NCOEMS PRACTICE EXAM 1 |120
QUESTIONS| WITH CORRECT
SOLUTIONS.
Airway & Breathing (Questions 1–20)
1. A 45-year-old male is unresponsive with gurgling respirations.
What is your priority action?
A) Insert an OPA
B) Suction the airway
C) Begin bag-valve-mask ventilation
D) Perform a head-tilt chin-lift
Correct Answer: B
Rationale: Gurgling indicates fluid in the airway. Suctioning must
precede any airway adjunct or ventilation to clear the obstruction.
2. Which of the following is the most reliable indicator of adequate
ventilation in an intubated patient?
A) Pulse oximetry reading of 94%
, B) Equal bilateral breath sounds
C) Chest rise and fall
D) End-tidal CO₂ between 35–45 mmHg
Correct Answer: D
Rationale: EtCO₂ provides real-time confirmation of ventilation
adequacy and tube placement. Chest rise can be misleading.
3. A 60-year-old with severe COPD has an SpO₂ of 82% on room
air. You should initially:
A) Apply a non-rebreather at 15 L/min
B) Start nasal cannula at 2 L/min
C) Intubate immediately
D) Use a bag-valve-mask with room air
Correct Answer: B
Rationale: COPD patients may rely on hypoxic drive. Start low-flow
oxygen and titrate to SpO₂ 88–92%.
4. Stridor in a pediatric patient suggests:
A) Lower airway obstruction
B) Upper airway obstruction
C) Pneumothorax
D) Pulmonary edema
,Correct Answer: B
Rationale: Stridor is a high-pitched inspiratory noise caused by
upper airway obstruction (croup, epiglottitis, foreign body).
5. The correct tidal volume for an adult during bag-valve-mask
ventilation is approximately:
A) 200–300 mL
B) 500–600 mL
C) 800–1000 mL
D) 1200 mL
Correct Answer: B
Rationale: Adult tidal volume is 6–7 mL/kg ideal body weight,
typically 500–600 mL. Overventilation causes gastric distension.
6. What is the primary benefit of using a supraglottic airway
(e.g., King LT, iGel)?
A) Protects against aspiration
B) Allows ventilation without visualizing cords
C) Provides a cuffed seal in the trachea
D) Decreases dead space ventilation
Correct Answer: B
Rationale: Supraglottic airways are inserted blindly and sit above the
glottis, allowing rapid ventilation without laryngoscopy.
7. A patient with a stoma is apneic. How should you ventilate?
, A) Mouth-to-stoma
B) BVM over the nose and mouth
C) BVM with a pediatric mask over the stoma
D) Nasal cannula at 6 L/min
Correct Answer: C
Rationale: Use a pediatric mask to seal over the stoma. Occlude
mouth and nose if the upper airway is intact.
8. Which finding is most concerning during CPAP application for
pulmonary edema?
A) Patient requesting the mask be removed
B) SpO₂ rising from 85% to 94%
C) Sudden drop in blood pressure
D) Increased respiratory rate from 24 to 28
Correct Answer: C
Rationale: Hypotension can result from decreased preload (positive
pressure reducing venous return). May require fluid challenge or
discontinuation.
9. A 7-year-old child has a foreign body obstruction with poor air
exchange. You should:
A) Perform abdominal thrusts
B) Start CPR immediately
C) Give back blows and chest thrusts
QUESTIONS| WITH CORRECT
SOLUTIONS.
Airway & Breathing (Questions 1–20)
1. A 45-year-old male is unresponsive with gurgling respirations.
What is your priority action?
A) Insert an OPA
B) Suction the airway
C) Begin bag-valve-mask ventilation
D) Perform a head-tilt chin-lift
Correct Answer: B
Rationale: Gurgling indicates fluid in the airway. Suctioning must
precede any airway adjunct or ventilation to clear the obstruction.
2. Which of the following is the most reliable indicator of adequate
ventilation in an intubated patient?
A) Pulse oximetry reading of 94%
, B) Equal bilateral breath sounds
C) Chest rise and fall
D) End-tidal CO₂ between 35–45 mmHg
Correct Answer: D
Rationale: EtCO₂ provides real-time confirmation of ventilation
adequacy and tube placement. Chest rise can be misleading.
3. A 60-year-old with severe COPD has an SpO₂ of 82% on room
air. You should initially:
A) Apply a non-rebreather at 15 L/min
B) Start nasal cannula at 2 L/min
C) Intubate immediately
D) Use a bag-valve-mask with room air
Correct Answer: B
Rationale: COPD patients may rely on hypoxic drive. Start low-flow
oxygen and titrate to SpO₂ 88–92%.
4. Stridor in a pediatric patient suggests:
A) Lower airway obstruction
B) Upper airway obstruction
C) Pneumothorax
D) Pulmonary edema
,Correct Answer: B
Rationale: Stridor is a high-pitched inspiratory noise caused by
upper airway obstruction (croup, epiglottitis, foreign body).
5. The correct tidal volume for an adult during bag-valve-mask
ventilation is approximately:
A) 200–300 mL
B) 500–600 mL
C) 800–1000 mL
D) 1200 mL
Correct Answer: B
Rationale: Adult tidal volume is 6–7 mL/kg ideal body weight,
typically 500–600 mL. Overventilation causes gastric distension.
6. What is the primary benefit of using a supraglottic airway
(e.g., King LT, iGel)?
A) Protects against aspiration
B) Allows ventilation without visualizing cords
C) Provides a cuffed seal in the trachea
D) Decreases dead space ventilation
Correct Answer: B
Rationale: Supraglottic airways are inserted blindly and sit above the
glottis, allowing rapid ventilation without laryngoscopy.
7. A patient with a stoma is apneic. How should you ventilate?
, A) Mouth-to-stoma
B) BVM over the nose and mouth
C) BVM with a pediatric mask over the stoma
D) Nasal cannula at 6 L/min
Correct Answer: C
Rationale: Use a pediatric mask to seal over the stoma. Occlude
mouth and nose if the upper airway is intact.
8. Which finding is most concerning during CPAP application for
pulmonary edema?
A) Patient requesting the mask be removed
B) SpO₂ rising from 85% to 94%
C) Sudden drop in blood pressure
D) Increased respiratory rate from 24 to 28
Correct Answer: C
Rationale: Hypotension can result from decreased preload (positive
pressure reducing venous return). May require fluid challenge or
discontinuation.
9. A 7-year-old child has a foreign body obstruction with poor air
exchange. You should:
A) Perform abdominal thrusts
B) Start CPR immediately
C) Give back blows and chest thrusts
