with this
patient, you should assume that she is 120. Your patient is a 6-year-old female who fell off
a. incompetent; speak directly with the daughter. her bicycle. She has a suspected broken ankle,
b. hard of hearing; speak extremely slowly no respiratory compromise, and no suspected
and loudly. internal injuries. After providing necessary care
c. competent and able to understand; speak at the scene, you are transporting the child and
respectfully. her father to the hospital. The father loudly
d. confused; explain your treatment clearly to insists that you use your siren and lights en
the daughter. route. You should
a. request medical direction in dealing with
118. Which statement about patient confidentiality the father.
is correct? b. request permission from dispatch to use
a. Patients who are cared for in a public place lights and siren.
lose their right to confidentiality. c. refuse, because it may cause an unnecessary
b. The right to confidentiality does not apply to hazard.
minors or to wards of the state. d. comply, it will relax the father and comfort
c. The patient who signs a statement releasing the patient.
confidential information relinquishes all
rights to privacy.
d. A patient must sign a written release before
any confidential information can be
disclosed.

22

–THE EMT PRACTICE EXAM 1–

Answers 5. c. Fluids containing blood have the highest
potential for disease transmission.
1. b. HEPA respirators are worn when in contact
with patients who have airborne infections 6. c. An infant who is alert to verbal stimuli will
such as TB. HIV/AIDS and hepatitis B are still try to locate the parents’ voices; choice a
both blood-borne pathogens. Contaminants describes an alert infant; choice d describes
from open wounds would also be blood an infant who is responsive to painful stim-
borne. uli; choice b is incorrect because infants of
this age are not developed enough to tell you
2. c. Your first action should be to remove your their age regardless of their mental status.
crew and the patient from the possible nox-
ious gas and to notify the gas company of the 7. b. Assess circulation in an infant by palpating
leak. You may also be required to alert the the brachial pulse in the upper arm. The
hazardous-materials response team. You carotid and radial pulses are difficult to locate
should not attempt to locate the gas leak in infants. Capillary refill time shows that the
yourself. Treatment for the patient will begin patient has impaired circulation, but it is not
with an ABC assessment and management of the first tool to use in assessing circulation
any problems you might encounter. because it is affected by external factors (like
the environment) as well as internal factors
3. b. Because ventricular fibrillation is the most like poor perfusion.
common cause of sudden cardiac arrest, it is
critical to apply an AED on an unconscious 8. c. There is no information to indicate that the
apneic and pulseless patient as quickly as patient requires ventilatory support. Any
possible. The other rhythms can also cause a patient experiencing chest discomfort should
patient to be in cardiac arrest, but they do receive the highest possible concentration of
not occur as frequently as “V-fib.” oxygen.

4. a. The patient with chest pain and systolic blood 9. a. The rapid trauma survey is used when you
pressure less than 100 is the highest priority are unsure of the presence of hidden injuries
patient of the four. A leg injury may be life or if the mechanism of injury (MOI) is
threatening if the femoral artery is injured, unclear or severe enough to suggest the need
but most often, a single extremity injury is for a rapid assessment. A 2-year-old child
not a threat to life. The elderly gentleman may could be severely injured by a medium-speed
be exhibiting his normal mental status, or he collision, even if he or she appears alert and
may be having problems due to an ongoing was properly restrained. The other choices
health problem. You need more information do not represent MOIs considered to be high
before you can make that determination, but risk for hidden injury.
he is not in any imminent danger right now.
Labor with contractions six minutes apart is 23
not considered imminent delivery. If you have
any questions, however, you should continue
assessing this patient as well by asking perti-
nent questions and checking for crowning.

–THE EMT PRACTICE EXAM 1–

10. c. A supine patient may or may not have jugu- information to gather, but it should never
lar veins that are prominent enough to pal- come before any treatment that may be
pate. However, even if the neck veins are needed to correct an ABC abnormality.
normally present when an individual is 16. b. Trauma and medical patients who are unre-
supine, they will not be engorged in blood sponsive, and all patients who have altered
and overly firm to the touch. This is what is mental status, should receive a detailed phys-
meant by the phrase distended neck veins. ical assessment. It is easy to overlook some-
Distended neck veins (in any position) are a thing when the patient is not conscious
sign of increased circulatory pressure. The enough to tell you what hurts or if the MOI
carotid pulse should always be palpable. A and nature of illness (NOI) are unclear.
decreased radial pulse may indicate hypovo- 17. c. The purpose of ongoing assessment is to
lemic shock or an injured extremity. check the adequacy of your initial interven-
tions. The detailed examination is designed
11. c. The other rhythms do not benefit from an to find missed injuries.
electrical shock. The purpose of early defi- 18. d. Do CPR. American Heart Association guide-
brillation is to stop a highly chaotic, disorga- lines advise that even if there is an organized
nized electrical rhythm such as ventricular rhythm, a pulse may not be palpable
fibrillation, with the hope that an organized immediately after a shock. CPR is crucial to
rhythm will begin and generate a pulse. maintain blood flow and ventilation during
this time.
12. b. Assess motor function by asking the patient 19. c. Only those patients who are unresponsive,
to wiggle his toes; moving the leg or having pulseless, and apneic should have the AED
the patient bend the knee can compromise applied.
spinal stability; option d describes assess- 20. d. A patient who has taken an erectile dysfunc-
ment of sensation, not motor function. tion drug within the past 24 hours is at
increased risk of a rapid decrease in blood
13. b. Patient b is the only one both responsive and pressure and is therefore a contraindication
who has no significant mechanism of injury. for the administration of nitroglycerin. The
other choices are either indications or are
14. c. The P component of the OPQRST acronym unrelated to the administration of nitroglyc-
refers to provocation or palliation, or what erin.
makes the pain feel worse or better. 21. a. You could make the argument that you need
additional help in the management of each
15. a. You should perform the initial assessment of these situations; however, the one with the
first, because the unresponsive patient cannot most critical need is when you must care for
direct you to the specific complaint. Vital more than one critical patient. Both patients
signs are completed during your second phase with gunshot wounds need immediate atten-
of patient assessment after you determine tion, so you should call for backup. In the
treatment priority and have a baseline ABC other three situations, you should not
assessment. You cannot determine the appro-
priate course of treatment of any airway
problem (including the need for positioning—
choice c) until you have first assessed the
airway. The SAMPLE history is important

