NCOEMS Practice Exam 1 2026 Exam Questions
COMPREHENSIVE FREQUENTLY TESTED 120
QUESTIONS and verifi ed ANSWERS
Section 1: Scene Size-Up & Primary Assessment (Initial
Approach)
1. 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
Rationale: Scene safety is the absolute priority in any emergency situation. You must remove
the patient (and yourself) from the dangerous environment (natural gas leak) before
providing any care. Your safety comes first.
2. In which of the following situations should you call for immediate assistance?
A) You must care for two critical patients with gunshot wounds.
B) Your patient is a 26-year-old female in active labor.
C) Your patient is a child with fever who has had a brief seizure.
D) Your partner is needed to stabilize the cervical spine.
Correct Answer: A
Rationale: Two critical patients exceed the capacity of a single EMT crew. You need
immediate ALS or additional rescue units to manage two life-threats simultaneously.
3. What is the first action you should take when arriving at the scene of an unconscious
patient?
A) Check the patient's pulse.
B) Assess the environment for safety.
C) Administer oxygen.
D) Begin CPR.
Correct Answer: B
Rationale: You cannot help a patient if you become a victim yourself. The first step in any
patient encounter (per NCOEMS guidelines) is to ensure the scene is safe for you, your
partner, and the patient.
,4. A bystander is performing CPR when you arrive. You evaluate the scene and practice
BSI. What is your next step regarding the bystander?
A) Verify pulselessness.
B) Continue CPR.
C) Stop CPR to assess.
D) Switch places immediately.
Correct Answer: B
Rationale: Interrupting CPR causes a drop in coronary perfusion pressure. Have the
bystander continue CPR while you attach the AED and prepare your equipment to minimize
"hands-off" time .
5. In a multiple-casualty situation, which patient should be assigned the highest priority?
A) Adequate breathing, venous bleeding.
B) Adequate breathing, responsive, suspected spine injury.
C) Inadequate breathing, responsive, suspected broken tibia.
D) Inadequate breathing, unresponsive, suspected internal bleeding.
Correct Answer: D
Rationale: This patient has an airway/breathing problem AND a circulation problem (internal
bleeding). In triage, patients with inadequate breathing or perfusion (shock) are prioritized
over those with adequate breathing and minor injuries .
6. 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
Rationale: Chest pain with a systolic BP of 80 indicates cardiogenic shock. This patient is
perfusing poorly and has a high likelihood of cardiac arrest, making them the highest
priority .
7. You are transporting a patient who has been resuscitated but is still unresponsive. You
should check the patient's pulse every:
A) Thirty seconds.
B) Minute.
C) Five minutes.
D) Ten minutes.
Correct Answer: A
,Rationale: A resuscitated patient is unstable and at high risk for re-arrest. Frequent pulse
checks (every 30 seconds) are necessary to immediately recognize deterioration .
8. After opening the airway, the next step in patient management is to:
A) Insert an endotracheal tube.
B) Assess adequacy of respirations.
C) Begin mouth-to-mouth ventilation.
D) Apply bag-valve-mask ventilation.
Correct Answer: B
Rationale: Opening the airway is the first step; you must immediately assess if the patient is
breathing adequately (rate, depth, tidal volume) to determine if you need to assist
ventilations .
9. Which patient can safely receive only a focused physical examination rather than a rapid
trauma assessment?
A) 10-year-old male with a deformed right lower leg who is responsive after falling off his
bicycle.
B) 20-year-old female who complains of severe pain in her ankle after stepping off a curb.
C) 70-year-old male who complains of neck pain after a medium-speed car collision.
D) 30-year-old male who is unresponsive but has only minor cuts on the extremities.
Correct Answer: B
Rationale: A focused physical exam is appropriate for patients with isolated injuries and no
significant mechanism of injury (MOI). The ankle injury after stepping off a curb is low-
mechanism and isolated .
10. 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
Rationale: Medium-speed motor vehicle crashes involve a significant MOI. Children are at
high risk for hidden injuries due to their anatomy and inability to localize pain. Rapid trauma
survey is indicated for any significant MOI .
