AEM CERTIFICATION EXAM: COMPLETE
Practice Questions with Solutions -
Advanced Emergency Medical Technician
National Registry Assessment
SECTION 1: AIRWAY, RESPIRATION & VENTILATION
Questions 1–17 | 21-25% of Exam
Q1. A 62-year-old male with a history of COPD presents with severe respiratory distress.
He is tripoding, unable to speak in full sentences, with accessory muscle use. Vital
signs: HR 118, BP 168/92, RR 32, SpO₂ 81% on room air. Lung sounds are diminished
bilaterally with expiratory wheezing. The AEMT applies oxygen via nasal cannula at 4
LPM with minimal improvement. What is the NEXT most appropriate intervention?
A. Initiate transport and reassess in 5 minutes
B. Apply CPAP at 10 cmH₂O with FiO₂ at 100%
C. Insert a nasopharyngeal airway and ventilate with BVM
D. Administer albuterol 2.5 mg via nebulizer
Correct Answer: B
,Rationale: This patient presents with severe respiratory distress and hypoxemia
refractory to low-flow oxygen. CPAP is within AEMT scope and is indicated for
pulmonary edema and severe COPD exacerbation with hypoxemia. It provides positive
pressure to recruit alveoli and improve oxygenation.
Why A is incorrect: EMT-level thinking – delayed intervention for critical patient.
Transport without stabilizing respiratory failure is inappropriate.
Why C is incorrect: NPA is indicated for unconscious patients with airway obstruction;
this patient is conscious and protecting airway. BVM ventilation would be poorly
tolerated.
Why D is incorrect: Albuterol is indicated but delivery is ineffective with current
oxygenation status; CPAP with nebulization is superior and addresses the respiratory
failure first.
Scope Justification: CPAP is an AEMT-level intervention (increasingly authorized for
AEMTs, though Paramedic in some states). This question tests the transition from EMT
oxygen delivery to AEMT advanced ventilation support. EMTs cannot administer CPAP;
Paramedics may intubate if CPAP fails.
Q2. An AEMT inserts an i-gel supraglottic airway in a 45-year-old male in cardiac arrest.
After securing the device and attaching the BVM, the AEMT notes poor chest rise and
an absence of end-tidal CO₂ waveform. What is the MOST appropriate immediate
action?
A. Remove the i-gel and attempt intubation
B. Reposition the patient's head and jaw thrust
C. Withdraw the i-gel 1-2 cm and reassess
,D. Increase ventilation pressure to overcome resistance
Correct Answer: C
Rationale: The most common cause of SGA malfunction is improper depth – either
inserted too far (epiglottis displaced) or insufficient depth (tip in oropharynx).
Withdrawing 1-2 cm often corrects malposition and restores ventilation.
Why A is incorrect: Intubation is beyond AEMT scope in most states; also, removing a
functional device without troubleshooting violates the algorithm. Paramedics may
intubate, but AEMTs must troubleshoot SGA first.
Why B is incorrect: Head repositioning is less effective with SGA than ET tube; SGAs are
designed to seat without manipulation. This is more appropriate for BVM-OPA
management.
Why D is incorrect: Increasing pressure risks gastric insufflation, regurgitation, and
aspiration without addressing the underlying malposition.
Scope Justification: SGA insertion and troubleshooting is a core AEMT advanced airway
skill distinguishing them from EMTs (limited to BVM and OPA/NPA). Paramedics may
proceed to intubation if SGA fails; AEMTs must optimize SGA performance.
Q3. A 24-year-old female with a history of asthma presents after using her albuterol
inhaler 10 times over the past 2 hours without relief. She is speaking 2-3 word
sentences, HR 124, RR 28, SpO₂ 91% on room air, lung sounds with minimal air
movement and faint expiratory wheezes. Which medication administration is within the
AEMT's scope and MOST appropriate?
A. Epinephrine 0.3 mg IM
, B. Albuterol 2.5 mg with ipratropium 0.5 mg nebulized
C. Methylprednisolone 125 mg IV
D. Magnesium sulfate 2 g IV
Correct Answer: B
Rationale: This patient is in severe acute asthma exacerbation with inadequate
response to albuterol alone. The addition of ipratropium bromide to nebulized albuterol
is within AEMT scope, is guideline-directed, and provides synergistic bronchodilation via
anticholinergic mechanism.
Why A is incorrect: IM epinephrine is indicated for anaphylaxis with bronchospasm, not
isolated asthma without allergic features or hypotension.
Why C is incorrect: Corticosteroids are paramedic-level or require online medical
direction for AEMTs in most systems; also delayed onset makes them less critical than
immediate bronchodilation.
Why D is incorrect: Magnesium sulfate is paramedic-level and reserved for near-fatal
asthma or refractory bronchospasm unresponsive to beta-agonists and
anticholinergics.
Scope Justification: AEMTs may administer albuterol and ipratropium via nebulizer. This
tests the distinction between asthma rescue therapy (AEMT) and anaphylaxis therapy
(epinephrine) and advanced pharmacotherapy (Paramedic).
