EMT Block 5 Exam (PDF) | 2026 Medical Emergencies
1. A 65-year-old patient reports substernal chest pressure that started 30 minutes ago. The
pain radiates to the left arm and is accompanied by diaphoresis and nausea. The patient has a
history of hypertension. What should the EMT suspect?
A) Aortic dissection
B) Acute coronary syndrome
C) Pulmonary embolism
D) Esophageal rupture
Correct Answer: B
Rationale: Substernal pressure, diaphoresis, nausea, and radiation to the left arm are classic
signs of acute coronary syndrome. Immediate transport and aspirin administration (if no
contraindications) are indicated.
2. A patient with a history of atrial fibrillation suddenly develops right-sided weakness and
slurred speech. The EMT should suspect:
A) Hypoglycemia
B) Embolic stroke
C) Migraine headache
D) Bell's palsy
,Correct Answer: B
Rationale: Atrial fibrillation can cause clots to form in the heart, which can embolize to the
brain, causing an ischemic stroke. Right-sided weakness and slurred speech are classic signs.
3. A patient who is allergic to peanuts is stung by a bee and develops hives, wheezing, and
swelling of the lips and tongue. Blood pressure is 82/50 mm Hg. The priority medication is:
A) Diphenhydramine
B) Epinephrine
C) Albuterol
D) Prednisone
Correct Answer: B
Rationale: Epinephrine is the first-line treatment for anaphylaxis and should be administered
intramuscularly into the lateral thigh. It reverses bronchoconstriction, vasodilation, and
angioedema.
4. A 22-year-old patient is found unresponsive with a known history of type 1 diabetes. The
patient has cool, clammy skin and a blood glucose reading of 38 mg/dL. The EMT should first:
A) Administer oral glucose
B) Administer glucagon or IV dextrose per protocol
C) Initiate CPR
D) Apply high-flow oxygen only
Correct Answer: B
Rationale: The patient is hypoglycemic and unresponsive. Oral glucose is contraindicated due to
the risk of aspiration. Glucagon IM or IV dextrose (if ALS available) should be administered.
5. A patient with a history of COPD presents with increased shortness of breath, a productive
cough with green sputum, and a fever of 101.5°F. The EMT should suspect:
A) Pulmonary embolism
B) COPD exacerbation with possible infection
C) Spontaneous pneumothorax
D) Congestive heart failure
Correct Answer: B
Rationale: Fever, purulent sputum, and worsening dyspnea suggest a respiratory infection
triggering a COPD exacerbation.
6. A 45-year-old female with a history of gallstones complains of severe right upper quadrant
abdominal pain after eating a fatty meal. The pain radiates to her right shoulder. The EMT
should suspect:
A) Acute pancreatitis
,B) Cholecystitis
C) Appendicitis
D) Kidney stones
Correct Answer: B
Rationale: Postprandial RUQ pain radiating to the right shoulder is classic for acute cholecystitis
(gallbladder inflammation).
7. A patient is found sitting in a chair, leaning forward, drooling, and making a high-pitched
inspiratory sound. The patient has a fever of 103°F and refuses to lie down. The EMT should:
A) Perform a throat exam with a tongue depressor
B) Keep the patient calm, do not examine the throat, and transport
C) Encourage the patient to drink cold water
D) Perform abdominal thrusts
Correct Answer: B
Rationale: The classic presentation of epiglottitis includes drooling, stridor, tripod positioning,
and fever. Do not examine the throat as it may trigger laryngospasm. Keep the patient calm and
transport.
8. A 30-year-old patient is hyperventilating after an argument. The patient complains of
tingling around the mouth and fingers and carpopedal spasms. The EMT should:
A) Administer high-flow oxygen
B) Have the patient breathe into a paper bag
C) Calmly reassure the patient and coach them to slow their breathing
D) Administer a sedative
Correct Answer: C
Rationale: Hyperventilation syndrome leads to respiratory alkalosis and hypocalcemic
symptoms. Reassurance and coaching to slow breathing resolve the symptoms. Paper bag
rebreathing is no longer recommended.
