EMT Block 4 Exam (PDF) | 2026 Patient Assessment
1. The scene size-up is the first step in the assessment process. Which of the following is NOT
a component of the scene size-up?
A) Evaluating scene safety
B) Determining the mechanism of injury or nature of illness
C) Obtaining a SAMPLE history from the patient
D) Identifying the number of patients
Correct Answer: C
Rationale: The scene size-up includes safety, MOI/NOI, number of patients, and the need for
additional resources. The SAMPLE history is obtained later during history taking.
2. Upon arrival at a motor vehicle crash, the EMT notices a strong smell of gasoline and a
downed power line across the vehicle. The EMT should:
A) Immediately approach the vehicle to assess patients
B) Park at a safe distance, request the power company and fire department, and do not
approach until the scene is safe
C) Carefully move the power line with a wooden broom
D) Instruct the patients to exit the vehicle immediately
,Correct Answer: B
Rationale: Scene safety is the highest priority. The EMT must not enter an unsafe scene.
Specialized resources are required to mitigate hazards.
3. A patient who is awake, alert, and oriented to person, place, time, and event is rated on the
AVPU scale as:
A) V
B) P
C) A
D) U
Correct Answer: C
Rationale: "A" stands for Alert. The patient is fully awake and oriented.
4. During the primary assessment of a medical patient, the EMT should form a general
impression based on:
A) Vital signs and ECG
B) The patient's overall appearance, level of consciousness, and any obvious life threats
C) The patient's past medical history
D) A detailed head-to-toe physical exam
Correct Answer: B
Rationale: The general impression is a rapid visual and auditory assessment to determine if the
patient is sick or not sick, including LOC and obvious distress.
5. The mnemonic XABC is used in trauma to prioritize care. The "X" stands for:
A) X-ray the cervical spine
B) Exsanguinating hemorrhage control
C) Examine the pupils
D) Extended transport decision
Correct Answer: B
Rationale: In the XABC (or MARCH) approach, control of life-threatening external hemorrhage
takes priority before airway and breathing.
6. A patient who is breathing at 6 breaths per minute with cyanosis requires:
A) High-flow oxygen by non-rebreather mask
B) Immediate positive pressure ventilation with a bag-valve mask
C) Nasal cannula at 2 L/min
D) Observation and reassessment in 5 minutes
,Correct Answer: B
Rationale: A rate that is too slow and accompanied by cyanosis indicates inadequate ventilation.
Positive pressure ventilation is required.
7. Which of the following is a sign of inadequate breathing?
A) Respiratory rate of 16 breaths/min
B) Clear, equal breath sounds
C) Accessory muscle use and shallow chest rise
D) Pink, warm skin
Correct Answer: C
Rationale: Accessory muscle use and shallow tidal volume indicate increased work of breathing
and risk of respiratory failure.
8. The first step in managing a patient's airway is to:
A) Insert an oropharyngeal airway
B) Open the airway using the appropriate maneuver (head-tilt, chin-lift or jaw-thrust)
C) Suction the airway for 30 seconds
D) Apply a non-rebreather mask
Correct Answer: B
Rationale: The airway must be opened manually first. Adjuncts and suctioning follow if needed.
9. A patient who responds to a loud verbal stimulus by opening their eyes and making a
sound but does not answer questions is rated on AVPU as:
A) A
B) V
C) P
D) U
Correct Answer: B
Rationale: The patient is responding to Verbal stimuli.
10. The "C" in the ABCs of the primary assessment includes all of the following EXCEPT:
A) Checking for major bleeding
B) Assessing pulse presence and quality
C) Evaluating skin color, temperature, and moisture
D) Checking blood glucose
Correct Answer: D
Rationale: Circulation assessment includes bleeding control, pulse, and skin signs. Blood glucose
is part of the secondary assessment or history.
, 11. A radial pulse is typically palpated when the systolic blood pressure is at least:
A) 60 mm Hg
B) 80 mm Hg
C) 90 mm Hg
D) 100 mm Hg
Correct Answer: B
Rationale: The radial pulse generally disappears when systolic pressure falls below 80 mm Hg.
12. In a patient with dark skin, pallor is best assessed by examining the:
A) Nail beds
B) Palms and soles
C) Oral mucous membranes and conjunctivae
D) Hair
Correct Answer: C
Rationale: Mucous membranes and conjunctivae are less pigmented and provide a more
accurate assessment of pallor and cyanosis.
13. Which of the following findings during the primary assessment would make a patient a
high priority for immediate transport?
A) A minor laceration with controlled bleeding
B) An isolated ankle fracture with good distal pulses
C) Altered mental status and a systolic blood pressure of 80 mm Hg
D) A patient with a cold and sore throat
Correct Answer: C
Rationale: Altered mental status and hypotension indicate shock, which is an immediate life
threat.
14. The SAMPLE history component "P" stands for:
A) Pain assessment
B) Past medical history
C) Pulse rate
D) Pertinent negatives
Correct Answer: B
Rationale: Past medical history includes significant illnesses, surgeries, and chronic conditions.
