HOSA EMT STUDY GUIDE 2026/2027 | Complete Questions &
Solutions | NREMT & AHA Aligned | Graded A+ Standard |
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SECTION 1: AIRWAY MANAGEMENT & VENTILATION (15 Questions)
Q1: You arrive on scene to a 58-year-old male complaining of chest pain. He is
conscious, alert, and speaking in full sentences. What is your FIRST action regarding
airway management?
A. Insert an oropharyngeal airway immediately to prevent obstruction
B. Perform a jaw-thrust maneuver to open the airway
C. Assess airway patency; no immediate intervention needed if patient is speaking
clearly. [CORRECT]
D. Administer high-flow oxygen via non-rebreather mask before assessing airway
Correct Answer: C
Rationale: The NREMT Patient Assessment/Management - Medical skill sheet
establishes that airway assessment is the first step in the primary assessment. A
patient speaking in full sentences demonstrates a patent airway—this is the gold
standard for airway patency assessment. Option A is incorrect because OPA insertion is
contraindicated in conscious patients with intact gag reflex and would likely cause
vomiting/aspiration. Option B is unnecessary as there's no indication of airway
obstruction or trauma requiring spinal precautions. Option D violates assessment
sequence; oxygen administration follows airway and breathing assessment, not
,precedes it. The AHA BLS guidelines emphasize that a talking patient has a patent
airway.
Q2: A 4-year-old child was pulled from a swimming pool unconscious. The child is
apneic but has a weak pulse. What is the appropriate ventilation rate when using a BVM
with appropriately sized mask?
A. 1 ventilation every 2-3 seconds (20-30 breaths/minute)
B. 1 ventilation every 3-5 seconds (12-20 breaths/minute). [CORRECT]
C. 1 ventilation every 6 seconds (10 breaths/minute)
D. Continuous ventilations without pause
Correct Answer: B
Rationale: Per AHA 2020 Pediatric BLS guidelines, for children with a pulse but
inadequate respiratory effort (respiratory arrest), deliver 1 breath every 3-5 seconds
(12-20 breaths/minute). Option A represents the rate for neonatal resuscitation. Option
C is the adult ventilation rate for patients with pulses. Option D would cause gastric
insufflation, vomiting, aspiration, and decreased cardiac output due to impaired venous
return. The BVM should achieve visible chest rise without exceeding 20 breaths/minute
in pediatrics to prevent barotrauma and gastric insufflation.
Q3: During attempted endotracheal intubation of a 35-year-old trauma patient, you
visualize the vocal cords but cannot pass the tube after three attempts. The patient's
SpO2 drops from 94% to 78%. What is your immediate action?
A. Continue intubation attempts with a smaller tube
,B. Remove the laryngoscope and ventilate the patient with a BVM for 2 minutes.
[CORRECT]
C. Perform a surgical cricothyrotomy immediately
D. Insert a nasopharyngeal airway and continue attempts
Correct Answer: B
Rationale: The NREMT Airway Management skill sheet and Difficult Airway Algorithm
prioritize oxygenation over intubation. When SpO2 drops below 90% during intubation
attempts, immediately stop, remove equipment, and provide high-quality BVM
ventilations with 100% oxygen. This "stop and oxygenate" principle prevents hypoxic
brain injury. Option A risks further hypoxia and airway trauma. Option C is indicated only
when ventilation/oxygenation cannot be achieved by other means. Option D is
inappropriate for primary airway management in apneic patients. Per the 2020 AHA
ACLS guidelines, any intubation attempt should be limited to 30 seconds with
immediate return to BVM if desaturation occurs.
Q4: You are ventilating a 70-year-old COPD patient with a BVM. The patient's abdomen
appears to be expanding more than the chest. What adjustment should you make?
A. Increase ventilation rate to compensate for poor chest rise
B. Decrease tidal volume and ensure proper mask seal; reassess technique. [CORRECT]
C. Switch to a larger bag-valve mask device
D. Perform abdominal thrusts to reduce gastric distension
Correct Answer: B
, Rationale: Gastric insufflation (air entering stomach instead of lungs) indicates
excessive ventilation pressure, poor mask seal, or improper head positioning. Per
NREMT protocols, deliver just enough volume to produce visible chest rise
(approximately 500-600mL adults). Option A worsens gastric insufflation and reduces
venous return. Option C doesn't address the underlying technique issue. Option D is
contraindicated during active ventilation and could cause regurgitation. The AHA
emphasizes "just enough to make the chest rise" to prevent gastric insufflation, which
increases aspiration risk and compromises lung compliance.
Q5: A patient with a suspected spinal injury from a diving accident is vomiting while
supine. How do you manage the airway while maintaining spinal precautions?
A. Log-roll the patient to the side while maintaining inline stabilization. [CORRECT]
B. Perform the jaw-thrust maneuver and suction while supine
C. Place the patient in Trendelenburg position to prevent aspiration
D. Insert an oropharyngeal airway and continue transport supine
Correct Answer: A
Rationale: The NREMT Spinal Motion Restriction skill sheet and AHA BLS guidelines
specify that patients with suspected spinal injury who are vomiting require immediate
log-roll to the lateral recumbent position with one provider maintaining manual inline
stabilization (MILS) of the head/neck. This prevents aspiration while minimizing spinal
movement. Option B doesn't address the vomiting/aspiration risk. Option C
(Trendelenburg) increases intracranial pressure and doesn't protect against aspiration.