24

–THE EMT PRACTICE EXAM 1–

require assistance unless some complicating move air. Normal breathing does not pro-
factor presents itself. Patient b may or may duce any audible sounds, but it will produce
not require ALS assistance, but most (over auscultatory sounds (heard with a stetho-
80%) deliveries are simple and uncompli- scope). Warm, dry skin and equal chest
cated and can be easily managed by basic life expansion are both signs of adequate
support (BLS) providers. Patient c is having breathing.
a febrile seizure, which is managed by stabi- 27. d. Bell’s palsy is the most common form of
lizing the ABCs and transporting. In patient facial paralysis. Muscular dystrophy is a
d, even if your partner is required to stabilize degenerative disease characterized by the
the cervical spine, you should be able to weakening of skeletal muscle fibers. ALS, also
manage the patient for the time being until known as Lou Gehrig’s disease, affects the
other assistance arrives to assist with packag- nerve cells that control voluntary movement.
ing and moving the patient. Dystonia describes repetitive motions or
22. c. The epiglottis is the leaf-shaped structure abnormal posturing.
that closes off the trachea during swallowing. 28. a. A gurgling sound means that the patient
The larynx is the voice box, the structure needs to be suctioned immediately; ventila-
that produces speech vibrations; the cricoid tion cannot be adequate when the airway is
cartilage forms the lower portion of the lar- blocked from mucous, blood, or other
ynx; the diaphragm is a large muscle that secretions.
contracts to initiate inhalation. 29. c. The best indication of the proper tidal vol-
23. d. The alveoli are the numerous minute air sacs ume with any assisted ventilations is visible
that make up the lungs; bronchioles are rise and fall of the chest. The alarm on an
small branches of the bronchi, which are the ATV indicates increased airway pressures
two main tubes branching from the trachea; and has nothing to do with the tidal volume
the epiglottis is the structure that closes off setting. Capnography is a good indicator of
the trachea during swallowing. ET tube placement and respiration, but does
24. a. Other symptoms of pulmonary edema may not truly indicate an adequate tidal volume.
include difficulty breathing, excessive sweat- 30. b. The seizure event is referred to as ictal, hence
ing, anxiety, and pale skin. postictal refers to the period after the seizure
25. c. During capillary–cellular exchange, oxygen wherein a patent is often confused for a
enters the body cells and carbon dioxide period of time.
enters the capillaries; choices a and b 31. b. Choice b is the correct procedure. Choice a
describe alveolar-capillary exchange; choice is correct for a rigid catheter, choice c is the
d has carbon monoxide, not carbon dioxide. correct method for inserting an oropharyn-
26. d. Accessory muscles may be seen in use in the geal airway, and choice d is applicable only
neck and as retractions above the clavicles to endotracheal intubation.
and/or between the ribs. These muscles are 32. c. Choice c is the correct procedure for clearing
used when greater than normal inspiratory the airway when simple suctioning is not
and/or expiratory pressures are needed to working. Choice b is appropriate for a

25

–THE EMT PRACTICE EXAM 1–

patient with copious frothy secretions like If you are using mechanical or hand-pow-
the kind produced with pulmonary edema. ered suction equipment in infants of this
Choices a and d are inappropriate without age, be very careful to use the lowest possible
first clearing the airway. pressures needed to accomplish the job.
33. d. The purpose of the head-tilt/chin-lift is to 42. b. The standard pad placement for a child
move the tongue and epiglottis out of the between the ages of one and eight or weighing
way of the airway; it is not useful for intuba- less than 55 lbs is to place one on the lower
tion (use the sniffing position), to remove left anterior chest (apex of the heart) and one
foreign bodies, or to visualize the larynx. on the upper right or left posterior thorax.
34. b. After opening the airway, the EMT should Placement of both pads on the anterior tho-
assess the rate and depth of ventilations; rax is used on adults; children’s chests are gen-
choices a, c, and/or d would occur only after erally too small to accommodate both pads
respiratory adequacy has been assessed and on the front.
they are appropriate to use. 43. c. The right ventricle receives oxygen-poor
35. d. Cyanosis, or a bluish coloration of the blood from the right atrium. It then pumps
mucus membranes and skin, is caused by the blood to the lungs via the pulmonary
inadequate oxygen supply to the body tis- artery, where it receives oxygen and releases
sues; the other choices are unrelated to carbon dioxide.
oxygen supply. 44. c. The role of the EMT is not to diagnose the
36. c. After sealing the mask to the patient’s face, exact cause of the patient’s chief complaint.
you should begin mouth-to-mask ventila- Maintaining a high suspicion for a cardiac
tion with a long, slow breath; steps a, b, and emergency will guide your next step in man-
d should be done before applying the mask. aging this patient appropriately.
37. d. The correct rate is 12 ventilations per minute 45. d. Your first action would be to administer oxy-
for an adult (one breath every five seconds), gen and place the patient in a comfortable
and the correct rate for a child is 20 ventila- position; next, if not contraindicated, you
tions per minute. would request permission to administer
38. d. During a two-person bag-valve-mask proce- nitroglycerin. You should first obtain a set of
dure, one EMT ventilates the patient while vital signs to ensure he is not in cardiogenic
the other maintains the airway and monitors shock. Never put defibrillator pads onto a
the patient’s chest rise. conscious patient with a pulse; this proce-
39. a. The cricoid cartilage forms a ring of firm car- dure is contraindicated. AED pads are not
tilage and is located inferior to (below) the serving the same function as the electrodes
larynx. used by ALS providers to monitor the heart
40. a. A means alert. The other letters in the acro- rhythm.
nym stand for verbal, pain, and unrespon- 46. a. Prehospital ACLS provides additional medi-
sive. cations and other therapies that may help
41. b. A bulb syringe is used to suction an infant’s either terminate the cardiac arrest state or
nasal passage or mouth and is generally used help prevent the patient who has regained a
with infants up to age three to four months. pulse from going back into cardiac arrest.