11. What is the purpose of the ongoing assessment?
A) Find any injuries missed during the initial assessment.
B) Reassure the patient that you are still caring for him or her.
C) Check the adequacy of each intervention performed.
D) Protect the EMT against liability from malpractice.
, Correct Answer: C
Rationale: The ongoing assessment (reassessment) is performed during transport to monitor
the patient's condition, re-triage, and specifically evaluate whether your treatments (e.g.,
oxygen, splinting, bleeding control) are working .
12. Where is a detailed physical exam typically performed?
A) At the scene of the accident or injury.
B) In the hospital emergency department.
C) In the ambulance during transport.
D) In the triage area of the trauma center.
Correct Answer: C
Rationale: The detailed physical exam (head-to-toe) is performed en route to the hospital to
save time. The goal is to find non-life-threatening injuries that were missed in the rapid
assessment while moving toward definitive care .
13. What is the first step in the physical assessment of an unresponsive medical patient?
A) Perform the initial assessment.
B) Assess a complete set of vital signs.
C) Position the patient to protect the airway.
D) Obtain SAMPLE history from a family member.
Correct Answer: A
Rationale: The initial assessment (primary survey for ABCs) is always first. You must identify
and treat life threats (Airway, Breathing, Circulation) before moving to secondary
assessments or history taking .
14. You are using the OPQRST acronym. What question would you ask to assess the "P"
component?
A) What were you doing when the pain started?
B) Can you describe the character of the pain?
C) What makes the pain feel worse or better?
D) On a scale of 1 to 10, how would you rate the pain?
Correct Answer: C
Rationale: In OPQRST, "P" stands for Provocation/Palliation (what makes it worse or better).
"O" is Onset, "Q" is Quality, "R" is Region/Radiation, "S" is Severity, and "T" is Time .
Airway Management & Respiratory Emergencies
15. A 2-year-old male is in respiratory failure when he has:
A) Altered mental status and breathing rate of 68 per minute.
B) Limp muscle tone and weak or absent distal pulses.
COMPREHENSIVE FREQUENTLY TESTED 120
QUESTIONS and verifi ed ANSWERS
Section 1: Scene Size-Up & Primary Assessment (Initial
Approach)
1. 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
Rationale: Scene safety is the absolute priority in any emergency situation. You must remove
the patient (and yourself) from the dangerous environment (natural gas leak) before
providing any care. Your safety comes first.
2. In which of the following situations should you call for immediate assistance?
A) You must care for two critical patients with gunshot wounds.
B) Your patient is a 26-year-old female in active labor.
C) Your patient is a child with fever who has had a brief seizure.
D) Your partner is needed to stabilize the cervical spine.
Correct Answer: A
Rationale: Two critical patients exceed the capacity of a single EMT crew. You need
immediate ALS or additional rescue units to manage two life-threats simultaneously.
3. What is the first action you should take when arriving at the scene of an unconscious
patient?
A) Check the patient's pulse.
B) Assess the environment for safety.
C) Administer oxygen.
D) Begin CPR.
Correct Answer: B
Rationale: You cannot help a patient if you become a victim yourself. The first step in any
patient encounter (per NCOEMS guidelines) is to ensure the scene is safe for you, your
partner, and the patient.
,4. A bystander is performing CPR when you arrive. You evaluate the scene and practice
BSI. What is your next step regarding the bystander?
A) Verify pulselessness.
B) Continue CPR.
C) Stop CPR to assess.
D) Switch places immediately.
Correct Answer: B
Rationale: Interrupting CPR causes a drop in coronary perfusion pressure. Have the
bystander continue CPR while you attach the AED and prepare your equipment to minimize
"hands-off" time .
5. In a multiple-casualty situation, which patient should be assigned the highest priority?
A) Adequate breathing, venous bleeding.
B) Adequate breathing, responsive, suspected spine injury.
C) Inadequate breathing, responsive, suspected broken tibia.
D) Inadequate breathing, unresponsive, suspected internal bleeding.
