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

2. An EMT arrives at a residence and finds a 45-year-old male sitting on the edge of his bed, leaning forward with his hands on his knees. His skin is pale and diaphoretic, and he speaks in two-word sentences. Based on the general impression, what is this patient’s priority status?

3. A 32-year-old woman is found lying comfortably on a couch after a minor motor vehicle collision. She has pink, warm, dry skin, is speaking in full sentences, and appears calm. She states she was rear-ended while stopped at a red light. What should the EMT do next?

4. What is the primary indication for using the jaw thrust maneuver instead of the head-tilt/chin-lift technique?

5. An EMT is assessing an unconscious 68-year-old male who fell from a ladder. The patient is unresponsive with sonorous respirations. Manual opening of the airway does not improve breathing quality. What is the most appropriate next step?

6. A 22-year-old male was ejected from a vehicle during a high-speed collision. Upon arrival, the EMT finds the patient unresponsive, with shallow respirations at 8 breaths per minute. There is significant bleeding from a facial laceration. The EMT’s partner stabilizes the patient’s head. What is the most appropriate sequence of actions?

7. An EMT responds to a residence for a “sick person.” Upon entering, the EMT observes a 58-year-old woman sitting upright in bed, appearing anxious. Her skin is cool and diaphoretic, and she is using accessory muscles to breathe. She tries to answer questions but can only manage one or two words before gasping. Her husband reports she has a history of congestive heart failure. Based on this general impression and the patient’s presentation, what is the MOST appropriate interpretation and initial action?

8. An EMT crew arrives at a factory where a 35-year-old worker’s arm was caught in machinery. The patient is lying on the floor, pale, and has an amputation at the mid-forearm level. A coworker has applied a tourniquet. The patient is answering questions appropriately but appears very anxious. His skin is cool and slightly diaphoretic. The EMT notes that the patient is shivering despite the warm environment. Based on the general impression, which interpretation is MOST accurate?

9. During the primary assessment of an unconscious diabetic patient, an EMT attempts to insert an oropharyngeal airway. When the device touches the patient’s posterior pharynx, the patient gags but does not vomit. What is the most appropriate action?

10. An EMT is treating a 70-year-old female who fell down a flight of stairs. She is responsive to painful stimuli only, with sonorous respirations at 16 breaths per minute. Her skin is pink, warm, and dry. After opening her airway with a jaw thrust, the sonorous respirations stop and her breathing becomes quiet, but her chest rise remains adequate. What is the most appropriate next action?

11. When assessing a patient’s level of consciousness using the AVPU scale, what does the “V” represent?

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

13. A 67-year-old male was found lying on the floor at his residence. He opens his eyes when you say his name but is confused and cannot follow simple commands. His skin is pale, cool, and diaphoretic. How should you categorize his level of consciousness?

14. A 54-year-old female with a history of diabetes is found unresponsive in her bedroom. Her skin is pale, cool, and diaphoretic. Her pulse is rapid and thready. What is the MOST likely cause of her presentation?

15. You are assessing a 72-year-old male whose wife reports he suddenly developed slurred speech and right-sided weakness 30 minutes ago. When you ask him to smile, the right side of his face droops. When you ask him to raise both arms, his right arm drifts downward. What should you document about his level of consciousness?

16. A 3-year-old child fell from a swing and is crying loudly. Her skin is pink and warm, and her capillary refill time is 2 seconds. What does capillary refill time indicate about her circulation?

17. 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?

18. 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?

19. A 62-year-old female presents with sudden onset of severe headache followed by vomiting and rapid deterioration in consciousness. She now responds only to painful stimuli with decorticate posturing. Her blood pressure is 220/130 mmHg, and her pulse is 50 beats/min. Her skin is warm and dry. Which combination of findings is MOST concerning and indicates the need for immediate transport?

20. A 19-year-old male was found unresponsive at a party. His friends report he was drinking alcohol and may have taken “some pills.” His skin is pale, cool, and diaphoretic. His respiratory rate is 8 breaths/min, and his pulse is weak and thready. What is the relationship between his level of consciousness and circulation status?

21. Which of the following patients should be classified as high priority based solely on the general impression during the initial assessment?

22. During your general impression of a patient, you notice they are sitting upright, leaning forward with their hands on their knees, and appear anxious. This position is most indicative of which condition?

23. You arrive on scene to find a 68-year-old male who was involved in a low-speed motor vehicle collision. He is walking around the scene, talking to bystanders, and states he feels “fine.” He has a small bruise on his forehead. What is the most appropriate determination regarding this patient’s priority status?

24. You are assessing a 5-year-old child who fell from a playground structure. The child is crying loudly, reaching for a parent, and has a visible deformity to the left forearm. Based on your general impression, what is the most accurate statement about this child’s status?

25. You are dispatched to a multi-vehicle collision on the highway. Upon arrival, you identify the following patients: Patient A is a 35-year-old male walking around asking for help with his bleeding nose. Patient B is a 28-year-old female sitting on the ground, holding her chest and breathing rapidly. Patient C is a 40-year-old male lying motionless in the back seat of one vehicle. Which patient should be your highest priority?

26. You respond to a residence for a “sick person.” Upon entering, you find a 72-year-old female lying in bed. She opens her eyes when you speak to her but is confused and unable to answer questions appropriately. Her skin is pale, cool, and diaphoretic. Based on your general impression, which condition should you most suspect?

27. A 22-year-old male was struck in the chest with a baseball bat during an altercation. He is sitting against a wall, appears anxious, and has rapid, shallow breathing. You note bruising to the right side of his chest. He states his pain is “8 out of 10.” What finding during your general impression would most strongly indicate this is a high-priority patient?

