1. In the Incident Command System, which section is responsible for providing resources, facilities, and services to support incident objectives?

2. What is the process called when command is transferred from one Incident Commander to another?

3. What is the normal fasting blood glucose level range for an adult patient?

4. You arrive at a motor vehicle collision with three patients. Patient A is a 28-year-old female walking around the scene with a minor forehead laceration, complaining of a headache. Patient B is a 45-year-old male sitting on the ground, holding his chest, breathing rapidly with visible bruising on his steering wheel. Patient C is a 22-year-old male lying motionless on the ground with a large scalp laceration. Based on your general impression, which patient should be assessed first?

5. You arrive at a restaurant where a patron collapsed. Bystanders report the 55-year-old male was eating when he suddenly grabbed his throat, turned blue, and became unresponsive. During your primary assessment, you find him supine on the floor, unresponsive, with cyanosis around his lips. He is not breathing. You attempt to ventilate with a BVM, but the chest does not rise. You reposition the head and try again—still no chest rise. What is your immediate priority action?

6. A 19-year-old male was found unresponsive at a party. When you pinch his trapezius muscle, he pulls his arm away and mumbles something unintelligible. His pupils are equal and reactive to light. What is his AVPU status, and what does his response to pain indicate?

7. During a head-to-toe trauma assessment, the EMT assesses the neck for several potential findings. Which of the following is NOT typically assessed during the neck examination?

8. An 82-year-old female presents with vague abdominal discomfort that she describes as “not really pain, just not right.” She has had decreased appetite for three days and occasional nausea. Her abdomen is soft but mildly tender in the right lower quadrant. Vital signs are: BP 118/72 mmHg, HR 88/min, RR 18/min, Temp 99.2°F. What is your primary concern?

9. A 72-year-old female fell at home and has a hip fracture. She is alert but her blood pressure is 148/92 mmHg and heart rate is 88 bpm. Her skin is warm and dry. Why might this patient still be considered a priority despite normal vital signs?

10. A 72-year-old nursing home resident has a productive cough with green sputum, fever, and increased work of breathing. Her SpO2 is 89% on room air. Auscultation reveals crackles in the right lower lung field. What is the MOST appropriate oxygen therapy for transport?

11. After treating a patient, you discover that your gloves have a small tear. You had contact with the patient’s blood. What should you do?

12. A 35-year-old male was working in a hot environment and is now confused, has hot and dry skin, and a rapid pulse. What condition does this suggest and what is the appropriate treatment?

13. You arrive on scene of a motor vehicle collision on a rural highway. There are three vehicles involved with a total of seven patients complaining of various injuries. Two patients are ambulatory, four are still in vehicles, and one is unresponsive on the ground. What is your FIRST resource consideration?

14. You are returning from a non-emergency call when your ambulance is struck by another vehicle that ran a red light. Your partner is injured. What should you do FIRST?

15. You are called to a scene where a 35-year-old male with type 1 diabetes was found acting “drunk” by police. The officers smell alcohol on his breath and want to arrest him for public intoxication. His blood glucose is 42 mg/dL. He is confused and unable to follow commands. Which statement BEST describes the appropriate medical-legal approach?

16. Which statement about tourniquet use in the prehospital setting is correct?

17. You are treating a 3-year-old child with respiratory distress. The child is alert, crying, and has audible stridor. The mother reports the symptoms began suddenly while the child was eating. Which oxygen delivery method is most appropriate?

18. What is the FIRST action an EMT should take when arriving at the scene of a motor vehicle collision?

19. A 62-year-old male with a history of COPD presents with severe wheezing and dyspnea. He has his prescribed albuterol inhaler with him. His blood pressure is 146/92 mmHg, pulse is 104/min, and SpO2 is 88% on room air. After initiating oxygen therapy, what is the most appropriate action regarding his medication?

20. You respond to a motor vehicle collision on a rural highway. A 32-year-old male was the unrestrained driver in a high-speed head-on collision. Upon arrival, you find him still in the driver’s seat, unconscious. During your rapid primary assessment, you note the following: his airway is open, he has shallow respirations at 12 breaths per minute, his radial pulse is absent but you palpate a weak femoral pulse at 130 beats per minute. His skin is pale, cool, and clammy. You notice significant deformity to his steering wheel and dashboard. What do these primary assessment findings indicate, and what is your immediate priority?

21. A patient has a blood pressure of 140/90 with no symptoms. What does this indicate?

22. An EMT is completing a PCR for a patient who refused transport after being assessed for a minor head laceration. The patient was alert and oriented, had normal vital signs, and signed a refusal form. The EMT documents: “Patient seen for head lac. Refused transport. AMA form signed.” Which statement BEST describes the adequacy of this documentation?

