EMT-I Emergency Medical Technician Intermediate Practice Exam
Questions and Answers Updated 2026 | Complete EMT Intermediate
Certification Study Guide with Verified Questions, Detailed Rationales,
Advanced Airway Management, Trauma Emergencies, IV Therapy, Cardiac
Care, Pharmacology, Patient Assessment, EMS Operations & NREMT Exam
Prep
Question 1: Which of the following is the MOST appropriate initial intervention for
an adult patient in respiratory distress with inadequate breathing and a pulse?
A. Apply a non-rebreather mask at 15 L/min
B. Assist ventilations with a bag-valve-mask device
C. Administer albuterol via nebulizer
D. Insert a supraglottic airway device
CORRECT ANSWER: B. Assist ventilations with a bag-valve-mask device
Rationale: For a patient with inadequate breathing but a present pulse, the priority is to
support ventilation. Bag-valve-mask ventilation provides immediate positive pressure
ventilation to ensure adequate oxygenation and ventilation. While oxygen via non-
rebreather is appropriate for patients breathing adequately, this patient has inadequate
breathing requiring assisted ventilations. Advanced airway insertion may be considered
but is not the initial intervention.
Question 2: When performing endotracheal intubation on an adult patient, which
landmark is MOST critical for proper visualization of the vocal cords?
A. Epiglottis
B. Uvula
C. Vallecula
D. Cricoid cartilage
CORRECT ANSWER: A. Epiglottis
Rationale: The epiglottis is the key anatomical landmark during direct laryngoscopy.
Proper placement of the laryngoscope blade in the vallecula (for a Macintosh blade) or
lifting the epiglottis directly (for a Miller blade) allows visualization of the vocal cords.
The uvula is visible during oropharyngeal examination but not during laryngoscopy. The
cricoid cartilage is used for Sellick's maneuver, not visualization.
Question 3: Which medication administered by an EMT-Intermediate is classified
as a sympathomimetic bronchodilator?
A. Ipratropium bromide
B. Albuterol sulfate
C. Methylprednisolone
D. Magnesium sulfate
CORRECT ANSWER: B. Albuterol sulfate
,Rationale: Albuterol is a selective beta-2 adrenergic agonist (sympathomimetic) that
causes bronchodilation by relaxing smooth muscle in the airways. Ipratropium is an
anticholinergic bronchodilator. Methylprednisolone is a corticosteroid that reduces
inflammation. Magnesium sulfate is used for severe bronchospasm but works via
calcium channel blockade, not sympathomimetic action.
Question 4: During intravenous therapy, infiltration is BEST identified by which
clinical sign?
A. Redness and warmth along the vein
B. Swelling, coolness, and pallor at the insertion site
C. Purulent drainage from the catheter hub
D. Patient report of sharp, radiating pain
CORRECT ANSWER: B. Swelling, coolness, and pallor at the insertion site
Rationale: Infiltration occurs when IV fluid leaks into surrounding tissues, causing
localized swelling, coolness due to reduced blood flow, and pallor. Redness and
warmth suggest phlebitis or infection. Purulent drainage indicates infection. Sharp,
radiating pain may indicate nerve irritation or arterial puncture, not infiltration.
Question 5: A patient presents with chest pain, diaphoresis, and nausea. The 12-
lead ECG shows ST-segment elevation in leads II, III, and aVF. Which coronary
artery is MOST likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Posterior descending artery
CORRECT ANSWER: C. Right coronary artery
Rationale: ST-elevation in leads II, III, and aVF indicates an inferior wall myocardial
infarction, which is most commonly caused by occlusion of the right coronary artery.
The left anterior descending artery supplies the anterior wall (V1-V4). The left circumflex
supplies the lateral wall (I, aVL, V5-V6). The posterior descending artery is typically a
branch of the RCA or LCx and supplies the inferior/posterior wall.
Question 6: Which of the following is the CORRECT dosage for epinephrine 1:1,000
administered intramuscularly for anaphylaxis in an adult patient?
A. 0.15 mg
B. 0.3 mg
C. 1 mg
D. 3 mg
CORRECT ANSWER: B. 0.3 mg
Rationale: The standard adult dose of epinephrine 1:1,000 for anaphylaxis is 0.3 mg
intramuscularly, typically administered in the mid-outer thigh. The 0.15 mg dose is for
,pediatric patients or auto-injectors designed for children. 1 mg is the concentration
used for IV/IO cardiac arrest (1:10,000), not IM anaphylaxis. 3 mg is not a standard
epinephrine dose.
