Free EMT Practice Test – Part 9

1. A 72-year-old female is found lying in bed at a nursing home. Staff reports she was “fine this morning.” On assessment, she does not open her eyes when you speak to her, but she moans and pulls away when you pinch her trapezius. What is her AVPU status?

2. You arrive on scene to find a single-vehicle collision with the driver still inside. What is the FIRST piece of information you should determine during scene size-up?

3. You are treating an unresponsive 34-year-old female with a suspected drug overdose. Her respirations are 6 per minute and shallow. You attempt to insert an OPA but she gags when you place it at the back of her throat. What should be your next action?

4. Which statement best explains why compensated shock can be missed during initial assessment?

5. You are treating an unresponsive patient in respiratory distress. During airway management, you notice the patient has oral candidiasis (white patches in the mouth) and appears cachectic. What is your most appropriate action regarding PPE?

6. A patient has a blood pressure of 100/70 with a heart rate of 130. What do these findings suggest?

7. Which of the following patients would benefit most from high-flow oxygen via a non-rebreather mask?

8. Under HIPAA regulations, which principle requires EMTs to share only the minimum amount of patient information necessary to accomplish the intended purpose?

9. Who has the authority to expand the Incident Command System by establishing branches, divisions, or groups?

10. What is the minimum personal protective equipment (PPE) an EMT should don before providing care to a patient with active respiratory symptoms and a productive cough?

11. A 45-year-old male has a deep laceration on his forearm with bright red blood flowing steadily. After applying direct pressure with a sterile dressing for 5 minutes, the bleeding continues to soak through. What should the EMT do next?

12. You are providing BVM ventilations to an apneic adult patient. After each squeeze, you notice the patient’s stomach is becoming increasingly distended. What is the MOST likely cause and appropriate action?

13. You are assessing an unresponsive 68-year-old male. You open his airway using the head-tilt, chin-lift maneuver and hear gurgling sounds. What is your IMMEDIATE action?

14. You are dispatched to an assault at a bar. Upon arrival, police have secured the scene. A 45-year-old male was struck in the head and face multiple times with a baseball bat. He is conscious but combative, with visible swelling and deformity to the left side of his face. His left eye is swollen shut, and you note clear fluid draining from his left ear. He is agitated and trying to stand despite your instructions. What do these findings indicate, and what is your priority?

15. You respond to a nursing home for a 76-year-old female with altered mental status. Staff report she was normal yesterday but today is difficult to arouse and “not making sense.” Assessment reveals a GCS of 11, blood glucose of 380 mg/dL, and deep, rapid respirations at 28 breaths per minute. Her skin is warm and dry. Which condition is most likely, and what metabolic process is occurring?

16. A patient is lying still on the floor and appears to be sleeping. When you approach, you notice uneven chest rise. What should you do?

17. You are caring for a patient who claims to have no pain but is grimacing and guarding their abdomen. How should you document this?

18. You are assessing a 34-year-old male patient who was involved in a house fire. He is conscious but agitated, with soot around his nose and mouth. His respiratory rate is 32 breaths per minute, and you note inspiratory stridor. His SpO2 reading on room air is 88%. Which of the following is the MOST appropriate immediate intervention?

19. You respond to a factory where workers are reporting difficulty breathing and nausea. You notice a yellow placard with a number 6 on a storage container. What does this indicate?

20. A 28-year-old male was involved in a motorcycle crash. He has a partially amputated right leg below the knee with pulsatile bright red bleeding. The EMT applies direct pressure, but blood continues to spurt. The patient’s skin is pale, cool, and diaphoretic. His radial pulse is absent, but carotid pulse is present. What is the patient’s estimated blood pressure range, and what intervention is most critical?

21. Which of the following best describes the principle of early resource activation?

22. A patient has a regular radial pulse of 110 beats per minute. What is this called?

23. A patient has audible wheezing. What does this indicate?

24. A 7-year-old boy with a history of asthma is experiencing an acute exacerbation. His mother states he has used his albuterol inhaler twice in the past hour with minimal improvement. The child is alert but anxious, with diffuse wheezing, intercostal retractions, and SpO2 of 91% on room air. His respiratory rate is 32. What is your MOST appropriate action regarding albuterol?

