NCOEMS Practice Exam 2026| North Carolina Office of
Emergency Medical Services Actual Exam Questions and
Correct Answers
1. EMTs should wear high-efficiency particulate air (HEPA) respirators when they are in contact
with patients who have which of the following?
A. HIV (Human Immunodeficiency Virus) or AIDS (Acquired Immune Deficiency Syndrome)
B. Tuberculosis (TB)
C. Open Wounds
D. Hepatitis B
Correct Answer: B
Explanation: HEPA respirators are specifically required for airborne precautions. Tuberculosis
spreads through airborne droplets, so EMTs must wear HEPA or N95 masks when caring for
suspected or confirmed TB patients.
2. You are called to assist a 60-year-old female complaining of a severe headache. Upon entering
the home, you smell a strong odor of natural gas. What is your first action?
A. Check the patient's airway, breathing, and circulation.
B. Insert a nasopharyngeal airway and assess vital signs.
C. Remove the patient from the house to your ambulance.
D. Open all windows and determine the source of the gas leak.
Correct Answer: C
Explanation: Scene safety is always the top priority. A strong natural gas odor indicates a
potential explosion or carbon monoxide risk. The first action is to immediately remove the
patient (and yourself) from the hazardous environment.
3. The most common electrical rhythm disturbance that results in sudden cardiac arrest is called:
A. Pulseless electrical activity
B. Ventricular Fibrillation
C. Ventricular Tachycardia
D. Asystole
,Correct Answer: B
Explanation: Ventricular fibrillation (V-fib) is the most common shockable rhythm causing
sudden cardiac arrest. It causes chaotic quivering of the ventricles with no effective cardiac
output.
4. A non-trauma patient was pulseless and apneic. Assisted ventilation was attempted, but
unsuccessful. If the head is repositioned and a repeat ventilation is unsuccessful, which of the
following is the next most appropriate step?
A. Check for an airway obstruction.
B. Continue with chest compressions only.
C. Attempt ventilations using an alternative method.
D. Continue to reposition the head until assisted ventilations are successful.
Correct Answer: A
Explanation: If basic airway maneuvers (head repositioning) fail to allow ventilation, the next
step is to look for and relieve a foreign body airway obstruction.
5. During the management of a cardiac arrest, the AED gives a 'no shock advised' message.
Which of the following conditions most likely prompted this message?
A. The patient is in V tach.
B. The patient is hypothermic.
C. The patient is in V fib.
D. The patient's rhythm is asystole.
Correct Answer: D
Explanation: AEDs analyze for shockable rhythms (V-fib or pulseless V-tach). Asystole and
pulseless electrical activity are non-shockable, so the AED advises “no shock.”
6. ALS and EMS providers are preparing to hyperventilate a patient who has a suspected
brainstem herniation. As capnography becomes available, what should be the target end-tidal
carbon-dioxide level during hyperventilation?
A. 20-25 mmHg
B. 60-70 mmHg
C. 30-35 mmHg
D. 40-45 mmHg
,Correct Answer: C
Explanation: For suspected increased intracranial pressure with herniation, controlled
hyperventilation targets an EtCO₂ of 30–35 mmHg to cause mild vasoconstriction and reduce
intracranial pressure without causing excessive cerebral ischemia.
7. Which of the following is the highest priority patient?
A. 57-year-old male with chest pain and systolic blood pressure of 80.
B. 40-year-old female with moderate pain from a leg injury.
C. 75-year-old male who appears confused but responds to commands.
D. 25-year-old female in labor with contractions six minutes apart.
Correct Answer: A
Explanation: Hypotension (SBP 80) with chest pain indicates cardiogenic shock or acute
coronary syndrome — this is an immediate life threat and has the highest priority.
8. Of the following, which body fluid has the most potential to transmit blood-borne diseases?
A. Nasal discharge
B. Vomitus
C. Amniotic fluid
D. Feces
Correct Answer: C
Explanation: Amniotic fluid is considered a high-risk body fluid for blood-borne pathogens
(HIV, Hepatitis B/C) because it may contain blood or fetal blood products.
