NSC EMT FINAL ACTUAL EXAM PREP 2026 ALL
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ALREADY A
GRADED WITH EXPERT FEEDBACK |NEW AND
REVISED
SECTION 1: QUESTIONS 1–50
1. You are first on scene of a two-vehicle collision. Your first action should be to:
A. Begin triage of the injured
B. Call for additional resources
C. Ensure scene safety, including traffic control
D. Remove patients from the vehicles
C. Ensure scene safety, including traffic control
Rationale: Scene safety is the highest priority. Approaching an unsafe scene puts
the rescuer at risk. After ensuring safety, call for resources and then provide
patient care.
2. A 45-year-old male is complaining of substernal chest pressure radiating to the
left arm. He is diaphoretic and nauseated. His vital signs are BP 110/70, HR 110,
RR 22, SpO2 94%. What should you do first?
A. Administer 324 mg chewable aspirin
B. Apply oxygen at 15 L/min via non-rebreather
C. Obtain a 12-lead ECG
D. Transport immediately
A. Administer 324 mg chewable aspirin
Rationale: Aspirin reduces mortality in acute coronary syndrome and should be
given unless contraindicated. Oxygen is indicated only if SpO2 <94% (current
94% is borderline). ECG and transport are important but aspirin is a
time-critical, easily administered intervention.
3. A 6-year-old child is sitting upright, drooling, with stridor and a high fever. The
child refuses to lie down. What is your priority?
A. Attempt to visualize the throat with a tongue depressor
,B. Lay the child flat to assess the airway
C. Allow the child to remain in a position of comfort and transport
D. Administer a nebulized bronchodilator
C. Allow the child to remain in a position of comfort and transport
Rationale: This presentation suggests epiglottitis. Manipulating the airway or
forcing supine can cause complete obstruction. Allow sitting, do not examine the
throat, and transport emergently.
4. A 55-year-old male is unresponsive, not breathing, and has no pulse. After
calling for help, you begin CPR. What is the correct compression depth for an
adult?
A. At least 1.5 inches (4 cm)
B. At least 2 inches (5 cm)
C. At least 2.5 inches (6 cm)
D. Exactly 1 inch (2.5 cm)
B. At least 2 inches (5 cm)
Rationale: AHA guidelines for adult CPR require a compression depth of at least
2 inches (5 cm), but not more than 2.4 inches (6 cm). Adequate depth is essential
for generating blood flow.
5. A patient has a deep laceration on the forearm that is spurting bright red blood.
Direct pressure does not stop the bleeding. What is your next action?
A. Elevate the arm above the heart
B. Apply a tourniquet 2-3 inches proximal to the wound
C. Apply pressure to the brachial artery pressure point
D. Apply a bulky dressing and transport
B. Apply a tourniquet 2-3 inches proximal to the wound
Rationale: Life-threatening extremity hemorrhage that does not stop with direct
pressure requires a tourniquet. Apply it proximal to the bleeding site, not over a
joint. Pressure points are less effective and delay definitive control.
6. A patient with a history of diabetes is found unconscious. A glucometer reads
“LO” (below 20 mg/dL). The patient has a gag reflex and is breathing. What
should you do?
A. Administer oral glucose paste
B. Place the patient in the recovery position and transport rapidly
C. Administer glucagon IM
D. Start an IV of D50
,B. Place the patient in the recovery position and transport rapidly
Rationale: Unconscious patients cannot safely receive oral glucose (aspiration
risk). If you do not carry glucagon or IV dextrose, protect the airway (recovery
position) and transport rapidly. Many BLS protocols do not include glucagon.
7. A patient with a history of COPD is in respiratory distress. Her SpO2 is 85% on
room air. She has a barrel chest and is using accessory muscles. Which oxygen
delivery device is most appropriate?
A. Nasal cannula at 2-4 L/min titrated to SpO2 88-92%
B. Non-rebreather mask at 15 L/min
C. Bag-valve-mask with oxygen
D. Venturi mask at 24%
A. Nasal cannula at 2-4 L/min titrated to SpO2 88-92%
Rationale: COPD patients may have chronic hypercapnia and rely on hypoxic
drive. High-flow oxygen can cause CO2 retention. Target SpO2 88-92% using
low-flow oxygen initially. If severe hypoxia persists despite low flow, increase as
needed, but start low.
8. A 28-year-old male has a knife wound to the left chest. He is short of breath, and
you note absent breath sounds on the left. His trachea is deviated to the right. What
is the priority intervention?
