West Coast EMT Block Exam #3 – Complete Practice
Questions with Verified Answers & Detailed
Rationales | Latest 2025–2026 Update | Grade A+
1. A 45-year-old male is unresponsive, with agonal respirations at 6
breaths/min and a palpable carotid pulse. What is the priority action?
A. Insert an oropharyngeal airway
B. Apply a non-rebreather mask at 15 L/min
C. Begin positive pressure ventilation with a bag-valve mask (BVM) and
supplemental oxygen
D. Place the patient in the recovery position
Rationale: Agonal respirations are ineffective. The patient needs immediate
ventilatory support. BVM with oxygen (15 L/min) and a reservoir is indicated. An
OPA alone does not provide ventilation.
2. A patient has a tracheostomy tube and requires suctioning. The catheter
should be inserted:
A. Only as far as the visible end of the tube
B. Until resistance is met, then withdraw 1 cm before applying suction
C. To the carina for deep suctioning
D. With continuous suction during insertion
Rationale: Insert without suction until resistance (at the carina), then withdraw
slightly and apply suction intermittently while withdrawing. Never suction during
insertion to avoid hypoxia.
3. Which of the following is the most reliable sign of adequate bag-valve mask
ventilation in an adult?
A. Cyanosis resolves
B. Pulse oximetry > 94%
C. Visible chest rise and fall
D. Gastric distention is absent
Rationale: Visible chest rise is the primary indicator of adequate tidal volume.
Pulse oximetry lags; cyanosis resolves late. Gastric distention may occur even with
good ventilation if too much pressure.
,4. A 6-year-old child is choking on a piece of hot dog, is conscious, and cannot
speak or cough. The EMT should:
A. Perform blind finger sweeps
B. Perform abdominal thrusts (Heimlich maneuver)
C. Give back blows and chest thrusts (infant technique)
D. Perform a head-tilt chin-lift and look for the object
Rationale: For a conscious choking child (≥1 year), abdominal thrusts are
indicated. Blind finger sweeps are not recommended (may push object deeper).
Back blows/chest thrusts are for infants.
5. A patient has a stoma and is in respiratory distress. To ventilate, the EMT
should:
A. Cover the stoma and ventilate through the mouth
B. Use a pediatric mask over the stoma or a stoma adapter
C. Perform cricothyrotomy
D. Ventilate through the nose
Rationale: Stoma patients breathe through the stoma. A pediatric mask or
specialized stoma adapter creates a seal over the stoma. The mouth and nose are
not connected to the lower airway.
6. Which of the following oxygen delivery devices provides the highest
concentration of oxygen (up to 90-95%) in a spontaneously breathing patient?
A. Nasal cannula at 6 L/min
B. Simple face mask at 10 L/min
C. Non-rebreather mask (NRB) with reservoir bag at 15 L/min
D. Venturi mask at 15 L/min
Rationale: NRB with a well-inflated reservoir and tight seal can deliver FiO₂
~0.90-0.95. Nasal cannula max ~44%, simple mask ~60%. Venturi delivers precise
but lower FiO₂.
7. An unresponsive patient has gurgling respirations. The EMT should first:
A. Insert a nasopharyngeal airway
B. Suction the oropharynx
C. Administer high-flow oxygen
D. Perform a jaw-thrust maneuver
Rationale: Gurgling indicates fluid or secretions in the upper airway. Suctioning is
the priority to clear the airway before any airway adjunct or oxygen.
, 8. When using a BVM on an apneic adult with a palpable pulse, the
ventilation rate should be:
A. 5-6 breaths/min (every 10-12 seconds)
B. 10-12 breaths/min (every 5-6 seconds)
C. 20 breaths/min
D. As fast as possible
Rationale: For an adult with a pulse, rescue breathing rate is 1 breath every 5-6
seconds (10-12/min). For cardiac arrest with an advanced airway, 1 breath every 6
seconds (10/min).
9. A 70-year-old patient with COPD is on home oxygen at 2 L/min via nasal
cannula. The patient is lethargic and has a SpO₂ of 82%. The EMT should:
A. Leave the oxygen at 2 L/min because high flow may suppress respiratory drive
B. Increase to 15 L/min via non-rebreather mask
C. Switch to a simple face mask at 6 L/min
D. Remove oxygen and bag with room air
Rationale: Hypoxic drive is rare and overemphasized. The patient is hypoxic
(82%) and lethargic. High-concentration oxygen is indicated. Hypoxic drive is not
a contraindication to oxygen in an emergency.
10. A patient has a suspected cervical spine injury and is apneic. The EMT
should open the airway using:
A. Head-tilt, chin-lift
B. Jaw-thrust maneuver
C. Oropharyngeal airway only
D. Supraglottic airway
Rationale: Jaw-thrust is the preferred technique when cervical spine injury is
suspected because it opens the airway without extending the neck.
11. Which finding indicates proper placement of a nasopharyngeal airway
(NPA)?
