Page 1 of 183
NORTH CAROLINA OFFICE OF EMERGENCY
NEDICAL SERVICES (NCOEMS) / NCOEMS
EXAM 2026/2027 ACCURATE QUESTIONS
WITH WELL ELABORATED ANSWERS AND
RATIONALES (100% CORRECT VERIFIED
SOLUTIONS) NEWEST UPDATED VERSION
|GUARANTEED PASS A+ |BRAND NEW!
1. A 68-year-old male is unresponsive, snoring respirations at
6/min, SpO₂ 82%. What is your priority?
A) Apply non-rebreather at 15 LPM
,Page 2 of 183
B) Jaw-thrust maneuver + BVM ventilation
C) Oropharyngeal airway with nasal cannula
D) Suction for 30 seconds
Answer: B
Rationale: Snoring indicates partial airway obstruction from
the tongue. Jaw-thrust opens the airway without cervical
motion. BVM at 10–12 breaths/min corrects hypoxia. OPA can
follow after opening the airway.
2. You intubate a cardiac arrest patient. Which confirms
proper tube placement in NC prehospital setting?
A) Fogging in tube
B) 5-point auscultation + capnography
C) Pulse oximetry improvement
D) Chest rise alone
Answer: B
Rationale: NC OEMS mandates waveform capnography +
bilateral breath sounds + epigastric auscultation +
,Page 3 of 183
condensation + chest rise. ETCO₂ > 10–15 mmHg confirms
placement.
3. A 7-year-old child has stridor, drooling, and tripod
positioning. What is the most appropriate initial action?
A) Direct laryngoscopy to visualize the airway
B) Nebulized epinephrine while preparing for advanced
airway
C) Blind nasotracheal intubation
D) Immediate cricothyrotomy
Answer: B
Rationale: Stridor + drooling + tripod suggest epiglottitis.
Nebulized epinephrine reduces edema. Avoid agitating the
child. Do not perform blind intubation or DL in the field without
RSI capability.
4. Which of the following is an absolute contraindication to
inserting an oropharyngeal airway (OPA)?
A) Conscious patient with intact gag reflex
, Page 4 of 183
B) Suspected cervical spine injury
C) Severe facial trauma
D) Age less than 8 years
Answer: A
Rationale: An OPA in a conscious patient with a gag reflex
can cause vomiting, aspiration, and laryngospasm. Cervical
injury is not a contraindication; proper sizing and technique
are used.
5. Your patient has a tracheostomy tube that is partially
dislodged. He is in respiratory distress. You cannot reinsert the
tube. What next?
A) Apply oxygen mask over the stoma
B) Seal the stoma and ventilate via BVM over mouth/nose
C) Insert a smaller endotracheal tube into the stoma
D) Perform needle cricothyrotomy
Answer: C
Rationale: If the tracheostomy tube cannot be reinserted, a
smaller ETT (e.g., 5.0 or 6.0 cuffed) can be inserted into the
NORTH CAROLINA OFFICE OF EMERGENCY
NEDICAL SERVICES (NCOEMS) / NCOEMS
EXAM 2026/2027 ACCURATE QUESTIONS
WITH WELL ELABORATED ANSWERS AND
RATIONALES (100% CORRECT VERIFIED
SOLUTIONS) NEWEST UPDATED VERSION
|GUARANTEED PASS A+ |BRAND NEW!
1. A 68-year-old male is unresponsive, snoring respirations at
6/min, SpO₂ 82%. What is your priority?
A) Apply non-rebreather at 15 LPM
,Page 2 of 183
B) Jaw-thrust maneuver + BVM ventilation
C) Oropharyngeal airway with nasal cannula
D) Suction for 30 seconds
Answer: B
Rationale: Snoring indicates partial airway obstruction from
the tongue. Jaw-thrust opens the airway without cervical
motion. BVM at 10–12 breaths/min corrects hypoxia. OPA can
follow after opening the airway.
2. You intubate a cardiac arrest patient. Which confirms
proper tube placement in NC prehospital setting?
A) Fogging in tube
B) 5-point auscultation + capnography
C) Pulse oximetry improvement
D) Chest rise alone
Answer: B
Rationale: NC OEMS mandates waveform capnography +
bilateral breath sounds + epigastric auscultation +
,Page 3 of 183
condensation + chest rise. ETCO₂ > 10–15 mmHg confirms
placement.
3. A 7-year-old child has stridor, drooling, and tripod
positioning. What is the most appropriate initial action?
A) Direct laryngoscopy to visualize the airway
B) Nebulized epinephrine while preparing for advanced
airway
C) Blind nasotracheal intubation
D) Immediate cricothyrotomy
Answer: B
Rationale: Stridor + drooling + tripod suggest epiglottitis.
Nebulized epinephrine reduces edema. Avoid agitating the
child. Do not perform blind intubation or DL in the field without
RSI capability.
4. Which of the following is an absolute contraindication to
inserting an oropharyngeal airway (OPA)?
A) Conscious patient with intact gag reflex
, Page 4 of 183
B) Suspected cervical spine injury
C) Severe facial trauma
D) Age less than 8 years
Answer: A
Rationale: An OPA in a conscious patient with a gag reflex
can cause vomiting, aspiration, and laryngospasm. Cervical
injury is not a contraindication; proper sizing and technique
are used.
5. Your patient has a tracheostomy tube that is partially
dislodged. He is in respiratory distress. You cannot reinsert the
tube. What next?
A) Apply oxygen mask over the stoma
B) Seal the stoma and ventilate via BVM over mouth/nose
C) Insert a smaller endotracheal tube into the stoma
D) Perform needle cricothyrotomy
Answer: C
Rationale: If the tracheostomy tube cannot be reinserted, a
smaller ETT (e.g., 5.0 or 6.0 cuffed) can be inserted into the
