EMT Emergency Medical Technicians Exam Question and Answers

Comprehensive and Detailed Explanation From Exact Extract:

Contraindications to CPAP (Continuous Positive Airway Pressure) include:

Hypotension: CPAP can reduce preload and worsen shock (BP < 90 systolic is a contraindication)

Respiratory rate too low: A rate of 10 is at the low threshold; CPAP requires spontaneous adequate effort

Active vomiting or nausea: CPAP increases aspiration risk

Crackles and hypoxia are indications, not contraindications, for CPAP. Pulse rate does not influence CPAP use directly.

Even in high-acuity situations, NREMT standards require EMTs to perform a scene size-up before patient contact. Scene size-up includes ensuring scene safety, determining the mechanism of injury, identifying hazards, and assessing the need for additional resources. Entering a scene without confirming safety places the EMT at risk and can result in additional victims.

Although the patient is unresponsive and apneic, EMTs must first confirm the scene is safe to enter. Only after scene safety is established should patient care begin.

Option B is incorrect because CPR cannot be initiated until the EMT has safely accessed the patient.

Option C is incorrect because airway maneuvers are performed after scene safety and patient access are confirmed.

Option D is incorrect because spinal stabilization occurs after initial access and assessment.

NREMT emphasizes: rescuer safety always comes first, even in life-threatening emergencies.

A deposition is a formal legal proceeding in which sworn testimony is taken prior to trial. NREMT education on EMS operations, documentation, and legal responsibilities emphasizes that EMTs may be required to participate in depositions as part of civil or criminal cases involving patient care.

Option C is correct because attorneys for all involved parties are typically present during a deposition. These may include attorneys representing the plaintiff, defendant, EMS agency, or insurance providers. The EMT provides sworn testimony under oath, and the deposition may later be used in court.

Option A is incorrect because deposition testimony is admissible in court under many circumstances.

Option B is incorrect because depositions are not presided over by a judge; they are conducted by attorneys.

Option D is incorrect because exhibits such as patient care reports, protocols, or photographs may be introduced during a deposition.

NREMT stresses the importance of accurate documentation, professionalism, and honesty, as EMTs are legally accountable for their actions and statements.

Comprehensive and Detailed Explanation From Exact Extract:

Secondary prevention focuses on early detection and intervention to reduce the severity or impact of an illness or injury that has already occurred or is inevitable. Examples in EMS include:

AED deployment in public

Stroke recognition training

Early CPR

Primary prevention aims to stop the injury from occurring at all (e.g., vaccination, seatbelts). "Reactive" and "proactive" are not recognized formal categories in EMS public health strategy.

Comprehensive and Detailed Explanation From Exact Extract:

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

Planning: Collects data and develops response strategies

Logistics: Supplies and personnel

Finance/Administration: Cost tracking, contracts, compensation

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

NREMT medication management standards require EMTs to ensure that all medications are stored properly and are safe for administration. The presence of ice crystals indicates that a medication has frozen, which can alter its chemical stability, concentration, and effectiveness.

Option C is correct because medications that have frozen must be discarded and replaced, even if they later thaw. Freezing can cause separation of active ingredients or damage to the medication vial or syringe.

Option A is insufficient because expiration status does not address medication integrity.

Option B is incorrect because frozen medications are unsafe and should not be reused.

Option D is dangerous and explicitly prohibited, as warming does not restore medication safety.

NREMT emphasizes strict medication safety checks to prevent patient harm and ensure effective treatment.

Comprehensive and Detailed Explanation (Based on NREMT standards):

NREMT trauma care guidelines clearly state that distal circulation, sensation, and motor function (CSM) must be assessed both before and after splinting any musculoskeletal injury.

Option C is correct because the pre-splint assessment establishes a baseline, while the post-splint assessment confirms that the splint has not compromised blood flow or nerve function.

Option A is incomplete and unsafe.

Option B misses baseline data.

Option D violates standard trauma care practices.

Proper documentation of distal neurological status is critical for patient safety and medico-legal protection.

Appearance (Skin Color): → 2 points

The neonate is completely pink.

APGAR criteria:

0 = blue/pale

1 = pink body, blue extremities

2 = completely pink

Pulse (Heart Rate): → 2 points

Heart rate is 108/min.

APGAR criteria:

0 = absent

1 = < 100/min

2 = ≥ 100/min

Activity (Muscle Tone): → 1 point

The neonate has some flexion of extremities, but not active motion.

APGAR criteria:

0 = limp

1 = some flexion

2 = active motion

Respirations: → 1 point

Breathing is slow, not strong crying.

