EMT Refresher CE Exam Prep – Real Practice Questions, Answers
& Detailed Rationales (Updated 2026) | Patient Assessment &
Trauma Care, Airway Management & Oxygen Therapy, Cardiac &
Respiratory Emergencies, CPR & AED Skills, Shock Management,
Medical Emergencies, EMS Pharmacology Basics, Pediatric &
Geriatric Care, EMS Operations & NREMT Continuing Education
Review
Question 1: Which of the following is the MOST appropriate initial action for an EMT
when encountering an unresponsive patient with no obvious trauma?
A. Apply a cervical collar immediately
B. Begin chest compressions at a rate of 100-120 per minute
C. Open the airway using the head-tilt/chin-lift maneuver
D. Administer high-flow oxygen via non-rebreather mask
CORRECT ANSWER: C. Open the airway using the head-tilt/chin-lift maneuver
Rationale: In an unresponsive patient without suspected trauma, the priority is
establishing a patent airway. The head-tilt/chin-lift maneuver is the standard initial
technique to open the airway. Cervical spine precautions are only applied when trauma
is suspected. Chest compressions are initiated only if the patient is pulseless, and
oxygen administration follows airway management in the assessment sequence.
Question 2: During the primary assessment of a trauma patient, which finding
would MOST urgently require immediate intervention?
A. Deformity of the left forearm
B. Stridor and labored breathing
C. Abrasions on the forehead
D. Complaint of abdominal pain
CORRECT ANSWER: B. Stridor and labored breathing
Rationale: Stridor indicates upper airway obstruction, which is immediately life-
threatening and requires prompt intervention to secure the airway. While deformities,
abrasions, and abdominal pain require assessment and treatment, they do not pose the
same immediate threat to life as a compromised airway. The primary assessment
follows the ABCs (Airway, Breathing, Circulation), prioritizing airway and breathing
issues first.
Question 3: An adult patient presents with chest pain, diaphoresis, and nausea.
Vital signs are BP 90/60, P 110, R 24. Which intervention should the EMT perform
FIRST?
A. Administer aspirin 324 mg chewable
B. Apply the AED and analyze rhythm
,C. Administer high-flow oxygen via non-rebreather mask
D. Obtain a 12-lead ECG
CORRECT ANSWER: C. Administer high-flow oxygen via non-rebreather mask
Rationale: For a patient with suspected acute coronary syndrome showing signs of
shock (hypotension, tachycardia), the EMT's first intervention after ensuring scene
safety and completing the primary assessment is to administer high-flow oxygen to
improve myocardial oxygenation. Aspirin administration is important but follows oxygen
therapy. AED application is reserved for pulseless patients, and 12-lead ECG acquisition
is typically beyond the EMT scope in most systems.
Question 4: Which statement regarding the use of a bag-valve-mask (BVM) device is
CORRECT for an EMT?
A. A BVM should always be used with a reservoir attached to deliver 100% oxygen
B. One rescuer can effectively ventilate an adult patient using a BVM without difficulty
C. Ventilations should be delivered at a rate of 20-24 breaths per minute for an adult
D. The mask should be held with the E-C clamp technique to ensure a proper seal
CORRECT ANSWER: D. The mask should be held with the E-C clamp technique to
ensure a proper seal
Rationale: The E-C clamp technique (thumb and index finger forming a "C" over the
mask, remaining fingers forming an "E" along the jaw) is the recommended method for
maintaining an effective mask seal during BVM ventilation. While a reservoir increases
oxygen concentration, it is not always mandatory depending on the clinical situation.
Effective one-rescuer BVM ventilation is challenging and often requires two rescuers for
optimal results. The recommended ventilation rate for an adult with a pulse is 10-12
breaths per minute, not 20-24.
Question 5: A patient with a history of asthma is experiencing acute respiratory
distress. After assisting with the patient's prescribed albuterol inhaler, the EMT
should NEXT:
A. Reassess breath sounds and respiratory status
B. Prepare for immediate transport without further assessment
C. Administer a second dose of albuterol immediately
D. Apply a pulse oximeter and withhold oxygen if SpO2 is above 94%
CORRECT ANSWER: A. Reassess breath sounds and respiratory status
Rationale: After administering any medication, reassessment is critical to evaluate the
patient's response to treatment. The EMT should reassess respiratory status, including
breath sounds, work of breathing, and vital signs, to determine if the intervention was
effective and if additional treatments or interventions are needed. Transport should not
be delayed, but ongoing assessment guides care. Additional doses of albuterol require
medical direction in most protocols. Oxygen should be administered based on clinical
need, not withheld solely based on a pulse oximetry reading if the patient is in distress.
