1. An EMT responds to a call for a 34-year-old male with chest pain. The patient appears alert but is disoriented to time and place. The EMT wants to administer aspirin per protocol. Which statement best describes the legal situation regarding consent?

2. A patient with chest trauma has unequal chest expansion. What should you suspect?

3. At a crime scene, what is your PRIMARY concern?

4. You have three patients from a motor vehicle collision. Patient A has a deformed thigh and is screaming in pain. Patient B is unresponsive with sonorous respirations. Patient C is ambulatory with a laceration on the forearm. Which patient is the HIGHEST priority?

5. What is the primary purpose of analyzing the mechanism of injury (MOI) during scene size-up?

6. A 68-year-old male with a history of COPD is found sitting upright in bed, using accessory muscles to breathe. He can only speak one or two words at a time. His wife reports he has been “getting worse over the past three days” with increased cough and green sputum. She also mentions he ran out of his “inhaler medications” one week ago. Which aspect of this history is MOST significant for understanding the cause of his current presentation?

7. Upon arrival at a scene where a violent assault has just occurred, what is the EMT’s FIRST priority?

8. A 34-year-old female involved in a fall from height presents with: BP 100/68 mmHg, pulse 118, respirations 24, and skin that is cool, pale, and moist. She is alert but anxious. Based on these findings, what stage of shock is she in, and what does her blood pressure indicate?

9. Which of the following patients should be classified as a “load-and-go” priority based solely on the general impression?

10. After responding to a pediatric cardiac arrest where the child did not survive, you are having difficulty sleeping and feel emotionally drained. What is the MOST appropriate action?

11. You respond to a report of an “elderly fall victim” at a private residence. Upon arrival, an elderly woman meets you at the door and says her husband fell in the living room. As you enter, you notice: the home is extremely cluttered with narrow pathways between stacks of newspapers, multiple cats are roaming freely, the floors appear sticky, and you smell a strong odor of urine and mold. The patient is on the floor in the living room, moaning in pain. He states he fell about two hours ago and cannot get up. He appears to have a deformed left hip. Analyze the scene and determine the most appropriate approach to ensure scene safety while providing patient care.

12. You are assessing a 52-year-old male with chest pain. His radial pulse is strong and regular at 76 beats per minute. His skin is warm, pink, and dry. How would you characterize his circulatory status based on these findings?

13. When using the “sick versus not sick” approach during the primary assessment, which of the following clinical findings would MOST strongly classify a patient as “sick”?

14. You respond to a residence for a 58-year-old female with altered mental status. Her husband states she has a history of diabetes, hypertension, and “mini-strokes.” She was found on the floor this morning, confused and unable to move her right arm. Assessment reveals: eyes open when you call her name, she follows simple commands but cannot speak clearly, right-sided facial droop, and right arm weakness. Blood glucose is 142 mg/dL. Which interpretation of her AVPU status and likely condition is MOST accurate?

15. A 68-year-old male with COPD is experiencing increased shortness of breath. He is alert but appears anxious. His respirations are 24 breaths/min with labored effort, and SpO2 reads 88%. What is the MOST appropriate oxygen delivery approach?

16. Your ambulance is dispatched to a residence for an “unconscious person.” Upon arrival, you notice through the window an unconscious male on the couch, an open pill bottle on the table, and a small child crying in the corner. What is the MOST appropriate initial action?

17. You respond to a motor vehicle collision involving a 17-year-old female driver. She has a visible laceration on her forehead and complains of neck pain. She is alert and oriented but states she does not want to be transported and wants to go home with her parents who just arrived on scene. Her parents agree and want to take her home. What is your MOST appropriate action?

18. A patient with an isolated wrist fracture wants to refuse transport. He is alert, oriented, and understands the risks. What should you do?

19. A 72-year-old nursing home resident is being evaluated for possible pneumonia. Staff report she has had a productive cough with yellow-green sputum for three days and fever. On assessment, you note decreased breath sounds over the right lower lung field. Which additional finding would be most consistent with this diagnosis?

20. You respond to an apartment complex for a reported cardiac arrest. As you enter the building with your equipment, you notice a strong odor of bitter almonds and see two other residents lying motionless in the hallway. Your partner is already at the patient’s apartment door. Analyze this situation and determine the most appropriate course of action.