23. An EMT arrives at the emergency department with a 68-year-old female patient who fell at home. The EMT needs to give a verbal report to the receiving nurse. Using the MIST format, which information should the EMT provide FIRST?

24. You respond to a reported overdose at a public library. Upon arrival, the librarian meets you at the door and states that a man in his 30s is “passed out” in the computer area. As you approach with your equipment, you observe the patient slumped in a chair with a needle and syringe visible in his lap. There is an open backpack on the floor next to him with what appears to be drug paraphernalia and small plastic bags. Two library patrons are standing nearby, appearing concerned. The patient is breathing but unresponsive to voice. What is your most appropriate initial action?

25. You arrive at a motor vehicle collision involving a minivan and a truck. There are four patients. A 6-year-old child in the minivan is crying loudly and has a visible laceration to the forehead. The 35-year-old mother is ambulatory but holding her abdomen and states she is “fine.” The 70-year-old grandfather is unresponsive with a large hematoma to the forehead and unequal pupils. The truck driver is walking around the scene complaining of back pain. Based on your primary assessment and triage principles, how should you prioritize these patients?

26. You are assessing a 45-year-old driver involved in a high-speed head-on collision. The steering column is bent, the windshield is starred, and the patient was not wearing a seatbelt. Based on this MOI, which transport decision is most appropriate?

27. You respond to a 22-year-old male found unresponsive at a college party. Bystanders state he was drinking heavily and possibly using “something he smoked.” Assessment reveals: unresponsive to verbal stimuli, withdraws from painful stimuli (localizes to sternal rub), respirations 10 breaths/min and shallow, pupils 2mm and reactive, skin pale and cool. Blood glucose is 95 mg/dL. Cardiac monitor shows sinus bradycardia at 52 bpm. Which interpretation BEST explains the pathophysiology connecting these findings?

28. A paramedic asks you to confirm the aspirin dose before he administers it to a 67-year-old patient with crushing chest pain. The patient has no allergies and is not on blood thinners. What dose should you confirm for this suspected acute coronary syndrome patient?

29. A 19-year-old female was involved in a high-speed motor vehicle collision. She was wearing a lap-only seatbelt. She has ecchymosis across her lower abdomen and is complaining of severe abdominal pain. Her vital signs are: BP 102/70 mmHg, HR 108/min, RR 22/min. Which injury pattern should you MOST suspect based on the mechanism and findings?

30. You respond to a 56-year-old male who fell from a ladder. He is unresponsive to all stimuli (AVPU: U). His GCS is 4 (E1, V1, M2). Breathing is irregular and noisy. You note clear fluid draining from his left ear. What is the MOST appropriate sequence of interventions for this patient?

31. You respond to a single-vehicle collision. The car struck a utility pole at moderate speed. The driver is complaining of abdominal pain. You notice the steering wheel is bent. What does this finding indicate?

32. A 34-year-old female complains of dizziness and nausea. During your primary assessment, you note she is alert but pale. Her radial pulse is weak and thready at 112 beats per minute. Her skin is cool and moist. What do these findings suggest about her circulatory status?

33. You are called to a nursing home for a 78-year-old female with an altered level of consciousness. The nursing staff reports she has a feeding tube, a urinary catheter, and has been experiencing episodes of vomiting. She currently has bloody drainage from her catheter site. As you prepare to assess and transport, what PPE is most appropriate for this encounter?

34. A 72-year-old female fell down a flight of stairs. During your primary assessment, you note she is confused and only responds to verbal stimuli with inappropriate words. Her left pupil is 6mm and non-reactive; her right pupil is 3mm and reactive. She has a large contusion on the left side of her head. Blood pressure is 170/100 mmHg, heart rate is 52 bpm, and respiratory rate is 14 with irregular pattern. What is your interpretation of these findings, and what is your priority action?

35. You respond to a two-vehicle collision. There are three patients. Patient A is walking around with a bleeding hand laceration. Patient B is sitting on the curb, holding his chest, and has labored breathing. Patient C is unconscious and slumped over the steering wheel with visible facial trauma. Using the START triage system, which patient should receive your IMMEDIATE attention?

36. A 55-year-old female is being assessed for a syncopal episode. Her capillary refill time is 4 seconds. Which statement best explains the significance of this finding?

