Practice Free EMT Emergency Medical Technicians Exam Exam Questions Answers With Explanation

Comprehensive and Detailed Explanation From Exact Extract:

In any unresponsive patient, the first step is to assess and open the airway to determine patency and identify obstruction or inadequate breathing.

Gasping respirations (agonal) are not effective; they require BVM ventilation support. The airway must be open before checking for a pulse or performing auscultation. A secondary assessment is performed only after primary survey and stabilization.

Comprehensive and Detailed Explanation From Exact Extract:

For suspected or confirmed tuberculosis (TB), the EMT should place a surgical mask on the patient, not a HEPA respirator. Surgical masks are used to contain droplets from the patient and reduce airborne transmission.

The EMT should wear a N95 or HEPA respirator to protect against inhaling airborne particles. Notification to the CDC is not the EMT’s responsibility — that falls to public health officials.

Comprehensive and Detailed Explanation From Exact Extract:

Use the Glasgow Coma Scale (GCS) to calculate:

Eye Opening (E): Opens to speech = 3

Verbal Response (V): Confused but appropriate words = 4

Motor Response (M): Obeys commands = 6Total = 3 + 4 + 6 = 13

However, the question states he opens eyes to voice, knows name (orientation to person), and follows commands — this would mean:

Eye = 3

Verbal = 5 (Oriented to person, but disoriented to place/time)

Motor = 6

Correct Total: 14

Posttraumatic stress disorder (PTSD) is a stress-related psychiatric condition that may develop after exposure to a traumatic event. NREMT education addresses PTSD particularly in the context of crisis intervention, behavioral emergencies, and responder mental health awareness.

Option C (Flashback phenomena) is correct. Flashbacks are a hallmark feature of PTSD and involve intrusive, vivid recollections of the traumatic event that may feel as though it is happening again. These episodes can be triggered by sights, sounds, or smells associated with the trauma.

Option E (Difficulty concentrating) is also correct. Patients with PTSD frequently experience cognitive symptoms such as impaired concentration, memory problems, and difficulty completing tasks. These symptoms result from persistent hyperarousal and stress responses.

Option A is incorrect because PTSD is associated with nightmares, not an inability to dream.

Option B is incorrect because violent behavior is not a defining or consistent feature of PTSD, although irritability may be present.

Option D is incorrect because increased compassion is not a recognized symptom.

NREMT emphasizes recognizing PTSD symptoms to ensure appropriate patient interaction, safety, and referral for further care.

Comprehensive and Detailed Explanation From Exact Extract:

In infants, improper insertion of an OPA (oropharyngeal airway) can stimulate the vagus nerve, leading to bradycardia or even complete airway obstruction. If cyanosis and bradycardia develop after OPA insertion, immediate removal and resumption of ventilations with a bag-valve mask is critical.

The OPA must be properly sized and inserted only in patients without a gag reflex. Ventilations alone often reverse vagally induced bradycardia.

Comprehensive and Detailed Explanation (Based on NREMT standards):

Electrical injuries commonly disrupt the heart’s electrical conduction system. NREMT teaching emphasizes that cardiac dysrhythmias are the leading cause of unresponsiveness following electrical exposure, even when external burns appear minor.

Option A is correct because electrical current can induce lethal dysrhythmias such as ventricular fibrillation or asystole, resulting in sudden loss of consciousness.

Option B is incorrect because internal bleeding is not a primary consequence of electrical injury.

Option C may occur but does not typically cause immediate unresponsiveness.

Option D is less likely than cardiac involvement and is not the most common cause.

NREMT stresses continuous cardiac monitoring and rapid transport for all electrical injury patients due to the high risk of sudden cardiac arrest.

Subcutaneous emphysema following blunt chest trauma strongly suggests air leaking from the lung into surrounding tissues, often associated with pneumothorax. NREMT trauma priorities stress that airway and breathing take precedence over all other interventions.

Option D is correct because the child is already in moderate respiratory distress, indicating inadequate ventilation. Assisting ventilations with a BVM ensures oxygen delivery and adequate tidal volume while preparing for rapid transport.

Option A is important but does not address the immediate life threat.

