EMT-I Emergency Medical Technician Intermediate Certification Exam Prep | 200+
Practice Questions with Verified Answers and Detailed Rationales | Advanced
Patient Assessment, Airway Management and Ventilation, IV Therapy and
Medication Administration, Trauma and Medical Emergencies, Cardiac and
Respiratory Care, Shock Management, EMS Operations and Prehospital Protocols |
Complete EMT-Intermediate Licensing Exam Study Guide
Question 1: Which of the following medications may an EMT-Intermediate administer via
the intravenous route for the treatment of hypoglycemia when peripheral IV access is
established?
A. Oral glucose gel
B. Glucagon intramuscular injection
C. Dextrose 50% solution
D. Epinephrine 1:1,000
CORRECT ANSWER: C. Dextrose 50% solution
RATIONALE: EMT-Intermediates are authorized to administer dextrose intravenously for the
treatment of hypoglycemia when IV access has been established. Oral glucose and glucagon
are alternative treatments but are not administered via IV. Epinephrine 1:1,000 is used for
anaphylaxis, not hypoglycemia.
www.gallup.unm.edu
Question 2: During endotracheal intubation, what is the primary purpose of applying
cricoid pressure (Sellick maneuver)?
A. To improve visualization of the vocal cords
B. To prevent gastric insufflation and aspiration
C. To stabilize the cervical spine during manipulation
D. To facilitate passage of the endotracheal tube
CORRECT ANSWER: B. To prevent gastric insufflation and aspiration
RATIONALE: Cricoid pressure applies backward pressure on the cricoid cartilage to compress
the esophagus against the cervical spine, reducing the risk of gastric contents entering the
airway during intubation attempts. It does not primarily improve visualization or stabilize the
spine.
Question 3: An EMT-Intermediate is preparing to administer nitroglycerin sublingually to a
patient with chest pain. Which prerequisite must be met before administration according
to most EMT-I protocols?
A. Patient must have a systolic blood pressure greater than 100 mmHg
B. Intravenous access must be established prior to administration
C. Patient must have taken nitroglycerin within the past 24 hours
D. Online medical control must be contacted for authorization
CORRECT ANSWER: B. Intravenous access must be established prior to administration
RATIONALE: Most EMT-I protocols require that IV access be established before administering
nitroglycerin due to the risk of significant hypotension. This allows for rapid fluid resuscitation if
needed. Blood pressure parameters may also apply, but IV access is the foundational
prerequisite.
,www.gallup.unm.edu
Question 4: Which anatomical structure is most commonly injured in a patient who
experiences a rapid deceleration mechanism, such as a frontal-impact motor vehicle
collision?
A. Liver
B. Spleen
C. Aorta at the ligamentum arteriosum
D. Kidneys
CORRECT ANSWER: C. Aorta at the ligamentum arteriosum
RATIONALE: Rapid deceleration forces can cause shearing injuries at points where mobile
structures attach to fixed structures. The aorta is particularly vulnerable at the ligamentum
arteriosum, where the relatively mobile aortic arch meets the fixed descending aorta. This is a
classic injury pattern in high-speed deceleration trauma.
Question 5: When performing a rapid trauma assessment on an unresponsive patient,
which finding would most urgently require immediate intervention?
A. Deformity of the left forearm
B. Absent breath sounds on the right side with tracheal deviation to the left
C. Laceration on the scalp with minor bleeding
D. Tenderness in the right lower quadrant of the abdomen
CORRECT ANSWER: B. Absent breath sounds on the right side with tracheal deviation to
the left
RATIONALE: Absent breath sounds with tracheal deviation suggest a tension pneumothorax, a
life-threatening condition requiring immediate needle decompression. This finding represents
an immediate threat to ventilation and circulation, taking priority over extremity injuries, minor
bleeding, or abdominal tenderness.
Question 6: Which route of medication administration is characterized by the fastest onset
of action for an EMT-Intermediate-administered drug?
A. Oral (PO)
B. Intramuscular (IM)
C. Intravenous (IV)
D. Subcutaneous (SC)
CORRECT ANSWER: C. Intravenous (IV)
RATIONALE: Intravenous administration delivers medication directly into the systemic
circulation, resulting in immediate bioavailability and the fastest onset of action. Other routes
require absorption through tissues, delaying therapeutic effect.
Question 7: An EMT-Intermediate is managing a patient with suspected anaphylaxis. Which
medication should be administered FIRST via intramuscular injection?