,Question 6: Which of the following is a LATE sign of hypovolemic shock in an adult
patient?
A. Tachycardia
B. Pale, cool, clammy skin
C. Hypotension
D. Anxiety or restlessness
CORRECT ANSWER: C. Hypotension
Rationale: Hypotension is a late and ominous sign of hypovolemic shock, indicating
that compensatory mechanisms (such as tachycardia and peripheral vasoconstriction)
are failing. Early signs include tachycardia, anxiety, pale/cool/clammy skin, and delayed
capillary refill. Recognizing early signs allows for earlier intervention before the patient
decompensates to hypotension, which significantly worsens prognosis.
Question 7: When assessing a pediatric patient, which finding is MOST concerning
for respiratory failure?
A. Respiratory rate of 40 breaths per minute in a 2-year-old
B. Nasal flaring and intercostal retractions
C. Grunting and head bobbing
D. Oxygen saturation of 92% on room air
CORRECT ANSWER: C. Grunting and head bobbing
Rationale: Grunting and head bobbing are signs of severe respiratory distress and
impending respiratory failure in pediatric patients. Grunting is an attempt to maintain
positive end-expiratory pressure to keep alveoli open, while head bobbing indicates use
of accessory muscles and fatigue. While tachypnea, nasal flaring, retractions, and mild
hypoxia are concerning, grunting and head bobbing signal that the child is tiring and
may soon arrest, requiring immediate intervention.
Question 8: An EMT is caring for a patient with suspected stroke. Which
assessment tool is MOST appropriate for prehospital stroke screening?
A. Glasgow Coma Scale
B. Cincinnati Prehospital Stroke Scale
C. APGAR score
D. Revised Trauma Score
CORRECT ANSWER: B. Cincinnati Prehospital Stroke Scale
Rationale: The Cincinnati Prehospital Stroke Scale (CPSS) is a validated, rapid
assessment tool designed for prehospital use to identify potential stroke patients. It
assesses three criteria: facial droop, arm drift, and abnormal speech. The Glasgow
Coma Scale assesses level of consciousness but is not stroke-specific. The APGAR
score is for newborn assessment, and the Revised Trauma Score is for trauma triage.
, Question 9: Which of the following medications is within the EMT scope of practice
to administer in most jurisdictions for a patient with suspected opioid overdose?
A. Epinephrine
B. Naloxone
C. Nitroglycerin
D. Albuterol
CORRECT ANSWER: B. Naloxone
Rationale: Naloxone (Narcan) is an opioid antagonist that reverses the effects of opioid
overdose and is within the EMT scope of practice in most states, often administered
intranasally. Epinephrine is typically administered by EMTs only for anaphylaxis via auto-
injector. Nitroglycerin may be assisted by EMTs if prescribed to the patient. Albuterol is
typically assisted via patient's own inhaler or nebulizer per protocol, but naloxone is
specifically indicated for opioid overdose and widely authorized for EMT administration.
Question 10: During transport, a patient with a history of diabetes becomes
confused, diaphoretic, and tachycardic. Blood glucose is 55 mg/dL. The patient is
conscious and able to swallow. What is the MOST appropriate intervention?
A. Administer glucagon intramuscularly
B. Provide oral glucose gel or paste
C. Start an intravenous line with D50
D. Withhold treatment and transport rapidly
CORRECT ANSWER: B. Provide oral glucose gel or paste
Rationale: For a conscious patient with hypoglycemia who can protect their airway and
swallow safely, oral glucose (gel, paste, or liquid) is the treatment of choice at the EMT
level. Glucagon is typically administered by paramedics or when the patient cannot take
oral glucose. D50 IV is beyond the EMT scope. Withholding treatment is inappropriate as
hypoglycemia can rapidly progress to seizures or unconsciousness.
Question 11: Which of the following is the PRIMARY purpose of the secondary
assessment in patient care?
A. To identify and treat immediate life threats
B. To obtain a complete medical history and perform a head-to-toe examination
C. To determine the need for spinal immobilization
D. To establish rapport with the patient
CORRECT ANSWER: B. To obtain a complete medical history and perform a head-
to-toe examination
Rationale: The secondary assessment follows the primary assessment and is focused
on gathering a thorough history (using SAMPLE or OPQRST) and performing a systematic
physical examination to identify non-life-threatening injuries or medical conditions.