Option B may help with pain or flail segments but does not correct ventilation.

Option C is no longer routinely indicated and does not address breathing.

NREMT emphasizes correcting life-threatening airway and breathing problems before movement or transport.

NREMT guidelines emphasize that EMTs must be able to rapidly release any restraints applied to a patient in the event of airway compromise, vomiting, cardiac arrest, or sudden deterioration.

Option B is correct because exchanging handcuffs for EMS-controlled restraints ensures patient safety while maintaining custody. The EMT having the key allows immediate access if emergency care is required.

Option A is unsafe because the EMT does not have control over the restraints, potentially delaying lifesaving interventions.

Option C is incorrect because patient safety standards must always be met.

Option D is incorrect because transport is necessary for evaluation and care.

NREMT stresses that custody never supersedes patient safety, and EMS must maintain control of patient restraints during transport.

Comprehensive and Detailed Explanation From Exact Extract:

In Incident Command System (ICS) for Mass Casualty Incidents (MCI), the four major sections are:

Planning: Collects data and develops response strategies

Logistics: Supplies and personnel

Finance/Administration: Cost tracking, contracts, compensation

Staging is a tactical location, not a management section. Catering and aviation are not command-level ICS designations unless part of specific tasks under logistics or operations.

This scenario suggests a potential multiple-casualty incident with a possible environmental hazard, such as carbon monoxide or another toxic gas. NREMT places strong emphasis on scene size-up as the first and most critical step in EMS operations.

Option B is correct because determining the size and scope of the incident allows the EMT to assess scene safety, identify hazards, estimate the number of patients, and determine the need for additional resources. Entering the scene without this assessment could result in responder injury or death.

Option A is incorrect because establishing command typically follows an initial size-up. Command cannot be effectively established without understanding the nature of the incident.

Option C is incorrect because announcing the presence of poisonous gas without confirmation may cause panic and is not an appropriate first action.

Option D is incorrect because attempting rescue before confirming scene safety violates NREMT’s core principle that rescuer safety comes first.

NREMT standards clearly state that EMTs must never enter a potentially hazardous scene until it has been properly assessed and deemed safe or appropriate resources are requested.

Comprehensive and Detailed Explanation From Exact Extract:

The patient’s complaint of difficulty breathing is an airway/breathing issue and takes precedence over a controlled extremity bleed. The first action is to administer oxygen and evaluate respiratory effort.

Though reassessing the wound is important, oxygenation is the priority when airway compromise or respiratory distress is present. Tourniquets are for uncontrolled bleeding, which is not the case here.

Comprehensive and Detailed Explanation From Exact Extract:

An epidural hematoma classically presents with a “lucid interval” — a brief period of regained consciousness following head trauma, followed by rapid deterioration. This is due to arterial bleeding, often from the middle meningeal artery, leading to increasing intracranial pressure.

Signs include:

High blood pressure

Decreasing respiratory rate

Altered LOC or unresponsiveness

Subdural hemorrhages are slower venous bleeds, common in elderly patients. Subarachnoid hemorrhage often presents with "worst headache of life." Intracerebral bleeds are less commonly linked to lucid intervals.

In an unresponsive diabetic patient, EMTs must rapidly determine whether the cause is hypoglycemia (low blood glucose) or hyperglycemia (high blood glucose) because immediate management priorities differ. According to NREMT education, skin signs are the most reliable and quickly observable indicator when a blood glucose reading is not immediately available.

Hypoglycemia typically presents with cool, pale, and diaphoretic skin due to a sympathetic nervous system response. In contrast, hyperglycemia often presents with warm, dry skin, reflecting dehydration and lack of insulin-mediated glucose uptake.

Option D is correct because skin color and condition provide the most useful differentiation in the field.

Option A may help identify diabetic ketoacidosis (Kussmaul respirations) but is not the most consistent finding.

Option B is unreliable and nonspecific.

Option C may vary but does not clearly distinguish between the two conditions.

NREMT emphasizes treating unresponsive diabetics as hypoglycemic until proven otherwise, while using skin findings to guide clinical suspicion.