A. Diphenhydramine
B. Albuterol via nebulizer
,C. Epinephrine 1:1,000
D. Methylprednisolone
CORRECT ANSWER: C. Epinephrine 1:1,000
RATIONALE: Epinephrine is the first-line treatment for anaphylaxis because it rapidly reverses
bronchospasm, vasodilation, and increased vascular permeability. Antihistamines and
corticosteroids are adjunctive therapies but do not address the immediate life threats. Albuterol
addresses bronchospasm but not the systemic effects of anaphylaxis.
Question 8: During patient assessment, the EMT-Intermediate uses the OPQRST
mnemonic. What does the "P" in OPQRST represent?
A. Past medical history
B. Provocation/Palliation
C. Pulse quality
D. Pain level
CORRECT ANSWER: B. Provocation/Palliation
RATIONALE: OPQRST is a mnemonic for assessing a patient's chief complaint: Onset,
Provocation/Palliation (what makes it worse or better), Quality, Radiation, Severity, and Time.
This systematic approach helps gather comprehensive history about the present illness.
Question 9: Which of the following is an absolute contraindication to the administration of
nitroglycerin by an EMT-Intermediate?
A. Patient reports headache after previous dose
B. Systolic blood pressure of 95 mmHg
C. Patient took sildenafil (Viagra) within the past 24 hours
D. Patient has a history of migraine headaches
CORRECT ANSWER: C. Patient took sildenafil (Viagra) within the past 24 hours
RATIONALE: Phosphodiesterase-5 inhibitors like sildenafil can cause profound, life-threatening
hypotension when combined with nitroglycerin due to synergistic vasodilation. This is an
absolute contraindication. Mild hypotension may be a relative contraindication depending on
protocol, but PDE-5 inhibitor use is absolute.
Question 10: When establishing peripheral intravenous access, which vein is generally
preferred for initial cannulation in an adult patient?
A. Femoral vein
B. External jugular vein
C. Cephalic vein in the antecubital fossa
D. Dorsal hand veins
CORRECT ANSWER: C. Cephalic vein in the antecubital fossa
RATIONALE: The antecubital fossa veins (cephalic, basilic, median cubital) are large,
superficial, and relatively stable, making them ideal for initial IV access. Hand veins are smaller
and more painful. Femoral and external jugular access are typically reserved for emergencies
when peripheral access fails.
, Question 11: A patient presents with signs of compensated shock. Which clinical finding
would you MOST expect to observe?
A. Hypotension with altered mental status
B. Tachycardia with cool, clammy skin and normal blood pressure
C. Bradycardia with warm, flushed skin
D. Apnea with cyanosis
CORRECT ANSWER: B. Tachycardia with cool, clammy skin and normal blood pressure
RATIONALE: In compensated shock, the body maintains perfusion to vital organs through
sympathetic activation, resulting in tachycardia, peripheral vasoconstriction (cool/clammy
skin), and preserved blood pressure. Hypotension indicates decompensated shock.
Question 12: Which advanced airway device is classified as a supraglottic airway and may
be used by an EMT-Intermediate when endotracheal intubation is not immediately
feasible?
A. Endotracheal tube with stylet
B. King LT-D airway
C. Nasotracheal tube
D. Cricothyrotomy tube
CORRECT ANSWER: B. King LT-D airway
RATIONALE: The King LT-D is a supraglottic airway device that sits above the glottis and can be
inserted blindly. It is within the EMT-I scope of practice in many systems. Endotracheal and
nasotracheal tubes require direct or indirect visualization of the vocal cords. Cricothyrotomy is
a surgical airway beyond EMT-I scope.
www.gallup.unm.edu
Question 13: An EMT-Intermediate administers albuterol via nebulizer to a patient with
acute asthma exacerbation. What is the primary pharmacologic effect of albuterol?
A. Decreased airway inflammation
B. Bronchodilation through beta-2 adrenergic receptor stimulation
C. Reduced mucus production
D. Inhibition of histamine release
CORRECT ANSWER: B. Bronchodilation through beta-2 adrenergic receptor stimulation
RATIONALE: Albuterol is a selective beta-2 agonist that relaxes bronchial smooth muscle,
resulting in bronchodilation. It does not significantly reduce inflammation, mucus production,
or histamine release; those effects are associated with corticosteroids and antihistamines.
Question 14: During the primary assessment of a trauma patient, which intervention takes
priority if the patient has an obstructed airway?