37. You are assessing a 6-month-old infant who is crying vigorously. You note her skin is pink, warm, and dry. You palpate the brachial pulse and count 140 beats per minute. The infant’s capillary refill time is less than 2 seconds. How would you interpret these findings?

38. A 65-year-old male with a known history of stroke was found on the floor by his wife approximately 2 hours after she last saw him normal. On assessment, he does not open his eyes to voice. When you apply a sternal rub, he extends both arms and legs rigidly with internal rotation of the wrists. His respirations are 8 per minute and irregular. Based on the LOC findings and posturing, what is the MOST likely level of brain dysfunction, and what does this indicate about his prognosis?

39. During a head-to-toe physical exam of an unconscious patient, the EMT notices clear fluid draining from the patient’s left ear following a motor vehicle crash. There is also bruising behind the left ear. What should the EMT do?

40. A patient was involved in a rollover motor vehicle collision. Why does this mechanism warrant a higher index of suspicion for serious injury compared to a frontal impact at the same speed?

41. A 62-year-old female complains of chest pain. Her skin is warm and dry, and she has a capillary refill time of less than 2 seconds. Her radial pulse is strong and regular at 78 beats per minute. What do these findings indicate about her circulatory status?

42. You are preparing to assess a patient with active tuberculosis who is coughing. Which combination of PPE is most appropriate for this encounter?

43. A patient is confused and cannot follow commands but responds to pain by localizing the stimulus. What is the motor component of GCS?

44. A 28-year-old female presents with intense itching between her fingers, on her wrists, and around her waist. Her skin shows small, raised, red tracks. She mentions several family members have similar symptoms. What level of PPE is most appropriate for this encounter?

45. You are assessing a 68-year-old male with difficulty breathing. He is able to speak in full sentences but appears anxious. His respirations are 22 per minute with adequate chest rise. His skin is warm and dry, and his oxygen saturation is 94% on room air. What is the MOST appropriate initial intervention?

46. You arrive on scene of a motor vehicle collision with downed power lines across the vehicle. A patient is trapped inside, conscious and waving for help. What is your immediate action?

47. You are treating a 32-year-old construction worker with a deep laceration to his right thigh. Bright red blood is spurting from the wound. During your circulation assessment, you note a strong radial pulse of 100, warm pink skin, and the patient is alert. What is your IMMEDIATE priority?

48. During a secondary assessment physical exam, which technique should the EMT use to assess for crepitus in a suspected fracture?

49. You respond to a residence for a 34-year-old female with severe headache. Upon arrival, she describes the headache as “the worst of my life” and says it began suddenly 30 minutes ago while she was watching television. She is alert but appears anxious and has photophobia. Her blood pressure is 168/94 mmHg, pulse is 88, respirations 18. She has no significant medical history. During your assessment, you note her right eyelid is drooping and her right pupil is dilated. Based on these findings, what is your assessment and transport priority?

50. Why is it important to document a patient’s last oral intake when obtaining a SAMPLE history?

51. A pedestrian was struck by a vehicle traveling approximately 40 mph. The patient was thrown approximately 30 feet and is currently unconscious. Which mechanism factors most strongly indicate the need for spinal immobilization and comprehensive trauma assessment?

52. A 61-year-old male with type 2 diabetes presents with confusion, dry mucous membranes, and blood glucose of 680 mg/dL. His family reports he has been urinating frequently and drinking large amounts of water over the past week. Which condition should you suspect?

53. You are documenting a patient encounter. Which of the following is the MOST appropriate way to document the patient’s description of pain?

54. A 4-year-old child is brought to you by his mother after falling from a swing. The child is crying loudly, holding his left arm, and reaching for his mother. What does this general impression indicate about the child’s status?

55. A patient is described as “alert and oriented times three.” What does this specifically indicate about the patient’s mental status?

56. A 22-year-old patient with asthma is experiencing an acute exacerbation. Which finding is MOST characteristic of asthma during expiration?

57. You respond to a motor vehicle collision on a busy highway. Upon arrival, you notice fluid leaking from one of the vehicles and a strong odor of gasoline. What should be your FIRST priority action?

58. You are assessing a 67-year-old female with sudden onset of difficulty breathing. She is sitting upright in bed, leaning forward with her hands on her knees. Her skin is cool and diaphoretic. What does this patient’s position MOST likely indicate about her respiratory status?

59. What is the normal respiratory rate range for a 3-year-old child?

60. A 72-year-old female with a history of stroke presents with gurgling respirations and is unable to swallow her secretions. She opens her eyes when you call her name but does not follow commands. What is the MOST appropriate airway management sequence?