25. A patient has crackles (rales) heard in both lung bases. What condition does this suggest?

26. A 67-year-old male with severe COPD presents with acute respiratory distress. He is using accessory muscles, cannot speak in full sentences, and has SpO2 of 89% on room air. He appears exhausted. What makes this patient a priority?

27. You respond to a nursing home for a 78-year-old female with “altered mental status.” On arrival, staff report she was found unresponsive in bed this morning. Your general impression reveals an elderly female lying motionless in bed. She does not respond to your voice. When you squeeze her shoulder firmly, she grimaces but does not open her eyes. Her skin is pale and very cool to touch, and you note mottling on her arms and legs. Her breathing is irregular with periods of apnea lasting 10-15 seconds. Analyze this general impression and determine the most likely clinical picture.

28. What is the primary purpose of an oropharyngeal airway (OPA)?

29. You are caring for an unconscious 34-year-old male who was found down at a construction site. He has a Glasgow Coma Scale score of 6, shallow respirations at 8/min, and no gag reflex. Which airway adjunct is most appropriate for this patient?

30. A 22-year-old female fell from a third-story apartment window. Witnesses report she landed on her back on concrete. She is conscious and complaining of severe back pain. Based on the mechanism, which assessment approach is most appropriate?

31. A 62-year-old male with chest pain has a blood pressure of 110/70 and is sweating. He has a prescription for nitroglycerin. Which of the following is a contraindication to administering this medication?

32. A patient responds to a painful stimulus by pulling away from the stimulus but does not open their eyes or respond to verbal commands. According to the AVPU scale, how should this patient’s level of consciousness be documented?

33. Which of the following patient presentations would be classified as the HIGHEST transport priority?

34. An EMT is obtaining a blood pressure on a 72-year-old female with dizziness. The EMT inflates the cuff to 180 mmHg and begins slowly releasing the pressure. The first Korotkoff sound is heard at 156 mmHg, and the sounds disappear at 88 mmHg. Which documentation is MOST accurate?

35. Which of the following patients should be classified as the HIGHEST transport priority?

36. A 28-year-old male with difficulty breathing states, “I’m allergic to penicillin.” Which response should the EMT provide NEXT?

37. When forming a general impression of a patient, which combination of findings suggests a “sick” appearance requiring immediate intervention?

38. You respond to a factory where a worker has been splashed with an unknown chemical. The patient is conscious and alert, complaining of burning eyes and skin pain. A safety data sheet is not immediately available, but coworkers mention the chemical is in a drum labeled “Industrial Solvent.” What is your FIRST priority regarding PPE and scene safety?

39. You are assessing a 68-year-old female with a history of atrial fibrillation who complains of sudden onset of weakness and dizziness. Her blood pressure is 88/54 mmHg, heart rate is 156 and irregular, and her skin is cool and pale. She is alert but appears anxious. What is the MOST likely cause of her circulatory compromise?

40. A 22-year-old male was found unconscious at a college party. Bystanders state he was drinking heavily. On assessment, his eyes are closed, he does not respond to verbal stimuli, and when you apply a sternal rub, he extends his arms and legs with internal rotation. Using the AVPU scale, what is this patient’s level of consciousness, and what is your primary concern?

41. You respond to a two-vehicle collision. Driver A is ambulatory with neck pain. Driver B is trapped in the vehicle with an obvious deformity to the thigh and is screaming in pain. A passenger in Driver B’s vehicle is unresponsive with a weak, thready pulse. Which patient is your highest priority?

42. A 72-year-old female is found confused and weak. Her husband reports she has diabetes, hypertension, and “had a small stroke last year.” She takes metformin, lisinopril, and “some other pills.” Her skin is warm and dry, pulse is 98 and regular, respirations are 18, and BP is 146/84. Blood glucose reads 42 mg/dL. Given this presentation, which question would be MOST critical to ask NEXT?

43. A 55-year-old male was the unrestrained driver in a moderate-speed motor vehicle collision. The vehicle sustained significant front-end damage, and the steering column is bent. The patient is alert and oriented, complaining of mild neck pain and pain in his left wrist, which has an obvious deformity. He states he “hit the steering wheel hard.” His vital signs are stable. Which finding would most strongly indicate the need for spinal motion restriction?

