Exam | Complete Questions & Detailed Rationales |
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TABLE OF CONTENTS
Section 1 | Airway, Respiration, and Ventilation | Q1 – Q10
Section 2 | Cardiology and Resuscitation | Q11 – Q20
Section 3 | Trauma and Bleeding Control | Q21 – Q30
Section 4 | Medical Emergencies and Obstetrics | Q31 – Q40
Section 5 | EMS Operations, Scene Safety, and Professionalism | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
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SECTION 1: AIRWAY, RESPIRATION, AND VENTILATION Q1 – Q10
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Question 1 of 50
A 34-year-old male was struck in the face with a baseball bat during a recreational
league game. He is sitting upright on the bench, spitting blood, and speaking in short,
gurgled phrases. You note significant swelling of the lips and tongue, and a loose upper
incisor is visible. His SpO2 is 89% on room air. What is your immediate priority?
A. Apply a non-rebreather mask at 15 L/min
B. Suction the oropharynx for no more than 15 seconds ✓ CORRECT
C. Insert an oropharyngeal airway
D. Perform a jaw-thrust maneuver while maintaining C-spine stabilization
Correct Answer: B
,Rationale: Blood and secretions in the airway are causing gurgling and hypoxia, so
immediate suctioning is the first step to clear the airway before any other intervention.
Applying oxygen without clearing the airway first will be ineffective because the blood
will continue to obstruct airflow. In trauma with possible spinal injury, suctioning does
not compromise C-spine precautions and must come before airway adjunct placement.
Question 2 of 50
A 67-year-old female with COPD is found by her daughter sitting in a tripod position,
using pursed-lip breathing. Her respiratory rate is 28, she is diaphoretic, and her SpO2 is
84%. She has a home nebulizer but has not used it today. What is the most appropriate
initial oxygen delivery method?
A. Nasal cannula at 2 L/min
B. Non-rebreather mask at 15 L/min
C. Venturi mask at 28% FiO2 ✓ CORRECT
D. Bag-valve mask with supplemental oxygen at 15 L/min
Correct Answer: C
Rationale: COPD patients are chronically hypoxic and rely on hypoxic drive; a Venturi
mask delivers a precise low concentration of oxygen to avoid suppressing that drive. A
non-rebreather at 15 L/min could cause CO2 retention and respiratory depression in this
patient. The Venturi mask also allows you to titrate oxygen upward gradually while
monitoring the patient's mental status and respiratory effort.
Question 3 of 50
You are ventilating a 22-year-old male who overdosed on opioids and is apneic. You
have inserted an oropharyngeal airway and are using a bag-valve mask with
supplemental oxygen. Your partner notes that the patient's abdomen is rising with each
squeeze, but the chest is barely moving. What adjustment should you make first?
,A. Increase the ventilation rate to 20 breaths per minute
B. Reposition the head and reassess the seal of the mask ✓ CORRECT
C. Switch to a smaller bag-valve mask
D. Perform a needle decompression on the right side
Correct Answer: B
Rationale: Abdominal rise with poor chest excursion indicates air is entering the
stomach rather than the lungs, most commonly due to poor mask seal or improper head
position. Repositioning the head and resealing the mask should be attempted before
any invasive intervention. Gastric distension from improper ventilation technique can
lead to vomiting and aspiration if not corrected promptly.
Question 4 of 50
A 19-year-old male was ejected from a motorcycle and is unconscious. He has snoring
respirations at a rate of 6 per minute, and you note facial trauma with blood in the
airway. C-spine precautions are being maintained. What is the correct sequence of
airway interventions?
A. Suction, insert an oropharyngeal airway, ventilate with BVM
B. Suction, insert a nasopharyngeal airway, ventilate with BVM ✓ CORRECT
C. Insert an oropharyngeal airway, suction, ventilate with BVM
D. Insert a nasopharyngeal airway, suction, ventilate with BVM
Correct Answer: B
Rationale: In a trauma patient with possible facial fractures, a nasopharyngeal airway is
preferred over an oropharyngeal airway because it avoids manipulating the jaw and
potentially worsening facial injuries. The airway must be suctioned first to clear blood
and secretions before inserting any adjunct. An oropharyngeal airway would require jaw
manipulation that could displace facial fractures and is contraindicated in patients who
are not completely unresponsive.
Question 5 of 50
, A 4-year-old child is having an asthma exacerbation at daycare. The teacher reports
wheezing that started 30 minutes ago after playing outside. The child is alert, sitting
upright, and speaking in short sentences. Respiratory rate is 36, SpO2 is 92%, and you
hear diffuse wheezing bilaterally. What is your priority intervention?
A. Administer albuterol via nebulizer with supplemental oxygen ✓ CORRECT
B. Administer epinephrine 1:1000 intramuscularly
C. Apply a non-rebreather mask at 15 L/min
D. Prepare for immediate intubation
Correct Answer: A
Rationale: A child with moderate asthma who is alert and speaking in short sentences
should receive bronchodilator therapy via nebulizer as the first-line treatment.
Epinephrine is reserved for severe allergic reactions or impending respiratory failure, not
for a responsive asthmatic child. Intubation is not indicated because the child is
maintaining their own airway and has adequate mental status.
Question 6 of 50
A 52-year-old male construction worker collapses at a job site. Bystanders report he
was working in a trench when a pile of dirt caved in on him. He is unconscious, has
gurgling respirations, and his face and mouth are packed with mud and debris. What is
your first action?
A. Begin chest compressions immediately
B. Log-roll the patient and perform a jaw thrust
C. Manually remove large debris and suction the airway ✓ CORRECT
D. Insert an oropharyngeal airway and ventilate
Correct Answer: C
Rationale: Large particulate matter like mud must be manually removed before
suctioning can be effective, as a suction catheter cannot clear solid debris. You cannot
ventilate or place an airway adjunct until the airway is cleared of obstructive material.