26

–THE EMT PRACTICE EXAM 1–

47. b. ABC has changed to CAB in bleeding patients. may not present externally recognizable
Profuse bleeding is controlled first and then signs or symptoms.
airway is addressed second. You should treat 54. d. This patient has the classic signs and symp-
the patient for shock, but the deformity to his toms of shock. Do not offer anything to eat
leg contraindicates elevating his legs. Once or drink to a patient you suspect of being in
on a backboard the patient could be placed shock, since surgery may be necessary later.
in the Trendelenburg position. There is no 55. c. Speed is squared in the calculation of kinetic
indication that this patient needs ventilation energy. A one-pound object traveling at 30
assistance. mph is nine times more injurious than a
one-pound object traveling at 10 mph.
48. d. When the SAED is attempting to analyze the 56. c. The patient is most likely suffering from
patient’s electrical rhythm, any movement of right-sided heart failure. Her signs and
the patient or the unit could cause the symptoms indicated blood is backing up in
machine to misinterpret the signal. the peripheral circulation due to the weak-
ened right ventricle. Left-sided failure would
49. c. Safety is critical when performing defibrilla- present with wet lung sounds as the blood
tion. Any defibrillation attempt in the rain backed up into the pulmonary system.
may possibly harm anyone near the patient 57. b. Ventricular tachycardia often converts to
during the discharge of the unit. ventricular fibrillation, a life-threatening
heart rhythm that the AED is designed to
50. b. Tourniquet application has replaced pressure correct.
points as the next step in the control of pro- 58. c. Apply the AED in a manner that does not
fuse bleeding. A tourniquet should be placed interrupt cardiac compressions. Once the
proximal to the wound and in accordance AED is applied and ready to analyze the car-
with your local protocol. diac rhythm, stop CPR and allow the AED to
analyze the rhythm. Stopping CPR allows the
51. a. Kinetic energy is the energy an object has AED to evaluate the cardiac rhythm and min-
while in motion. Choice b describes mass, imizes interference from muscle movement.
choice c describes energy, and choice d 59. c. When an AED either indicates “no shock
describes inertia. advised” or has delivered a shock to a patient
the EMT’s next action should be to continue
52. c. Having the bystander stop CPR will allow CPR. Research has shown that even if a
you to reassess the patient’s ventilatory and patient has regained a pulse the next round of
circulatory status. This will tell you whether cardiac compressions is not harmful and may
you need to continue CPR or whether the be beneficial. When the AED indicates “no
patient has regained a pulse or is breathing. shock advised” it has detected a non-shock-
able rhythm, but the AED has no way of
53. a. Venous bleeding flows in a steady, dark-red assessing a patient’s pulse.
stream. Arterial bleeding is bright red and
spurts from the wound, while capillary
bleeding oozes. Internal bleeding may or

27

–THE EMT PRACTICE EXAM 1–

60. a. If the patient has been resuscitated but is still 66. d. Lifting the jaw is necessary to dislodge the
unresponsive, check the pulse every 30 sec- tongue from the back of the throat and pro-
onds during transport and keep the AED vide a patent airway.
leads attached to the patient.
67. b. The head-tilt/chin-lift may jeopardize the
61. c. If it becomes necessary to deliver shocks patient’s cervical spine. The other two proce-
while en route with the patient, the proper dures will not adequately open the airway.
procedure is to stop the vehicle before reana-
lyzing the rhythm because the AED has a 68. c. Injuries obtained from a collapse, such
motion detector sensor in place that will not as crush injuries, are considered quater-
allow the unit to operate in the presence of nary. Primary injures are obtained from
motion. the blast wave; secondary injuries are
obtained from blast debris; tertiary in-
62. d. The primary action of nitroglycerin is to juries are obtained by being thrown
dilate the myocardial (coronary) arteries, from the blast.
therefore easing the heart’s workload by
increasing the blood flow. Lowering of blood 69. d. Assess pulse, motor function, and sensation
pressure is a secondary effect seen with vessel distal to a splint both before and after apply-
dilation. Reflex tachycardia, not bradycardia, ing the splint to ensure that the splint is not
may occur as a result of nitroglycerine adversely affecting circulation to the limb.
administration. It does not have any direct
effects on the muscles of the heart. 70. c. Tilting the head may compromise the stabili-
zation of the cervical spine when using the
63. b. Myocardial pain is often difficult to deter- modified jaw thrust.
mine because it can take on many different
characters; however, patients most com- 71. b. The first 60 minutes after the occurrence of
monly (more than 40% of the time) describe multisystem trauma is the golden period.
the pain of a myocardial infarction as a
crushing, squeezing pressure that radiates 72. a. Blood is too fluid to be cleared adequately by
outward to the arms and upper back. a finger sweep. The other answers are not
appropriate unless the airway was cleared
64. a. Children often turn toward the impact and first by suction.
are often thrown down and under the
vehicle. 73. a. The factors the EMT should consider when
evaluating the MOI of a fall are the height of
65. a. The combination of direct pressure, eleva- the fall, surface landed on, and body part
tion, and pressure dressings is almost always making first contact. In adults, a fall of > 15’
successful in controlling hemorrhage in an or 3 times their height is significant, whereas
extremity. In the event these three methods a child falling > 10’ or falling < 10’ with loss
do not work a tourniquet is your next choice. of consciousness is significant. The surface
Pressure points are no longer recommended landed on dictates how much energy a
and PASG is never the first method for con- surface can absorb and the first body part
trolling hemorrhage. making contact helps you determine the path
of the energy and systems damaged.
28
74. c. While the other answers may be true, they
may occur regardless of the time interval.

75. c. The one-way valve minimizes potential
cross-exposure of the patient’s secretions
and exhaled breath to the rescuer.

–THE EMT PRACTICE EXAM 1–

76. a. Administer oral glucose on medical direction a pediatric autoinjection device (EpiPen Jr or
(through protocol or standing order) only to Twinject). The other dosages are all too high.
patients with altered mental status and his- 81. b. Care for a hypothermic patient with a dimin-
tory of diabetes. Patient b should be first ished level of responsiveness should include
treated as a trauma patient, and because passive rewarming (blankets and heated
research shows poor outcomes following room) only; active rewarming should take
brain injuries and glucose administration, it place only in the hospital environment, and
is best to withhold its use until blood sugar hypothermic patients should not be allowed
can be checked (which is an ALS-provider to exercise or to take stimulants, such as coffee
skill in many areas). Patient c is not appro- or tea. However, your protocols may allow
priate because of an inability to swallow you to give warmed liquids that are not alco-
properly; ALS should be called to provide IV holic or caffeinated to slightly hypothermic
dextrose to this patient. Glucose should be patients with a normal mental status.
withheld until you can better determine if 82. d. Cool skin on the abdomen is a reliable sign
patient d is actually diabetic or not. (A blood of hypothermia in a patient because the
glucose reading would be helpful with this abdomen is in the central core of the body
patient as well.) and is generally covered under layers of
clothing.
77. c. Common causes of altered mental status 83. c. The goal of care in cases of localized cold
include trauma, diabetes, seizures, and infec- damage is to prevent further damage by
tious disease. Asking about fever helps deter- removing the patient from the cold environ-
mine if there is a history of recent infection. ment and protecting the damaged tissues
from further injury. Rewarming is best
78. d. Signs of allergic reactions include increased accomplished in the hospital setting, where
heart rate, as the heart attempts to compen- pain medication can be administered and
sate for hypoperfusion. The two primary the danger of reinjury due to recooling is
life-threatening events that occur during an diminished.
allergic reaction are profound vasoconstric- 84. a. A hyperthermic patient with hot skin must
tion (resulting in shock) and compromised be treated aggressively before permanent
airway due to swelling, constriction, or organ damage sets in. When the skin is hot
mucous production. and dry, the normal sweating mechanisms
have stopped functioning and the patient is
79. c. EMTs can administer epinephrine for ana- in danger of brain damage due to excessive
phylactic reactions under medical direction. high body temperature.
In many areas the medication must be pre- 85. c. Grabbing a stinger with tweezers or your fin-
scribed for the patient; in some states epi- gers can squeeze more venom into the
nephrine is carried by the EMT and can be wound (also, there is personal risk of acci-
administered according to local protocol. dental exposure to the venom if you use your
Always adhere to your local protocols when hands). Instead, scrape the stinger out of the
providing medications to a patient.

