NCOEMS Practice Exam 1 – North Carolina EMS Certification
Study Guide, Practice Questions & Exam Review 2026-2027
This document is a comprehensive study resource for candidates preparing for the North
Carolina Office of Emergency Medical Services (NCOEMS) Certification Exam. It covers
essential EMS topics commonly tested on state credentialing examinations, including EMS
operations, patient assessment, airway management, respiration and ventilation, cardiovascular
emergencies, medical emergencies, traumatic injuries, and special patient populations. The guide
includes practice questions, answer explanations, clinical scenarios, and exam-focused review
material designed to strengthen critical-thinking skills and improve readiness for EMT, AEMT,
and Paramedic credentialing examinations. NCOEMS exams are developed from a job task
analysis and assess real-world EMS knowledge and decision-making across multiple domains.
EMTs should wear high-efficiency particulate air (HEPA) respirators when they are in
contact with patients who have which of the following?
A. HIV (Human Immunodeficiency Virus) or AIDS (Acquired Immune Deficiency
Syndrome)
B. Tuberculosis (TB)
C. Open Wounds
D. Hepatitis B - CORRECT ANSWER B.
QUESTION :You are called to assist a 60-year-old female complaining of a severe
headache. Upon entering the home, you smell a strong odor of natural gas. What is
your first action?
A. Check the patient's airway, breathing, and circulation.
B. Insert a nasopharyngeal airway and assess vital signs.
C. Remove the patient from the house to your ambulance.
D. Open all windows and determine the source of the gas leak. - CORRECT ANSWER
C.
QUESTION :The most common electrical rhythm disturbance that results in sudden
cardiac arrest is called:
A. Pulseless electrical activity
B. Ventricular Fibrillation
C. Ventricular Tachycardia
D. Asystole - CORRECT ANSWER B.
QUESTION :A non-trauma patient was pulseless and apneic. Assisted ventilation was
attempted, but unsuccessful. If the head is repositioned and a repeat ventilation is
unsuccessful, which of the following is the next most appropriate step?
A. Check for an airway obstruction.
B. Continue with chest compressions only.
C. Attempt ventilations using an alternative method.
,D. Continue to reposition the head until assisted ventilations are successful. -
CORRECT ANSWER A.
QUESTION :During the management of a cardiac arrest, the AED gives a 'no shock
advised' message. Which of the following conditions most likely prompted this
message?
A. The patient is in V tach.
B. The patient is hypothermic.
C. The patient is in V fib.
D. The patient's rhythm is asystole. - CORRECT ANSWER D.
QUESTION :ALS and EMS providers are preparing to hyperventilate a patient who has
a suspected brainstem herniation. As capnography becomes available, what should be
the target end-tidal carbon-dioxide level during hyperventilation?
A. 20-25 mmHg
B. 60-70 mmHg
C. 30-35 mmHg
D. 40-45 mmHg - CORRECT ANSWER C.
QUESTION :Which of the following is the highest priority patient?
A. 57-year-old male with chest pain and systolic blood pressure of 80.
B. 40-year-old female with moderate pain from a leg injury.
C. 75-year-old male who appears confused but responds to commands.
D. 25-year-old female in labor with contractions six minutes apart. - CORRECT
ANSWER A.
QUESTION :Of the following, which body fluid has the most potential to transmit blood-
borne diseases?
A. Nasal discharge
B. Vomitus
C. Amniotic fluid
D. Feces - CORRECT ANSWER C.
QUESTION :Your patient is an 11-month-old female. How can you determine if she has
a decreased mental status and is responsive to verbal stimuli?
A. She will be upset when you take her from her mother's arms.
B. She will be unable to tell you how old she is if you ask her.
C. She will attempt to locate her parents' voices when they speak.
D. She will try to pull away from a painful stimulus on her toe. - CORRECT ANSWER
C.
QUESTION :What is the best method to asses circulation in an infant?
