1|Page
WEST COAST EMT BLOCK 3 QUIZ – ALREADY
PASSED GRADED A+ (2026): 165 PRACTICE
QUESTIONS WITH ANSWERS & RATIONALES |
HIGH-YIELD.
# Table of Contents
| Section | Topic | Question Count |
|---------|-------|----------------|
| 1 | Cardiovascular Emergencies (ACS, CHF, Shock, Cardiac Arrest) |
25 |
| 2 | Respiratory Emergencies (Asthma, COPD, Pulmonary Edema,
Airway) | 20 |
| 3 | Neurological Emergencies (Stroke, Seizure, Altered Mental Status) |
15 |
| 4 | Endocrine Emergencies (Diabetes, DKA, HHNS, Adrenal) | 15 |
| 5 | Toxicology & Overdose (Opioids, Stimulants, Alcohol, Antidotes) |
20 |
| 6 | Environmental Emergencies (Heat, Cold, Drowning, Bites, Altitude)
| 15 |
| 7 | Behavioral Emergencies (Psychiatric, Agitation, Suicide, Restraint) |
10 |
| 8 | Obstetrics & Gynecology (Pregnancy, Delivery, Complications,
Sexual Assault) | 15 |
,2|Page
| 9 | Infectious Diseases & Sepsis | 10 |
| 10 | High-Yield Clinical Case Questions | 20 |
| **Total** | | **165** |
---
# SECTION 1: Cardiovascular Emergencies (ACS, CHF, Shock, Cardiac
Arrest) – 25 Questions
**1. A 65-year-old male complains of substernal chest pressure radiating
to the left arm, nausea, and diaphoresis. He is anxious and pale. Vital
signs: BP 140/90, HR 110, RR 22, SpO2 95%. What is the most
appropriate initial action?**
A. Administer nitroglycerin
B. Administer aspirin and oxygen
C. Perform a 12-lead ECG
D. Transport immediately
**Answer: B – Administer aspirin and oxygen**
*Rationale:* Standard ACS protocol: aspirin (chewable, 324 mg)
reduces mortality. Oxygen if SpO2 <90% or signs of shock.
Nitroglycerin after establishing IV and BP >100 systolic.
,3|Page
**2. Which of the following is a contraindication to nitroglycerin
administration?**
A. Systolic BP <100 mmHg
B. Heart rate >100 bpm
C. Chest pain lasting more than 10 minutes
D. History of diabetes
**Answer: A – Systolic BP <100 mmHg**
*Rationale:* Nitroglycerin causes vasodilation and can worsen
hypotension. Contraindications: SBP <100, HR <50 or >150, suspected
right ventricular infarct, or phosphodiesterase inhibitor use (sildenafil,
tadalafil) within 24-48 hours.
**3. A patient with congestive heart failure (CHF) presents with severe
respiratory distress, pink frothy sputum, and crackles in all lung fields.
Vital signs: BP 160/90, HR 120, RR 32, SpO2 82% on room air. What is
the priority intervention?**
A. Assist ventilations with BVM and high-flow oxygen
B. Place in supine position
C. Administer nitroglycerin
D. Obtain IV access
**Answer: A – Assist ventilations with BVM and high-flow oxygen**
, 4|Page
*Rationale:* This patient has pulmonary edema (flash pulmonary
edema). Airway and breathing are priority. CPAP or BVM with high-
flow O2, then consider nitroglycerin for preload reduction.
**4. Which medication is often used in the prehospital setting for acute
pulmonary edema to reduce preload?**
A. Aspirin
B. Nitroglycerin
C. Epinephrine
D. Albuterol
**Answer: B – Nitroglycerin**
*Rationale:* Nitroglycerin causes venodilation, reducing preload and
decreasing pulmonary congestion. May also be given as SL or IV in
some protocols.
**5. A patient in cardiac arrest has a rhythm of ventricular fibrillation
(VF). What is the first treatment?**
A. Epinephrine 1 mg IV push
B. Defibrillation (unsynchronized) at 200J (biphasic)
C. Amiodarone 300 mg IV
D. Chest compressions only
**Answer: B – Defibrillation (unsynchronized) at 200J (biphasic)**
WEST COAST EMT BLOCK 3 QUIZ – ALREADY
PASSED GRADED A+ (2026): 165 PRACTICE
QUESTIONS WITH ANSWERS & RATIONALES |
HIGH-YIELD.