80. b. The pediatric dose of epinephrine for ana-
phylaxis is 0.15 mg and is administered with

29

–THE EMT PRACTICE EXAM 1–

skin with a piece of cardboard or rigid plas- 93. b. Profuse vaginal bleeding may indicate a true
tic (a credit card is ideal). Cutting around obstetrical emergency such as uterine rup-
the stinger causes more tissue damage. ture or torn placenta.
86. d. SLUDGE stands for salivation, lacrimation
(tearing), urination, defecation, gastric dis- 94. b. Select the correct-size oral airway for an
tress, and emesis resulting from the inhibition infant or child by measuring from the corner
of acetylcholinesterase, which allows the neu- of the patient’s mouth to the angle of the jaw.
rotransmitter acetylcholine to accumulate.
Atropine, an anticholinergic, is the antidote 95. a. Vitreous humor is found behind the lens of
for these symptoms. SLUDGE can also be the eye. It is the clear gel that fills the space
seen in patients exposed to organophosphate between the lens and the retina. Aqueous
poisonings. humor is a thick, watery substance that fills
87. b. Choice b describes early respiratory distress. the space between the lens and the cornea.
Choice a describes the signs of impending
respiratory arrest from insufficiency, choice c 96. c. If the cord is wrapped around the infant’s
describes respiratory failure, and choice d neck and you cannot easily loosen and
describes airway obstruction. remove it, you should clamp it in two places
88. d. For patients who have routine seizures and and cut the cord.
whose condition returns to normal quickly
after a seizure, you should request medical 97. a. This newborn has a high Apgar score; there
direction about whether to transport. is no need for respiratory support unless the
89. b. Multiple injuries, conflicting stories of the condition changes. You should always follow
cause, and repeated calls to the same address the steps in the inverted pyramid for neona-
are characteristic of child abuse. tal resuscitation by drying and warming,
90. a. Suctioning the baby’s mouth and nose will positioning the head down for drainage, suc-
help to open the airway while the baby has tioning the airway and nose as needed, and
not yet begun breathing. You should not providing tactile stimulation to stimulate
force any part of the delivery process. breathing.
91. b. Care for a responsive child consists of stand-
ing behind the child and attempting to 98. c. The presence of a bloody show (which is the
relieve the obstruction with a series of sub- expulsion of the mucous plug from the
diaphragmatic thrusts. mouth of the cervix) occurs during the first
92. a. Signs of respiratory failure include altered stage of labor. It is normal and indicates that
mental status and a slow or fast breathing the cervix is beginning to open or dilate and
rate with fatigue. There is not enough infor- may occur several hours prior to delivery.
mation to determine if patients b and c are The second stage of labor continues until the
in respiratory insufficiency, respiratory fail- baby is born.
ure, or impending respiratory arrest.
Patient d is in respiratory arrest. 99. d. There can be large blood loss suffered by the
mother during a miscarriage. The EMT
should treat the patient for possible shock as
well as provide emotional care.

100. a. More than 500 mL of blood loss after deliv-
ery is excessive; massage the mother’s abdo-
men by rubbing firmly in one direction from

30

–THE EMT PRACTICE EXAM 1–

the symphasis pubis bone toward the umbi- the mother, you will get the secondary effect
licus. This will help the uterus contract and of increasing blood flow to the uterus, but
stop the bleeding. Oxygen administration, this is a secondary effect seen in correcting
shock treatment, and rapid transport will supine hypotension syndrome.
follow uterine massage. 104. b. The patient is likely to deliver imminently, so
101. d. If meconium is present in the amniotic fluid, prepare for a normal delivery.
suction the infant before stimulating it to 105. c. Never enter a scene where hazardous materi-
cry, then notify the hospital of the presence als are present until you have verified that
of meconium. An ALS crew may be able to the scene is safe. Use binoculars to survey the
perform tracheal suctioning and intubate the scene from a distance in order to identify
infant. If the lungs are stiff and noncompli- hazardous materials placards. Consider vic-
ant, it may indicate that aspiration of the tims and bystanders contaminated and take
meconium has occurred. Aspiration pneu- appropriate precautions.
monia due to meconium is often fatal. 106. a. Abandonment occurs when you relinquish
102. d. In addition to providing routine emergency care without a patient’s consent or without
care, care for a rape victim should focus on insuring that care is continued by someone
preserving evidence and providing comfort of the same or higher level, such as a para-
and reassurance. Although you want to pro- medic, ALS unit, or physician.
vide comfort to the patient, you should not 107. c. EMTs should not enter a crime scene until it
allow him or her to shower or change has been secured by police. As you travel to
clothes, as this will destroy evidence. Any the scene, you should determine where it is
clothing or personal effects that are removed most appropriate to park your vehicle. Gen-
from the patient should be placed in paper erally, you want cover (protection from
bags to prevent the growth of bacteria that attack) and concealment (out of direct visual
might occur if stored in plastic bags. You range) in your staging area.
should not need to examine the genital or 108. b. To avoid misunderstanding, always repeat
rectal area unless you note significant medical orders exactly as you heard them.
bleeding. Once you have done that, you can question
103. a. This condition, called supine hypotension any order you do not understand or about
syndrome, is the result of compression that which you are unclear. When you complete
the enlarged uterus causes on the vena cava your written patient-care report, you should
of the maternal circulatory system. This cor- include the order in your report.
rective position, called the left lateral recum- 109. b. The sensation of needing to move one’s bow-
bent position, is accomplished by placing the els during labor is the result of the head
mother on her left side with her legs bent pressing down on the anal sphincter as the
slightly or kept straight. Maternal positional baby passes through the birth canal. The
changes have no effect on the speed of labor head is very close to the opening of the birth
or the position of the infant in the birth canal, and delivery is imminent.
canal. By assisting in venous blood return in

31

–THE EMT PRACTICE EXAM 1–

110. b. An adult of sound mind can refuse treat- 115. b. Placing napkins in the birth canal will not
ment, but the EMT should first make an stop the source of bleeding. Placing bulky
effort to clearly explain the consequences; dressings or sanitary napkins at the vaginal
refusal of treatment should be documented opening will help prevent the blood from
in writing. spreading.