Comprehensive and Detailed Explanation (Based on NREMT standards):

This scenario strongly suggests a hazardous environment involving chemical crowd-control agents such as tear gas or pepper spray. During the scene survey, NREMT prioritizes scene safety, hazard recognition, and incident size-up before any patient contact.

Option D (Determine the control agent being used) is correct because identifying the chemical agent helps determine the level of risk, appropriate personal protective equipment, and whether EMS can safely operate in the area.

Option E (Identify the number of patients) is correct because determining the number of patients is essential for assessing the scope of the incident and requesting additional resources if needed.

Option A is incorrect because removing restraints is not part of the initial scene survey and must be coordinated with law enforcement.

Option B is incorrect because patient decontamination occurs only after scene safety is ensured.

Option C is not a priority until hazards are identified and the scene is safe.

NREMT teaches that EMTs must never compromise their own safety and must fully assess hazards before providing care.

Comprehensive and Detailed Explanation (Based on NREMT standards):

When a previously choking adult becomes unresponsive, NREMT guidelines require the EMT to immediately begin the cardiac arrest sequence.

Option A (Check for a pulse) is correct because determining pulselessness directs the next intervention.

Option B (Begin chest compressions) is correct because chest compressions are initiated if the patient is pulseless and unresponsive. Compressions may also help dislodge the foreign body.

Option C is incorrect because the airway is checked only after compressions begin and ventilations are attempted.

Option D is incorrect because ventilations are attempted after compressions, with airway checks between cycles.

Option E is inappropriate for an unresponsive adult.

NREMT emphasizes following BLS algorithms precisely for airway obstruction leading to unresponsiveness.

To rapidly determine a pediatric patient’s condition, NREMT emphasizes the Pediatric Assessment Triangle (PAT), which allows EMTs to form a quick clinical impression without hands-on assessment. The PAT consists of appearance, work of breathing, and circulation to skin.

Option F (Response to environment) evaluates appearance, including interaction, awareness, and mental status—critical in a confused child.

Option E (Accessory muscle use) assesses work of breathing, identifying respiratory compromise through visible effort such as retractions or nasal flaring.

Option A (Pallor) reflects circulation to skin, helping identify poor perfusion or shock.

Options B, C, and D are part of more detailed assessments but are not part of the rapid initial determination emphasized by NREMT.

Using the PAT allows EMTs to quickly identify life-threatening problems and prioritize care.

Comprehensive and Detailed Explanation From Exact Extract:

Missing dialysis leads to fluid overload, causing:

Pulmonary edema, evident by crackles on auscultation

Dyspnea and chest discomfort

Bradycardia is less likely; patients more often present with tachycardia due to volume stress. Fever would suggest infection (not stated here), and hypotension can occur later, but hypertension is more common in early fluid overload.

Comprehensive and Detailed Explanation From Exact Extract:

The patient's symptoms are consistent with a stroke (CVA). Proper prehospital care focuses on maintaining airway, breathing, circulation, and protecting the affected limbs. Positioning the patient with head elevated (not supine) reduces intracranial pressure and aspiration risk.

Protecting the paralyzed side (e.g., left arm) from injury during transport is critical. EMS should still communicate with the patient — even if speech is impaired — and perform a stroke assessment using tools like Cincinnati Prehospital Stroke Scale (CPSS) or FAST.

NREMT standards emphasize scene safety, infection control, and proper sharps handling to reduce the risk of occupational exposure. A contaminated needle left in a mattress presents a serious needlestick hazard to EMS providers, hospital staff, and patients.

Option B is correct because the appropriate action is to carefully remove the needle and immediately dispose of it in an approved sharps container. This follows OSHA and NREMT infection-control principles, which state that sharps must be disposed of promptly in puncture-resistant containers without unnecessary handling.

Option A is incorrect because recapping needles is strictly prohibited under standard precautions. Recapping significantly increases the risk of accidental needlestick injuries and violates established safety guidelines.

Option C is incorrect because confronting a paramedic in front of a patient is unprofessional and undermines team dynamics. Any concerns regarding unsafe practices should be addressed privately and through appropriate supervisory channels.

Option D is incorrect because ignoring an exposed sharp creates an ongoing safety hazard and fails the EMT’s responsibility to maintain a safe environment.