A. Apply a cervical collar
B. Perform jaw-thrust maneuver with in-line stabilization
C. Obtain baseline vital signs
D. Initiate rapid trauma assessment
Practice Questions with Verified Answers and Detailed Rationales | Advanced
Patient Assessment, Airway Management and Ventilation, IV Therapy and
Medication Administration, Trauma and Medical Emergencies, Cardiac and
Respiratory Care, Shock Management, EMS Operations and Prehospital Protocols |
Complete EMT-Intermediate Licensing Exam Study Guide
Question 1: Which of the following medications may an EMT-Intermediate administer via
the intravenous route for the treatment of hypoglycemia when peripheral IV access is
established?
A. Oral glucose gel
B. Glucagon intramuscular injection
C. Dextrose 50% solution
D. Epinephrine 1:1,000
CORRECT ANSWER: C. Dextrose 50% solution
RATIONALE: EMT-Intermediates are authorized to administer dextrose intravenously for the
treatment of hypoglycemia when IV access has been established. Oral glucose and glucagon
are alternative treatments but are not administered via IV. Epinephrine 1:1,000 is used for
anaphylaxis, not hypoglycemia.
www.gallup.unm.edu
Question 2: During endotracheal intubation, what is the primary purpose of applying
cricoid pressure (Sellick maneuver)?
A. To improve visualization of the vocal cords
B. To prevent gastric insufflation and aspiration
C. To stabilize the cervical spine during manipulation
D. To facilitate passage of the endotracheal tube
CORRECT ANSWER: B. To prevent gastric insufflation and aspiration
RATIONALE: Cricoid pressure applies backward pressure on the cricoid cartilage to compress
the esophagus against the cervical spine, reducing the risk of gastric contents entering the
airway during intubation attempts. It does not primarily improve visualization or stabilize the
spine.
Question 3: An EMT-Intermediate is preparing to administer nitroglycerin sublingually to a
patient with chest pain. Which prerequisite must be met before administration according
to most EMT-I protocols?
A. Patient must have a systolic blood pressure greater than 100 mmHg
B. Intravenous access must be established prior to administration
C. Patient must have taken nitroglycerin within the past 24 hours
D. Online medical control must be contacted for authorization
CORRECT ANSWER: B. Intravenous access must be established prior to administration
RATIONALE: Most EMT-I protocols require that IV access be established before administering
nitroglycerin due to the risk of significant hypotension. This allows for rapid fluid resuscitation if
needed. Blood pressure parameters may also apply, but IV access is the foundational
prerequisite.
,www.gallup.unm.edu
Question 4: Which anatomical structure is most commonly injured in a patient who
experiences a rapid deceleration mechanism, such as a frontal-impact motor vehicle
collision?
A. Liver
B. Spleen
C. Aorta at the ligamentum arteriosum
D. Kidneys
CORRECT ANSWER: C. Aorta at the ligamentum arteriosum
RATIONALE: Rapid deceleration forces can cause shearing injuries at points where mobile
structures attach to fixed structures. The aorta is particularly vulnerable at the ligamentum
arteriosum, where the relatively mobile aortic arch meets the fixed descending aorta. This is a
classic injury pattern in high-speed deceleration trauma.
Question 5: When performing a rapid trauma assessment on an unresponsive patient,
which finding would most urgently require immediate intervention?
A. Deformity of the left forearm
B. Absent breath sounds on the right side with tracheal deviation to the left
C. Laceration on the scalp with minor bleeding
D. Tenderness in the right lower quadrant of the abdomen
CORRECT ANSWER: B. Absent breath sounds on the right side with tracheal deviation to
the left
RATIONALE: Absent breath sounds with tracheal deviation suggest a tension pneumothorax, a
life-threatening condition requiring immediate needle decompression. This finding represents
an immediate threat to ventilation and circulation, taking priority over extremity injuries, minor
bleeding, or abdominal tenderness.
Question 6: Which route of medication administration is characterized by the fastest onset
of action for an EMT-Intermediate-administered drug?
A. Oral (PO)
B. Intramuscular (IM)
C. Intravenous (IV)
D. Subcutaneous (SC)
CORRECT ANSWER: C. Intravenous (IV)
RATIONALE: Intravenous administration delivers medication directly into the systemic
circulation, resulting in immediate bioavailability and the fastest onset of action. Other routes
require absorption through tissues, delaying therapeutic effect.
Question 7: An EMT-Intermediate is managing a patient with suspected anaphylaxis. Which
medication should be administered FIRST via intramuscular injection?