APGAR criteria:

0 = absent

1 = slow or irregular respirations

2 = strong cry

Total APGAR Score at 5 Minutes: 6 / 10

Interpretation (NREMT-based):

A score of 6 indicates the newborn requires continued supportive care, such as warming, positioning, stimulation, and close monitoring.

No immediate chest compressions are indicated because the heart rate is >100/min.

Respiratory effort should continue to be assessed closely.

This scoring aligns with NREMT neonatal assessment and APGAR scoring guidelines used for evaluating newborn transition after birth.

The foundation of effective multiple-casualty incident (MCI) management is the Incident Command System (ICS). NREMT teaches that ICS provides clear leadership, communication, accountability, and coordination of resources.

Option D is correct because ICS allows for scalable management, efficient delegation, and integration of multiple agencies.

Option B is important but is a component of ICS, not the core principle.

Option C is a tactical step that occurs within the command structure.

Option A misunderstands ICS, as command is established based on arrival, not rank alone.

NREMT stresses that without ICS, MCIs become chaotic and unsafe, regardless of clinical skill.

Positive pressure ventilation (PPV) forces air into the lungs under pressure rather than relying on negative intrathoracic pressure. NREMT education emphasizes that while PPV is lifesaving, it carries important risks—most notably decreased venous return to the heart.

Option C (Profound hypotension) is correct because increased intrathoracic pressure reduces preload by compressing the vena cava, which can significantly lower cardiac output and blood pressure. This effect is especially pronounced in hypovolemic or trauma patients.

Option A is incorrect because diaphragmatic movement is not a complication.

Option B is unrelated to ventilation.

Option D describes a ventilation parameter, not a complication.

NREMT stresses careful ventilation rates and volumes to avoid hypotension, gastric inflation, and barotrauma.

Comprehensive and Detailed Explanation From Exact Extract:

Mental status reflects perfusion and oxygen delivery to the brain, which is highly sensitive to hypoxia and hypercapnia. Even if respiratory rate and SpOâ‚‚ are normal, altered mental status suggests ineffective gas exchange or hypoperfusion.

Pulse oximetry may be falsely normal in CO poisoning or poor perfusion. Skin color is subjective and not as sensitive or specific as neurological status.

Using the START triage system, patients are categorized based on Respirations, Perfusion, and Mental Status (RPM).

A respiratory rate greater than 30 breaths per minute immediately qualifies the patient as RED (Immediate). Additionally, delayed capillary refill (>2 seconds) further supports this classification.

Option A is correct.

Option B applies to stable patients who can wait.

Option C is for deceased or nonsalvageable patients.

Option D is for minor injuries.

NREMT teaches that patients with compromised airway or perfusion are the highest priority.

Comprehensive and Detailed Explanation From Exact Extract:

In cases of sexual assault, preserving evidence integrity is critical. Clothing or other forensic evidence must be placed in paper bags. Plastic or non-breathable materials can trap moisture, promoting mold or degradation of evidence like DNA or bodily fluids.

This approach follows chain-of-custody protocols used by law enforcement and medical facilities for handling forensic material.

Comprehensive and Detailed Explanation From Exact Extract:

Under HIPAA (Health Insurance Portability and Accountability Act), only designated personnel are authorized to handle inquiries regarding a patient’s Protected Health Information (PHI). The Privacy Officer is responsible for enforcing compliance with privacy regulations and addressing PHI access requests.

Shift supervisors or hospitals do not have the legal authority to release PHI unless specifically designated.

Comprehensive and Detailed Explanation From Exact Extract:

The symptoms described are classic for a stroke (CVA). Additional hallmark findings include:

Arm drift (motor weakness or hemiparesis)

Facial droop (Cranial nerve VII involvement)

Slurred speech (dysarthria or aphasia)

These form the basis of prehospital stroke assessment tools like FAST:

Face drooping

Arm weakness

Speech difficulty

Time to call 911

Miosis (pupil constriction) and tremors are not associated with stroke in EMS context. Syncope is an isolated event and not a reliable CVA symptom.

Comprehensive and Detailed Explanation (Based on NREMT standards):

For unresponsive children, NREMT guidelines recommend checking central pulses to determine circulation.

Option B (Carotid) is correct and is the preferred pulse site for children over 1 year old.

Option C (Femoral) is also acceptable as a central pulse, especially if the carotid pulse is difficult to locate.

Option A is a peripheral pulse and unreliable in shock.

Option D is used for infants under 1 year.

Option E is not used for pulse assessment.

Accurate pulse assessment guides CPR decisions and must be completed within 10 seconds.