15. The "E" in SAMPLE stands for:
A) Examination findings
B) Events leading to the illness or injury
1. The scene size-up is the first step in the assessment process. Which of the following is NOT
a component of the scene size-up?
A) Evaluating scene safety
B) Determining the mechanism of injury or nature of illness
C) Obtaining a SAMPLE history from the patient
D) Identifying the number of patients
Correct Answer: C
Rationale: The scene size-up includes safety, MOI/NOI, number of patients, and the need for
additional resources. The SAMPLE history is obtained later during history taking.
2. Upon arrival at a motor vehicle crash, the EMT notices a strong smell of gasoline and a
downed power line across the vehicle. The EMT should:
A) Immediately approach the vehicle to assess patients
B) Park at a safe distance, request the power company and fire department, and do not
approach until the scene is safe
C) Carefully move the power line with a wooden broom
D) Instruct the patients to exit the vehicle immediately
,Correct Answer: B
Rationale: Scene safety is the highest priority. The EMT must not enter an unsafe scene.
Specialized resources are required to mitigate hazards.
3. A patient who is awake, alert, and oriented to person, place, time, and event is rated on the
AVPU scale as:
A) V
B) P
C) A
D) U
Correct Answer: C
Rationale: "A" stands for Alert. The patient is fully awake and oriented.
4. During the primary assessment of a medical patient, the EMT should form a general
impression based on:
A) Vital signs and ECG
B) The patient's overall appearance, level of consciousness, and any obvious life threats
C) The patient's past medical history
D) A detailed head-to-toe physical exam
Correct Answer: B
Rationale: The general impression is a rapid visual and auditory assessment to determine if the
patient is sick or not sick, including LOC and obvious distress.
5. The mnemonic XABC is used in trauma to prioritize care. The "X" stands for:
A) X-ray the cervical spine
B) Exsanguinating hemorrhage control
C) Examine the pupils
D) Extended transport decision
Correct Answer: B
Rationale: In the XABC (or MARCH) approach, control of life-threatening external hemorrhage
takes priority before airway and breathing.
6. A patient who is breathing at 6 breaths per minute with cyanosis requires:
A) High-flow oxygen by non-rebreather mask
B) Immediate positive pressure ventilation with a bag-valve mask
C) Nasal cannula at 2 L/min
D) Observation and reassessment in 5 minutes
,Correct Answer: B
Rationale: A rate that is too slow and accompanied by cyanosis indicates inadequate ventilation.
Positive pressure ventilation is required.
7. Which of the following is a sign of inadequate breathing?
A) Respiratory rate of 16 breaths/min
B) Clear, equal breath sounds
C) Accessory muscle use and shallow chest rise
D) Pink, warm skin
Correct Answer: C
Rationale: Accessory muscle use and shallow tidal volume indicate increased work of breathing
and risk of respiratory failure.
8. The first step in managing a patient's airway is to:
A) Insert an oropharyngeal airway
B) Open the airway using the appropriate maneuver (head-tilt, chin-lift or jaw-thrust)
C) Suction the airway for 30 seconds
D) Apply a non-rebreather mask
Correct Answer: B
Rationale: The airway must be opened manually first. Adjuncts and suctioning follow if needed.
9. A patient who responds to a loud verbal stimulus by opening their eyes and making a
sound but does not answer questions is rated on AVPU as:
A) A
B) V
C) P
D) U
Correct Answer: B
Rationale: The patient is responding to Verbal stimuli.
10. The "C" in the ABCs of the primary assessment includes all of the following EXCEPT:
A) Checking for major bleeding
B) Assessing pulse presence and quality
C) Evaluating skin color, temperature, and moisture
D) Checking blood glucose
Correct Answer: D
Rationale: Circulation assessment includes bleeding control, pulse, and skin signs. Blood glucose
is part of the secondary assessment or history.
, 11. A radial pulse is typically palpated when the systolic blood pressure is at least:
A) 60 mm Hg
B) 80 mm Hg
C) 90 mm Hg
D) 100 mm Hg
Correct Answer: B
Rationale: The radial pulse generally disappears when systolic pressure falls below 80 mm Hg.
12. In a patient with dark skin, pallor is best assessed by examining the:
A) Nail beds
B) Palms and soles
C) Oral mucous membranes and conjunctivae
D) Hair
Correct Answer: C
Rationale: Mucous membranes and conjunctivae are less pigmented and provide a more
accurate assessment of pallor and cyanosis.
13. Which of the following findings during the primary assessment would make a patient a
high priority for immediate transport?
A) A minor laceration with controlled bleeding
B) An isolated ankle fracture with good distal pulses
C) Altered mental status and a systolic blood pressure of 80 mm Hg
D) A patient with a cold and sore throat
Correct Answer: C
Rationale: Altered mental status and hypotension indicate shock, which is an immediate life
threat.
14. The SAMPLE history component "P" stands for:
A) Pain assessment
B) Past medical history
C) Pulse rate
D) Pertinent negatives
Correct Answer: B
Rationale: Past medical history includes significant illnesses, surgeries, and chronic conditions.
15. The "E" in SAMPLE stands for:
A) Examination findings
B) Events leading to the illness or injury