A. Diphenhydramine
B. Albuterol via nebulizer
,C. Epinephrine 1:1,000
D. Methylprednisolone
CORRECT ANSWER: C. Epinephrine 1:1,000
RATIONALE: Epinephrine is the first-line treatment for anaphylaxis because it rapidly reverses
bronchospasm, vasodilation, and increased vascular permeability. Antihistamines and
corticosteroids are adjunctive therapies but do not address the immediate life threats. Albuterol
addresses bronchospasm but not the systemic effects of anaphylaxis.
Question 8: During patient assessment, the EMT-Intermediate uses the OPQRST
mnemonic. What does the "P" in OPQRST represent?
A. Past medical history
B. Provocation/Palliation
C. Pulse quality
D. Pain level
CORRECT ANSWER: B. Provocation/Palliation
RATIONALE: OPQRST is a mnemonic for assessing a patient's chief complaint: Onset,
Provocation/Palliation (what makes it worse or better), Quality, Radiation, Severity, and Time.
This systematic approach helps gather comprehensive history about the present illness.
Question 9: Which of the following is an absolute contraindication to the administration of
nitroglycerin by an EMT-Intermediate?
A. Patient reports headache after previous dose
B. Systolic blood pressure of 95 mmHg
C. Patient took sildenafil (Viagra) within the past 24 hours
D. Patient has a history of migraine headaches
CORRECT ANSWER: C. Patient took sildenafil (Viagra) within the past 24 hours
RATIONALE: Phosphodiesterase-5 inhibitors like sildenafil can cause profound, life-threatening
hypotension when combined with nitroglycerin due to synergistic vasodilation. This is an
absolute contraindication. Mild hypotension may be a relative contraindication depending on
protocol, but PDE-5 inhibitor use is absolute.
Question 10: When establishing peripheral intravenous access, which vein is generally
preferred for initial cannulation in an adult patient?
A. Femoral vein
B. External jugular vein
C. Cephalic vein in the antecubital fossa
D. Dorsal hand veins
CORRECT ANSWER: C. Cephalic vein in the antecubital fossa
RATIONALE: The antecubital fossa veins (cephalic, basilic, median cubital) are large,
superficial, and relatively stable, making them ideal for initial IV access. Hand veins are smaller
and more painful. Femoral and external jugular access are typically reserved for emergencies
when peripheral access fails.
, Question 11: A patient presents with signs of compensated shock. Which clinical finding
would you MOST expect to observe?
A. Hypotension with altered mental status
B. Tachycardia with cool, clammy skin and normal blood pressure
C. Bradycardia with warm, flushed skin
D. Apnea with cyanosis
CORRECT ANSWER: B. Tachycardia with cool, clammy skin and normal blood pressure
RATIONALE: In compensated shock, the body maintains perfusion to vital organs through
sympathetic activation, resulting in tachycardia, peripheral vasoconstriction (cool/clammy
skin), and preserved blood pressure. Hypotension indicates decompensated shock.
Question 12: Which advanced airway device is classified as a supraglottic airway and may
be used by an EMT-Intermediate when endotracheal intubation is not immediately
feasible?
A. Endotracheal tube with stylet
B. King LT-D airway
C. Nasotracheal tube
D. Cricothyrotomy tube
CORRECT ANSWER: B. King LT-D airway
RATIONALE: The King LT-D is a supraglottic airway device that sits above the glottis and can be
inserted blindly. It is within the EMT-I scope of practice in many systems. Endotracheal and
nasotracheal tubes require direct or indirect visualization of the vocal cords. Cricothyrotomy is
a surgical airway beyond EMT-I scope.
www.gallup.unm.edu
Question 13: An EMT-Intermediate administers albuterol via nebulizer to a patient with
acute asthma exacerbation. What is the primary pharmacologic effect of albuterol?
A. Decreased airway inflammation
B. Bronchodilation through beta-2 adrenergic receptor stimulation
C. Reduced mucus production
D. Inhibition of histamine release
CORRECT ANSWER: B. Bronchodilation through beta-2 adrenergic receptor stimulation
RATIONALE: Albuterol is a selective beta-2 agonist that relaxes bronchial smooth muscle,
resulting in bronchodilation. It does not significantly reduce inflammation, mucus production,
or histamine release; those effects are associated with corticosteroids and antihistamines.
Question 14: During the primary assessment of a trauma patient, which intervention takes
priority if the patient has an obstructed airway?
A. Apply a cervical collar
B. Perform jaw-thrust maneuver with in-line stabilization
C. Obtain baseline vital signs
D. Initiate rapid trauma assessment