111. a. An emergency move is required in a situation 116. d. Patients with breathing difficulties and seri-
where a patient is in immediate life- ous bleeding receive the highest priority in a
threatening danger. Emergency moves require multiple-casualty situation.
only cervical spine stabilization (if it is a
trauma situation) and should be performed 117. c. Do not assume that an elderly patient is
quickly. Once the patient is in a safer location, incompetent, deaf, or confused. Address all
you should begin with your initial assessment patients respectfully.
as you do in all patient situations.
118. d. Patient information can be released only if
112. c. Bacterial meningitis has an incubation the patient has signed a specific consent
period of 2–10 days. Bacterial infections of form.
the meninges are extremely serious illnesses,
and may result in death or brain damage 119. a. If you are informed of a do not resuscitate
even if treated. order but do not actually see it, you must
still provide all necessary care.
113. b. The uterus is most easily felt just above the
navel. 120. c. You are responsible for helping make your
patient feel at ease, but you are also responsi-
114. b. This patient is most likely suffering from an ble for operating your ambulance in the saf-
opioid overdose and subsequent CNS depres- est possible way.
sion. He is in immediate need of a patent airway
and assisted ventilations at 10–12 breaths per
minute. Some states are allowing EMTs to
administer Narcan, but not by IV. Always refer
to your local protocol.

32

CHAPTER 3 EMT
PRACTICE EXAM 2

Chapter Summary

This is the second of ten practice exams in this book based on
the National Registry’s EMT cognitive exam. Having taken one
test before, you should feel more confident of your ability to
pick the correct answers. Use this test to continue your study
and practice. Notice how knowing what to expect makes you
feel better prepared!

Like the first exam in this book, this test is based on the National Registry exam. It should not, however,
look exactly like the first test you took, because you know more now about how the test is put together.
You have seen how different types of questions are presented and are perhaps beginning to notice pat-
terns in the order of questions. You see that questions on each area are grouped together. This pattern will help
you develop your own test-taking strategy.
If you’re following the advice of this book, you’ve done some studying between this exam and the first. This
second exam will give you a chance to see how much you’ve improved.
Read the answer explanations that follow the test carefully, especially the explanations for the questions
you missed.

33

Blank Page

–THE EMT PRACTICE EXAM 2–

EMT Practice Exam 2 4. A 45-year-old female is breathing at a rate of 22
times per minute with adequate tidal volume
1. Which patient’s vital signs are NOT within and an SpO2 of 90%. She is alert, but her skin
normal limits? signs are cool, pale, and diaphoretic. You should
a. newborn: pulse, 100; respirations, 30; BP, a. provide oxygen at 6 L/min using a nasal
70/30 cannula.
b. 3-year-old child: pulse, 90; respirations, 28; b. provide oxygen at 12 L/min using a
BP, 86/50 nonrebreather mask.
c. 10-year-old child: pulse, 88; respirations, 18; c. provide artificial ventilation with a bag-valve
BP, 100/60 and high-flow oxygen.
d. adult: pulse, 76; respirations, 17; BP, 116/86 d. place the patient into the left lateral
“recovery” position.
2. A 45-year-old male is breathing at a rate of
32 times per minute with shallow respirations. 5. You would locate a patient’s carotid pulse by
He is altered, and his skin signs are cool, first finding the Adam’s apple and then
cyanotic, and diaphoretic. You should a. pressing hard on only one side of the
a. provide oxygen at 6 L/min using a nasal patient’s neck.
cannula. b. placing one hand gently on each side of the
b. provide oxygen at 12 L/min using a neck.
nonrebreather mask. c. pressing with your thumb on one side of the
c. provide artificial ventilation with a bag-valve neck.
mask and high-flow oxygen. d. sliding two fingers toward one side of
d. place the patient into the left lateral the neck.
“recovery” position.
6. Your patient’s pupils react unequally to light.
3. Your patient is behaving abnormally but refuses You should suspect the presence of
treatment after falling down a flight of stairs. a. head injury.
Before transporting the patient without b. shock.
consent, which action should you definitely c. airway obstruction.
take? d. cardiac arrest.
a. document the presence of any injury.
b. ask bystanders to serve as witnesses. 7. A 70-year-old female is complaining of
c. have bystanders help talk him into care. shortness of breath. She has a history of
d. contact medical direction for advice. emphysema. You should
a. withhold oxygen, since these patients do not
respond to oxygen.
b. withhold oxygen, because you could
eliminate the hypoxic drive.
c. administer oxygen, because in most cases, the
hypoxic drive will not be a problem.
d. administer oxygen, because all patients
should get oxygen just to be safe.

35

–THE EMT PRACTICE EXAM 2–

8. Ecchymosis refers to 13. Continuous monitoring of a patient’s mental
a. an unreactive left pupil. status is best accomplished by
b. bruising or discoloration. a. repeatedly asking the patient’s name and
c. motion sickness. address.
d. a bad taste in the mouth. b. continuously monitoring the patient’s
vital signs.
9. In which situation should you determine the c. continuously interacting with the patient.
patient’s blood pressure through palpation? d. repeatedly assessing the peripheral
a. Your patient is under one year old. circulation.
b. The setting is unusually quiet, such as a
private home. 14. You should assess the brachial pulse in
c. Your patient’s pulse is very weak and difficult patients who
to hear. a. have a weak peripheral pulse.
d. Your patient cannot tolerate pressure to the b. are younger than one year old.
cartoid artery. c. have a history of cardiac problems.
d. have a pulse rate less than 60/min.
10. The correct way to select the proper size
oropharyngeal airway (OPA) is to measure the 15. Which patient is showing early signs of shock
distance from the (decreased tissue perfusion)?
a. corner of the mouth to the tip of the earlobe. a. 23-year-old female: pulse, 104; respiration,
b. nose to the tip of the earlobe. 25/min; BP, 118/78; cool, clammy skin
c. corner of the mouth to the nose. b. 45-year-old female: pulse, 68; respiration,
d. nose to the tip of the chin. 20/min; BP, 110/72; warm, moist skin
c. 5-year-old male: pulse, 110; respiration,
11. On which patient are you more likely to get to a 22/min; BP, 88/52; cool, dry skin
focused physical exam and SAMPLE history d. 60-year-old male: pulse, 76; respiration,
earlier? 10/min; BP, 96/60; hot, dry skin
a. 46-year-old male, unresponsive after falling
from a 10-meter scaffold 16. Which of the following is the most important
b. 80-year-old male, responsive to painful sign of a diabetic emergency?
stimuli after being hit by a car a. altered mental status
c. 5-year-old female, responsive and in pain b. warm, dry skin
after falling from a standing position c. decreased heart rate
d. 16-year-old female, responsive to verbal d. nausea and vomiting
stimuli after a gunshot wound
17. Of the following diseases, which poses the most
12. Ethics is best described as risk to EMTs?
a. the principles of conduct; concerns for what a. hepatitis C
is right or wrong, good or bad. b. staphylococcal infection
b. a code of conduct put forward by a societyor c. HIV
some other group such as a religion. d. AIDS
c. the principle of doing good for the patient.
d. the obligation to treat all patients fairly.

