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SNHD EMS Protocol Exam Actual Exam 2026/2027 |
EMT Basic Practice Test with Complete Solutions |
Aligned with SNHD Protocols & NREMT Standards |
Pass Guaranteed - A+ Graded
SECTION 1: AIRWAY MANAGEMENT & VENTILATION (12 Questions - 17%)
Q1: An unresponsive 34-year-old male is found supine with snoring respirations. There is no
evidence of trauma. What is the FIRST priority airway maneuver?
A. Insert an oropharyngeal airway (OPA)
B. Perform the jaw-thrust maneuver
C. Perform the head-tilt chin-lift maneuver
D. Begin suctioning immediately
Correct Answer: C. [CORRECT]
Rationale: For unresponsive patients without suspected spinal trauma, the head-tilt chin-lift
maneuver is the initial intervention to open the airway by displacing the tongue from the
posterior pharynx. This maneuver aligns the oral, pharyngeal, and laryngeal axes to create a
patent airway before adjuncts are considered.
Q2: A 68-year-old patient with suspected cervical spine injury from a fall requires airway
opening. Which maneuver is indicated?
A. Head-tilt chin-lift
B. Jaw-thrust without head extension
C. Modified chin-lift only
D. Cricoid pressure
Correct Answer: B. [CORRECT]
Rationale: The jaw-thrust maneuver without head extension is the technique of choice for
trauma patients with suspected spinal injury. It opens the airway by lifting the mandible forward
without extending the cervical spine, minimizing risk of spinal cord injury.
,2
Q3: When inserting an oropharyngeal airway (OPA) in an adult patient, which measurement
technique ensures proper sizing?
A. Measure from the corner of the mouth to the tip of the earlobe
B. Measure from the corner of the mouth to the angle of the jaw
C. Measure from the center of the mouth to the thyroid cartilage
D. Measure from the tip of the nose to the earlobe
Correct Answer: B. [CORRECT]
Rationale: Proper OPA sizing is determined by measuring from the corner of the patient's mouth
to the angle of the jaw (posterior mandible). An improperly sized OPA can either push the tongue
posteriorly (too small) or impinge on the larynx/epiglottis (too large).
Q4: A patient with inadequate breathing requires ventilatory support. What is the correct
ventilation rate for an adult using a bag-valve mask (BVM) with supplemental oxygen?
A. 6-8 breaths per minute
B. 10-12 breaths per minute
C. 16-20 breaths per minute
D. 24-30 breaths per minute
Correct Answer: B. [CORRECT]
Rationale: Adult ventilation rate with BVM is 10-12 breaths per minute (one breath every 5-6
seconds) per AHA and NREMT standards. This rate provides adequate minute ventilation while
minimizing gastric distention and barotrauma risk. Each breath should be delivered over 1
second with visible chest rise.
Q5: During BVM ventilation, which technique is MOST effective for ensuring adequate tidal
volume delivery?
A. One-person technique with firm mask seal
B. Two-person technique with one person maintaining seal and the other squeezing the bag
C. Ventilating as rapidly as possible to ensure oxygenation
D. Using the largest available mask regardless of patient size
Correct Answer: B. [CORRECT]
Rationale: The two-person BVM technique is superior for effective ventilation. One provider
uses both hands to create a complete mask seal using the C-E technique (thumbs and index
fingers form "C" on mask, remaining fingers form "E" to lift jaw), while the second provider
delivers ventilations. This reduces air leakage and improves tidal volume delivery.
, 3
Q6: A 5-year-old child requires oxygen therapy. The child is alert with mild respiratory distress
and an SpO2 of 91%. Which oxygen delivery device is MOST appropriate initially?
A. Non-rebreather mask at 15 LPM
B. Nasal cannula at 2-6 LPM
C. Bag-valve mask ventilation
D. Simple face mask at 10 LPM
Correct Answer: B. [CORRECT]
Rationale: For pediatric patients with mild respiratory distress and adequate spontaneous
ventilations, a nasal cannula at 2-6 LPM (titrated to maintain SpO2 >94%) is appropriate.
Starting with lower-flow devices allows titration based on response. Reserve NRB for moderate-
severe distress or SpO2 <90%.
Q7: Which of the following is an ABSOLUTE contraindication for nasopharyngeal airway
(NPA) insertion?
A. History of epistaxis
B. Suspected basilar skull fracture
C. Conscious patient with gag reflex
D. Patient on anticoagulant therapy
Correct Answer: B. [CORRECT]
Rationale: Suspected basilar skull fracture is an absolute contraindication for NPA insertion. The
NPA may penetrate the cranial vault through a fractured cribriform plate, causing brain injury.
Signs of basilar skull fracture include Battle's sign, raccoon eyes, CSF rhinorrhea, and
hemotympanum.
Q8: When performing oropharyngeal suctioning, what is the MAXIMUM recommended
duration for suctioning attempts in an adult?
A. 5 seconds
B. 10 seconds
C. 15 seconds
D. 30 seconds
Correct Answer: C. [CORRECT]
Rationale: Suctioning should not exceed 15 seconds per attempt in adults to prevent hypoxia.
Prolonged suctioning removes oxygen from the airway and can cause vagal stimulation, leading
to bradycardia. Pre-oxygenate before suctioning and monitor SpO2 throughout.