Option D leaves the patient supine with active vomiting, guaranteeing aspiration. The
Solutions | NREMT & AHA Aligned | Graded A+ Standard |
Pass Guaranteed - A+ Graded
SECTION 1: AIRWAY MANAGEMENT & VENTILATION (15 Questions)
Q1: You arrive on scene to a 58-year-old male complaining of chest pain. He is
conscious, alert, and speaking in full sentences. What is your FIRST action regarding
airway management?
A. Insert an oropharyngeal airway immediately to prevent obstruction
B. Perform a jaw-thrust maneuver to open the airway
C. Assess airway patency; no immediate intervention needed if patient is speaking
clearly. [CORRECT]
D. Administer high-flow oxygen via non-rebreather mask before assessing airway
Correct Answer: C
Rationale: The NREMT Patient Assessment/Management - Medical skill sheet
establishes that airway assessment is the first step in the primary assessment. A
patient speaking in full sentences demonstrates a patent airway—this is the gold
standard for airway patency assessment. Option A is incorrect because OPA insertion is
contraindicated in conscious patients with intact gag reflex and would likely cause
vomiting/aspiration. Option B is unnecessary as there's no indication of airway
obstruction or trauma requiring spinal precautions. Option D violates assessment
sequence; oxygen administration follows airway and breathing assessment, not
,precedes it. The AHA BLS guidelines emphasize that a talking patient has a patent
airway.
Q2: A 4-year-old child was pulled from a swimming pool unconscious. The child is
apneic but has a weak pulse. What is the appropriate ventilation rate when using a BVM
with appropriately sized mask?
A. 1 ventilation every 2-3 seconds (20-30 breaths/minute)
B. 1 ventilation every 3-5 seconds (12-20 breaths/minute). [CORRECT]
C. 1 ventilation every 6 seconds (10 breaths/minute)
D. Continuous ventilations without pause
Correct Answer: B
Rationale: Per AHA 2020 Pediatric BLS guidelines, for children with a pulse but
inadequate respiratory effort (respiratory arrest), deliver 1 breath every 3-5 seconds
(12-20 breaths/minute). Option A represents the rate for neonatal resuscitation. Option
C is the adult ventilation rate for patients with pulses. Option D would cause gastric
insufflation, vomiting, aspiration, and decreased cardiac output due to impaired venous
return. The BVM should achieve visible chest rise without exceeding 20 breaths/minute
in pediatrics to prevent barotrauma and gastric insufflation.
Q3: During attempted endotracheal intubation of a 35-year-old trauma patient, you
visualize the vocal cords but cannot pass the tube after three attempts. The patient's
SpO2 drops from 94% to 78%. What is your immediate action?
A. Continue intubation attempts with a smaller tube
,B. Remove the laryngoscope and ventilate the patient with a BVM for 2 minutes.
[CORRECT]
C. Perform a surgical cricothyrotomy immediately
D. Insert a nasopharyngeal airway and continue attempts
Correct Answer: B
Rationale: The NREMT Airway Management skill sheet and Difficult Airway Algorithm
prioritize oxygenation over intubation. When SpO2 drops below 90% during intubation
attempts, immediately stop, remove equipment, and provide high-quality BVM
ventilations with 100% oxygen. This "stop and oxygenate" principle prevents hypoxic
brain injury. Option A risks further hypoxia and airway trauma. Option C is indicated only
when ventilation/oxygenation cannot be achieved by other means. Option D is
inappropriate for primary airway management in apneic patients. Per the 2020 AHA
ACLS guidelines, any intubation attempt should be limited to 30 seconds with
immediate return to BVM if desaturation occurs.
Q4: You are ventilating a 70-year-old COPD patient with a BVM. The patient's abdomen
appears to be expanding more than the chest. What adjustment should you make?
A. Increase ventilation rate to compensate for poor chest rise
B. Decrease tidal volume and ensure proper mask seal; reassess technique. [CORRECT]
C. Switch to a larger bag-valve mask device
D. Perform abdominal thrusts to reduce gastric distension
Correct Answer: B
, Rationale: Gastric insufflation (air entering stomach instead of lungs) indicates
excessive ventilation pressure, poor mask seal, or improper head positioning. Per
NREMT protocols, deliver just enough volume to produce visible chest rise
(approximately 500-600mL adults). Option A worsens gastric insufflation and reduces
venous return. Option C doesn't address the underlying technique issue. Option D is
contraindicated during active ventilation and could cause regurgitation. The AHA
emphasizes "just enough to make the chest rise" to prevent gastric insufflation, which
increases aspiration risk and compromises lung compliance.
Q5: A patient with a suspected spinal injury from a diving accident is vomiting while
supine. How do you manage the airway while maintaining spinal precautions?
A. Log-roll the patient to the side while maintaining inline stabilization. [CORRECT]
B. Perform the jaw-thrust maneuver and suction while supine
C. Place the patient in Trendelenburg position to prevent aspiration
D. Insert an oropharyngeal airway and continue transport supine
Correct Answer: A
Rationale: The NREMT Spinal Motion Restriction skill sheet and AHA BLS guidelines
specify that patients with suspected spinal injury who are vomiting require immediate
log-roll to the lateral recumbent position with one provider maintaining manual inline
stabilization (MILS) of the head/neck. This prevents aspiration while minimizing spinal
movement. Option B doesn't address the vomiting/aspiration risk. Option C
(Trendelenburg) increases intracranial pressure and doesn't protect against aspiration.
Option D leaves the patient supine with active vomiting, guaranteeing aspiration. The