In summary, NREMT expects EMTs to act proactively to reduce hazards, follow standard precautions, and safely dispose of sharps without recapping or delay. Removing the needle carefully and placing it in a sharps container is the safest and most appropriate response.

Comprehensive and Detailed Explanation From Exact Extract:

After ROSC in an unresponsive patient, the left lateral recumbent position (also called the recovery position) is preferred to:

Maintain an open airway

Prevent aspiration if vomiting occurs

Promote drainage of secretions

Supine or Trendelenburg positions increase the risk of aspiration. Elevating the head to 45° may reduce intracranial pressure, but it’s not standard post-ROSC care in an unresponsive patient unless airway protection is ensured.

Comprehensive and Detailed Explanation (Based on NREMT standards):

For a conscious adult with complete airway obstruction, abdominal thrusts are typically indicated. However, NREMT guidelines specify that chest thrusts should be used instead for patients who are morbidly obese or pregnant, because abdominal thrusts may be ineffective or unsafe.

Option D is correct because chest thrusts provide effective airway clearance while accommodating body habitus.

Options A and B are inappropriate for a conscious patient.

Option C is incorrect because abdominal thrusts may not be effective in morbidly obese patients.

NREMT stresses modifying airway obstruction techniques based on patient size and condition.

Return of spontaneous circulation (ROSC) indicates that the patient has regained a perfusing rhythm. If the patient is pushing away the BVM, this suggests improving mental status and spontaneous respirations.

Option D is correct because NREMT post-resuscitation care requires EMTs to reassess airway, breathing, and circulation, including confirming a pulse, and transition from assisted ventilations to supplemental oxygen if the patient is breathing adequately.

Options A and B are inappropriate because restraining a post-ROSC patient is rarely indicated and may worsen agitation.

Option C omits reassessment of circulation, which is critical after ROSC.

NREMT stresses frequent reassessment and supportive care following successful resuscitation.

Comprehensive and Detailed Explanation From Exact Extract:

An externally rotated, shortened leg is a classic sign of a proximal femur fracture, specifically a femoral neck or intertrochanteric fracture, commonly seen in elderly fall patients. This presentation reflects muscle pull and fracture displacement.

Posterior hip dislocations cause internal rotation.

Pelvic fractures may cause instability but not specific leg rotation/shortening.

Colles' fracture is a distal radius (wrist) injury, unrelated to leg trauma.

Comprehensive and Detailed Explanation From Exact Extract:

CPAP works by delivering continuous positive pressure to keep alveoli open and improve oxygenation. However, complications include:

Hypotension: Due to reduced venous return and cardiac preload

Feeling of suffocation: Common psychological reaction to a tight-fitting mask and forced airflow

It is used to treat, not cause, pulmonary edema. It does not induce bronchospasm or myocardial infarction.

This patient’s presentation is highly suspicious for acute coronary syndrome (ACS). NREMT education emphasizes that epigastric pain, especially in elderly patients, may represent myocardial ischemia. The lack of relief after three doses of nitroglycerin further increases concern for an evolving myocardial infarction.

Option A (Give aspirin) is correct because aspirin inhibits platelet aggregation and is a cornerstone of early ACS management. NREMT guidelines recommend administering aspirin as soon as possible unless contraindications exist.

Option B (Apply oxygen) is correct because the patient’s oxygen saturation is 92%, which is below normal. NREMT recommends supplemental oxygen for patients with suspected cardiac ischemia who are hypoxic or in respiratory distress.

Option C may provide comfort but does not address the underlying ischemia.

Option D is incorrect because the patient has already taken the maximum recommended prehospital doses of nitroglycerin.

Option E is outside the EMT scope of practice in many systems and is not a priority EMT intervention.

NREMT emphasizes early aspirin administration, oxygenation, continuous monitoring, and rapid transport for suspected ACS.

Comprehensive and Detailed Explanation From Exact Extract:

The position of the patient’s head within the aircraft affects access to airway management and crew maneuverability. If the head is oriented away from providers or toward a non-accessible bulkhead, this can delay critical interventions (airway suctioning, ventilations).