36

–THE EMT PRACTICE EXAM 2–

18. In legal terms, a tort is a(n)? 23. When assessing your patient’s airway, you hear
a. civil wrong committed by one individual snoring sounds. You should suspect that
against another. a. there is fluid in the airway.
b. criminal wrongdoing. b. the tongue is blocking the airway.
c. action by an employee for a workers’ c. the bronchioles are constricted.
compensation claim. d. the patient is forcefully exhaling.
d. breach of contract.
24. How many vertebrae are there in the human
19. The zygomatic bones are found in spinal column?
a. the face. a. 33
b. the wrist. b. 66
c. the nasal passages. c. 44
d. none of the above. d. 77

20. What is the most common cause of airway 25. You hear gurgling in your patient’s airway. You
obstruction in an unconscious patient? should immediately
a. vomitus a. administer high-flow oxygen.
b. mucous b. open and suction the airway.
c. the tongue c. insert a nasopharyngeal airway.
d. blood d. insert an oropharyngeal airway.

21. All of the following are reasons that infants and 26. According to the American Heart Association,
children are prone to respiratory difficulties at least ______________of air should be delivered
EXCEPT that they to the patient when using an adult bag-valve
a. breathe faster than adults. mask.
b. have smaller air passages. a. 500 mL
c. have underdeveloped intercostal muscles. b. 1,000 mL
d. are prone to respiratory infections. c. 80 L
d. 8 L
22. Your patient is a newborn. You should consider
the possibility of breathing difficulty if the 27. The advantages of using an Automatic
respiratory rate is Transport Ventilator (ATV) include
a. 20/min. a. the relief valve prevents barotrauma.
b. 40/min. b. once tidal volume is set all oxygen goes to
c. 50/min. the lungs.
d. 60/min. c. it can allow the EMT to perform other tasks.
d. oxygen powered ATVs never stop working.

37

–THE EMT PRACTICE EXAM 2–

28. In what position should you place a child’s 33. You should remove your patient’s dentures in
head for ventilation? order to provide ventilation when
a. in the neutral position a. head trauma has occurred.
b. slightly hyperextended b. it is necessary to insert an oral airway.
c. slightly flexed foward c. they become dislodged.
d. in the recovery position d. they make the patient uncomfortable.

29. You are out walking in the park and you find a 34. During the management of a cardiac arrest, the
6-year-old male unresponsive, pulseless, and AED gives a “no shock indicated” message.
apneic. Your first action is to Which of the following statements will most
a. locate the closest AED and apply it to the likely prompt this condition?
patient. a. The patient’s rhythm is asystole.
b. begin CPR. b. The patient has a pulse.
c. find the closest phone and call for help. c. The patient is in ventricular tachycardia.
d. attempt to locate the parent(s) to obtain d. The patient is in ventricular fibrillation.
consent to treat.
35. Which patient is breathing adequately?
30. After obtaining medical direction, you are a. 3-month-old male: respiratory rate, 62/min,
helping your patient use a prescribed inhaler. using diaphragm and muscles in chest and
You should tell the patient to neck
a. take three quick, shallow breaths. b. 7-year-old female: respiratory rate, 12/min,
b. inhale deeply and hold her breath. irregular rhythm, using diaphragm primarily
c. exhale as slowly as she can. c. 18-year-old male: respiratory rate, 28/min,
d. lie down to prevent dizziness. shallow chest motions
d. 43-year-old female: respiratory rate, 15/min,
31. Your patient, a 78-year-old male, has no pulse regular chest motions
and agonal respirations. You should
a. begin CPR immediately. 36. The signs and symptoms of myocardial
b. administer high-flow oxygen via bag- infarction include
valve mask. a. crushing substernal chest pain lasting longer
c. transport immediately to the closest medical than 20 minutes.
facility. b. polydipsia.
d. request the patient’s permission to c. chest pressure alleviated by rest.
administer nitroglycerin. d. hemiparesis.

32. You have assisted a patient in administering a
prescribed inhaler. After one dose of the
medication, the patient’s pulse rate increases,
and he reports feeling nauseated. You should
a. administer another dose of the medication.
b. assess respiratory rate, rhythm, and quality.
c. document and report the signs and
symptoms.
d. begin cardiopulmonary resuscitation.

38

–4THE EMT PRACTICE EXAM 2–

37. You have delivered a shock with the SAED. 41. Stable angina differs from a heart attack
Your cardiac arrest patient has shallow, agonal because in an attack of angina, the
respirations with a pulse. What should you do a. patient feels severe chest pain.
next? b. pain radiates outward from the heart.
a. Deliver second shock to assure patient does c. administration of nitroglycerin provides
not arrest again. no relief.
b. Provide artificial ventilation with high- d. heart muscle is not permanently
concentration oxygen. damaged.
c. Give high-concentration oxygen by
nonrebreather mask. 42. The following patients all have signs and
d. Check pulse and deliver two more shocks. symptoms of cardiac chest pain and have their
own prescriptions for nitroglycerin. Which
38. A danger of using a rigid suction catheter with patient should you NOT assist with taking
infants and young children is that stimulating nitroglycerin?
the back of the throat can a. 67-year-old male: pulse, 90; respirations,
a. cause changes in the heart rhythm. 26/min; BP, 98/72
b. be ineffective in suctioning. b. 72-year-old female: pulse, 88; respirations,
c. lead to immediate vomiting. 23/min; BP, 140/96
d. cause the tongue to fall into the airway. c. 78-year-old male: pulse, 98; respirations,
26/min; BP, 160/112
39. You have been called to a 48-year-old female d. 51-year-old female: pulse, 72; respirations,
patient complaining of a severe headache and a 14/min; BP, 130/80
stabbing pain in the center of her chest. The
patient has a history of hypertension, her vital 43. When deciding whether to assist a patient in
signs include a pulse of 100 and is strong, her administering nitroglycerin, you should check
blood pressure is 200/110, respirations are 20 the medicine for the patient’s name, the route
and regular, and her skin is warm and dry. You of administration, the dose, and the
decide to check the blood pressure in both a. doctor who prescribed it.
arms and find the second blood pressure is b. quantity still available.
160/96. What life threatening condition should c. pharmacy.
you suspect? d. expiration date.
a. Acute pulmonary edema
b. Spontaneous pneumothorax 44. Your patient, a 67-year-old male with a history
c. Myocardial infarction of cardiac disease, is unresponsive. After
d. Dissecting aortic aneurysm checking ABCs and finding no pulse, you begin
CPR. The next thing you should do is
40. The function of the white blood cells is to a. administer oxygen.
a. form clots. b. call for ALS backup.
b. fight infection. c. attach the AED.
c. carry oxygen. d. request medical direction.
d. carry nutrients.