61. You are triaging at the scene of a house explosion with multiple casualties. You assess four patients simultaneously. Patient A is walking around asking for help with a bleeding arm. Patient B is lying motionless, breathing rapidly at 35 breaths/min. Patient C is sitting against a wall, breathing normally, with an obvious leg deformity but following commands. Patient D is unresponsive with no breathing despite opening the airway. Which patient should be treated FIRST?

62. A patient requires supplemental oxygen at a precise concentration of 40%. Which oxygen delivery device would be most appropriate?

63. What is the FIRST priority upon arrival at any emergency scene?

64. You are called to assess a 5-year-old child who fell from a second-story window. On arrival, the child appears pale and is sitting quietly, not crying. The parent says, “He was screaming earlier but now he’s acting fine.” The child’s capillary refill is 4 seconds, skin is cool and clammy, and his heart rate is 160. How would you interpret these findings?

65. A patient opens his eyes only when you apply a painful stimulus, makes incomprehensible sounds, and withdraws from the pain. What is this patient’s Glasgow Coma Scale (GCS) score?

66. A 22-year-old female was an unrestrained passenger in a high-speed rollover motor vehicle crash. She was partially ejected and has multiple abrasions and a deformed left thigh. She is answering questions appropriately but complains of abdominal pain. Which finding from the MOI would necessitate trauma center transport rather than the local emergency department?

67. You are treating a 34-year-old male who was involved in a high-speed motor vehicle collision. He has an open femur fracture with significant bleeding, is pale and diaphoretic, and has a SpO2 of 94% on room air. His respiratory rate is 24 breaths per minute. What is the MOST appropriate oxygen intervention?

68. An EMT arrives at the scene of a motor vehicle collision. The patient is unconscious and lying supine on the ground. The EMT observes gurgling sounds during the patient’s breathing. What is the most likely cause of this finding?

69. You respond to a nursing home for an 82-year-old female with “altered mental status.” Staff report she was “completely normal yesterday” but this morning was found unresponsive in bed. Your primary assessment reveals: she does not open her eyes to voice, but withdraws from painful stimuli; her breathing is rapid at 24 breaths per minute with adequate tidal volume; her skin is warm and dry; her radial pulse is 88 and regular. Her blood glucose is 245 mg/dL. Based on your general impression and primary assessment, what is the MOST likely explanation for her altered mental status?

70. During the primary assessment of an unresponsive adult, you find no radial pulse but a weak carotid pulse. The patient’s skin is cool, pale, and dry. What is your estimated systolic blood pressure and what does this finding indicate?

71. You are assessing a 58-year-old male with severe respiratory distress. He is able to speak only two to three words at a time before gasping for breath. He has audible stridor on inspiration. His oxygen saturation is 88% on room air. What condition should you suspect?

72. You are treating a 34-year-old patient with significant facial trauma from an assault. There is blood around the mouth and nose, and the patient is spitting blood while combative and screaming. Police are on scene and have secured the patient. The hospital reports this patient is known to have hepatitis C. Which PPE combination is MOST appropriate for this scenario?

73. You are assessing a 22-year-old female patient who is 32 weeks pregnant. Her vital signs are: BP 108/70 mmHg, HR 98 bpm, RR 18 breaths/min, SpO2 99%. Which vital sign finding is consistent with normal pregnancy-related changes and does NOT indicate pathology?

74. A patient has absent breath sounds bilaterally. What could this indicate?

75. A patient with a suspected stroke needs transport. What time is critical to document?

76. A 58-year-old male with a history of COPD is experiencing a respiratory emergency. He is using accessory muscles and has an SpO2 of 89%. You have his prescribed albuterol inhaler. What should you do?

77. You are transporting a patient who was involved in a domestic violence incident. During transport, the patient asks you not to tell police certain details about how the assault occurred because she fears retaliation. You know that police are waiting at the hospital to take a statement. Which action best balances your ethical obligations?

78. When providing a patient report via radio to the receiving hospital, which information should be communicated FIRST?

79. You respond to a 45-year-old male who collapsed while jogging. He is unresponsive, not breathing normally, and you cannot feel a carotid pulse. What is your immediate priority?

80. A patient has absent breath sounds on the left side and decreased chest movement after a stabbing. What should you suspect?

81. You respond to a factory where a 40-year-old worker has a partial amputation of three fingers on his right hand from a machine. There is significant bleeding but it is controlled with direct pressure. The amputated fingers are available. How should you transport the amputated parts?