Use of air splints, maintaining oxygen saturation, or environmental humidity are not major complications relative to physical positioning and in-cabin access limitations.

According to NREMT guidelines and standard EMS ethics, a competent adult patient has the legal right to refuse any portion of medical care, including spinal immobilization, as long as they demonstrate decision-making capacity. In this scenario, the patient is refusing one specific intervention (the cervical collar), not transportation or overall care. Therefore, EMS providers must respect the patient’s autonomy while continuing to act in the patient’s best interest.

Option A is correct because the appropriate action is to clearly document the patient’s informed refusal of the cervical collar and continue transport. Documentation should include the patient’s mental status, orientation, explanation of risks provided, the patient’s understanding of those risks, and the patient’s explicit refusal. This protects both the patient and the EMS provider legally and ethically.

Option B is incorrect because restraining a patient to force treatment constitutes assault and battery unless the patient lacks decision-making capacity or poses an immediate danger to themselves or others. There is no indication in the question that the patient is incompetent or combative.

Option C is incorrect because the patient has not refused all care—only spinal immobilization. Abandoning care by leaving the scene would violate EMS duty to act once patient contact has been established.

Option D is incorrect because withholding transport unless the patient complies is coercive and unethical. EMS providers must not threaten or pressure patients into accepting treatment.

In summary, NREMT emphasizes patient rights, informed consent, and thorough documentation. Transporting the patient while documenting refusal of immobilization is the safest, most professional, and legally sound course of action.

Comprehensive and Detailed Explanation From Exact Extract:

EMS professionals are expected to use empathetic yet clear language when communicating a death. The phrase "She has passed" is both respectful and commonly accepted as an appropriate way to convey death compassionately without being overly clinical or harsh.

“Died” may sound too blunt in an emotional moment, while “didn’t make it” and “at peace” can feel vague or dismissive. Clear, empathetic communication is critical for patient dignity and family support during death notifications.

Comprehensive and Detailed Explanation From Exact Extract:

This is a high-risk cardiac event due to unstable angina or possible myocardial infarction. The EMT should:

Administer oxygen if SpO? is <94%

Avoid nitroglycerin if systolic BP is <90 mmHg

Obtain a 12-lead ECG to identify ST-elevation MI (STEMI) and transmit it if trained and authorized

CPAP is indicated for pulmonary edema, and albuterol is for bronchospasm, neither of which applies here.

When an incident involves multiple agencies with shared responsibility, NREMT teaches that a Unified Command structure is used. This allows police, fire, EMS, and other agencies to work together under a common set of objectives while maintaining their individual authority.

Option C is correct because the defining feature of unified command is multi-agency involvement, not rank or arrival order.

Option A is incorrect because no single agency automatically has authority.

Option B misunderstands unified command, which still functions with coordinated leadership.

Option D is incorrect because EMS does not automatically become part of command.

NREMT emphasizes unified command to improve coordination, communication, and safety during MCIs.

Comprehensive and Detailed Explanation From Exact Extract:

Clavicle deformity suggests potential rib or thoracic trauma. Unequal chest rise may indicate a flail segment, pneumothorax, or hemothorax. Subcutaneous emphysema, the presence of air under the skin, is a classic finding in pneumothorax or tracheobronchial injury.

Occipital depression is not chest related; epigastric distension is a GI symptom; and jugular vein distention would suggest tension pneumothorax or cardiac tamponade, which are more advanced complications.

Comprehensive and Detailed Explanation (Based on NREMT standards):

Nerve agents are highly toxic organophosphate chemicals that inhibit acetylcholinesterase, leading to excess acetylcholine accumulation and life-threatening cholinergic effects. NREMT hazardous materials education highlights recognition of these agents due to their rapid lethality.

Option C (Tabun) and D (Sarin) are correct. Both are internationally recognized nerve agents historically used in chemical warfare and terrorist attacks.

Option A (Naloxone) is an opioid antagonist, not a nerve agent.

Option B (Metoprolol) is a beta-blocker medication.

Option E (Atropine) is not a nerve agent; it is an antidote used to treat nerve agent poisoning.

NREMT emphasizes scene safety, recognition of toxidromes, and early antidote administration for nerve agent exposure.