A. Apply an occlusive dressing taped on three sides
B. Perform needle decompression at the second intercostal space, midclavicular
line
C. Insert an oropharyngeal airway
D. Administer high-flow oxygen via non-rebreather
B. Perform needle decompression at the second intercostal space,
midclavicular line
Rationale: Tracheal deviation away from the affected side indicates tension
pneumothorax, a life-threatening condition. Needle decompression (by ALS or
EMT with advanced skills) is required. An occlusive dressing is for open
pneumothorax but will not relieve tension.
9. A 22-year-old female is 34 weeks pregnant and has a seizure. She is now
postictal and confused. Her blood pressure is 160/110 mm Hg. What is your
priority?
A. Administer magnesium sulfate
B. Transport on her left side with high-flow oxygen
, C. Administer oral glucose
D. Prepare for immediate delivery
B. Transport on her left side with high-flow oxygen
Rationale: This is eclampsia. Place the patient in the left lateral recumbent
position to prevent supine hypotensive syndrome, administer high-flow oxygen,
and transport emergently. Magnesium sulfate is a hospital drug. Do not attempt
delivery unless imminent.
10. Which of the following is a correct statement about implied consent?
A. It applies to conscious adults who refuse care
B. It applies to unresponsive adults with a life-threatening condition
C. It requires a signed written consent form
D. It does not apply to minors
B. It applies to unresponsive adults with a life-threatening condition
Rationale: Implied consent (emergency doctrine) assumes a reasonable person
would consent to life-saving care. It applies to unresponsive patients, minors
without a parent, or those with altered mental status. It does not override a
competent adult’s refusal.
11. A patient has a large piece of glass impaled in his thigh. There is moderate
bleeding. What is the correct management?
A. Remove the glass to control bleeding
B. Stabilize the glass with bulky dressings and transport
C. Apply a tourniquet above the glass
D. Cut the glass flush with the skin
B. Stabilize the glass with bulky dressings and transport
Rationale: Impaled objects should never be removed in the field because they
may be tamponading a vessel. Stabilize the object with bulky dressings and
transport. A tourniquet may be applied proximal if bleeding is life-threatening,
but stabilization is first.
12. A patient is in cardiac arrest. After 2 minutes of CPR, the AED advises “No
shock advised.” What should you do next?
A. Stop CPR and check for a pulse
B. Resume CPR for 2 more minutes
C. Check the patient’s airway
D. Administer epinephrine
B. Resume CPR for 2 more minutes
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ALREADY A
GRADED WITH EXPERT FEEDBACK |NEW AND
REVISED
SECTION 1: QUESTIONS 1–50
1. You are first on scene of a two-vehicle collision. Your first action should be to:
A. Begin triage of the injured
B. Call for additional resources
C. Ensure scene safety, including traffic control
D. Remove patients from the vehicles
C. Ensure scene safety, including traffic control
Rationale: Scene safety is the highest priority. Approaching an unsafe scene puts
the rescuer at risk. After ensuring safety, call for resources and then provide
patient care.
2. A 45-year-old male is complaining of substernal chest pressure radiating to the
left arm. He is diaphoretic and nauseated. His vital signs are BP 110/70, HR 110,
RR 22, SpO2 94%. What should you do first?
A. Administer 324 mg chewable aspirin
B. Apply oxygen at 15 L/min via non-rebreather
C. Obtain a 12-lead ECG
D. Transport immediately
A. Administer 324 mg chewable aspirin
Rationale: Aspirin reduces mortality in acute coronary syndrome and should be
given unless contraindicated. Oxygen is indicated only if SpO2 <94% (current
94% is borderline). ECG and transport are important but aspirin is a
time-critical, easily administered intervention.
3. A 6-year-old child is sitting upright, drooling, with stridor and a high fever. The
child refuses to lie down. What is your priority?
A. Attempt to visualize the throat with a tongue depressor
,B. Lay the child flat to assess the airway
C. Allow the child to remain in a position of comfort and transport
D. Administer a nebulized bronchodilator
C. Allow the child to remain in a position of comfort and transport
Rationale: This presentation suggests epiglottitis. Manipulating the airway or
forcing supine can cause complete obstruction. Allow sitting, do not examine the
throat, and transport emergently.
4. A 55-year-old male is unresponsive, not breathing, and has no pulse. After
calling for help, you begin CPR. What is the correct compression depth for an
adult?
A. At least 1.5 inches (4 cm)
B. At least 2 inches (5 cm)
C. At least 2.5 inches (6 cm)
D. Exactly 1 inch (2.5 cm)
B. At least 2 inches (5 cm)
Rationale: AHA guidelines for adult CPR require a compression depth of at least
2 inches (5 cm), but not more than 2.4 inches (6 cm). Adequate depth is essential
for generating blood flow.