9. A 58-year-old patient with a history of diabetes is found unresponsive. The EMT notes
rapid, deep respirations (Kussmaul), warm dry skin, and a fruity breath odor. Blood glucose
reads "HIGH." The EMT should suspect:
A) Hypoglycemia
B) Diabetic ketoacidosis (DKA)
C) Hyperosmolar hyperglycemic state (HHS)
D) Alcohol intoxication
Correct Answer: B
Rationale: Kussmaul respirations, fruity breath (acetone), and hyperglycemia indicate DKA,
, more common in type 1 diabetes. HHS typically does not produce Kussmaul breathing or
ketosis.
10. A patient who is 36 weeks pregnant reports a severe headache, visual disturbances, and
has significant swelling of the face and hands. Blood pressure is 160/110 mm Hg. The EMT
should suspect:
A) Gestational diabetes
B) Preeclampsia
C) Placenta previa
D) Normal pregnancy
Correct Answer: B
Rationale: Hypertension, headache, visual changes, and edema in a pregnant patient are signs
of preeclampsia, which can progress to eclampsia (seizures). Transport with left lateral
positioning.
11. A patient with a history of deep vein thrombosis develops sudden onset of dyspnea and
sharp, pleuritic chest pain. The patient is tachycardic and has an SpO2 of 88%. The EMT
should suspect:
A) Myocardial infarction
B) Pulmonary embolism
C) Tension pneumothorax
D) Asthma exacerbation
Correct Answer: B
Rationale: Sudden dyspnea and pleuritic chest pain in a patient with DVT risk factors is classic
for pulmonary embolism.
12. A 70-year-old patient complains of a sudden, severe headache described as "the worst of
my life," followed by nausea, vomiting, and neck stiffness. The patient is confused. The EMT
should suspect:
A) Migraine headache
B) Subarachnoid hemorrhage
C) Meningitis
D) Tension headache
Correct Answer: B
Rationale: A thunderclap headache with nuchal rigidity and altered mental status suggests a
ruptured cerebral aneurysm causing subarachnoid hemorrhage.
13. A patient with a known seizure disorder is actively seizing. The EMT should:
A) Insert a bite block between the teeth
1. A 65-year-old patient reports substernal chest pressure that started 30 minutes ago. The
pain radiates to the left arm and is accompanied by diaphoresis and nausea. The patient has a
history of hypertension. What should the EMT suspect?
A) Aortic dissection
B) Acute coronary syndrome
C) Pulmonary embolism
D) Esophageal rupture
Correct Answer: B
Rationale: Substernal pressure, diaphoresis, nausea, and radiation to the left arm are classic
signs of acute coronary syndrome. Immediate transport and aspirin administration (if no
contraindications) are indicated.
2. A patient with a history of atrial fibrillation suddenly develops right-sided weakness and
slurred speech. The EMT should suspect:
A) Hypoglycemia
B) Embolic stroke
C) Migraine headache
D) Bell's palsy
,Correct Answer: B
Rationale: Atrial fibrillation can cause clots to form in the heart, which can embolize to the
brain, causing an ischemic stroke. Right-sided weakness and slurred speech are classic signs.
3. A patient who is allergic to peanuts is stung by a bee and develops hives, wheezing, and
swelling of the lips and tongue. Blood pressure is 82/50 mm Hg. The priority medication is:
A) Diphenhydramine
B) Epinephrine
C) Albuterol
D) Prednisone
Correct Answer: B
Rationale: Epinephrine is the first-line treatment for anaphylaxis and should be administered
intramuscularly into the lateral thigh. It reverses bronchoconstriction, vasodilation, and
angioedema.