44. A 70-year-old female complains of dizziness and weakness. During your primary assessment, you find her skin is pale, cool, and diaphoretic. Her radial pulse is irregular and thready at 92 beats per minute. She reports a history of “heart problems.” What do these findings suggest about her circulatory status?

45. You are driving in emergency mode and approach a school bus with its red lights flashing and stop sign extended. What should you do?

46. You are called to care for a patient with significant bleeding from a leg wound. What PPE should you don before making patient contact?

47. A 45-year-old male was involved in a motor vehicle collision. During the rapid trauma assessment, the EMT notes deformity, contusions, and swelling to the right thigh. The right leg appears shorter than the left and is externally rotated. Palpation reveals crepitus. Based on these findings, which injury should the EMT suspect?

48. A 72-year-old male with a history of stroke presents with labored breathing. During your assessment, you note stridorous sounds during inspiration, significant accessory muscle use, and the patient is unable to speak more than one or two words at a time. His oxygen saturation is 86% on room air. What is your priority intervention?

49. Which of the following medications can an EMT administer without requiring prior authorization or medical direction approval for each specific administration?

50. An EMT with 10 years of experience is paired with a new EMT who graduated last month. During a cardiac arrest, the experienced EMT notices the new EMT performing CPR compressions that are too shallow. The experienced EMT is frustrated and wants to take over. Considering professional development, team dynamics, and patient care, what is the MOST appropriate approach?

51. A patient presents with a significant mechanism of injury but has no spinal pain, no tenderness on palpation, is alert and oriented, has no neurological deficits, and has no evidence of intoxication. Which additional finding would still indicate the need for spinal motion restriction?

52. You respond to a single-vehicle collision on an isolated country road at 0300 hours. The vehicle struck a utility pole at moderate speed. One patient is trapped with obvious leg deformity, conscious but in severe pain. Power lines are down on the vehicle. You are the first unit on scene with a 25-minute ETA for additional resources. Analyze this scenario and determine the appropriate initial action.

53. In an unresponsive adult patient with no suspected spinal injury, where should the EMT first assess for a pulse during the primary assessment?

54. You respond to a residence for a 62-year-old male with “difficulty breathing.” As you enter the room, you observe him sitting on the edge of the bed in a tripod position, using accessory muscles, with visible diaphoresis on his forehead. He attempts to speak but can only manage one or two words between breaths. Based on your general impression, what is your immediate priority?

55. You are treating a patient who is actively vomiting bright red blood. The emesis is projecting onto your uniform. What should you do immediately after this exposure?

56. A 45-year-old male is found sitting on a park bench. When you approach and ask, “Are you okay?” he slowly opens his eyes, looks at you, and says, “I think so… where am I?” He cannot tell you the day of the week. Using the AVPU scale and orientation assessment, how would you describe his mental status?

57. At 0200 hours, you respond to a residence for a “difficulty breathing” call. Upon arrival, the front door is open, lights are on, and you hear arguing inside. A male voice yells “She’s faking it!” and a female voice responds with labored breathing sounds. You see through the window a male standing over a female who is sitting on the couch. The male does not appear to have any weapons visible. Analyze the scene and determine the appropriate response.

58. A 55-year-old female with diabetes is found unresponsive. Her husband states she has been sick with vomiting for two days and has not been able to keep food or medications down. Blood glucose is 78 mg/dL. She has rapid, deep breathing and a fruity odor on her breath. What should you suspect?

59. An unresponsive patient has blood in the oropharynx. What should you do?

60. A 45-year-old male is found lying on the ground after a witnessed fall. He does not open his eyes when you approach, but when you firmly squeeze his trapezius muscle, he opens his eyes and tries to push your hand away. How would you document his AVPU status?

61. A 58-year-old male with a history of type 2 diabetes is found confused and diaphoretic in his home. His family states he skipped breakfast and took his insulin this morning. His blood glucose reads 45 mg/dL. Which condition is most likely causing his presentation?

62. You are treating a 62-year-old male with severe chest pain radiating to his left arm. Vital signs are: BP 104/68 mmHg, pulse 58/min, respirations 18/min, SpO2 95% on room air. The patient hands you his nitroglycerin bottle and asks you to help him take a pill. His last dose was 45 minutes ago with no relief. What is your BEST course of action?

