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SECTION 1: AIRWAY MANAGEMENT & RESPIRATION
Q1: You arrive on scene to find a 58-year-old male patient who is conscious but struggling to breathe. He is
sitting in the tripod position and has audible stridor. His skin is pale and diaphoretic. What is your PRIORITY
intervention?
A. Apply a non-rebreather mask at 15 LPM
B. Assist the patient with his prescribed inhaler
C. Begin positive pressure ventilation with a BVM [CORRECT]
D. Perform a head-tilt chin-lift maneuver
Correct Answer: C
Rationale: Stridor indicates an upper airway obstruction or severe partial blockage; positive pressure
ventilation forces air past the obstruction to ventilate the patient. A non-rebreather (A) relies on patient effort
and may not be effective if air cannot pass the obstruction. An inhaler (B) treats lower airway
bronchoconstriction, not upper airway obstruction. Head-tilt chin-lift (D) is a positioning technique that does
not actively force air past an obstruction.
Q2: A 67-year-old female with a history of COPD is complaining of shortness of breath. Her SpO2 is 88%.
You should initiate oxygen therapy. What is the target SpO2 range for this patient according to current
guidelines?
A. 94% - 99%
B. 88% - 92% [CORRECT]
C. 80% - 85%
D. 100%
Correct Answer: B
Rationale: For patients with COPD, the target SpO2 is typically 88%–92% to avoid suppressing their hypoxic
respiratory drive. Administering oxygen to achieve 94-99% (A) or 100% (D) can lead to hypercapnia and
respiratory failure in severe COPD retainers. An SpO2 of 80-85% (C) is dangerously hypoxic and insufficient
for tissue perfusion.
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Q3: During transport of an intubated patient, you notice a sudden drop in SpO2 and the waveform
capnography shows a loss of the rectangular waveform. What is the MOST likely cause?
A. Bronchospasm
B. Right mainstem intubation
C. Displacement of the endotracheal tube [CORRECT]
D. Hyperventilation
Correct Answer: C
Rationale: A sudden loss of the CO2 waveform (flatline) indicates that the tube is no longer in the trachea or
the airway is completely disconnected; displacement is a primary concern. Bronchospasm (A) would cause a
shark-fin waveform, not a loss of waveform. Right mainstem intubation (B) would show a waveform but
might cause decreased breath sounds on the left. Hyperventilation (D) would lower the EtCO2 number but
the waveform would still be present.
Q4: You are managing the airway of an unconscious patient with no gag reflex. You insert an oropharyngeal
airway (OPA). Which of the following is a contraindication for OPA use?
A. The patient has dentures
B. The patient has a gag reflex [CORRECT]
C. The patient is breathing shallowly
D. The patient has a history of asthma
Correct Answer: B
Rationale: An OPA is contraindicated in patients with an intact gag reflex as it may stimulate vomiting and
aspiration. Dentures (A) should be removed before insertion, but their presence isn't a contraindication to the
device itself. Shallow breathing (C) indicates a need for airway support. Asthma (D) is a medical history that
does not affect OPA insertion safety.
Q5: Which of the following patients would benefit MOST from a nasopharyngeal airway (NPA)?
A. An unconscious patient with a suspected basilar skull fracture
B. A semiconscious patient with a gag reflex [CORRECT]
C. A patient with severe nasal trauma and bleeding
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D. A conscious patient with clear lung sounds
Correct Answer: B
Rationale: An NPA is the airway adjunct of choice for semiconscious patients who cannot tolerate an OPA
due to a gag reflex. A basilar skull fracture (A) is a relative contraindication due to the risk of inserting the
tube into the cranial vault. Severe nasal trauma (C) prevents safe insertion. A conscious patient with clear
lungs (D) does not require an advanced airway adjunct.
Q6: A patient is in respiratory distress due to a foreign body obstruction. He is conscious but unable to speak
or cough. After attempting the Heimlich maneuver without success, the patient becomes unresponsive. What
is your immediate next action?
A. Continue abdominal thrusts
B. Perform a blind finger sweep
C. Start chest compressions [CORRECT]
D. Insert a supraglottic airway
Correct Answer: C
Rationale: If a choking patient becomes unresponsive, the EMT must immediately begin CPR starting with
chest compressions; the pressure may dislodge the object. Continuing abdominal thrusts (A) is not the
priority over CPR. Blind finger sweeps (B) are no longer recommended as they may push the object deeper.
Inserting a supraglottic airway (D) is impossible if the obstruction is not cleared.
Q7: You are assisting ventilations with a bag-valve-mask (BVM) on an apneic patient. You notice the patient's
stomach is distending with each breath. What is the MOST likely cause?
A. Ventilating too slowly
B. Inadequate oxygen flow rate
C. Excessive ventilation volume or rate [CORRECT]
D. Using a pulse oximeter
Correct Answer: C
Rationale: Gastric distention occurs when air enters the esophagus and stomach, typically caused by
ventilating with too much volume or too much pressure (often due to rapid rate). Ventilating too slowly (A)
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JB LEARNING | REAL EXAM QUESTIONS | SOLVED 100% |
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would not cause this. Oxygen flow rate (B) does not cause gastric distention; volume and pressure do. Using a
pulse oximeter (D) is irrelevant to airway management mechanics.
Q8: What is the primary advantage of using a multi-lumen esophageal airway (e.g., Combitube/King Airway)
over a standard endotracheal tube for an EMT?
A. It allows for direct visualization of the vocal cords
B. It requires minimal training and visualization to insert [CORRECT]
C. It provides a definitive airway for long-term care
D. It prevents aspiration 100% of the time
Correct Answer: B
Rationale: Supraglottic airways are advantageous for EMTs because they can be inserted blindly without the
need for laryngoscopy (visualizing cords). Direct visualization (A) is required for ET tubes, not these devices.
They are not considered "definitive" long-term airways (C) compared to ET tubes. While they reduce
aspiration risk, they do not prevent it 100% (D).
Q9: A 4-year-old child is in respiratory distress. You note stridor and drooling. The child is leaning forward
on his hands. What condition should you suspect, and how should you manage the airway?
A. Epiglottitis; do not attempt to visualize the airway [CORRECT]
B. Croup; administer humidified oxygen
C. Bronchiolitis; perform deep suctioning
D. Asthma; assist with a bronchodilator
Correct Answer: A
Rationale: The signs (stridor, drooling, tripod position) are classic for epiglottitis, a life-threatening infection;
you must avoid agitating the child or attempting to visualize the throat to prevent total obstruction. Croup (B)
typically presents with a barking cough and no drooping. Bronchiolitis (C) involves wheezing and lower
airway issues. Asthma (D) is lower airway obstruction.
Q10: Which statement regarding suctioning of the airway is correct?
A. Suction attempts should last no longer than 30 seconds