Correct Answers (2025/2026) | Complete Study
Guide with Verified Solutions | Already Graded
A+
WEST COAST EMT BLOCK EXAM 3
Complete Study Guide — 300 Questions
Question 1 You arrive on scene to find a 58-year-old male who collapsed at a gym. Bystanders
say he fell while on the treadmill. He is unresponsive, apneic, and pulseless. An AED is
immediately available. What is your FIRST action?
A. Apply AED pads and analyze the rhythm B. Begin high-quality CPR immediately C.
Open the airway with head-tilt chin-lift D. Administer oxygen via non-rebreather mask E. Obtain
a SAMPLE history from bystanders
CORRECT ANSWER: B RATIONALE: CPR is initiated immediately for a pulseless,
apneic patient. High-quality compressions should begin before the AED is applied; compressions
maintain perfusion until defibrillation is possible.
Question 2 A 62-year-old female calls 911 for chest pain. She describes pressure-like discomfort
radiating to her left arm, diaphoresis, and nausea for the past 30 minutes. Vitals: BP 138/88, HR
92, RR 18, SpO2 96%. She has no known drug allergies. What is the MOST appropriate
intervention?
A. Administer nitroglycerin 0.4 mg sublingual immediately B. Place her in a position of comfort
and apply oxygen via NRB C. Administer aspirin 324 mg chewable and provide supportive care
D. Start an IV and administer morphine for pain relief E. Perform a 12-lead ECG and
transport without further treatment
CORRECT ANSWER: C RATIONALE: Chewable aspirin (324 mg) is indicated for
suspected AMI when the patient has no contraindications. It inhibits platelet aggregation and
reduces myocardial damage. Nitroglycerin requires a physician order in many protocols and is
contraindicated with certain medications.
Question 3 You are treating a 70-year-old male in cardiac arrest. After 2 minutes of CPR, the
AED analyzes and advises a shock. You deliver the shock. What is your IMMEDIATE next
action?
,A. Check for a pulse before resuming CPR B. Resume CPR immediately for 2 minutes C.
Reanalyze the rhythm with the AED D. Reassess the patient's airway E. Administer epinephrine
via IV if available
CORRECT ANSWER: B RATIONALE: After delivering a shock, CPR must resume
immediately without a pulse check. A 2-minute cycle of CPR is completed before the next AED
rhythm analysis to maintain perfusion and increase the chance of successful defibrillation.
Question 4 A 55-year-old male presents with sudden onset of sharp, tearing chest pain that
radiates to his back. He has a history of hypertension. BP is 188/110 in the right arm and 152/96
in the left arm. What condition should you MOST suspect?
A. Acute myocardial infarction B. Aortic dissection C. Pulmonary embolism D. Spontaneous
pneumothorax E. Cardiac tamponade
CORRECT ANSWER: B RATIONALE: Unequal blood pressures between arms,
hypertension history, and tearing pain radiating to the back are classic signs of aortic dissection.
This is a life-threatening emergency requiring rapid transport.
Question 5 You respond to a 48-year-old female who is unresponsive. The monitor shows a
disorganized, chaotic rhythm with no identifiable QRS complexes. What rhythm is MOST likely
present?
A. Ventricular tachycardia B. Asystole C. Ventricular fibrillation D. Pulseless electrical
activity E. Atrial fibrillation
CORRECT ANSWER: C RATIONALE: Ventricular fibrillation (VF) appears as a
chaotic, disorganized rhythm with no identifiable QRS complexes. It is a shockable rhythm and
the most common initial rhythm in sudden cardiac arrest in adults.
Question 6 During CPR on a 67-year-old male, you feel a pulse return. The patient remains
unresponsive with a BP of 88/60 and HR of 110. He is breathing inadequately at 6 breaths/min.
What is your PRIORITY intervention?
A. Administer a fluid bolus of 500 mL NS B. Apply oxygen via non-rebreather mask at 15 L/min
C. Assist ventilations with a BVM at 10–12 breaths/min D. Place the patient in
Trendelenburg position E. Reassess pupils and neurological status
,CORRECT ANSWER: C RATIONALE: Post-ROSC management includes assisted
ventilations when the patient is breathing inadequately. With only 6 breaths/min, BVM assistance
is critical to prevent hypoxia and secondary brain injury.