Comprehensive and Detailed Explanation From Exact Extract:

Laundry detergent ingestion — especially in the case of liquid detergent pods — is associated with caustic airway and gastrointestinal injuries. The presence of crackles and drowsiness are signs of aspiration and possible respiratory failure. Vomiting increases the risk of aspiration pneumonitis, and esophageal perforation is a life-threatening complication from corrosive ingestion.

While seizure and hypoglycemia are possible complications of toxic ingestion, they are not as immediately linked to the detergent profile as airway injury and aspiration risk.

Comprehensive and Detailed Explanation From Exact Extract:

Albuterol, a common beta-2 adrenergic agonist used in inhalers, stimulates bronchial smooth muscle relaxation. However, stimulation of beta receptors can also produce systemic effects such as:

Tachycardia (due to beta-1 cross-reactivity)

Nervousness (from central stimulation)

Coughing (a local airway response)

Confusion and drowsiness are not typical side effects of beta-agonists. Hypotension is rare unless severe overdose occurs.

Comprehensive and Detailed Explanation From Exact Extract:

Negligence occurs when an EMT:

Has a duty to act

Breaches that duty (e.g., by withholding basic care like warmth)

Causes harm or risk of harm

Establishes causation

The EMT’s failure to treat the patient with respect and dignity — even if the patient improved — still constitutes negligence, especially if tied to a discriminatory or dismissive attitude.

Comprehensive and Detailed Explanation From Exact Extract:

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

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

Comprehensive and Detailed Explanation From Exact Extract:

In pediatric START or JumpSTART triage, a "delayed" status is appropriate if the child is breathing adequately, has palpable pulses, and follows commands. The respiratory rate of 16 is normal for a 9-year-old, and being able to walk also supports the “delayed” tag.

"Mottled skin" and "breathing only after airway opening" would more likely lead to "immediate" or even "expectant" categories depending on associated symptoms.

Comprehensive and Detailed Explanation From Exact Extract:

SALT (Sort, Assess, Lifesaving interventions, Treatment/Transport) is a mass casualty triage method recommended by the CDC and the National Association of EMS Physicians (NAEMSP). During the "Assess" step, responders:

Check respirations

Provide lifesaving interventions such as rescue breaths if the patient is not breathing but has a pulse

Evaluate mentation (e.g., ability to follow commands)

Airway adjuncts and full transport do not happen at this stage. Scorecards and pediatric-specific modifications are addressed later in the protocol.

Crowing, also known as stridor, is a high-pitched sound heard during inspiration and indicates upper airway obstruction, often caused by swelling, foreign body, or infection such as croup or epiglottitis.

Option D is correct.

Option A (Rhonchi) and B (Wheezing) are lower airway sounds.

Option C (Bubbling) suggests fluid in the airway, not obstruction.

NREMT emphasizes rapid recognition of stridor because upper airway obstruction can quickly become fatal.

Comprehensive and Detailed Explanation (Based on NREMT standards):

This patient has signs of penetrating chest trauma, severe hypotension, tachycardia, and respiratory distress. A gurgling chest wound suggests an open pneumothorax, which can progress to tension pneumothorax.

Option C (Obstructive shock) is correct because air trapped in the chest can compress the heart and great vessels, preventing adequate cardiac output.

Option A is less likely because although blood loss may be present, the chest injury suggests impaired circulation due to pressure.

Option B involves pump failure, not trauma-related compression.

Option D involves abnormal vessel dilation, not mechanical obstruction.

NREMT emphasizes rapid recognition of obstructive shock and immediate intervention with occlusive dressings and rapid transport.

Comprehensive and Detailed Explanation From Exact Extract:

Hepatitis A is transmitted primarily via the fecal-oral route, often through contaminated food or water. It leads to an acute liver infection, not a chronic condition. Unlike Hepatitis C, which has no vaccine, Hepatitis A has an effective vaccine and is preventable with proper hygiene and immunization.

Hepatitis B is spread through blood and sexual contact, not fecal-oral. Hepatitis E is also fecal-oral but is rare in the U.S. and doesn't have a widely used vaccine.

Comprehensive and Detailed Explanation From Exact Extract:

Hemoptysis (coughing up blood) in a physically active person, such as a mountain climber, strongly suggests a pulmonary embolism (PE), particularly due to:

Dehydration

Prolonged exertion or immobility

High altitude increasing clot risk

Symptoms may include:

Shortness of breath

Chest pain

Tachypnea

Hemoptysis

Pulmonary edema generally causes pink frothy sputum and is more associated with heart failure. Neoplasm (lung cancer) is possible but much less acute in onset. Spontaneous pneumothorax causes dyspnea and pleuritic chest pain but not typically hemoptysis.