9. Your patient is an 11-month-old female. How can you determine if she has a decreased mental
status and is responsive to verbal stimuli?
A. She will be upset when you take her from her mother's arms.
B. She will be unable to tell you how old she is if you ask her.
C. She will attempt to locate her parents' voices when they speak.
D. She will try to pull away from a painful stimulus on her toe.
Correct Answer: C
Explanation: In infants, responsiveness to verbal stimuli is assessed by observing if the child
turns toward or reacts to a parent’s voice. This is age-appropriate for an 11-month-old.
, 10. What is the best method to assess circulation in an infant?
A. Palpate the carotid pulse.
B. Palpate the brachial pulse.
C. Palpate the radial pulse.
D. Observe capillary refill time.
Correct Answer: B
Explanation: In infants, the brachial pulse is the most reliable central pulse to assess circulation
during CPR or shock evaluation.
11. A 45-year-old male is experiencing chest discomfort. After placing him in his position of
comfort, your next action should be to:
A. Ventilate the patient with a nonrebreather mask at 15 L/min.
B. Ventilate the patient with the bag-valve mask at 15 L/min.
C. Administer oxygen by nonrebreather mask at 15 L/min.
D. Administer oxygen by the nasal cannula at 6 L/min.
Correct Answer: C
Explanation: Suspected cardiac chest pain requires high-concentration oxygen via nonrebreather
mask at 15 L/min to maximize oxygen delivery.
12. Which patient should receive a rapid trauma survey to determine hidden injuries?
A. Alert 2-year-old child in a car seat who was in a medium-speed crash.
B. Alert 20-year-old male who fell ten feet and is complaining of leg pain.
C. Alert 65-year-old female who fell in the bathtub and is complaining of wrist pain.
D. Alert 11-year-old female who tripped while roller-skating and fell down three steps.
Correct Answer: A
Explanation: Pediatric patients involved in significant mechanisms of injury (even if they appear
alert) require a rapid trauma survey because they can have serious internal injuries with minimal
external signs.
13. Which of the following is a sign of increased pressure in the circulatory system?
A. Flat neck veins.
B. Palpable carotid pulse.
Emergency Medical Services Actual Exam Questions and
Correct Answers
1. EMTs should wear high-efficiency particulate air (HEPA) respirators when they are in contact
with patients who have which of the following?
A. HIV (Human Immunodeficiency Virus) or AIDS (Acquired Immune Deficiency Syndrome)
B. Tuberculosis (TB)
C. Open Wounds
D. Hepatitis B
Correct Answer: B
Explanation: HEPA respirators are specifically required for airborne precautions. Tuberculosis
spreads through airborne droplets, so EMTs must wear HEPA or N95 masks when caring for
suspected or confirmed TB patients.
2. You are called to assist a 60-year-old female complaining of a severe headache. Upon entering
the home, you smell a strong odor of natural gas. What is your first action?
A. Check the patient's airway, breathing, and circulation.
B. Insert a nasopharyngeal airway and assess vital signs.
C. Remove the patient from the house to your ambulance.
D. Open all windows and determine the source of the gas leak.
Correct Answer: C
Explanation: Scene safety is always the top priority. A strong natural gas odor indicates a
potential explosion or carbon monoxide risk. The first action is to immediately remove the
patient (and yourself) from the hazardous environment.
3. The most common electrical rhythm disturbance that results in sudden cardiac arrest is called:
A. Pulseless electrical activity
B. Ventricular Fibrillation
C. Ventricular Tachycardia
D. Asystole
,Correct Answer: B
Explanation: Ventricular fibrillation (V-fib) is the most common shockable rhythm causing
sudden cardiac arrest. It causes chaotic quivering of the ventricles with no effective cardiac
output.
4. A non-trauma patient was pulseless and apneic. Assisted ventilation was attempted, but
unsuccessful. If the head is repositioned and a repeat ventilation is unsuccessful, which of the
following is the next most appropriate step?
A. Check for an airway obstruction.
B. Continue with chest compressions only.
C. Attempt ventilations using an alternative method.
D. Continue to reposition the head until assisted ventilations are successful.
Correct Answer: A
Explanation: If basic airway maneuvers (head repositioning) fail to allow ventilation, the next
step is to look for and relieve a foreign body airway obstruction.