A. Palpate the carotid pulse.
B. Palpate the brachial pulse.
C. Palpate the radial pulse.
D. Observe capillary refill time. - CORRECT ANSWER B.
, QUESTION :A 45-year-old male is experiencing chest discomfort. After placing him in
his position of comfort, your next action should be to:
A. Ventilate the patient with a nonrebreather mask at 15 L/min.
B. Ventilate the patient with the bag-valve mask at 15 L/min.
C. Administer oxygen by nonrebreather mask at 15 L/min.
D. Administer oxygen by the nasal cannula at 6 L/min. - CORRECT ANSWER C.
QUESTION :Which patient should receive a rapid trauma survey to determine hidden
injuries?
A. Alert 2-year-old child in a car seat who was in a medium-speed crash.
B. Alert 20-year-old male who fell ten feet and is complaining of leg pain.
C. Alert 65-year-old female who fell in the bathtub and is complaining of wrist pain.
D. Alert 11-year-old female who tripped while roller-skating and fell down three steps. -
CORRECT ANSWER A.
QUESTION :Which of the following is a sign of increased pressure in the circulatory
system?
A. Flat neck veins.
B. Palpable carotid pulse.
C. Distended jugular veins.
D. Decreased radial pulse - CORRECT ANSWER C.
QUESTION :An automated external defibrillator (AED) will shock which of the following
rhythms?
A. Sinus rhythm.
B. Asystole.
C. Ventricular fibrillation.
D. Pulseless electrical activity - CORRECT ANSWER C.
QUESTION :To assess the motor functions in the lower extremities of a responsive
patient, you would:
A. Ask the patient to bend his knees.
B. Ask the patient to wiggle his toes.
C. Carefully move the patient's leg.
D. Touch the skin of the patient's foot. - CORRECT ANSWER B.
QUESTION :Which patient can safely receive only a focused physical examination
rather than a rapid trauma assessment?
A. 10-year-old male with a deformed right lower leg who is responsive after falling off his
bicycle.
B. 20-year-old female who complains of severe pain in her ankle after stepping off a
curb.
C. 70-year-old male who complains of neck pain after a medium-speed car collision.
D. 30-year-old male who is unresponsive but has only minor cuts on the extremities. -
CORRECT ANSWER B.
, QUESTION :You are using the OPQRST acronym to assess a responsive medical
patient. What question would you ask to assess the P component?
A. What were you doing when the pain started?
B. Can you describe the character of the pain for me?
C. What makes the pain feel worse or better?
D. On a scale of 1 to 10, how would you rte the pain? - CORRECT ANSWER C.
QUESTION :What is the first step in the physical assessment of an unresponsive
medical patient?
A. Perform the initial assessment.
B. Assess a complete set of vital signs.
C. Position the patient to protect the airway.
D. Obtain SAMPLE history from a family member. - CORRECT ANSWER A.
QUESTION :Which patient needs a detailed physical examination?
A. 48-year-old male with a history of heart disease who is complaining of chest pain.
B. 35-year-old female who has been in a single-car collision and who briefly lost
consciousness.
C. 28-year-old full-term pregnant female whose water has broken and who is having
contractions every two minutes.
D. 53-year-old female with a history of smoking who is distressed and short of breath. -
CORRECT ANSWER B.
QUESTION :Where is a detailed physical exam typically performed?
A. At the scene of the accident or injury.
B. In the hospital emergency department.
C. In the ambulance during transport.
D. In the triage area of the trauma center. - CORRECT ANSWER C.
QUESTION :The purpose of the ongoing assessment is to re-evaluate the patient's
condition and to:
A. Find any injuries missed during the initial assessment.
B. Reassure the patient that you are still caring for him or her.
C. Check the adequacy of each intervention performed.
D. Protect the EMT against liability from malpractice. - CORRECT ANSWER C.
QUESTION :Immediately after delivering a shock with an AED to a patient in cardiac
arrest, you should:
A. Check for a pulse.
B. Check breathing and provide rescue breaths as necessary.
C. Analyze with the AED and shock again if indicated.
D. Do CPR. - CORRECT ANSWER D.
QUESTION :You should apply an AED to:
A. Adult patients experiencing chest discomfort.
Study Guide, Practice Questions & Exam Review 2026-2027
This document is a comprehensive study resource for candidates preparing for the North
Carolina Office of Emergency Medical Services (NCOEMS) Certification Exam. It covers
essential EMS topics commonly tested on state credentialing examinations, including EMS
operations, patient assessment, airway management, respiration and ventilation, cardiovascular
emergencies, medical emergencies, traumatic injuries, and special patient populations. The guide
includes practice questions, answer explanations, clinical scenarios, and exam-focused review
material designed to strengthen critical-thinking skills and improve readiness for EMT, AEMT,
and Paramedic credentialing examinations. NCOEMS exams are developed from a job task
analysis and assess real-world EMS knowledge and decision-making across multiple domains.
EMTs should wear high-efficiency particulate air (HEPA) respirators when they are in
contact with patients who have which of the following?
A. HIV (Human Immunodeficiency Virus) or AIDS (Acquired Immune Deficiency
Syndrome)
B. Tuberculosis (TB)
C. Open Wounds
D. Hepatitis B - CORRECT ANSWER B.
QUESTION :You are called to assist a 60-year-old female complaining of a severe
headache. Upon entering the home, you smell a strong odor of natural gas. What is
your first action?
A. Check the patient's airway, breathing, and circulation.
B. Insert a nasopharyngeal airway and assess vital signs.
C. Remove the patient from the house to your ambulance.
D. Open all windows and determine the source of the gas leak. - CORRECT ANSWER
C.
QUESTION :The most common electrical rhythm disturbance that results in sudden
cardiac arrest is called:
A. Pulseless electrical activity
B. Ventricular Fibrillation
C. Ventricular Tachycardia
D. Asystole - CORRECT ANSWER B.
QUESTION :A non-trauma patient was pulseless and apneic. Assisted ventilation was
attempted, but unsuccessful. If the head is repositioned and a repeat ventilation is
unsuccessful, which of the following is the next most appropriate step?
A. Check for an airway obstruction.
B. Continue with chest compressions only.
C. Attempt ventilations using an alternative method.
,D. Continue to reposition the head until assisted ventilations are successful. -
CORRECT ANSWER A.
QUESTION :During the management of a cardiac arrest, the AED gives a 'no shock
advised' message. Which of the following conditions most likely prompted this
message?
A. The patient is in V tach.
B. The patient is hypothermic.
C. The patient is in V fib.
D. The patient's rhythm is asystole. - CORRECT ANSWER D.
QUESTION :ALS and EMS providers are preparing to hyperventilate a patient who has
a suspected brainstem herniation. As capnography becomes available, what should be
the target end-tidal carbon-dioxide level during hyperventilation?
A. 20-25 mmHg
B. 60-70 mmHg
C. 30-35 mmHg
D. 40-45 mmHg - CORRECT ANSWER C.
QUESTION :Which of the following is the highest priority patient?
A. 57-year-old male with chest pain and systolic blood pressure of 80.
B. 40-year-old female with moderate pain from a leg injury.
C. 75-year-old male who appears confused but responds to commands.
D. 25-year-old female in labor with contractions six minutes apart. - CORRECT
ANSWER A.
QUESTION :Of the following, which body fluid has the most potential to transmit blood-
borne diseases?
A. Nasal discharge
B. Vomitus
C. Amniotic fluid
D. Feces - CORRECT ANSWER C.
QUESTION :Your patient is an 11-month-old female. How can you determine if she has
a decreased mental status and is responsive to verbal stimuli?
A. She will be upset when you take her from her mother's arms.
B. She will be unable to tell you how old she is if you ask her.
C. She will attempt to locate her parents' voices when they speak.
D. She will try to pull away from a painful stimulus on her toe. - CORRECT ANSWER
C.
QUESTION :What is the best method to asses circulation in an infant?