82. What is the appropriate ventilation rate during CPR with an advanced airway in place?

83. A 19-year-old male was found unconscious at a party. Friends state he was drinking alcohol and may have taken “something else.” His respirations are 6 per minute with shallow chest rise, his pulse is 58 and weak, and his skin is pale, cool, and cyanotic around the lips. His pupils are 2mm and reactive. You open his airway with a head-tilt, chin-lift maneuver, but his breathing does not improve. What is your immediate priority, and why?

84. A 67-year-old female is coughing productively and has been diagnosed with influenza at an urgent care center. She is being transported for hospital admission. The urgent care staff placed her in a surgical mask. What PPE should the transporting EMTs wear?

85. A 56-year-old male was found down in his bathroom. He is unresponsive to painful stimuli. You note his skin is cyanotic, cold, and mottled. His pulse is 40 bpm and very weak. His blood pressure is 72/48 mmHg. He has slow, agonal respirations at 6 per minute. Your partner is preparing to assist ventilations with a bag-valve mask. Based on these primary assessment findings, what is your interpretation of this patient’s condition and immediate priority?

86. When sizing an oropharyngeal airway (OPA) for an adult patient, what is the correct measurement technique?

87. A 69-year-old male with type 2 diabetes, hypertension, and heart failure was discharged from the hospital three days ago with new medications. His wife called 911 because he is confused and weak today. She reports he has been taking “all his pills, including the new ones.” His blood glucose is 285 mg/dL, BP 88/52 mmHg, HR 110/min, RR 22/min. He is oriented only to person. What is the most likely cause of his presentation?

88. You are assessing a 34-year-old female who was found by her roommate after an unknown period of time. She does not open her eyes when you call her name, but when you tap her shoulder, her eyes open and she says “What’s happening?” She cannot tell you where she is or what day it is. How should you document her AVPU and orientation status?

89. A medium-sized city operates a hospital-based EMS system. The local fire department also responds to medical emergencies with first-responder capabilities. The hospital administration is concerned about duplicated services and response time delays due to miscommunication between units. Analysis reveals that firefighters arrive first on 60% of calls but often lack proper equipment, and EMS ambulances from the hospital average 14-minute response times due to distance from certain areas. Which system-wide improvement would MOST effectively address these issues?

90. You are first on scene at a motor vehicle collision. The driver is unconscious with an obvious deformed thigh and absent pulses in the leg. A passenger is ambulatory with a bleeding forehead laceration. A third person is trapped in the back seat with unknown injuries. What is your FIRST priority for resource requests?

91. What is the correct adult dose of aspirin for a patient with suspected acute coronary syndrome?

92. During a patient care transfer at the hospital, you realize you documented the wrong medication dosage in your PCR. The patient actually received 0.4 mg nitroglycerin, but you wrote 4.0 mg. What is the MOST appropriate action?

93. A patient appears acutely ill with grunting respirations. What does grunting typically indicate?

94. You are dispatched to a motor vehicle collision involving three patients. Patient A is walking around the scene with a bleeding forehead laceration. Patient B is sitting on the curb holding his arm and states he has pain. Patient C is still in the vehicle, unresponsive, with labored breathing. Which patient should be your FIRST priority for assessment and treatment?

95. You are called to a group home for a 42-year-old male with cerebral palsy who has a suspected respiratory infection. He uses a wheelchair and has limited verbal communication. Staff report he has had a fever and decreased appetite for two days. Today he is breathing faster than usual. What is the most appropriate approach to assess this patient?

96. A 55-year-old male fell from a ladder approximately 12 feet. He is alert and oriented but complains of lower back pain. During your head-to-toe trauma assessment, you note the following: contusion to the left temporal region, tenderness to palpation of the cervical spine, equal breath sounds bilaterally, rigid abdomen with left upper quadrant tenderness, and point tenderness over the lumbar spine. Based on these assessment findings, which of the following represents the MOST appropriate sequence for your secondary assessment priorities?

97. You arrive at a single-vehicle collision. The driver is slumped over the steering wheel. What is the FIRST thing you should determine?

98. You are called to a nursing home for an 82-year-old male who fell 4 hours ago. Staff report he “seems fine” and has been resting in bed. His vital signs are BP 134/82, pulse 76, respirations 16. He denies pain. However, you note he is on warfarin for atrial fibrillation. Despite normal vital signs and no complaints, why should this patient be considered high priority?

99. A 54-year-old male with a massive stroke has ineffective respiratory effort with agonal breathing. You decide to provide positive pressure ventilation with a BVM. Which combination of technique elements is MOST important for effective ventilation?

100. What is the normal resting respiratory rate range for a healthy adult?