21. When assessing a conscious patient’s mental status using the AVPU scale, what does the “P” represent?

22. You arrive at a motor vehicle collision to find a 30-year-old male driver who was unrestrained. He is walking around the scene and states he feels “fine.” You notice a small contusion on his forehead. His skin is pink, warm, and dry. What is the most accurate general impression?

23. A 32-year-old pregnant female at 38 weeks gestation is in active labor. You visualize the baby’s head crowning. What should you do?

24. A 34-year-old male was involved in a motor vehicle collision. He is unconscious with possible spinal injury. During your primary assessment, you note his airway is partially obstructed by his tongue falling back. Which airway maneuver is MOST appropriate?

25. A 40-year-old male was found unconscious by bystanders. A bystander hands the EMT the patient’s wallet, which contains a card stating “Type 1 Diabetic – Insulin Pump.” The patient is unresponsive with rapid, deep respirations and fruity-smelling breath. Which SAMPLE component is MOST critical to confirm with bystanders?

26. A 72-year-old male with a history of diabetes and hypertension presents with sudden onset of weakness and nausea. He describes feeling “tired and short of breath” but denies chest pain. His blood pressure is 148/94 mmHg, pulse is 92/min and irregular, respirations are 20/min. He appears diaphoretic. Which finding is most concerning for an atypical acute coronary syndrome presentation?

27. Which of the following findings would categorize a patient as a priority patient requiring immediate transport?

28. A 58-year-old diabetic male presents with confusion and altered mental status. His wife mentions he takes insulin for diabetes and has been complaining of feeling “shaky” before becoming confused. Which component of SAMPLE history is MOST relevant to his current presentation?

29. Which of the following mechanisms of injury is considered a high-energy impact that requires a comprehensive trauma assessment?

30. A patient with diabetes is confused and has a blood glucose of 35 mg/dL. What is the immediate treatment?

31. The principle of nonmaleficence in EMS practice is best described by which statement?

32. You respond to a residential fire with multiple occupants. Firefighters bring you four patients. Patient 1 is a 6-year-old child with singed nasal hairs and hoarse voice. Patient 2 is a 34-year-old pregnant female at 32 weeks gestation with minor burns to her arms. Patient 3 is a 72-year-old male with chest pain and a history of cardiac stents. Patient 4 is a 28-year-old male with a fractured ankle who is ambulatory. Based on the general impression, who is the highest priority?

33. What is the minimum safe distance an EMT should maintain from a downed power line?

34. Which of the following patients should be classified as “load-and-go” based solely on the general impression during the primary assessment?

35. A 34-year-old female with diabetes is conscious but exhibits slurred speech and unsteady gait. Her roommate states the patient has been drinking alcohol at a party. Blood glucose is 55 mg/dL. What is the MOST appropriate action?

36. You respond to an assisted living facility for a 79-year-old woman with “difficulty breathing.” Upon arrival, the facility director greets you at the door and seems unusually anxious to have you evaluate the patient quickly. The patient is in bed, appears thin and frail with multiple ecchymoses in various stages of healing on her arms and upper back. She has a small, healing laceration on her lip. When you ask what happened, she looks fearfully at the facility director before quietly saying, “I fell.” Her vital signs show mild tachycardia but are otherwise stable. She has no acute respiratory distress. Which action is most appropriate for this patient?

37. You are assessing a 34-year-old male who fell from a ladder. He is alert and complaining of severe right leg pain. His respirations are 18 per minute with adequate chest rise. His radial pulse is strong at 88 beats per minute. His skin is warm and pink. During your assessment, he suddenly becomes confused and his skin becomes pale and clammy. What should you do FIRST?

38. A patient with a history of alcoholism presents with confusion and ataxia. What should you consider?

39. A 32-year-old male was struck in the face during an altercation. He has a decreased level of consciousness (responds to voice), clear fluid draining from his right ear, and bruising behind the right ear. Which airway adjunct is MOST appropriate for this patient?

40. You respond to a residence for a “person not feeling well.” Upon arrival, you find a 68-year-old male lying on the couch. His wife states he complained of “indigestion” earlier and has been lying down for two hours. During your primary assessment, you note the following: He responds to verbal stimuli by opening his eyes and mumbling incomprehensible sounds. His respirations are 8 per minute and shallow with poor chest rise. His radial pulse is weak and irregular at approximately 120 beats per minute. His skin is pale, cool, and diaphoretic. His blood pressure is 82/58 mmHg. His wife tells you he has a history of “heart problems” and takes several cardiac medications. What is your PRIORITY intervention and transport decision?