A. Palpate the carotid pulse.
B. Palpate the brachial pulse.
C. Palpate the radial pulse.
D. Observe capillary refill time. - CORRECT ANSWER B.
, QUESTION :A 45-year-old male is experiencing chest discomfort. After placing him in
his position of comfort, your next action should be to:
A. Ventilate the patient with a nonrebreather mask at 15 L/min.
B. Ventilate the patient with the bag-valve mask at 15 L/min.
C. Administer oxygen by nonrebreather mask at 15 L/min.
D. Administer oxygen by the nasal cannula at 6 L/min. - CORRECT ANSWER C.
QUESTION :Which patient should receive a rapid trauma survey to determine hidden
injuries?
A. Alert 2-year-old child in a car seat who was in a medium-speed crash.
B. Alert 20-year-old male who fell ten feet and is complaining of leg pain.
C. Alert 65-year-old female who fell in the bathtub and is complaining of wrist pain.
D. Alert 11-year-old female who tripped while roller-skating and fell down three steps. -
CORRECT ANSWER A.
QUESTION :Which of the following is a sign of increased pressure in the circulatory
system?
A. Flat neck veins.
B. Palpable carotid pulse.
C. Distended jugular veins.
D. Decreased radial pulse - CORRECT ANSWER C.
QUESTION :An automated external defibrillator (AED) will shock which of the following
rhythms?
A. Sinus rhythm.
B. Asystole.
C. Ventricular fibrillation.
D. Pulseless electrical activity - CORRECT ANSWER C.
QUESTION :To assess the motor functions in the lower extremities of a responsive
patient, you would:
A. Ask the patient to bend his knees.
B. Ask the patient to wiggle his toes.
C. Carefully move the patient's leg.
D. Touch the skin of the patient's foot. - CORRECT ANSWER B.
QUESTION :Which patient can safely receive only a focused physical examination
rather than a rapid trauma assessment?
A. 10-year-old male with a deformed right lower leg who is responsive after falling off his
bicycle.
B. 20-year-old female who complains of severe pain in her ankle after stepping off a
curb.
C. 70-year-old male who complains of neck pain after a medium-speed car collision.
D. 30-year-old male who is unresponsive but has only minor cuts on the extremities. -
CORRECT ANSWER B.
, QUESTION :You are using the OPQRST acronym to assess a responsive medical
patient. What question would you ask to assess the P component?
A. What were you doing when the pain started?
B. Can you describe the character of the pain for me?
C. What makes the pain feel worse or better?
D. On a scale of 1 to 10, how would you rte the pain? - CORRECT ANSWER C.
QUESTION :What is the first step in the physical assessment of an unresponsive
medical patient?
A. Perform the initial assessment.
B. Assess a complete set of vital signs.
C. Position the patient to protect the airway.
D. Obtain SAMPLE history from a family member. - CORRECT ANSWER A.
QUESTION :Which patient needs a detailed physical examination?
A. 48-year-old male with a history of heart disease who is complaining of chest pain.
B. 35-year-old female who has been in a single-car collision and who briefly lost
consciousness.
C. 28-year-old full-term pregnant female whose water has broken and who is having
contractions every two minutes.
D. 53-year-old female with a history of smoking who is distressed and short of breath. -
CORRECT ANSWER B.
QUESTION :Where is a detailed physical exam typically performed?
A. At the scene of the accident or injury.
B. In the hospital emergency department.
C. In the ambulance during transport.
D. In the triage area of the trauma center. - CORRECT ANSWER C.
QUESTION :The purpose of the ongoing assessment is to re-evaluate the patient's
condition and to:
A. Find any injuries missed during the initial assessment.
B. Reassure the patient that you are still caring for him or her.
C. Check the adequacy of each intervention performed.
D. Protect the EMT against liability from malpractice. - CORRECT ANSWER C.
QUESTION :Immediately after delivering a shock with an AED to a patient in cardiac
arrest, you should:
A. Check for a pulse.
B. Check breathing and provide rescue breaths as necessary.
C. Analyze with the AED and shock again if indicated.
D. Do CPR. - CORRECT ANSWER D.
QUESTION :You should apply an AED to:
A. Adult patients experiencing chest discomfort.