# Table of Contents
| Section | Topic | Question Count |
|---------|-------|----------------|
| 1 | Cardiovascular Emergencies (ACS, CHF, Shock, Cardiac Arrest) |
25 |
| 2 | Respiratory Emergencies (Asthma, COPD, Pulmonary Edema,
Airway) | 20 |
| 3 | Neurological Emergencies (Stroke, Seizure, Altered Mental Status) |
15 |
| 4 | Endocrine Emergencies (Diabetes, DKA, HHNS, Adrenal) | 15 |
| 5 | Toxicology & Overdose (Opioids, Stimulants, Alcohol, Antidotes) |
20 |
| 6 | Environmental Emergencies (Heat, Cold, Drowning, Bites, Altitude)
| 15 |
| 7 | Behavioral Emergencies (Psychiatric, Agitation, Suicide, Restraint) |
10 |
| 8 | Obstetrics & Gynecology (Pregnancy, Delivery, Complications,
Sexual Assault) | 15 |
,2|Page
| 9 | Infectious Diseases & Sepsis | 10 |
| 10 | High-Yield Clinical Case Questions | 20 |
| **Total** | | **165** |
---
# SECTION 1: Cardiovascular Emergencies (ACS, CHF, Shock, Cardiac
Arrest) – 25 Questions
**1. A 65-year-old male complains of substernal chest pressure radiating
to the left arm, nausea, and diaphoresis. He is anxious and pale. Vital
signs: BP 140/90, HR 110, RR 22, SpO2 95%. What is the most
appropriate initial action?**
A. Administer nitroglycerin
B. Administer aspirin and oxygen
C. Perform a 12-lead ECG
D. Transport immediately
**Answer: B – Administer aspirin and oxygen**
*Rationale:* Standard ACS protocol: aspirin (chewable, 324 mg)
reduces mortality. Oxygen if SpO2 <90% or signs of shock.
Nitroglycerin after establishing IV and BP >100 systolic.
,3|Page
**2. Which of the following is a contraindication to nitroglycerin
administration?**
A. Systolic BP <100 mmHg
B. Heart rate >100 bpm
C. Chest pain lasting more than 10 minutes
D. History of diabetes
**Answer: A – Systolic BP <100 mmHg**
*Rationale:* Nitroglycerin causes vasodilation and can worsen
hypotension. Contraindications: SBP <100, HR <50 or >150, suspected
right ventricular infarct, or phosphodiesterase inhibitor use (sildenafil,
tadalafil) within 24-48 hours.
**3. A patient with congestive heart failure (CHF) presents with severe
respiratory distress, pink frothy sputum, and crackles in all lung fields.
Vital signs: BP 160/90, HR 120, RR 32, SpO2 82% on room air. What is
the priority intervention?**
A. Assist ventilations with BVM and high-flow oxygen
B. Place in supine position
C. Administer nitroglycerin
D. Obtain IV access
**Answer: A – Assist ventilations with BVM and high-flow oxygen**
, 4|Page
*Rationale:* This patient has pulmonary edema (flash pulmonary
edema). Airway and breathing are priority. CPAP or BVM with high-
flow O2, then consider nitroglycerin for preload reduction.
**4. Which medication is often used in the prehospital setting for acute
pulmonary edema to reduce preload?**
A. Aspirin
B. Nitroglycerin
C. Epinephrine
D. Albuterol
**Answer: B – Nitroglycerin**
*Rationale:* Nitroglycerin causes venodilation, reducing preload and
decreasing pulmonary congestion. May also be given as SL or IV in
some protocols.
**5. A patient in cardiac arrest has a rhythm of ventricular fibrillation
(VF). What is the first treatment?**
A. Epinephrine 1 mg IV push
B. Defibrillation (unsynchronized) at 200J (biphasic)
C. Amiodarone 300 mg IV
D. Chest compressions only
**Answer: B – Defibrillation (unsynchronized) at 200J (biphasic)**