Identifying immediate life threats is the purpose of the primary assessment. Spinal
& Detailed Rationales (Updated 2026) | Patient Assessment &
Trauma Care, Airway Management & Oxygen Therapy, Cardiac &
Respiratory Emergencies, CPR & AED Skills, Shock Management,
Medical Emergencies, EMS Pharmacology Basics, Pediatric &
Geriatric Care, EMS Operations & NREMT Continuing Education
Review
Question 1: Which of the following is the MOST appropriate initial action for an EMT
when encountering an unresponsive patient with no obvious trauma?
A. Apply a cervical collar immediately
B. Begin chest compressions at a rate of 100-120 per minute
C. Open the airway using the head-tilt/chin-lift maneuver
D. Administer high-flow oxygen via non-rebreather mask
CORRECT ANSWER: C. Open the airway using the head-tilt/chin-lift maneuver
Rationale: In an unresponsive patient without suspected trauma, the priority is
establishing a patent airway. The head-tilt/chin-lift maneuver is the standard initial
technique to open the airway. Cervical spine precautions are only applied when trauma
is suspected. Chest compressions are initiated only if the patient is pulseless, and
oxygen administration follows airway management in the assessment sequence.
Question 2: During the primary assessment of a trauma patient, which finding
would MOST urgently require immediate intervention?
A. Deformity of the left forearm
B. Stridor and labored breathing
C. Abrasions on the forehead
D. Complaint of abdominal pain
CORRECT ANSWER: B. Stridor and labored breathing
Rationale: Stridor indicates upper airway obstruction, which is immediately life-
threatening and requires prompt intervention to secure the airway. While deformities,
abrasions, and abdominal pain require assessment and treatment, they do not pose the
same immediate threat to life as a compromised airway. The primary assessment
follows the ABCs (Airway, Breathing, Circulation), prioritizing airway and breathing
issues first.
Question 3: An adult patient presents with chest pain, diaphoresis, and nausea.
Vital signs are BP 90/60, P 110, R 24. Which intervention should the EMT perform
FIRST?
A. Administer aspirin 324 mg chewable
B. Apply the AED and analyze rhythm
,C. Administer high-flow oxygen via non-rebreather mask
D. Obtain a 12-lead ECG
CORRECT ANSWER: C. Administer high-flow oxygen via non-rebreather mask
Rationale: For a patient with suspected acute coronary syndrome showing signs of
shock (hypotension, tachycardia), the EMT's first intervention after ensuring scene
safety and completing the primary assessment is to administer high-flow oxygen to
improve myocardial oxygenation. Aspirin administration is important but follows oxygen
therapy. AED application is reserved for pulseless patients, and 12-lead ECG acquisition
is typically beyond the EMT scope in most systems.
Question 4: Which statement regarding the use of a bag-valve-mask (BVM) device is
CORRECT for an EMT?
A. A BVM should always be used with a reservoir attached to deliver 100% oxygen
B. One rescuer can effectively ventilate an adult patient using a BVM without difficulty
C. Ventilations should be delivered at a rate of 20-24 breaths per minute for an adult
D. The mask should be held with the E-C clamp technique to ensure a proper seal
CORRECT ANSWER: D. The mask should be held with the E-C clamp technique to
ensure a proper seal
Rationale: The E-C clamp technique (thumb and index finger forming a "C" over the
mask, remaining fingers forming an "E" along the jaw) is the recommended method for
maintaining an effective mask seal during BVM ventilation. While a reservoir increases
oxygen concentration, it is not always mandatory depending on the clinical situation.
Effective one-rescuer BVM ventilation is challenging and often requires two rescuers for
optimal results. The recommended ventilation rate for an adult with a pulse is 10-12
breaths per minute, not 20-24.
Question 5: A patient with a history of asthma is experiencing acute respiratory
distress. After assisting with the patient's prescribed albuterol inhaler, the EMT
should NEXT:
A. Reassess breath sounds and respiratory status
B. Prepare for immediate transport without further assessment
C. Administer a second dose of albuterol immediately
D. Apply a pulse oximeter and withhold oxygen if SpO2 is above 94%
CORRECT ANSWER: A. Reassess breath sounds and respiratory status
Rationale: After administering any medication, reassessment is critical to evaluate the
patient's response to treatment. The EMT should reassess respiratory status, including
breath sounds, work of breathing, and vital signs, to determine if the intervention was
effective and if additional treatments or interventions are needed. Transport should not
be delayed, but ongoing assessment guides care. Additional doses of albuterol require
medical direction in most protocols. Oxygen should be administered based on clinical
need, not withheld solely based on a pulse oximetry reading if the patient is in distress.