Q4. An AEMT is monitoring capnography on a 58-year-old female with COPD
exacerbation receiving CPAP. The waveform shows a gradual upward slope of the
Practice Questions with Solutions -
Advanced Emergency Medical Technician
National Registry Assessment
SECTION 1: AIRWAY, RESPIRATION & VENTILATION
Questions 1–17 | 21-25% of Exam
Q1. A 62-year-old male with a history of COPD presents with severe respiratory distress.
He is tripoding, unable to speak in full sentences, with accessory muscle use. Vital
signs: HR 118, BP 168/92, RR 32, SpO₂ 81% on room air. Lung sounds are diminished
bilaterally with expiratory wheezing. The AEMT applies oxygen via nasal cannula at 4
LPM with minimal improvement. What is the NEXT most appropriate intervention?
A. Initiate transport and reassess in 5 minutes
B. Apply CPAP at 10 cmH₂O with FiO₂ at 100%
C. Insert a nasopharyngeal airway and ventilate with BVM
D. Administer albuterol 2.5 mg via nebulizer
Correct Answer: B
,Rationale: This patient presents with severe respiratory distress and hypoxemia
refractory to low-flow oxygen. CPAP is within AEMT scope and is indicated for
pulmonary edema and severe COPD exacerbation with hypoxemia. It provides positive
pressure to recruit alveoli and improve oxygenation.
Why A is incorrect: EMT-level thinking – delayed intervention for critical patient.
Transport without stabilizing respiratory failure is inappropriate.
Why C is incorrect: NPA is indicated for unconscious patients with airway obstruction;
this patient is conscious and protecting airway. BVM ventilation would be poorly
tolerated.
Why D is incorrect: Albuterol is indicated but delivery is ineffective with current
oxygenation status; CPAP with nebulization is superior and addresses the respiratory
failure first.
Scope Justification: CPAP is an AEMT-level intervention (increasingly authorized for
AEMTs, though Paramedic in some states). This question tests the transition from EMT
oxygen delivery to AEMT advanced ventilation support. EMTs cannot administer CPAP;
Paramedics may intubate if CPAP fails.
Q2. An AEMT inserts an i-gel supraglottic airway in a 45-year-old male in cardiac arrest.
After securing the device and attaching the BVM, the AEMT notes poor chest rise and
an absence of end-tidal CO₂ waveform. What is the MOST appropriate immediate
action?
A. Remove the i-gel and attempt intubation
B. Reposition the patient's head and jaw thrust
C. Withdraw the i-gel 1-2 cm and reassess
,D. Increase ventilation pressure to overcome resistance
Correct Answer: C
Rationale: The most common cause of SGA malfunction is improper depth – either
inserted too far (epiglottis displaced) or insufficient depth (tip in oropharynx).
Withdrawing 1-2 cm often corrects malposition and restores ventilation.
Why A is incorrect: Intubation is beyond AEMT scope in most states; also, removing a
functional device without troubleshooting violates the algorithm. Paramedics may
intubate, but AEMTs must troubleshoot SGA first.
Why B is incorrect: Head repositioning is less effective with SGA than ET tube; SGAs are
designed to seat without manipulation. This is more appropriate for BVM-OPA
management.
Why D is incorrect: Increasing pressure risks gastric insufflation, regurgitation, and
aspiration without addressing the underlying malposition.
Scope Justification: SGA insertion and troubleshooting is a core AEMT advanced airway
skill distinguishing them from EMTs (limited to BVM and OPA/NPA). Paramedics may
proceed to intubation if SGA fails; AEMTs must optimize SGA performance.
Q3. A 24-year-old female with a history of asthma presents after using her albuterol
inhaler 10 times over the past 2 hours without relief. She is speaking 2-3 word
sentences, HR 124, RR 28, SpO₂ 91% on room air, lung sounds with minimal air
movement and faint expiratory wheezes. Which medication administration is within the
AEMT's scope and MOST appropriate?
A. Epinephrine 0.3 mg IM
, B. Albuterol 2.5 mg with ipratropium 0.5 mg nebulized
C. Methylprednisolone 125 mg IV
D. Magnesium sulfate 2 g IV
Correct Answer: B
Rationale: This patient is in severe acute asthma exacerbation with inadequate
response to albuterol alone. The addition of ipratropium bromide to nebulized albuterol
is within AEMT scope, is guideline-directed, and provides synergistic bronchodilation via
anticholinergic mechanism.
Why A is incorrect: IM epinephrine is indicated for anaphylaxis with bronchospasm, not
isolated asthma without allergic features or hypotension.
Why C is incorrect: Corticosteroids are paramedic-level or require online medical
direction for AEMTs in most systems; also delayed onset makes them less critical than
immediate bronchodilation.
Why D is incorrect: Magnesium sulfate is paramedic-level and reserved for near-fatal
asthma or refractory bronchospasm unresponsive to beta-agonists and
anticholinergics.
Scope Justification: AEMTs may administer albuterol and ipratropium via nebulizer. This
tests the distinction between asthma rescue therapy (AEMT) and anaphylaxis therapy
(epinephrine) and advanced pharmacotherapy (Paramedic).
Q4. An AEMT is monitoring capnography on a 58-year-old female with COPD
exacerbation receiving CPAP. The waveform shows a gradual upward slope of the