5. A patient has a deep laceration on the forearm that is spurting bright red blood.
Direct pressure does not stop the bleeding. What is your next action?
A. Elevate the arm above the heart
B. Apply a tourniquet 2-3 inches proximal to the wound
C. Apply pressure to the brachial artery pressure point
D. Apply a bulky dressing and transport
B. Apply a tourniquet 2-3 inches proximal to the wound
Rationale: Life-threatening extremity hemorrhage that does not stop with direct
pressure requires a tourniquet. Apply it proximal to the bleeding site, not over a
joint. Pressure points are less effective and delay definitive control.
6. A patient with a history of diabetes is found unconscious. A glucometer reads
“LO” (below 20 mg/dL). The patient has a gag reflex and is breathing. What
should you do?
A. Administer oral glucose paste
B. Place the patient in the recovery position and transport rapidly
C. Administer glucagon IM
D. Start an IV of D50
,B. Place the patient in the recovery position and transport rapidly
Rationale: Unconscious patients cannot safely receive oral glucose (aspiration
risk). If you do not carry glucagon or IV dextrose, protect the airway (recovery
position) and transport rapidly. Many BLS protocols do not include glucagon.
7. A patient with a history of COPD is in respiratory distress. Her SpO2 is 85% on
room air. She has a barrel chest and is using accessory muscles. Which oxygen
delivery device is most appropriate?
A. Nasal cannula at 2-4 L/min titrated to SpO2 88-92%
B. Non-rebreather mask at 15 L/min
C. Bag-valve-mask with oxygen
D. Venturi mask at 24%
A. Nasal cannula at 2-4 L/min titrated to SpO2 88-92%
Rationale: COPD patients may have chronic hypercapnia and rely on hypoxic
drive. High-flow oxygen can cause CO2 retention. Target SpO2 88-92% using
low-flow oxygen initially. If severe hypoxia persists despite low flow, increase as
needed, but start low.
8. A 28-year-old male has a knife wound to the left chest. He is short of breath, and
you note absent breath sounds on the left. His trachea is deviated to the right. What
is the priority intervention?
A. Apply an occlusive dressing taped on three sides
B. Perform needle decompression at the second intercostal space, midclavicular
line
C. Insert an oropharyngeal airway
D. Administer high-flow oxygen via non-rebreather
B. Perform needle decompression at the second intercostal space,
midclavicular line
Rationale: Tracheal deviation away from the affected side indicates tension
pneumothorax, a life-threatening condition. Needle decompression (by ALS or
EMT with advanced skills) is required. An occlusive dressing is for open
pneumothorax but will not relieve tension.
9. A 22-year-old female is 34 weeks pregnant and has a seizure. She is now
postictal and confused. Her blood pressure is 160/110 mm Hg. What is your
priority?
A. Administer magnesium sulfate
B. Transport on her left side with high-flow oxygen
, C. Administer oral glucose
D. Prepare for immediate delivery
B. Transport on her left side with high-flow oxygen
Rationale: This is eclampsia. Place the patient in the left lateral recumbent
position to prevent supine hypotensive syndrome, administer high-flow oxygen,
and transport emergently. Magnesium sulfate is a hospital drug. Do not attempt
delivery unless imminent.
10. Which of the following is a correct statement about implied consent?
A. It applies to conscious adults who refuse care
B. It applies to unresponsive adults with a life-threatening condition
C. It requires a signed written consent form
D. It does not apply to minors
B. It applies to unresponsive adults with a life-threatening condition
Rationale: Implied consent (emergency doctrine) assumes a reasonable person
would consent to life-saving care. It applies to unresponsive patients, minors
without a parent, or those with altered mental status. It does not override a
competent adult’s refusal.
11. A patient has a large piece of glass impaled in his thigh. There is moderate
bleeding. What is the correct management?
A. Remove the glass to control bleeding
B. Stabilize the glass with bulky dressings and transport
C. Apply a tourniquet above the glass
D. Cut the glass flush with the skin
B. Stabilize the glass with bulky dressings and transport
Rationale: Impaled objects should never be removed in the field because they
may be tamponading a vessel. Stabilize the object with bulky dressings and
transport. A tourniquet may be applied proximal if bleeding is life-threatening,
but stabilization is first.
12. A patient is in cardiac arrest. After 2 minutes of CPR, the AED advises “No
shock advised.” What should you do next?
A. Stop CPR and check for a pulse
B. Resume CPR for 2 more minutes
C. Check the patient’s airway
D. Administer epinephrine
B. Resume CPR for 2 more minutes