Correct Answer: D
Rationale: This patient has an airway/breathing problem AND a circulation problem (internal
bleeding). In triage, patients with inadequate breathing or perfusion (shock) are prioritized
over those with adequate breathing and minor injuries .
6. 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
Rationale: Chest pain with a systolic BP of 80 indicates cardiogenic shock. This patient is
perfusing poorly and has a high likelihood of cardiac arrest, making them the highest
priority .
7. You are transporting a patient who has been resuscitated but is still unresponsive. You
should check the patient's pulse every:
A) Thirty seconds.
B) Minute.
C) Five minutes.
D) Ten minutes.
Correct Answer: A
,Rationale: A resuscitated patient is unstable and at high risk for re-arrest. Frequent pulse
checks (every 30 seconds) are necessary to immediately recognize deterioration .
8. After opening the airway, the next step in patient management is to:
A) Insert an endotracheal tube.
B) Assess adequacy of respirations.
C) Begin mouth-to-mouth ventilation.
D) Apply bag-valve-mask ventilation.
Correct Answer: B
Rationale: Opening the airway is the first step; you must immediately assess if the patient is
breathing adequately (rate, depth, tidal volume) to determine if you need to assist
ventilations .
9. Which patient can safely receive only a focused physical examination rather than a rapid
trauma assessment?
A) 10-year-old male with a deformed right lower leg who is responsive after falling off his
bicycle.
B) 20-year-old female who complains of severe pain in her ankle after stepping off a curb.
C) 70-year-old male who complains of neck pain after a medium-speed car collision.
D) 30-year-old male who is unresponsive but has only minor cuts on the extremities.
Correct Answer: B
Rationale: A focused physical exam is appropriate for patients with isolated injuries and no
significant mechanism of injury (MOI). The ankle injury after stepping off a curb is low-
mechanism and isolated .
10. 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
Rationale: Medium-speed motor vehicle crashes involve a significant MOI. Children are at
high risk for hidden injuries due to their anatomy and inability to localize pain. Rapid trauma
survey is indicated for any significant MOI .
11. What is the purpose of the ongoing assessment?
A) Find any injuries missed during the initial assessment.
B) Reassure the patient that you are still caring for him or her.
C) Check the adequacy of each intervention performed.
D) Protect the EMT against liability from malpractice.
, Correct Answer: C
Rationale: The ongoing assessment (reassessment) is performed during transport to monitor
the patient's condition, re-triage, and specifically evaluate whether your treatments (e.g.,
oxygen, splinting, bleeding control) are working .
12. Where is a detailed physical exam typically performed?
A) At the scene of the accident or injury.
B) In the hospital emergency department.
C) In the ambulance during transport.
D) In the triage area of the trauma center.
Correct Answer: C
Rationale: The detailed physical exam (head-to-toe) is performed en route to the hospital to
save time. The goal is to find non-life-threatening injuries that were missed in the rapid
assessment while moving toward definitive care .
13. What is the first step in the physical assessment of an unresponsive medical patient?
A) Perform the initial assessment.
B) Assess a complete set of vital signs.
C) Position the patient to protect the airway.
D) Obtain SAMPLE history from a family member.
Correct Answer: A
Rationale: The initial assessment (primary survey for ABCs) is always first. You must identify
and treat life threats (Airway, Breathing, Circulation) before moving to secondary
assessments or history taking .
14. You are using the OPQRST acronym. What question would you ask to assess the "P"
component?
A) What were you doing when the pain started?
B) Can you describe the character of the pain?
C) What makes the pain feel worse or better?
D) On a scale of 1 to 10, how would you rate the pain?
Correct Answer: C
Rationale: In OPQRST, "P" stands for Provocation/Palliation (what makes it worse or better).
"O" is Onset, "Q" is Quality, "R" is Region/Radiation, "S" is Severity, and "T" is Time .
Airway Management & Respiratory Emergencies
15. A 2-year-old male is in respiratory failure when he has:
A) Altered mental status and breathing rate of 68 per minute.
B) Limp muscle tone and weak or absent distal pulses.