39

–THE EMT PRACTICE EXAM 2–

45. Your patient is showing signs and symptoms of 50. Stridor is a sign of
shock and has a tender abdomen. She reports a. mucus in the lower airway.
vomiting material that “looked like coffee b. accessory muscle use.
grounds.” You should suspect c. upper-airway obstruction.
a. ruptured appendix. d. altered mental status.
b. internal bleeding.
c. fractured pelvis. 51. Your patient is complaining of chest pain.
d. inhaled poisoning. Which question would you ask to assess the O
part of the OPQRST algorithm?
46. Which patient is showing signs and symptoms a. What were you doing when the pain started?
of cardiac compromise? b. What does the pain feel like?
a. 85-year-old male: difficulty breathing, high c. How long ago did the pain begin?
fever, rapid pulse d. How bad is the pain now?
b. 72-year-old female: wheezing, labored
breathing, tightness in throat 52. All of the following are contraindictions for the
c. 53-year-old female: dull chest pain, sudden administration of nitroglycerin EXCEPT when
sweating, difficulty breathing the patient
d. 51-year-old male: headache, dizziness, a. has a systolic blood pressure of less than
gagging, chest pain 100 mm Hg.
b. has taken a previous dose of nitroglycerin
47. Which blood vessel carries oxygen-poor blood two minutes ago.
to the heart? c. has a heart rate less than 60 beats per
a. vena cava minute.
b. aorta d. is an infant or child.
c. pulmonary artery
d. pulmonary vein 53. A patient is in greater danger of severe internal
bleeding from fracturing which bone?
48. Central pulses may be palpated at the a. pelvis
a. carotid and radial arteries. b. rib
b. radial and brachial arteries. c. femur
c. carotid and femoral arteries. d. tibia
d. brachial and femoral arteries.
54. Why is an infant more likely to suffer an airway
49. The diastolic blood pressure represents the obstruction than an adult?
pressure in the brachial artery when the a. An infant’s ribs are less flexible than an
a. ventricles contract. adult’s.
b. ventricles are at rest. b. The shape of the infant’s head will cause the
c. cardiac artery is stressed. neck to flex when the child is supine.
d. aorta is distended. c. The adult has a relatively larger tongue
compared to an infant.
d. The adult has a relatively smaller airway
compared to the infant.

40

–THE EMT PRACTICE EXAM 2–

55. Which patient would be most likely to have a 59. Your patient is a 24-year-old female with a
barrel chest? history of asthma. She is wheezing and gasping
a. 10-month-old male: premature birth and for air and has a pulse rate of 88/min. You may
history of respiratory problems assist her in using an inhaler if
b. 6-year-old female: history of asthma and a. she has not yet taken more than three doses
frequent respiratory infections of medication.
c. 58-year-old male: history of emphysema and b. she has her own inhaler and you obtain
years of smoking medical direction.
d. 70-year-old female: recent history of c. her respiratory rate is greater than 24/min.
pneumonia and bronchitis d. her blood pressure is greater than 100/70.

56. You have completed two minutes of CPR on a 60. After assisting a patient to administer
4-year-old female patient who was found nitroglycerin, you should
unresponsive, pulseless, and apneic. The a. transport the patient immediately.
patient has a cardiac history and you are b. place the patient in Trendelenburg position.
preparing the AED. As you open the AED you c. give a second dose two minutes later.
find there are no pediatric pads or dose- d. reassess vital signs and chest pain.
attenuating system. You should
a. not apply the AED as it will deliver an adult 61. The AED detects
energy dose. a. the patient’s pulse rate and rhythm.
b. apply the AED with pads on the upper right b. electrical activity of the heart.
chest and lower left and defibrillate if c. the contraction force of the heart.
indicated. d. the degree of cardiac compromise.
c. do twice as many compressions between
defibrillations. 62. Your patient, the victim of a car accident, has
d. apply the AED with the pads in an anterior an obvious injury to her right leg. You should
posterior configuration and defibrillate if splint the injury before moving her unless
indicated. a. transport time is less than 15 minutes.
b. the patient is in severe pain.
57. The primary reason you auscultate both sides c. bones are protruding through the skin.
of the chest is to determine whether breath d. life-threatening injuries are present.
sounds are
a. strong and regular. 63. Your 18-month-old patient is experiencing
b. fast or slow. respiratory distress. Which of the following
c. noisy or quiet. conditions is NOT a likely cause of the
d. present and equal. difficulty in breathing?
a. a partial foreign-body obstruction
58. For which of these procedures should you wear b. the flu
gloves, a gown, a mask, and protective eyewear? c. epiglottitis
a. Performing endotracheal intubation d. chronic obstruction pulmonary disease
b. Performing oral/nasal suctioning (COPD)
c. Cleaning contaminated instruments
d. Bleeding control with spurting blood 41