28. You respond to an industrial accident at a manufacturing plant. Your general impression reveals three injured workers. Worker 1 is standing and holding a bloody towel to his hand, requesting help loudly. Worker 2 is sitting on the ground, holding his abdomen, and appears pale with rapid breathing. Worker 3 is lying on the ground, unresponsive, with a chemical spill near his body and no obvious movement. You are the only EMS provider on scene with no additional resources for 10 minutes. Which patient should you assess and treat first?

29. You respond to a residence where a 58-year-old male is complaining of “not feeling well” for the past two days. On your general impression, you note he appears ill, is diaphoretic, and is sitting in a tripod position. His wife states he has a history of diabetes and “heart problems.” When you ask him what’s wrong, he responds with one-word answers in a soft voice. Analyze this general impression and determine which combination of findings most strongly suggests a high-priority condition requiring immediate intervention.

30. 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.

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

32. 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?

33. A 34-year-old male was found unconscious after a fall. You open his airway using the jaw-thrust maneuver and determine he is breathing adequately at 16 breaths/min. His SpO2 reads 96% on room air. What is the most appropriate next step?

34. You are assessing a 67-year-old female with sudden confusion and difficulty speaking. When you ask her name, she responds with “water… water… water” repeatedly. She follows simple commands such as “squeeze my hand” but cannot answer “what year is it?” What is her mental status?

35. A 5-year-old child is found unresponsive in a swimming pool. You pull him from the water and note no breathing or pulse. You begin CPR with chest compressions. After 30 compressions, you open the airway and prepare to give ventilations. What is the normal respiratory rate range for a child this age?

36. You are assessing a 72-year-old male with severe respiratory distress. He is sitting upright in a tripod position, using accessory muscles, and can only say two words before gasping for air. His SpO2 is 88% on room air. Auscultation reveals absent breath sounds on the left side and distant sounds on the right. What is your priority intervention?

37. A 22-year-old male was ejected from a vehicle during a crash. On your arrival, he is unresponsive to voice but withdraws his right arm when you pinch his left shoulder. He does not open his eyes even to painful stimulus. His breathing is irregular, with a rate of 8 breaths/min. What is his GCS score and immediate priority?

38. You respond to a residence for a “person not acting right.” The family states the 58-year-old male has diabetes and takes insulin. They found him this morning “staring at the wall and not making sense.” When you arrive, he opens his eyes when you speak, is mumbling words you cannot understand, and moves his arms around purposelessly when you try to examine him. His skin is pale, cool, and diaphoretic. Blood glucose is 42 mg/dL. What is his GCS and the most likely cause of his altered mental status?

39. You are called to a nursing home for a 84-year-old female with difficulty breathing. Staff report she has advanced dementia and a “do not resuscitate” order. On assessment, she is responsive only to painful stimulus with incomprehensible moaning. Her respiratory rate is 6/min with minimal chest rise, and her SpO2 is 74% on 2L nasal cannula. Auscultation reveals coarse crackles bilaterally. Her family has arrived and is asking what you will do for her. What is the most appropriate action?

40. A 3-year-old child is brought to you by his panicked mother. She states he was eating grapes when he suddenly started coughing and gagging, then became quiet and turned blue. The child is now silent, clutching his throat, and unable to cough or cry. What is the significance of the child being silent rather than coughing?

41. Which of the following vital sign changes indicates a patient has transitioned from compensated to decompensated shock?

42. You arrive at a motor vehicle collision and find three patients. Patient A is walking around complaining of neck pain. Patient B is sitting on the curb with a deformed left forearm. Patient C is unconscious, lying on the ground with rapid, shallow breathing and a weak, thready pulse. Which patient should receive your immediate attention?

43. A 68-year-old male complains of chest pain and difficulty breathing. Your assessment reveals: BP 148/94 mmHg, pulse 112 and irregular, respirations 28, JVD, bilateral crackles in the lungs, and pedal edema. The patient’s skin is warm and pink. Which type of shock should you suspect, and what is the underlying cause?

44. During a mass-casualty incident at a shopping mall, you encounter a 22-year-old female with a 2-inch laceration to her forearm with bright red, spurting blood. She is alert, pale, and anxious. Her pulse is 110 and strong. Using simple triage, how should you categorize this patient?

45. A 45-year-old male was found lying in an alley by bystanders. His radial pulse is absent, but you can palpate a carotid pulse. His skin is cool, pale, and diaphoretic. What do these findings indicate about his circulatory status?

46. 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?

47. You are assessing a 52-year-old male with a chief complaint of abdominal pain. He describes the pain as “tearing” and radiating to his back. His blood pressure is 180/110 mmHg in his right arm and 150/90 mmHg in his left arm. He appears anxious and diaphoretic. What is your primary concern, and how should this affect your transport decision?

48. A 29-year-old male was struck in the chest during a bar fight. Assessment reveals: absent breath sounds on the left, jugular vein distension, and a blood pressure of 88/54 mmHg. His trachea appears midline. Which condition should you suspect, and what intervention is most appropriate?

49. You respond to a residence for a 67-year-old female with chest pain. Upon arrival, you find her sitting in a chair, clutching her chest. She is able to speak in full sentences but appears uncomfortable. Her vital signs are: BP 162/98 mmHg, pulse 98, respirations 20. Which additional finding would cause you to upgrade this patient to highest priority?

50. You are dispatched to a residence for a “person not feeling well.” Upon arrival, you find a 71-year-old male who is responsive to painful stimuli only. Family reports he was fine an hour ago. His airway is patent, breathing is adequate but slightly rapid, and his radial pulse is weak and rapid. His skin is warm and flushed. What condition should you consider based on the skin findings?