A. The flange rests against the nare
B. The patient’s tongue is not obstructing the airway and the patient can
tolerate it
C. The patient coughs vigorously
D. The airway passes into the esophagus
Rationale: Proper NPA placement maintains airway patency. The flange should be
Questions with Verified Answers & Detailed
Rationales | Latest 2025–2026 Update | Grade A+
1. A 45-year-old male is unresponsive, with agonal respirations at 6
breaths/min and a palpable carotid pulse. What is the priority action?
A. Insert an oropharyngeal airway
B. Apply a non-rebreather mask at 15 L/min
C. Begin positive pressure ventilation with a bag-valve mask (BVM) and
supplemental oxygen
D. Place the patient in the recovery position
Rationale: Agonal respirations are ineffective. The patient needs immediate
ventilatory support. BVM with oxygen (15 L/min) and a reservoir is indicated. An
OPA alone does not provide ventilation.
2. A patient has a tracheostomy tube and requires suctioning. The catheter
should be inserted:
A. Only as far as the visible end of the tube
B. Until resistance is met, then withdraw 1 cm before applying suction
C. To the carina for deep suctioning
D. With continuous suction during insertion
Rationale: Insert without suction until resistance (at the carina), then withdraw
slightly and apply suction intermittently while withdrawing. Never suction during
insertion to avoid hypoxia.
3. Which of the following is the most reliable sign of adequate bag-valve mask
ventilation in an adult?
A. Cyanosis resolves
B. Pulse oximetry > 94%
C. Visible chest rise and fall
D. Gastric distention is absent
Rationale: Visible chest rise is the primary indicator of adequate tidal volume.
Pulse oximetry lags; cyanosis resolves late. Gastric distention may occur even with
good ventilation if too much pressure.
,4. A 6-year-old child is choking on a piece of hot dog, is conscious, and cannot
speak or cough. The EMT should:
A. Perform blind finger sweeps
B. Perform abdominal thrusts (Heimlich maneuver)
C. Give back blows and chest thrusts (infant technique)
D. Perform a head-tilt chin-lift and look for the object
Rationale: For a conscious choking child (≥1 year), abdominal thrusts are
indicated. Blind finger sweeps are not recommended (may push object deeper).
Back blows/chest thrusts are for infants.
5. A patient has a stoma and is in respiratory distress. To ventilate, the EMT
should:
A. Cover the stoma and ventilate through the mouth
B. Use a pediatric mask over the stoma or a stoma adapter
C. Perform cricothyrotomy
D. Ventilate through the nose
Rationale: Stoma patients breathe through the stoma. A pediatric mask or
specialized stoma adapter creates a seal over the stoma. The mouth and nose are
not connected to the lower airway.
6. Which of the following oxygen delivery devices provides the highest
concentration of oxygen (up to 90-95%) in a spontaneously breathing patient?
A. Nasal cannula at 6 L/min
B. Simple face mask at 10 L/min
C. Non-rebreather mask (NRB) with reservoir bag at 15 L/min
D. Venturi mask at 15 L/min
Rationale: NRB with a well-inflated reservoir and tight seal can deliver FiO₂
~0.90-0.95. Nasal cannula max ~44%, simple mask ~60%. Venturi delivers precise
but lower FiO₂.
7. An unresponsive patient has gurgling respirations. The EMT should first:
A. Insert a nasopharyngeal airway
B. Suction the oropharynx
C. Administer high-flow oxygen
D. Perform a jaw-thrust maneuver
Rationale: Gurgling indicates fluid or secretions in the upper airway. Suctioning is
the priority to clear the airway before any airway adjunct or oxygen.
, 8. When using a BVM on an apneic adult with a palpable pulse, the
ventilation rate should be:
A. 5-6 breaths/min (every 10-12 seconds)
B. 10-12 breaths/min (every 5-6 seconds)
C. 20 breaths/min
D. As fast as possible
Rationale: For an adult with a pulse, rescue breathing rate is 1 breath every 5-6
seconds (10-12/min). For cardiac arrest with an advanced airway, 1 breath every 6
seconds (10/min).
9. A 70-year-old patient with COPD is on home oxygen at 2 L/min via nasal
cannula. The patient is lethargic and has a SpO₂ of 82%. The EMT should:
A. Leave the oxygen at 2 L/min because high flow may suppress respiratory drive
B. Increase to 15 L/min via non-rebreather mask
C. Switch to a simple face mask at 6 L/min
D. Remove oxygen and bag with room air
Rationale: Hypoxic drive is rare and overemphasized. The patient is hypoxic
(82%) and lethargic. High-concentration oxygen is indicated. Hypoxic drive is not
a contraindication to oxygen in an emergency.
10. A patient has a suspected cervical spine injury and is apneic. The EMT
should open the airway using:
A. Head-tilt, chin-lift
B. Jaw-thrust maneuver
C. Oropharyngeal airway only
D. Supraglottic airway
Rationale: Jaw-thrust is the preferred technique when cervical spine injury is
suspected because it opens the airway without extending the neck.
11. Which finding indicates proper placement of a nasopharyngeal airway
(NPA)?
A. The flange rests against the nare
B. The patient’s tongue is not obstructing the airway and the patient can
tolerate it
C. The patient coughs vigorously
D. The airway passes into the esophagus
Rationale: Proper NPA placement maintains airway patency. The flange should be