,Question 6: Which of the following is a LATE sign of hypovolemic shock in an adult
patient?
A. Tachycardia
B. Pale, cool, clammy skin
C. Hypotension
D. Anxiety or restlessness
CORRECT ANSWER: C. Hypotension
Rationale: Hypotension is a late and ominous sign of hypovolemic shock, indicating
that compensatory mechanisms (such as tachycardia and peripheral vasoconstriction)
are failing. Early signs include tachycardia, anxiety, pale/cool/clammy skin, and delayed
capillary refill. Recognizing early signs allows for earlier intervention before the patient
decompensates to hypotension, which significantly worsens prognosis.
Question 7: When assessing a pediatric patient, which finding is MOST concerning
for respiratory failure?
A. Respiratory rate of 40 breaths per minute in a 2-year-old
B. Nasal flaring and intercostal retractions
C. Grunting and head bobbing
D. Oxygen saturation of 92% on room air
CORRECT ANSWER: C. Grunting and head bobbing
Rationale: Grunting and head bobbing are signs of severe respiratory distress and
impending respiratory failure in pediatric patients. Grunting is an attempt to maintain
positive end-expiratory pressure to keep alveoli open, while head bobbing indicates use
of accessory muscles and fatigue. While tachypnea, nasal flaring, retractions, and mild
hypoxia are concerning, grunting and head bobbing signal that the child is tiring and
may soon arrest, requiring immediate intervention.
Question 8: An EMT is caring for a patient with suspected stroke. Which
assessment tool is MOST appropriate for prehospital stroke screening?
A. Glasgow Coma Scale
B. Cincinnati Prehospital Stroke Scale
C. APGAR score
D. Revised Trauma Score
CORRECT ANSWER: B. Cincinnati Prehospital Stroke Scale
Rationale: The Cincinnati Prehospital Stroke Scale (CPSS) is a validated, rapid
assessment tool designed for prehospital use to identify potential stroke patients. It
assesses three criteria: facial droop, arm drift, and abnormal speech. The Glasgow
Coma Scale assesses level of consciousness but is not stroke-specific. The APGAR
score is for newborn assessment, and the Revised Trauma Score is for trauma triage.
, Question 9: Which of the following medications is within the EMT scope of practice
to administer in most jurisdictions for a patient with suspected opioid overdose?
A. Epinephrine
B. Naloxone
C. Nitroglycerin
D. Albuterol
CORRECT ANSWER: B. Naloxone
Rationale: Naloxone (Narcan) is an opioid antagonist that reverses the effects of opioid
overdose and is within the EMT scope of practice in most states, often administered
intranasally. Epinephrine is typically administered by EMTs only for anaphylaxis via auto-
injector. Nitroglycerin may be assisted by EMTs if prescribed to the patient. Albuterol is
typically assisted via patient's own inhaler or nebulizer per protocol, but naloxone is
specifically indicated for opioid overdose and widely authorized for EMT administration.
Question 10: During transport, a patient with a history of diabetes becomes
confused, diaphoretic, and tachycardic. Blood glucose is 55 mg/dL. The patient is
conscious and able to swallow. What is the MOST appropriate intervention?
A. Administer glucagon intramuscularly
B. Provide oral glucose gel or paste
C. Start an intravenous line with D50
D. Withhold treatment and transport rapidly
CORRECT ANSWER: B. Provide oral glucose gel or paste
Rationale: For a conscious patient with hypoglycemia who can protect their airway and
swallow safely, oral glucose (gel, paste, or liquid) is the treatment of choice at the EMT
level. Glucagon is typically administered by paramedics or when the patient cannot take
oral glucose. D50 IV is beyond the EMT scope. Withholding treatment is inappropriate as
hypoglycemia can rapidly progress to seizures or unconsciousness.
Question 11: Which of the following is the PRIMARY purpose of the secondary
assessment in patient care?
A. To identify and treat immediate life threats
B. To obtain a complete medical history and perform a head-to-toe examination
C. To determine the need for spinal immobilization
D. To establish rapport with the patient
CORRECT ANSWER: B. To obtain a complete medical history and perform a head-
to-toe examination
Rationale: The secondary assessment follows the primary assessment and is focused
on gathering a thorough history (using SAMPLE or OPQRST) and performing a systematic
physical examination to identify non-life-threatening injuries or medical conditions.
Identifying immediate life threats is the purpose of the primary assessment. Spinal
