NCOEMS EXAM AND PRACTICE EXAM NEWEST 2026
TEST BANK| NORTH CAROLINA OFFICE OF
EMERGENCY MEDICAL SERVICES (NCOEMS) EXAM
PREP WITH COMPLETE 300 REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS/ ALREADY
GRADED A+
Q1: According to the NCOEMS EMT protocols, the
recommended initial dose of naloxone (Narcan) for a
suspected opioid overdose in an adult is:
A) 0.4 mg intranasal (IN) or 0.4–2 mg IM/IN per protocol
B) 2 mg intranasal (one spray)
C) 4 mg intranasal (two sprays) – 4 mg IN is common
D) 10 mg IM
Answer: C (4 mg IN or 0.4–2 mg IM; check local protocols. NC
often uses 4 mg IN or 2 mg IN depending on concentration)
Rationale: NCOEMS protocols typically recommend 4 mg
intranasal or 0.4–2 mg IM/IV. Follow local protocol.
1
,Q2: Which of the following is the most reliable method to
confirm proper placement of an endotracheal (ET) tube in the
field?
A) Auscultation of breath sounds over the epigastrium and lungs
B) Continuous waveform capnography (end-tidal CO₂)
C) Condensation in the ET tube
D) Pulse oximetry reading
Answer: B
Rationale: Continuous waveform capnography is the gold
standard for confirming ET tube placement and monitoring CPR
quality.
Q3: A patient is found unresponsive, not breathing, and
pulseless. The first step after ensuring scene safety is:
A) Check for a carotid pulse for 10 seconds
B) Begin chest compressions immediately (high-quality CPR)
C) Apply an automated external defibrillator (AED)
D) Insert an oropharyngeal airway
Answer: B
Rationale: Current AHA guidelines prioritize immediate chest
compressions for unresponsive, pulseless patients.
2
,Q4: The appropriate compression-to-ventilation ratio for a
single rescuer performing CPR on a child (1 year to puberty)
is:
A) 30:2
B) 15:2 (two-rescuer child; single rescuer 30:2)
C) 30:2 for single rescuer all ages except newborn
D) 5:1
Answer: C
Rationale: Single rescuer: 30:2 for adults, children, infants
(except newborn). Two-rescuer child/infant: 15:2.
Q5: Which of the following is a contraindication for the use of
a nasopharyngeal airway (NPA)?
A) Gag reflex present
B) Suspected skull fracture or basilar skull fracture
C) Unresponsiveness
D) Foreign body airway obstruction
Answer: B
Rationale: NPA is contraindicated in suspected basilar skull
fracture due to risk of intracranial placement.
3
, Q6: A 45-year-old patient presents with chest pain radiating
to the left arm, diaphoresis, and nausea. The patient is alert
and has no allergies. Which medication should the EMT
administer first?
A) Oxygen at 15 L/min via non-rebreather
B) Aspirin 324 mg (chewed)
C) Nitroglycerin 0.4 mg sublingual
D) Morphine 4 mg IV
Answer: B
Rationale: Aspirin (300–324 mg chewed) reduces mortality in
suspected ACS and is given unless allergy or bleeding risk.
Q7: A patient with a severe allergic reaction develops stridor
and difficulty breathing. The most appropriate immediate
action is:
A) Albuterol nebulizer
B) Epinephrine 0.3 mg IM (1:1000)
C) Diphenhydramine 50 mg IM
D) Oxygen via nasal cannula
4
TEST BANK| NORTH CAROLINA OFFICE OF
EMERGENCY MEDICAL SERVICES (NCOEMS) EXAM
PREP WITH COMPLETE 300 REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS/ ALREADY
GRADED A+
Q1: According to the NCOEMS EMT protocols, the
recommended initial dose of naloxone (Narcan) for a
suspected opioid overdose in an adult is:
A) 0.4 mg intranasal (IN) or 0.4–2 mg IM/IN per protocol
B) 2 mg intranasal (one spray)
C) 4 mg intranasal (two sprays) – 4 mg IN is common
D) 10 mg IM
Answer: C (4 mg IN or 0.4–2 mg IM; check local protocols. NC
often uses 4 mg IN or 2 mg IN depending on concentration)
Rationale: NCOEMS protocols typically recommend 4 mg
intranasal or 0.4–2 mg IM/IV. Follow local protocol.
1
,Q2: Which of the following is the most reliable method to
confirm proper placement of an endotracheal (ET) tube in the
field?
A) Auscultation of breath sounds over the epigastrium and lungs
B) Continuous waveform capnography (end-tidal CO₂)
C) Condensation in the ET tube
D) Pulse oximetry reading
Answer: B
Rationale: Continuous waveform capnography is the gold
standard for confirming ET tube placement and monitoring CPR
quality.
Q3: A patient is found unresponsive, not breathing, and
pulseless. The first step after ensuring scene safety is:
A) Check for a carotid pulse for 10 seconds
B) Begin chest compressions immediately (high-quality CPR)
C) Apply an automated external defibrillator (AED)
D) Insert an oropharyngeal airway
Answer: B
Rationale: Current AHA guidelines prioritize immediate chest
compressions for unresponsive, pulseless patients.
2
,Q4: The appropriate compression-to-ventilation ratio for a
single rescuer performing CPR on a child (1 year to puberty)
is:
A) 30:2
B) 15:2 (two-rescuer child; single rescuer 30:2)
C) 30:2 for single rescuer all ages except newborn
D) 5:1
Answer: C
Rationale: Single rescuer: 30:2 for adults, children, infants
(except newborn). Two-rescuer child/infant: 15:2.
Q5: Which of the following is a contraindication for the use of
a nasopharyngeal airway (NPA)?
A) Gag reflex present
B) Suspected skull fracture or basilar skull fracture
C) Unresponsiveness
D) Foreign body airway obstruction
Answer: B
Rationale: NPA is contraindicated in suspected basilar skull
fracture due to risk of intracranial placement.
3
, Q6: A 45-year-old patient presents with chest pain radiating
to the left arm, diaphoresis, and nausea. The patient is alert
and has no allergies. Which medication should the EMT
administer first?
A) Oxygen at 15 L/min via non-rebreather
B) Aspirin 324 mg (chewed)
C) Nitroglycerin 0.4 mg sublingual
D) Morphine 4 mg IV
Answer: B
Rationale: Aspirin (300–324 mg chewed) reduces mortality in
suspected ACS and is given unless allergy or bleeding risk.
Q7: A patient with a severe allergic reaction develops stridor
and difficulty breathing. The most appropriate immediate
action is:
A) Albuterol nebulizer
B) Epinephrine 0.3 mg IM (1:1000)
C) Diphenhydramine 50 mg IM
D) Oxygen via nasal cannula
4