63. You are assessing a patient’s breathing. You count 28 breaths per minute with shallow chest rise. The patient appears anxious. What should you do?

64. A patient with a suspected heart attack is speaking full sentences, has pink warm skin, and denies shortness of breath. However, he reports chest pressure that began 20 minutes ago. How should this patient be prioritized?

65. You are dispatched to a 74-year-old female with difficulty breathing. Upon arrival, you find her sitting upright in a tripod position. She reports a history of congestive heart failure and has not taken her medications in three days. Vitals: BP 182/98 mmHg, HR 102 bpm, RR 32 breaths/min, SpO2 86%. She has crackles heard in both lung bases and +2 pitting edema in both lower extremities. What is the MOST appropriate treatment sequence?

66. A 68-year-old female complains of mild shortness of breath after climbing stairs. Her SpO2 is 92% on room air, and she has clear lung sounds bilaterally. She has no history of COPD. Which oxygen delivery device is MOST appropriate for this patient?

67. A 35-year-old female complains of severe right lower quadrant abdominal pain that started 12 hours ago. She reports nausea and one episode of vomiting. She says her last menstrual period was 2 weeks ago. She denies fever. Which additional history question is MOST important for narrowing the differential diagnosis?

68. You are dispatched to a nursing home for an 84-year-old female who was found on the floor by staff. She is unable to tell you what happened. Staff report she has dementia and takes medication for hypertension and anxiety. On assessment, you note a small bruise on her forehead. Her vital signs are: BP 136/84 mmHg, HR 78/min, RR 16/min. What is your priority assessment action?

69. What legal principle protects an EMT from liability for negligence when providing emergency care in good faith, within their scope of practice, and without expectation of payment?

70. You arrive at the scene of a motor vehicle collision. A 45-year-old male is sitting on the curb. As you approach, you note he is holding his chest, appears short of breath, and his lips have a bluish tint. What is your immediate priority?

71. A 7-year-old child weighing 22 kg (48 lbs) is experiencing anaphylaxis after eating a peanut butter cookie. The parent hands you two epinephrine auto-injectors: one labeled “0.15 mg” and one labeled “0.3 mg.” Which auto-injector should you use?

72. Your unit arrives at the scene of a domestic disturbance. Police are on scene and have secured one individual in the back of a patrol car. Another person is lying on the front lawn with visible injuries. Officers wave you forward, stating the scene is secure. Before approaching the patient, what is the MOST appropriate action?

73. A 28-year-old male was involved in a motor vehicle collision. He is unresponsive to verbal stimuli. When you apply a painful stimulus by squeezing his trapezius muscle, he extends his arms and legs stiffly and makes no other movement. His blood pressure is 180/100 mmHg, pulse is 58 beats/min, and respirations are irregular. What do these findings suggest?

74. You are providing a radio report to the receiving hospital. Which format is MOST appropriate for organizing your report?

75. A 35-year-old male was stung by a bee approximately 5 minutes ago. He is now experiencing difficulty breathing, widespread hives, and facial swelling. His BP is 90/60 mmHg, HR is 118 bpm, and he has audible stridor. What should you do FIRST?

76. Which type of medical direction involves real-time communication with a physician for orders during patient care?

77. What is the normal respiratory rate range for a healthy adult patient?

78. You are dispatched to a construction site where a worker fell 15 feet onto concrete. He is conscious, complaining of back and abdominal pain. During your scene size-up, you note no obvious hazards. What MOI considerations should guide your assessment and resource decisions?

79. A 34-year-old male has a deep laceration to his forearm from a table saw. Bright red blood is spurting from the wound. Direct pressure has been applied for 3 minutes but bleeding continues heavily. What is your next action?

80. You are assessing a patient’s breathing. You count 12 breaths per minute, with adequate chest rise and bilateral breath sounds. The patient is speaking in full sentences. How would you classify this breathing?

81. A pediatric patient has a respiratory rate of 50 with retractions, nasal flaring, and grunting. What is the transport priority?

82. Which ethical principle requires EMTs to act in the best interest of the patient and prioritize patient welfare above personal interests?

