SNHD EMT EMS PROTOCOLS EXAM 2026/2027 | 100%
Correct Answers with Complete Solutions | Emergency
Medical Technician | Southern Nevada Health District | Pass
Guaranteed - A+ Graded
Domain 1: Airway and Breathing/Oxygenation (15 Questions)
Q1: You respond to a 67-year-old male with sudden onset of difficulty breathing. He is
sitting upright, tripod positioning, diaphoretic, with circumoral cyanosis. Respiratory rate
is 32, shallow. SpO2 is 82% on room air. According to SNHD EMT protocols, what is your
immediate priority?
A. Begin transport immediately without intervention
B. Apply high-flow oxygen via non-rebreather mask at 15 LPM and assess for adequate
tidal volume [CORRECT]
C. Insert a nasopharyngeal airway immediately
D. Administer albuterol via nebulizer first
Correct Answer: B
Rationale: SNHD Airway Protocol prioritizes immediate oxygenation for hypoxemic
patients. SpO2 <90% requires high-flow O2 via NRB at 15 LPM. The patient shows signs
of respiratory failure (tripod positioning, cyanosis, tachypnea, shallow respirations).
Assessing tidal volume determines if BVM assistance is needed. Option A abandons
,critical care. NPA insertion (Option C) is indicated if airway obstruction is suspected, but
oxygenation takes precedence. Albuterol (Option D) is appropriate for bronchospasm
but doesn't address immediate hypoxemia—oxygen first, then medication if indicated.
Q2: A 4-year-old child is in respiratory distress after a choking episode. The child is
conscious, coughing forcefully, and making high-pitched noises between coughs. What
is your immediate action per SNHD Pediatric Airway Protocol?
A. Perform 5 back blows and 5 chest thrusts immediately
B. Encourage the child to continue coughing and monitor closely; do NOT intervene with
blows or thrusts while effective cough present [CORRECT]
C. Perform abdominal thrusts immediately
D. Insert an oropharyngeal airway
Correct Answer: B
Rationale: SNHD follows AHA guidelines: if the child is coughing forcefully and has
good air exchange, encourage coughing and do NOT intervene—intervention risks
converting partial obstruction to complete obstruction. Back blows/chest thrusts
(Option A) or abdominal thrusts (Option C) are indicated only if the cough becomes
ineffective (weak, silent), breathing becomes difficult, or cyanosis develops. OPA
(Option D) is contraindicated in conscious patients and doesn't address foreign body
obstruction. Stay with child, prepare for deterioration, and be ready to intervene if
condition worsens.
,Q3: You are ventilating an apneic adult patient with a BVM and oropharyngeal airway in
place. The patient's abdomen is rising more than the chest, and SpO2 is not improving.
What is your corrective action per SNHD Airway Management Protocol?
A. Increase ventilation rate to 20 breaths per minute
B. Reassess airway positioning, ensure adequate mask seal, and verify OPA is properly
sized and positioned; consider two-person BVM technique [CORRECT]
C. Insert a nasopharyngeal airway alongside the OPA
D. Begin chest compressions
Correct Answer: B
Rationale: Abdominal rise with poor chest rise indicates inadequate ventilation—likely
poor mask seal, improper airway positioning (head tilt-chin lift or jaw thrust), or OPA that
is too long (in esophagus) or too short (pushing tongue back). SNHD Protocol
emphasizes: E-C clamp technique for mask seal, two-person BVM if available (one
maintains seal, one squeezes bag), proper OPA sizing (corner of mouth to angle of jaw),
and reassessment after each intervention. Increasing rate (Option A) worsens gastric
insufflation. Adding NPA (Option C) doesn't address the ventilation problem.
Compressions (Option D) are for cardiac arrest, not respiratory failure.
Q4: According to SNHD EMT protocols, at what SpO2 threshold should you titrate
oxygen delivery from high-flow to lower concentration in a COPD patient with known
CO2 retention?
A. Maintain SpO2 at 100% regardless of patient history
, B. Titrate to maintain SpO2 between 88-92% to avoid CO2 narcosis from
oxygen-induced hypoventilation [CORRECT]
C. Maintain SpO2 >95% to ensure adequate tissue oxygenation
D. Discontinue all oxygen once SpO2 reaches 90%
Correct Answer: B
Rationale: SNHD Respiratory Distress Protocol recognizes that some COPD patients
have chronic CO2 retention and rely on hypoxic drive. While "hypoxic drive" theory is
debated, evidence supports avoiding hyperoxia (SpO2 >95%) which may cause
respiratory depression, hypercapnia, and acidosis. Target 88-92% using nasal cannula or
Venturi mask rather than high-flow NRB. Monitor for altered mental status, decreased
respiratory rate, or worsening acidosis. Option A risks respiratory arrest. Option C is
excessive. Option D abandons necessary oxygenation.
Q5: You are managing a patient with status asthmaticus. The patient is alert, speaking
in short phrases, with diffuse wheezing and SpO2 88%. After administering high-flow
oxygen, what is your next intervention per SNHD Asthma/COPD Protocol?