41. During an MCI, you encounter a patient with a partial amputation of the foot with controlled bleeding who can walk. Using START triage, how should this patient be categorized?

42. What is the purpose of determining the mechanism of injury (MOI)?

43. An EMT is called to care for a patient with severe vomiting and diarrhea. The patient estimates they have vomited at least five times in the past hour. Which PPE selection is MOST appropriate?

44. A 28-year-old male fell 15 feet from a ladder and landed on his left side. He is alert but guarding his left flank. His blood pressure is 100/70 mmHg, pulse is 118 beats/minute, and skin is cool and diaphoretic. When obtaining SAMPLE history, he reports taking no medications and having no medical conditions. His wife mentions he had surgery three years ago to remove a “growth on his kidney” but isn’t sure of the details. Based on the mechanism of injury, vital signs, and history, which finding should prompt the EMT to have the HIGHEST index of suspicion for life-threatening hemorrhage?

45. What is the correct sequence for hemorrhage control in an extremity with severe bleeding?

46. A 22-year-old male fell through the ice on a frozen pond. He was submerged for approximately 10 minutes and is now unresponsive with a core temperature of 86°F (30°C). What is the MOST appropriate action?

47. You respond to a residence for a 58-year-old male with difficulty breathing. Upon arrival, you find the patient sitting in a tripod position, using accessory muscles, with audible wheezing. His skin is pale and diaphoretic. He is able to speak in short phrases only. What is the PRIMARY reason this patient should be classified as high transport priority?

48. You are called to a domestic disturbance where a woman reports being assaulted. Her husband is present and appears intoxicated. He is pacing and yelling at your patient. Law enforcement has not yet arrived. What is the most appropriate action?

49. A 34-year-old male is having a severe allergic reaction after being stung by a bee. He presents with facial swelling, difficulty speaking, a rapid onset of stridor, and widespread hives. His SpO2 is 90% on room air, and he is using accessory muscles to breathe. Which intervention takes priority?

50. You arrive at a scene with multiple agencies responding (fire, police, EMS). Who is responsible for coordinating all agencies during the incident?

51. A 7-month-old infant presents with irritability, poor feeding, and a bulging anterior fontanelle. The mother reports the infant has had a fever for the past day and vomited twice this morning. On assessment, you note the infant is listless and has a high-pitched cry when disturbed. What is the MOST appropriate action?

52. You and your partner are performing two-rescuer CPR on a 6-month-old infant in cardiac arrest. After 2 minutes of high-quality CPR, your partner asks how long until you should switch roles. What is the correct response?

53. A patient opens eyes only to painful stimuli, makes incomprehensible sounds, and extends to pain. What is the GCS?

54. You are assessing a 5-year-old child who was found unresponsive in a swimming pool. Bystanders report the child was underwater for an unknown period. Upon your arrival, the child is unresponsive, not breathing, and has a weak pulse at 60 beats per minute. You open the airway and note water draining from the mouth. After suctioning, you deliver two rescue breaths and see the chest rise. The child remains unresponsive but begins gasping. His pulse is now 52 beats per minute. What is your interpretation and immediate management priority?

55. You respond to an industrial park for a report of an unconscious person. As you approach, you notice a large tanker truck with a placard displaying “3077” in an orange panel. A worker flags you down, saying his colleague collapsed while unloading the truck. There is a slight breeze blowing from the truck toward your position. Analyze this scene and determine the most appropriate initial response.

56. You respond to a construction site where a 45-year-old male fell 15 feet onto concrete. Coworkers state he landed on his back and complained of severe back pain before becoming “drowsy.” On primary assessment, his airway is patent with clear breath sounds bilaterally. His respirations are 24 per minute. You note a heart rate of 52 beats per minute, and his skin is warm and dry. His blood pressure is 90/60 mmHg. He responds to verbal stimuli but is confused. Based on these findings, what type of shock is MOST likely, and what finding supports this diagnosis?

57. A 58-year-old male with a history of angina calls 911 for chest pain that began 30 minutes ago. He has taken two of his own nitroglycerin tablets (0.4 mg each) 5 minutes apart with no relief. His current vital signs are: BP 142/88 mmHg, pulse 78/min, respirations 16/min. He asks if you can give him a third dose. What should you tell him?