83. A 45-year-old male complains of chest pain that started 20 minutes ago. He describes it as “pressure” in the center of his chest. His vital signs are: BP 148/92, pulse 98, respiratory rate 18, SpO2 96% on room air. He has no respiratory distress and clear lung sounds. What is the MOST appropriate oxygen administration for this patient?

84. Which component of OPQRST assesses whether the pain spreads to other areas of the body?

85. You have just administered epinephrine to a 28-year-old woman experiencing anaphylaxis. Which of the following findings would indicate a POSITIVE response to the medication?

86. You respond to a reported fire at a two-story residential home. Upon arrival, you observe moderate smoke coming from the first floor windows. The fire department has not yet arrived. A neighbor tells you three people live in the home and might still be inside. One adult is standing on the front lawn coughing, and you can hear someone calling for help from a second-floor window. What should you do?

87. You respond to a cardiac arrest and begin two-person BVM ventilation while your partner performs CPR. After each ventilation, you notice the patient’s abdomen rising more than the chest. Vital signs show SpO2 at 82% despite high-flow oxygen attached to the BVM. The patient has an OPA in place. Which intervention should you prioritize FIRST?

88. A 3-year-old child is brought to you by his father. The child has multiple bruises in various stages of healing on his back, buttocks, and thighs. The father states the child “falls a lot” because he is “clumsy.” The child is quiet, avoids eye contact, and clings to his father. What is the MOST appropriate action?

89. A 42-year-old male complains of chest pain. He describes the pain as sharp, worse when he breathes deeply, and improved when he sits forward. He reports he had a “bad cold” two weeks ago. He has no history of heart disease. Based on this history, which condition should the EMT consider MOST likely?

90. You respond to a call for a diabetic emergency at an address known to your service for drug activity. As you exit the ambulance, you observe several individuals in the driveway who appear agitated and are speaking loudly among themselves. One person shouts at you to “hurry up and get inside!” while blocking the front door. What is your most appropriate response?

91. What is the FIRST priority for an EMT when arriving at the scene of an emergency?

92. A 19-year-old male is found unconscious at a party. Friends report he “had a lot to drink.” The patient is unresponsive to painful stimuli, has vomit in his mouth, and is breathing at 6 breaths per minute with gurgling sounds. After you suction the airway, what finding would indicate that your airway intervention has been SUCCESSFUL?

93. What is the correct compression-to-ventilation ratio for one-resuer CPR on an adult patient?

94. A 62-year-old male with a history of COPD and congestive heart failure presents with severe shortness of breath. Assessment reveals: BP 168/94 mmHg, HR 112, RR 28, SpO2 86% on room air. He has diffuse wheezing, bilateral crackles, 2+ pitting edema in both lower extremities, and JVD. After administering bronchodilator therapy, minimal improvement is noted. Which condition is the PRIMARY cause of his respiratory distress, and what is the MOST appropriate next intervention?

95. You are called to a residence for a 4-year-old child who is choking. Upon arrival, you find the child alert but anxious, sitting upright, and making high-pitched noises when inhaling. His skin is pink. What is the MOST appropriate initial action?

96. A rural county is developing a new EMS system. Community leaders want to understand the difference between a fire-based EMS system and a third-service model. Which statement best describes a key distinction?

97. What is the minimum fall height that should be considered a significant mechanism of injury requiring a full trauma assessment?

98. You are dispatched to a residence for a “difficulty breathing” call. As you approach the address, you notice an unusual number of emergency vehicles – two police cars are parked with lights off, officers are positioned behind their vehicles with weapons drawn, and a SWAT vehicle is staging nearby. A police officer waves you forward. What is your BEST response?

99. You arrive on scene to find a 55-year-old male lying supine on the kitchen floor. His wife states he collapsed while eating dinner about 5 minutes ago. The patient is unresponsive, cyanotic around the lips, and not making any respiratory effort. You observe abdominal distension and hear no breath sounds. His pulse is rapid and weak. You attempt to ventilate with a BVM, but you cannot get the chest to rise despite proper mask seal and positioning. What is the most likely cause, and what is the appropriate intervention?

100. An EMT arrives at the bedside of a 72-year-old female with pneumonia. The patient is lying supine, appears cyanotic around the lips, and is using accessory muscles to breathe. She is diaphoretic and unable to speak. What general impression should be formed?