5. During the management of a cardiac arrest, the AED gives a 'no shock advised' message.
Which of the following conditions most likely prompted this message?
A. The patient is in V tach.
B. The patient is hypothermic.
C. The patient is in V fib.
D. The patient's rhythm is asystole.
Correct Answer: D
Explanation: AEDs analyze for shockable rhythms (V-fib or pulseless V-tach). Asystole and
pulseless electrical activity are non-shockable, so the AED advises “no shock.”
6. ALS and EMS providers are preparing to hyperventilate a patient who has a suspected
brainstem herniation. As capnography becomes available, what should be the target end-tidal
carbon-dioxide level during hyperventilation?
A. 20-25 mmHg
B. 60-70 mmHg
C. 30-35 mmHg
D. 40-45 mmHg
,Correct Answer: C
Explanation: For suspected increased intracranial pressure with herniation, controlled
hyperventilation targets an EtCO₂ of 30–35 mmHg to cause mild vasoconstriction and reduce
intracranial pressure without causing excessive cerebral ischemia.
7. Which of the following is the highest priority patient?
A. 57-year-old male with chest pain and systolic blood pressure of 80.
B. 40-year-old female with moderate pain from a leg injury.
C. 75-year-old male who appears confused but responds to commands.
D. 25-year-old female in labor with contractions six minutes apart.
Correct Answer: A
Explanation: Hypotension (SBP 80) with chest pain indicates cardiogenic shock or acute
coronary syndrome — this is an immediate life threat and has the highest priority.
8. Of the following, which body fluid has the most potential to transmit blood-borne diseases?
A. Nasal discharge
B. Vomitus
C. Amniotic fluid
D. Feces
Correct Answer: C
Explanation: Amniotic fluid is considered a high-risk body fluid for blood-borne pathogens
(HIV, Hepatitis B/C) because it may contain blood or fetal blood products.
9. Your patient is an 11-month-old female. How can you determine if she has a decreased mental
status and is responsive to verbal stimuli?
A. She will be upset when you take her from her mother's arms.
B. She will be unable to tell you how old she is if you ask her.
C. She will attempt to locate her parents' voices when they speak.
D. She will try to pull away from a painful stimulus on her toe.
Correct Answer: C
Explanation: In infants, responsiveness to verbal stimuli is assessed by observing if the child
turns toward or reacts to a parent’s voice. This is age-appropriate for an 11-month-old.
, 10. What is the best method to assess circulation in an infant?
A. Palpate the carotid pulse.
B. Palpate the brachial pulse.
C. Palpate the radial pulse.
D. Observe capillary refill time.
Correct Answer: B
Explanation: In infants, the brachial pulse is the most reliable central pulse to assess circulation
during CPR or shock evaluation.
11. A 45-year-old male is experiencing chest discomfort. After placing him in his position of
comfort, your next action should be to:
A. Ventilate the patient with a nonrebreather mask at 15 L/min.
B. Ventilate the patient with the bag-valve mask at 15 L/min.
C. Administer oxygen by nonrebreather mask at 15 L/min.
D. Administer oxygen by the nasal cannula at 6 L/min.
Correct Answer: C
Explanation: Suspected cardiac chest pain requires high-concentration oxygen via nonrebreather
mask at 15 L/min to maximize oxygen delivery.
12. Which patient should receive a rapid trauma survey to determine hidden injuries?
A. Alert 2-year-old child in a car seat who was in a medium-speed crash.
B. Alert 20-year-old male who fell ten feet and is complaining of leg pain.
C. Alert 65-year-old female who fell in the bathtub and is complaining of wrist pain.
D. Alert 11-year-old female who tripped while roller-skating and fell down three steps.
Correct Answer: A
Explanation: Pediatric patients involved in significant mechanisms of injury (even if they appear
alert) require a rapid trauma survey because they can have serious internal injuries with minimal
external signs.
13. Which of the following is a sign of increased pressure in the circulatory system?
A. Flat neck veins.
B. Palpable carotid pulse.