Question 7: When assessing a trauma patient with suspected spinal injury, which
maneuver is MOST appropriate for opening the airway?
A. Head-tilt/chin-lift
B. Jaw-thrust without head extension
C. Modified chin-lift with cervical collar
D. Nasopharyngeal airway insertion alone
CORRECT ANSWER: B. Jaw-thrust without head extension
Rationale: The jaw-thrust maneuver without head extension is the preferred technique
for opening the airway in trauma patients with suspected cervical spine injury because
it minimizes movement of the cervical spine. The head-tilt/chin-lift may exacerbate
spinal cord injury. While cervical collars provide immobilization, they do not replace
proper airway maneuver technique. NPA insertion may be adjunctive but does not
replace manual airway maneuvers.
Question 8: Which IV solution is classified as isotonic and is MOST appropriate for
initial fluid resuscitation in a hypovolemic trauma patient?
A. 5% Dextrose in Water (D5W)
B. 0.45% Sodium Chloride (Half-normal saline)
C. 0.9% Sodium Chloride (Normal saline)
D. Lactated Ringer's with 5% Dextrose
CORRECT ANSWER: C. 0.9% Sodium Chloride (Normal saline)
Rationale: Normal saline (0.9% NaCl) is an isotonic crystalloid solution that remains in
the intravascular space, making it ideal for volume expansion in hypovolemia. D5W is
hypotonic after dextrose metabolism and distributes into intracellular spaces. Half-
normal saline is hypotonic and not ideal for resuscitation. Lactated Ringer's with
dextrose is not standard for initial trauma resuscitation due to the dextrose component.
Question 9: A patient with a history of COPD presents with increased dyspnea,
wheezing, and use of accessory muscles. Which assessment finding would MOST
suggest impending respiratory failure?
A. Respiratory rate of 24 breaths/min
B. Oxygen saturation of 92% on room air
C. Confusion and lethargy
D. Prolonged expiratory phase
CORRECT ANSWER: C. Confusion and lethargy
Rationale: Confusion and lethargy indicate cerebral hypoxia and hypercapnia, signaling
impending respiratory failure in a COPD patient. While tachypnea, mild hypoxemia, and
, prolonged expiration are expected in COPD exacerbation, altered mental status
represents decompensation requiring immediate intervention. These neurological
changes suggest the patient is tiring and may soon require advanced airway
management.
Question 10: Which of the following is the PRIMARY purpose of applying cricoid
pressure (Sellick's maneuver) during rapid sequence intubation?
A. To improve visualization of the vocal cords
B. To reduce the risk of gastric aspiration
C. To facilitate passage of the endotracheal tube
D. To prevent laryngospasm
CORRECT ANSWER: B. To reduce the risk of gastric aspiration
Rationale: Cricoid pressure compresses the esophagus against the cervical vertebrae,
theoretically reducing the risk of passive regurgitation and aspiration during intubation
attempts. It does not improve visualization (may actually hinder it), facilitate tube
passage, or prevent laryngospasm. While its efficacy is debated, it remains within the
EMT-I scope in many protocols for patients at risk of aspiration.
Question 11: When administering nitroglycerin to a patient with chest pain, which
assessment is MOST critical to perform BEFORE administration?
A. Blood pressure measurement
B. Respiratory rate assessment
C. Pain scale rating
D. Peripheral pulse check
CORRECT ANSWER: A. Blood pressure measurement
Rationale: Nitroglycerin causes venous and arterial vasodilation, which can
significantly lower blood pressure. Administration is contraindicated if systolic BP is
below 90-100 mmHg (per protocol) due to risk of severe hypotension. While respiratory
rate, pain assessment, and pulses are important, blood pressure is the critical safety
check before nitroglycerin administration.
Question 12: Which cardiac rhythm requires immediate defibrillation by an EMT-
Intermediate?