–THE EMT PRACTICE EXAM 2–

64. A seesaw (chest and abdomen move in opposite 69. You are treating a 58-year-old male patient
directions) pattern of breathing is a sign of complaining of respiratory distress. The patient
a. breathing difficulty in infants. presents sitting up, his pulse is 112, BP is
b. normal respirations in elderly patients. 160/100, respirations are 22 and labored, you
c. adequate artificial respiration. hear crackles upon auscultating his breath
d. a disease such as COPD. sounds, and he has pedal edema bilaterally.
Your treatment for this patient should include
65. The best treatment for cardiac arrest in the a. high flow oxygen via non-rebreather mask
pediatric patient is and elevate the patient’s legs.
a. immediate defibrillation. b. Fowler’s position, high-flow oxygen via non-
b. prevention with aggressive airway and rebreather mask, assist the patient with his
ventilator management. meter dose inhaler.
c. early access to ALS medications. c. Fowler’s position, high-flow oxygen via non-
d. quality chest compressions focused on rebreather mask, consider contacting
adequate depth and recoil. medical direction for CPAP.
d. recovery position, 2–4 lpm oxygen via nasal
66. A sign of early respiratory distress in the cannula, consider assisting the patient with
pediatric patient is his nitroglycerin.
a. an increased blood pressure.
b. an increased heart rate. 70. Your patient is a 23-year-old female who calmly
c. flush, warm skin. tells you that her thoughts are controlling the
d. a decreased breathing rate. weather. Her body language and speech are
nonthreatening and gentle. You should
67. Your patient is a 33-year-old female with a a. request immediate police backup for
suspected spinal cord injury. After you have protection.
immobilized her to a long board, she vomits. b. talk quietly to this patient and keep her
What should you do? calm.
a. Reassess her vital signs. c. request permission to restrain the patient.
b. Ask her what she last ate. d. take a detailed medical history.
c. Remove the board and suction the airway.
d. Tilt the board to clear the airway. 71. A 17-year-old male patient is experiencing
difficulty breathing and abdominal pain after
68. Your patient is a 28-year-old male who appears being struck with a bat in his left lower
intoxicated. Bystanders report that the man quadrant. He is alert, cool, and diaphoretic,
seemed fine but suddenly began “acting with a tachycardic heart rate. You should
strange.” You should first suspect provide oxygen using a
a. alcohol abuse. a. nonrebreather mask at 15 L/min.
b. poisoning. b. nasal cannula at 6 L/min.
c. diabetic emergency. c. nasal cannula at 2 L/min.
d. allergic reaction. d. nonrebreather mask at 8 L/min.

42

–THE EMT PRACTICE EXAM 2–

72. The last vital sign to change in a patient going 76. Which of the following signs or symptoms
into shock is might you expect to see in a patient suffering
a. an increased pulse rate. from hypothermia?
b. a decreased blood pressure. a. confused behavior
c. an increased respiration rate. b. excessive mucous production
d. cool, clammy, pale skin. c. blood tinged sputum
d. burning or itching in the underarms
73. The central nervous system consists of the
brain and the 77. With medical direction, you may administer
a. spinal cord. epinephrine from a patient’s own autoinjector
b. spinal nerves. if the patient displays signs and symptoms of
c. cranial nerves. respiratory distress or
d. spinal vertebrae. a. cardiac arrest.
b. diabetic emergency.
74. Your male patient has climbed out of his car c. hypoperfusion.
unassisted after a car crash, but he is now d. poisoning.
complaining of back pain. You should
a. transport him in whatever position is the 78. Which set of vital signs suggests early
most comfortable. hypothermia?
b. immobilize him to a long spine board with a a. pulse, 56 and faint; respirations, 9/min,
standing take-down. shallow; BP, 96/60; cyanotic; sluggish pupils
c. immobilize him to a short spine board in the b. pulse, 74; respirations, 16/min, strong;
sitting position. BP, 124/80; cool, dry skin; reactive pupils
d. immobilize him with a Kendrick Extrication c. pulse, 92; respirations, 26/min; BP, 118/76,
Device. flushed (red) skin; reactive pupils
d. pulse, 68; respirations, 13/min, irregular;
75. Your patient is a 37-year-old female who has BP, 110/70; hot, moist skin; reactive pupils
been in a minor accident. The patient is alert
and oriented, and baseline vital signs are pulse, 79. A 2-year-old female is in severe respiratory
76 and regular; respirations, 16/min and distress. Her skin is mottled, and she does not
unlabored; and BP, 118/78. When you check respond to verbal or physical stimulus.You should
her vital signs 15 minutes later, you find that a. administer oxygen by the blow-by method.
her pulse rate is now 92 and her respirations b. assist her ventilations with a bag-valve mask
are 24/min and shallow. You should and supplemental oxygen.
a. continue to reassess her every 15 minutes. c. administer blind finger sweeps to attempt
b. call for medical direction to treat her removal of an obstruction.
dyspnea. d. provide oxygen by pediatric nonrebreather
c. administer oxygen by nonrebreather mask. mask.
d. treat for shock and reassess every five
minutes.

43

–8 THE EMT PRACTICE EXAM 2–

80. What is the goal of emergency care for a 85. Care for an unresponsive infant with a
hypothermic patient with a reduced level of complete airway obstruction includes
consciousness? a. giving sub-diaphragmatic thrusts and
a. to actively warm the patient ventilation.
b. to keep the patient active b. performing back blows and ventilation
c. to provide fluids and oxygen attempts.
d. to prevent further heat loss c. performing chest compressions and
ventilations.
81. The purpose of the National Incident d. giving back blows, chest thrusts, and
Management System is to provide a(n) ventilation.
a. clear chain of command in case of legal
liability. 86. Ventricular fibrillation is defined as
b. means of evaluating the EMS system’s a. a rapid organized heartrate that originates
response to an event. in the SA node.
c. orderly method for communications and b. a rapid heartrate that originates in the
decision making. ventricles usually greater than 150 bpm.
d. training program for first responders. c. a slow organized heartrate that originates in
the SA node.
82. What does the presence of abdominal breathing d. a rapid disorganized and ineffective
signify in infants and small children? pumping of the ventricles.
a. labored breathing
b. noisy breathing 87. A common side effect of high fever in infants
c. shallow breathing and small children is
d. normal breathing a. shock.
b. seizures.
83. While providing artificial ventilation to a c. hives.
14-year-old drowning patient, you feel d. cardiac arrest.
resistance during ventilations. The possible
cause of the resistance is that 88. Your patient is an 8-month-old infant with a
a. the trachea is too short. recent history of vomiting and diarrhea. Which
b. there is water in the stomach. signs should alert you to the possibility of
c. the patient has chronic obstructive shock?
pulmonary disease.
d. the epiglottis is swollen, causing an a. dry diaper and the absence of tears while
obstruction. crying

84. The correct rate for providing artificial b. capillary refill time of two seconds or less
ventilations to infants and children is c. strong peripheral pulses; heart rate of 100
a. 8 breaths per minute. d. skin that is flushed and hot to the touch
b. 12 breaths per minute.
c. 20 breaths per minute.
d. 24 breaths per minute.

44