58. A 32-year-old male has a deep laceration to his forearm with significant bleeding. You have applied direct pressure and a pressure dressing. The bleeding has slowed but his radial pulse is barely palpable and very rapid. What should you do next?

59. During a cardiac arrest resuscitation, an EMT makes an error in medication dosing. The error is caught immediately and corrected, but the EMT is embarrassed. When completing the patient care report, the EMT considers omitting the error to avoid scrutiny. Which action demonstrates the HIGHEST level of professionalism?

60. During CPR, you feel a carotid pulse return but the patient is still not breathing adequately. What should you do?

61. You are obtaining a SAMPLE history from a 45-year-old female with abdominal pain. Which component of SAMPLE directly guides your decision about whether to administer nitroglycerin for suspected cardiac chest pain?

62. A 52-year-old woman is found unresponsive in her home. Family states she has a history of alcoholism. On assessment, she does not open her eyes to voice, but opens her eyes and withdraws from a sternal rub. She moans but does not form words. What is her AVPU level and GCS score?

63. You are called to a residence for a 67-year-old male with chest pain. Upon arrival, you find the patient sitting in a chair, diaphoretic, clutching his chest. He states the pain started 20 minutes ago and describes it as “crushing.” His skin is pale and cool. Blood pressure is 148/94 mmHg, pulse is 98 bpm and irregular, respiratory rate is 22. He has a history of hypertension and diabetes. He is alert but appears anxious. Based on your primary assessment findings, which of the following represents the most accurate interpretation and priority status?

64. Which of the following BEST describes the purpose of a designated trauma center within an EMS system?

65. Which airway adjunct is appropriate for a patient who is semi-conscious with an intact gag reflex?

66. You are assessing a 3-year-old child at a playground. The child is sitting upright, crying loudly, and has pink, warm skin. The parent reports the child fell off a swing and hurt her arm. Based on your general impression, how would you categorize this patient?

67. A 19-year-old male is unresponsive with pinpoint pupils and slow, shallow respirations (8 breaths/min). Friends report he may have taken “something.” What should you suspect and do?

68. A 28-year-old female was involved in a high-speed motor vehicle collision. She was an unrestrained driver. She is alert but confused. Her skin is pale, cool, and diaphoretic. Blood pressure is 94/62 mmHg, pulse is 128 bpm, respirations are 28. She reports abdominal pain and you note distension and tenderness to palpation. Capillary refill is 4 seconds. Based on these findings, what is your assessment of this patient’s condition and the primary pathophysiology?

69. An unresponsive patient has vomited. After suctioning, what should you do?

70. Which oxygen saturation target is MOST appropriate for a patient with COPD who requires supplemental oxygen?

71. Which pulse site is preferred when assessing circulation in an unresponsive infant?

72. During a mass casualty incident, you encounter a patient with the following: RR 24, capillary refill 3 seconds, follows commands. Using START triage, what tag should be applied?

73. You arrive at a residence for a reported fall and find the front door open. You hear arguing inside and see broken glass on the porch. What is your most appropriate action?

74. You approach a patient and immediately notice pale, cool, diaphoretic skin and a weak, thready pulse. What is your general impression?

75. You respond to an industrial park for a reported “person down.” As you approach, you notice an overturned tanker truck with a visible placard displaying the number 3077. Several workers are lying motionless on the ground nearby. What should be your immediate action?

76. What is the appropriate flow rate range for a nasal cannula when administering oxygen to a patient?

77. Your agency has implemented a new protocol for cardiac arrest management. After several months, you notice the survival rate has improved. What QI activity does this represent?

78. When forming a general impression of a patient, which observation would be MOST concerning?

79. You recognize a patient as a coworker from your other job. The patient asks you not to tell anyone about this call. What should you do?

80. While assessing a 6-year-old child with a fever, the EMT obtains the following vital signs: heart rate 128, respiratory rate 32, blood pressure 100/64, and temperature 39.2°C (102.6°F). Based on these findings, which statement is MOST accurate?

81. You are preparing to transport a 55-year-old female who fell down a flight of stairs. She has midline cervical spine tenderness and bilateral arm weakness. Vital signs are stable. The nearest trauma center is 45 minutes away, while a community hospital is 10 minutes away. What is the MOST appropriate transport decision?

82. During the primary assessment, which pulse site should be palpated in an unresponsive adult patient when the radial pulse is not palpable?