A. Asystole
B. Pulseless electrical activity (PEA)
C. Ventricular fibrillation
D. Sinus bradycardia with pulse
CORRECT ANSWER: C. Ventricular fibrillation
Rationale: Ventricular fibrillation is a shockable rhythm that requires immediate
defibrillation to restore an organized cardiac rhythm. Asystole and PEA are non-
shockable rhythms treated with CPR and epinephrine. Sinus bradycardia with a pulse is
Questions and Answers Updated 2026 | Complete EMT Intermediate
Certification Study Guide with Verified Questions, Detailed Rationales,
Advanced Airway Management, Trauma Emergencies, IV Therapy, Cardiac
Care, Pharmacology, Patient Assessment, EMS Operations & NREMT Exam
Prep
Question 1: Which of the following is the MOST appropriate initial intervention for
an adult patient in respiratory distress with inadequate breathing and a pulse?
A. Apply a non-rebreather mask at 15 L/min
B. Assist ventilations with a bag-valve-mask device
C. Administer albuterol via nebulizer
D. Insert a supraglottic airway device
CORRECT ANSWER: B. Assist ventilations with a bag-valve-mask device
Rationale: For a patient with inadequate breathing but a present pulse, the priority is to
support ventilation. Bag-valve-mask ventilation provides immediate positive pressure
ventilation to ensure adequate oxygenation and ventilation. While oxygen via non-
rebreather is appropriate for patients breathing adequately, this patient has inadequate
breathing requiring assisted ventilations. Advanced airway insertion may be considered
but is not the initial intervention.
Question 2: When performing endotracheal intubation on an adult patient, which
landmark is MOST critical for proper visualization of the vocal cords?
A. Epiglottis
B. Uvula
C. Vallecula
D. Cricoid cartilage
CORRECT ANSWER: A. Epiglottis
Rationale: The epiglottis is the key anatomical landmark during direct laryngoscopy.
Proper placement of the laryngoscope blade in the vallecula (for a Macintosh blade) or
lifting the epiglottis directly (for a Miller blade) allows visualization of the vocal cords.
The uvula is visible during oropharyngeal examination but not during laryngoscopy. The
cricoid cartilage is used for Sellick's maneuver, not visualization.
Question 3: Which medication administered by an EMT-Intermediate is classified
as a sympathomimetic bronchodilator?
A. Ipratropium bromide
B. Albuterol sulfate
C. Methylprednisolone
D. Magnesium sulfate
CORRECT ANSWER: B. Albuterol sulfate
,Rationale: Albuterol is a selective beta-2 adrenergic agonist (sympathomimetic) that
causes bronchodilation by relaxing smooth muscle in the airways. Ipratropium is an
anticholinergic bronchodilator. Methylprednisolone is a corticosteroid that reduces
inflammation. Magnesium sulfate is used for severe bronchospasm but works via
calcium channel blockade, not sympathomimetic action.
Question 4: During intravenous therapy, infiltration is BEST identified by which
clinical sign?
A. Redness and warmth along the vein
B. Swelling, coolness, and pallor at the insertion site
C. Purulent drainage from the catheter hub
D. Patient report of sharp, radiating pain
CORRECT ANSWER: B. Swelling, coolness, and pallor at the insertion site
Rationale: Infiltration occurs when IV fluid leaks into surrounding tissues, causing
localized swelling, coolness due to reduced blood flow, and pallor. Redness and
warmth suggest phlebitis or infection. Purulent drainage indicates infection. Sharp,
radiating pain may indicate nerve irritation or arterial puncture, not infiltration.
Question 5: A patient presents with chest pain, diaphoresis, and nausea. The 12-
lead ECG shows ST-segment elevation in leads II, III, and aVF. Which coronary
artery is MOST likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Posterior descending artery
CORRECT ANSWER: C. Right coronary artery
Rationale: ST-elevation in leads II, III, and aVF indicates an inferior wall myocardial
infarction, which is most commonly caused by occlusion of the right coronary artery.
The left anterior descending artery supplies the anterior wall (V1-V4). The left circumflex
supplies the lateral wall (I, aVL, V5-V6). The posterior descending artery is typically a
branch of the RCA or LCx and supplies the inferior/posterior wall.
Question 6: Which of the following is the CORRECT dosage for epinephrine 1:1,000
administered intramuscularly for anaphylaxis in an adult patient?
A. 0.15 mg
B. 0.3 mg
C. 1 mg
D. 3 mg
CORRECT ANSWER: B. 0.3 mg
Rationale: The standard adult dose of epinephrine 1:1,000 for anaphylaxis is 0.3 mg
intramuscularly, typically administered in the mid-outer thigh. The 0.15 mg dose is for
,pediatric patients or auto-injectors designed for children. 1 mg is the concentration
used for IV/IO cardiac arrest (1:10,000), not IM anaphylaxis. 3 mg is not a standard
epinephrine dose.