SNHD EMS Protocol Exam Actual Exam 2026/2027 |
EMT Basic Practice Test with Complete Solutions |
Aligned with SNHD Protocols & NREMT Standards |
Pass Guaranteed - A+ Graded
SECTION 1: AIRWAY MANAGEMENT & VENTILATION (12 Questions - 17%)
Q1: An unresponsive 34-year-old male is found supine with snoring respirations. There is no
evidence of trauma. What is the FIRST priority airway maneuver?
A. Insert an oropharyngeal airway (OPA)
B. Perform the jaw-thrust maneuver
C. Perform the head-tilt chin-lift maneuver
D. Begin suctioning immediately
Correct Answer: C. [CORRECT]
Rationale: For unresponsive patients without suspected spinal trauma, the head-tilt chin-lift
maneuver is the initial intervention to open the airway by displacing the tongue from the
posterior pharynx. This maneuver aligns the oral, pharyngeal, and laryngeal axes to create a
patent airway before adjuncts are considered.
Q2: A 68-year-old patient with suspected cervical spine injury from a fall requires airway
opening. Which maneuver is indicated?
A. Head-tilt chin-lift
B. Jaw-thrust without head extension
C. Modified chin-lift only
D. Cricoid pressure
Correct Answer: B. [CORRECT]
Rationale: The jaw-thrust maneuver without head extension is the technique of choice for
trauma patients with suspected spinal injury. It opens the airway by lifting the mandible forward
without extending the cervical spine, minimizing risk of spinal cord injury.
,2
Q3: When inserting an oropharyngeal airway (OPA) in an adult patient, which measurement
technique ensures proper sizing?
A. Measure from the corner of the mouth to the tip of the earlobe
B. Measure from the corner of the mouth to the angle of the jaw
C. Measure from the center of the mouth to the thyroid cartilage
D. Measure from the tip of the nose to the earlobe
Correct Answer: B. [CORRECT]
Rationale: Proper OPA sizing is determined by measuring from the corner of the patient's mouth
to the angle of the jaw (posterior mandible). An improperly sized OPA can either push the tongue
posteriorly (too small) or impinge on the larynx/epiglottis (too large).
Q4: A patient with inadequate breathing requires ventilatory support. What is the correct
ventilation rate for an adult using a bag-valve mask (BVM) with supplemental oxygen?
A. 6-8 breaths per minute
B. 10-12 breaths per minute
C. 16-20 breaths per minute
D. 24-30 breaths per minute
Correct Answer: B. [CORRECT]
Rationale: Adult ventilation rate with BVM is 10-12 breaths per minute (one breath every 5-6
seconds) per AHA and NREMT standards. This rate provides adequate minute ventilation while
minimizing gastric distention and barotrauma risk. Each breath should be delivered over 1
second with visible chest rise.
Q5: During BVM ventilation, which technique is MOST effective for ensuring adequate tidal
volume delivery?
A. One-person technique with firm mask seal
B. Two-person technique with one person maintaining seal and the other squeezing the bag
C. Ventilating as rapidly as possible to ensure oxygenation
D. Using the largest available mask regardless of patient size
Correct Answer: B. [CORRECT]
Rationale: The two-person BVM technique is superior for effective ventilation. One provider
uses both hands to create a complete mask seal using the C-E technique (thumbs and index
fingers form "C" on mask, remaining fingers form "E" to lift jaw), while the second provider
delivers ventilations. This reduces air leakage and improves tidal volume delivery.
, 3
Q6: A 5-year-old child requires oxygen therapy. The child is alert with mild respiratory distress
and an SpO2 of 91%. Which oxygen delivery device is MOST appropriate initially?
A. Non-rebreather mask at 15 LPM
B. Nasal cannula at 2-6 LPM
C. Bag-valve mask ventilation
D. Simple face mask at 10 LPM
Correct Answer: B. [CORRECT]
Rationale: For pediatric patients with mild respiratory distress and adequate spontaneous
ventilations, a nasal cannula at 2-6 LPM (titrated to maintain SpO2 >94%) is appropriate.
Starting with lower-flow devices allows titration based on response. Reserve NRB for moderate-
severe distress or SpO2 <90%.
Q7: Which of the following is an ABSOLUTE contraindication for nasopharyngeal airway
(NPA) insertion?
A. History of epistaxis
B. Suspected basilar skull fracture
C. Conscious patient with gag reflex
D. Patient on anticoagulant therapy
Correct Answer: B. [CORRECT]
Rationale: Suspected basilar skull fracture is an absolute contraindication for NPA insertion. The
NPA may penetrate the cranial vault through a fractured cribriform plate, causing brain injury.
Signs of basilar skull fracture include Battle's sign, raccoon eyes, CSF rhinorrhea, and
hemotympanum.
Q8: When performing oropharyngeal suctioning, what is the MAXIMUM recommended
duration for suctioning attempts in an adult?
A. 5 seconds
B. 10 seconds
C. 15 seconds
D. 30 seconds
Correct Answer: C. [CORRECT]
Rationale: Suctioning should not exceed 15 seconds per attempt in adults to prevent hypoxia.
Prolonged suctioning removes oxygen from the airway and can cause vagal stimulation, leading
to bradycardia. Pre-oxygenate before suctioning and monitor SpO2 throughout.