Comprehensive and Detailed Explanation From Exact Extract:

Hepatitis A virus is transmitted exclusively via the fecal-oral route. Ingesting contaminated food or water allows the virus to enter the digestive tract, infecting liver cells. It's often spread through poor hand hygiene or unsanitary food handling.

It is not bloodborne, unlike Hepatitis B and C. It is not commonly spread through saliva or urine.

This pediatric presentation—fever, sore throat, and drooling—is highly concerning for acute epiglottitis, a life-threatening airway emergency emphasized in NREMT airway education. Epiglottitis causes rapid swelling of the epiglottis and surrounding tissues, which can lead to sudden and complete airway obstruction, especially in young children.

Option D is correct because the EMT should minimize agitation and transport the child in a position of comfort, typically sitting upright. NREMT guidelines stress that children with suspected epiglottitis should be kept calm, allowed to assume their preferred position, and transported rapidly without unnecessary interventions that could provoke airway spasm.

Option A is incorrect because finger sweeps are contraindicated unless a solid foreign body is clearly visible. Performing a finger sweep may worsen obstruction or trigger complete airway closure.

Option B is incorrect because positive-pressure ventilation with a BVM can increase agitation and is not indicated unless the patient is in respiratory failure. Oxygen may be offered gently, but forcing a BVM is dangerous.

Option C is incorrect because visual inspection of the airway using a tongue depressor can precipitate sudden airway obstruction and is specifically contraindicated by NREMT teaching.

The priority per NREMT is airway preservation through calm handling, rapid transport, and avoidance of invasive airway maneuvers.

Comprehensive and Detailed Explanation From Exact Extract:

The legal concept of tort negligence in EMS requires the plaintiff to establish four elements:

Duty to act

Breach of that duty

Damages (harm caused)

Causation — a direct link between the EMT’s action/inaction and the harm caused

Causation (often termed “proximate cause”) is the essential element that connects the EMT’s breach to the patient's injury or outcome. Abandonment, assault, and false imprisonment are other intentional torts, but not core elements of proving negligence.

Organophosphates are commonly found in pesticides and insecticides, which are often stored in tool sheds. NREMT training emphasizes recognition of cholinergic toxidrome, frequently summarized by the mnemonic SLUDGE (Salivation, Lacrimation, Urination, Defecation, Gastrointestinal distress, Emesis).

Option C is correct because the patient’s symptoms—drooling, tearing, abdominal pain, and runny nose—are hallmark signs of organophosphate poisoning.

Option A (naphthalene) primarily causes hemolysis and neurologic symptoms.

Option B (hydrogen sulfide) causes respiratory distress and altered mental status, not secretions.

Option D causes chemical pneumonitis, not cholinergic symptoms.

NREMT stresses early identification of toxic exposures, scene safety, decontamination awareness, and rapid transport for definitive care.

Comprehensive and Detailed Explanation From Exact Extract:

The symptoms and vital signs (wheezing, hypotension, high pulse rate, respiratory distress) are strongly indicative of anaphylaxis, which is a life-threatening allergic reaction. Bilateral wheezing and hypotension further confirm systemic involvement. The first-line treatment is intramuscular epinephrine, which:

Reverses bronchospasm (via beta-2 adrenergic effects)

Raises blood pressure (via alpha-1 vasoconstriction)

Improves airway tone and reduces mucosal edema

A metered-dose inhaler may help in mild bronchospasm but is insufficient during anaphylactic shock. Positive pressure ventilations are a secondary measure if respiratory failure occurs. Nitroglycerin is contraindicated due to low BP.

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

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

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

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

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

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

According to NREMT neonatal resuscitation principles, a newborn who is crying with a heart rate greater than 100 does not require aggressive resuscitation but does need supportive care.

Option A (Dry baby) is essential to stimulate breathing and prevent heat loss.

Option B (Keep baby warm) is critical, as neonates lose heat rapidly and hypothermia worsens hypoxia.

Option C (Administer blow-by oxygen) is appropriate for central cyanosis when respirations and heart rate are adequate.

Option D is only indicated if secretions are obstructing the airway.

Options E and F are contraindicated because the infant has an adequate heart rate and is breathing.

NREMT emphasizes warmth, oxygenation, and minimal intervention in stable newborns.

Comprehensive and Detailed Explanation From Exact Extract:

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

Signs include:

High blood pressure

Decreasing respiratory rate

Altered LOC or unresponsiveness

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