Question 7 A 74-year-old male has a witnessed cardiac arrest. You are 8 minutes from the
hospital. After 4 cycles of CPR and 2 AED shocks, ROSC has not been achieved. Medical
direction is unreachable. What is the BEST course of action?
A. Cease resuscitation efforts on scene B. Continue CPR and transport to the nearest hospital
C. Administer epinephrine if available per protocol D. Perform an advanced airway and pause
transport E. Check for DNR documentation before continuing
CORRECT ANSWER: B RATIONALE: In the absence of ROSC and when DNR is
absent, continue CPR and transport without delay. Resuscitation should continue en route;
hospital intervention (e.g., cath lab, ECMO) may be life-saving.
Question 8 You are caring for a 60-year-old female with chest pain. She takes sildenafil (Viagra)
daily for pulmonary hypertension. She has sublingual nitroglycerin prescribed. Should you
administer it?
A. Yes, nitroglycerin is safe with sildenafil B. No, nitroglycerin is contraindicated with sildenafil
due to severe hypotension risk C. Yes, but only if her BP is above 100 systolic D. No,
nitroglycerin is contraindicated with all cardiac medications E. Yes, but administer only half the
usual dose
CORRECT ANSWER: B RATIONALE: Nitroglycerin is absolutely contraindicated in
patients who have taken phosphodiesterase inhibitors (sildenafil, tadalafil) within 24–48 hours
due to the risk of severe, refractory hypotension.
Question 9 A 50-year-old male is conscious and complaining of palpitations. The monitor shows
a wide-complex tachycardia at a rate of 180 bpm. He has a BP of 70/40 and is diaphoretic. What
does this presentation MOST indicate?
A. Stable ventricular tachycardia B. Supraventricular tachycardia with aberrancy C. Unstable
ventricular tachycardia requiring immediate intervention D. Atrial flutter with rapid
ventricular response E. Wolff-Parkinson-White syndrome
, CORRECT ANSWER: C RATIONALE: Wide-complex tachycardia with
hemodynamic instability (BP 70/40, diaphoresis) indicates unstable ventricular tachycardia. This
requires immediate synchronized cardioversion per ACLS protocol.
Question 10 You are performing CPR on an adult. Your partner is providing ventilations. What
is the correct compression-to-ventilation ratio with an advanced airway in place?
A. 15:2 compressions to ventilations B. 30:2 compressions to ventilations C. Continuous
compressions at 100–120/min with 1 breath every 6 seconds D. Continuous compressions at
100/min with 1 breath every 5 seconds E. 5:1 compressions to ventilations
CORRECT ANSWER: C RATIONALE: Once an advanced airway is in place,
compressions become continuous at 100–120/min and ventilations are provided asynchronously
at 1 breath every 6 seconds (10/min).
Question 11 A 65-year-old male presents with JVD, muffled heart sounds, and hypotension (BP
80/50). He was involved in a chest trauma 2 hours ago. What condition should you MOST
suspect?
A. Tension pneumothorax B. Cardiac tamponade C. Hemothorax D. Aortic rupture E.
Myocardial contusion
CORRECT ANSWER: B RATIONALE: Beck's triad (JVD, muffled heart sounds,
hypotension) following chest trauma is classic for cardiac tamponade. Blood accumulates in the
pericardial sac, preventing the heart from filling properly.
Question 12 You arrive to find a 42-year-old male who has been shoveling snow. He has
crushing chest pain, diaphoresis, and says "I feel like I'm going to die." He is alert. SpO2 is 94%.
What is your FIRST priority?
A. Administer oxygen at 2 L/min via nasal cannula B. Perform a detailed physical exam C.
Administer aspirin 324 mg chewable and prepare for transport D. Apply the AED in case of
cardiac arrest E. Obtain IV access and administer nitroglycerin
CORRECT ANSWER: C RATIONALE: This patient presents with classic AMI
symptoms. Aspirin is the priority medication for suspected AMI in the field. Rapid transport with
ALS notification is critical for definitive care.