Question 7: When assessing a trauma patient with suspected spinal injury, which
maneuver is MOST appropriate for opening the airway?
A. Head-tilt/chin-lift
B. Jaw-thrust without head extension
C. Modified chin-lift with cervical collar
D. Nasopharyngeal airway insertion alone
CORRECT ANSWER: B. Jaw-thrust without head extension
Rationale: The jaw-thrust maneuver without head extension is the preferred technique
for opening the airway in trauma patients with suspected cervical spine injury because
it minimizes movement of the cervical spine. The head-tilt/chin-lift may exacerbate
spinal cord injury. While cervical collars provide immobilization, they do not replace
proper airway maneuver technique. NPA insertion may be adjunctive but does not
replace manual airway maneuvers.
Question 8: Which IV solution is classified as isotonic and is MOST appropriate for
initial fluid resuscitation in a hypovolemic trauma patient?
A. 5% Dextrose in Water (D5W)
B. 0.45% Sodium Chloride (Half-normal saline)
C. 0.9% Sodium Chloride (Normal saline)
D. Lactated Ringer's with 5% Dextrose
CORRECT ANSWER: C. 0.9% Sodium Chloride (Normal saline)
Rationale: Normal saline (0.9% NaCl) is an isotonic crystalloid solution that remains in
the intravascular space, making it ideal for volume expansion in hypovolemia. D5W is
hypotonic after dextrose metabolism and distributes into intracellular spaces. Half-
normal saline is hypotonic and not ideal for resuscitation. Lactated Ringer's with
dextrose is not standard for initial trauma resuscitation due to the dextrose component.
Question 9: A patient with a history of COPD presents with increased dyspnea,
wheezing, and use of accessory muscles. Which assessment finding would MOST
suggest impending respiratory failure?
A. Respiratory rate of 24 breaths/min
B. Oxygen saturation of 92% on room air
C. Confusion and lethargy
D. Prolonged expiratory phase
CORRECT ANSWER: C. Confusion and lethargy
Rationale: Confusion and lethargy indicate cerebral hypoxia and hypercapnia, signaling
impending respiratory failure in a COPD patient. While tachypnea, mild hypoxemia, and
, prolonged expiration are expected in COPD exacerbation, altered mental status
represents decompensation requiring immediate intervention. These neurological
changes suggest the patient is tiring and may soon require advanced airway
management.
Question 10: Which of the following is the PRIMARY purpose of applying cricoid
pressure (Sellick's maneuver) during rapid sequence intubation?
A. To improve visualization of the vocal cords
B. To reduce the risk of gastric aspiration
C. To facilitate passage of the endotracheal tube
D. To prevent laryngospasm
CORRECT ANSWER: B. To reduce the risk of gastric aspiration
Rationale: Cricoid pressure compresses the esophagus against the cervical vertebrae,
theoretically reducing the risk of passive regurgitation and aspiration during intubation
attempts. It does not improve visualization (may actually hinder it), facilitate tube
passage, or prevent laryngospasm. While its efficacy is debated, it remains within the
EMT-I scope in many protocols for patients at risk of aspiration.
Question 11: When administering nitroglycerin to a patient with chest pain, which
assessment is MOST critical to perform BEFORE administration?
A. Blood pressure measurement
B. Respiratory rate assessment
C. Pain scale rating
D. Peripheral pulse check
CORRECT ANSWER: A. Blood pressure measurement
Rationale: Nitroglycerin causes venous and arterial vasodilation, which can
significantly lower blood pressure. Administration is contraindicated if systolic BP is
below 90-100 mmHg (per protocol) due to risk of severe hypotension. While respiratory
rate, pain assessment, and pulses are important, blood pressure is the critical safety
check before nitroglycerin administration.
Question 12: Which cardiac rhythm requires immediate defibrillation by an EMT-
Intermediate?
A. Asystole
B. Pulseless electrical activity (PEA)
C. Ventricular fibrillation
D. Sinus bradycardia with pulse
CORRECT ANSWER: C. Ventricular fibrillation
Rationale: Ventricular fibrillation is a shockable rhythm that requires immediate
defibrillation to restore an organized cardiac rhythm. Asystole and PEA are non-
shockable rhythms treated with CPR and epinephrine. Sinus bradycardia with a pulse is