A. Immediate intubation
B. Administer albuterol via nebulizer or MDI with spacer; consider repeat doses and
contact ALS for severe distress [CORRECT]
C. Administer epinephrine 1:1000 IM
D. Place patient supine and restrict movement
Correct Answer: B
Correct Answers with Complete Solutions | Emergency
Medical Technician | Southern Nevada Health District | Pass
Guaranteed - A+ Graded
Domain 1: Airway and Breathing/Oxygenation (15 Questions)
Q1: You respond to a 67-year-old male with sudden onset of difficulty breathing. He is
sitting upright, tripod positioning, diaphoretic, with circumoral cyanosis. Respiratory rate
is 32, shallow. SpO2 is 82% on room air. According to SNHD EMT protocols, what is your
immediate priority?
A. Begin transport immediately without intervention
B. Apply high-flow oxygen via non-rebreather mask at 15 LPM and assess for adequate
tidal volume [CORRECT]
C. Insert a nasopharyngeal airway immediately
D. Administer albuterol via nebulizer first
Correct Answer: B
Rationale: SNHD Airway Protocol prioritizes immediate oxygenation for hypoxemic
patients. SpO2 <90% requires high-flow O2 via NRB at 15 LPM. The patient shows signs
of respiratory failure (tripod positioning, cyanosis, tachypnea, shallow respirations).
Assessing tidal volume determines if BVM assistance is needed. Option A abandons
,critical care. NPA insertion (Option C) is indicated if airway obstruction is suspected, but
oxygenation takes precedence. Albuterol (Option D) is appropriate for bronchospasm
but doesn't address immediate hypoxemia—oxygen first, then medication if indicated.
Q2: A 4-year-old child is in respiratory distress after a choking episode. The child is
conscious, coughing forcefully, and making high-pitched noises between coughs. What
is your immediate action per SNHD Pediatric Airway Protocol?
A. Perform 5 back blows and 5 chest thrusts immediately
B. Encourage the child to continue coughing and monitor closely; do NOT intervene with
blows or thrusts while effective cough present [CORRECT]
C. Perform abdominal thrusts immediately
D. Insert an oropharyngeal airway
Correct Answer: B
Rationale: SNHD follows AHA guidelines: if the child is coughing forcefully and has
good air exchange, encourage coughing and do NOT intervene—intervention risks
converting partial obstruction to complete obstruction. Back blows/chest thrusts
(Option A) or abdominal thrusts (Option C) are indicated only if the cough becomes
ineffective (weak, silent), breathing becomes difficult, or cyanosis develops. OPA
(Option D) is contraindicated in conscious patients and doesn't address foreign body
obstruction. Stay with child, prepare for deterioration, and be ready to intervene if
condition worsens.
,Q3: You are ventilating an apneic adult patient with a BVM and oropharyngeal airway in
place. The patient's abdomen is rising more than the chest, and SpO2 is not improving.
What is your corrective action per SNHD Airway Management Protocol?
A. Increase ventilation rate to 20 breaths per minute
B. Reassess airway positioning, ensure adequate mask seal, and verify OPA is properly
sized and positioned; consider two-person BVM technique [CORRECT]
C. Insert a nasopharyngeal airway alongside the OPA
D. Begin chest compressions
Correct Answer: B
Rationale: Abdominal rise with poor chest rise indicates inadequate ventilation—likely
poor mask seal, improper airway positioning (head tilt-chin lift or jaw thrust), or OPA that
is too long (in esophagus) or too short (pushing tongue back). SNHD Protocol
emphasizes: E-C clamp technique for mask seal, two-person BVM if available (one
maintains seal, one squeezes bag), proper OPA sizing (corner of mouth to angle of jaw),
and reassessment after each intervention. Increasing rate (Option A) worsens gastric
insufflation. Adding NPA (Option C) doesn't address the ventilation problem.
Compressions (Option D) are for cardiac arrest, not respiratory failure.
Q4: According to SNHD EMT protocols, at what SpO2 threshold should you titrate
oxygen delivery from high-flow to lower concentration in a COPD patient with known
CO2 retention?
A. Maintain SpO2 at 100% regardless of patient history
, B. Titrate to maintain SpO2 between 88-92% to avoid CO2 narcosis from
oxygen-induced hypoventilation [CORRECT]
C. Maintain SpO2 >95% to ensure adequate tissue oxygenation
D. Discontinue all oxygen once SpO2 reaches 90%
Correct Answer: B
Rationale: SNHD Respiratory Distress Protocol recognizes that some COPD patients
have chronic CO2 retention and rely on hypoxic drive. While "hypoxic drive" theory is
debated, evidence supports avoiding hyperoxia (SpO2 >95%) which may cause
respiratory depression, hypercapnia, and acidosis. Target 88-92% using nasal cannula or
Venturi mask rather than high-flow NRB. Monitor for altered mental status, decreased
respiratory rate, or worsening acidosis. Option A risks respiratory arrest. Option C is
excessive. Option D abandons necessary oxygenation.
Q5: You are managing a patient with status asthmaticus. The patient is alert, speaking
in short phrases, with diffuse wheezing and SpO2 88%. After administering high-flow
oxygen, what is your next intervention per SNHD Asthma/COPD Protocol?
A. Immediate intubation
B. Administer albuterol via nebulizer or MDI with spacer; consider repeat doses and
contact ALS for severe distress [CORRECT]
C. Administer epinephrine 1:1000 IM
D. Place patient supine and restrict movement
Correct Answer: B