83. You respond to a 56-year-old male with difficulty breathing. Upon entering the apartment, you note a strong smell of urine. The patient is sitting in a recliner, appears cachectic, and has a barrel-shaped chest. He is using accessory muscles and pursed-lip breathing. His skin is pale with a bluish tint around the lips. He can only speak one word at a time. He has an oxygen tank nearby but appears too weak to adjust it. What is your general impression, most likely diagnosis, and immediate priority?

84. A 28-year-old male is eating at a restaurant when he begins coughing forcefully and points to his throat. He is able to speak in short phrases between coughs. What is the most appropriate initial action?

85. A patient opens their eyes when you call their name, looks at you, and answers questions appropriately. How would you document their AVPU status?

86. Dispatch reports a 45-year-old male with sudden onset difficulty breathing after being stung by a bee. He is conscious but struggling to breathe, with facial swelling. Based on this NOI, what resources should be immediately requested?

87. An EMT responds to a patient who fell down a flight of stairs. The patient is complaining of back pain and has visible bruising along the spine. During initial assessment, the EMT notes the patient’s cervical collar has been removed by a well-meaning family member who stated, “It was hurting his neck.” The patient is now sitting up and moving his head. What is the most appropriate analysis of this situation?

88. A 72-year-old patient with severe COPD is experiencing dyspnea. His baseline SpO2 is typically 88-90%. He is currently alert but anxious, with SpO2 reading 84%. His respiratory rate is 24/min. What is the most appropriate oxygen therapy?

89. A 62-year-old male complains of chest pain. When asked about medications, he says, “I take pills for my blood pressure and my cholesterol, plus some vitamins.” Which response is MOST appropriate?

90. You respond to a fall at a nursing home. Staff report a 78-year-old female fell from bed approximately one hour ago. She has a history of dementia, hypertension, and atrial fibrillation. On your general impression, you note she is lying supine in bed, appears comfortable, and is oriented to person only. Staff state she “seems like her normal self.” She denies pain when asked. Her vital signs are BP 118/72, pulse 72 and irregular, respirations 16. Despite the normal appearance, analyze which factor most strongly indicates this patient should be considered high priority.

91. A 71-year-old male with chest pain is being assessed. His wife provides most of the history, stating he has “heart problems,” takes “heart pills and blood thinners,” and had “some kind of heart surgery years ago.” The patient nods in agreement but adds nothing. The EMT notes the patient appears pale and diaphoretic. Given this interaction, which consideration is MOST important?

92. An EMT is preparing to apply a cervical collar to a patient who was involved in a motor vehicle collision. When measuring for collar size, the EMT should measure from which anatomical landmarks?

93. A 23-year-old female with type 1 diabetes is unresponsive. Her blood glucose is 18 mg/dL. You note she is wearing an insulin pump. After positioning her airway, which intervention should you prioritize?

94. You respond to a pedestrian struck by a vehicle. Witnesses report the car was traveling approximately 35 mph, and the patient was thrown approximately 30 feet. What is the significance of this mechanism?

95. A 35-year-old male is experiencing anaphylaxis after a bee sting. He is conscious but has significant facial swelling, wheezing, and difficulty breathing. His BP is 88/54 mmHg. You have an adult epinephrine auto-injector available. After administering the medication, how long should you hold the auto-injector in place?

96. Which of the following is the most appropriate reason for an EMT to request ALS (Advanced Life Support) backup during scene size-up?

97. What is the most common cause of airway obstruction in an unconscious patient?

98. A 34-year-old male is found sitting on the curb after a motor vehicle collision. He is holding his chest and says, “It hurts when I breathe.” His skin is pale and diaphoretic. Based on your general impression, what is your INITIAL determination about this patient?

99. You respond to a bicycle versus motor vehicle collision. The 28-year-old cyclist was struck from behind by a car traveling approximately 40 mph. Witnesses report the cyclist was thrown over the handlebars and landed on the pavement, striking their head. They were wearing a helmet. The patient is now unconscious with a deformed helmet and a visible crack in the helmet’s outer shell. Based on this mechanism and presentation, what is your index of suspicion?

100. You are the first unit on scene of a multi-vehicle collision involving a tour bus, two passenger cars, and a tanker truck carrying an unknown product. You observe approximately 30-40 people of various ages walking around or sitting on the ground, some with visible injuries. You notice a hissing sound coming from the tanker and a strong chemical odor. What is your MOST appropriate sequence of actions?