4. A 22-year-old patient is found unresponsive with a known history of type 1 diabetes. The
patient has cool, clammy skin and a blood glucose reading of 38 mg/dL. The EMT should first:
A) Administer oral glucose
B) Administer glucagon or IV dextrose per protocol
C) Initiate CPR
D) Apply high-flow oxygen only
Correct Answer: B
Rationale: The patient is hypoglycemic and unresponsive. Oral glucose is contraindicated due to
the risk of aspiration. Glucagon IM or IV dextrose (if ALS available) should be administered.
5. A patient with a history of COPD presents with increased shortness of breath, a productive
cough with green sputum, and a fever of 101.5°F. The EMT should suspect:
A) Pulmonary embolism
B) COPD exacerbation with possible infection
C) Spontaneous pneumothorax
D) Congestive heart failure
Correct Answer: B
Rationale: Fever, purulent sputum, and worsening dyspnea suggest a respiratory infection
triggering a COPD exacerbation.
6. A 45-year-old female with a history of gallstones complains of severe right upper quadrant
abdominal pain after eating a fatty meal. The pain radiates to her right shoulder. The EMT
should suspect:
A) Acute pancreatitis
,B) Cholecystitis
C) Appendicitis
D) Kidney stones
Correct Answer: B
Rationale: Postprandial RUQ pain radiating to the right shoulder is classic for acute cholecystitis
(gallbladder inflammation).
7. A patient is found sitting in a chair, leaning forward, drooling, and making a high-pitched
inspiratory sound. The patient has a fever of 103°F and refuses to lie down. The EMT should:
A) Perform a throat exam with a tongue depressor
B) Keep the patient calm, do not examine the throat, and transport
C) Encourage the patient to drink cold water
D) Perform abdominal thrusts
Correct Answer: B
Rationale: The classic presentation of epiglottitis includes drooling, stridor, tripod positioning,
and fever. Do not examine the throat as it may trigger laryngospasm. Keep the patient calm and
transport.
8. A 30-year-old patient is hyperventilating after an argument. The patient complains of
tingling around the mouth and fingers and carpopedal spasms. The EMT should:
A) Administer high-flow oxygen
B) Have the patient breathe into a paper bag
C) Calmly reassure the patient and coach them to slow their breathing
D) Administer a sedative
Correct Answer: C
Rationale: Hyperventilation syndrome leads to respiratory alkalosis and hypocalcemic
symptoms. Reassurance and coaching to slow breathing resolve the symptoms. Paper bag
rebreathing is no longer recommended.
9. A 58-year-old patient with a history of diabetes is found unresponsive. The EMT notes
rapid, deep respirations (Kussmaul), warm dry skin, and a fruity breath odor. Blood glucose
reads "HIGH." The EMT should suspect:
A) Hypoglycemia
B) Diabetic ketoacidosis (DKA)
C) Hyperosmolar hyperglycemic state (HHS)
D) Alcohol intoxication
Correct Answer: B
Rationale: Kussmaul respirations, fruity breath (acetone), and hyperglycemia indicate DKA,
, more common in type 1 diabetes. HHS typically does not produce Kussmaul breathing or
ketosis.
10. A patient who is 36 weeks pregnant reports a severe headache, visual disturbances, and
has significant swelling of the face and hands. Blood pressure is 160/110 mm Hg. The EMT
should suspect:
A) Gestational diabetes
B) Preeclampsia
C) Placenta previa
D) Normal pregnancy
Correct Answer: B
Rationale: Hypertension, headache, visual changes, and edema in a pregnant patient are signs
of preeclampsia, which can progress to eclampsia (seizures). Transport with left lateral
positioning.
11. A patient with a history of deep vein thrombosis develops sudden onset of dyspnea and
sharp, pleuritic chest pain. The patient is tachycardic and has an SpO2 of 88%. The EMT
should suspect:
A) Myocardial infarction
B) Pulmonary embolism
C) Tension pneumothorax
D) Asthma exacerbation
Correct Answer: B
Rationale: Sudden dyspnea and pleuritic chest pain in a patient with DVT risk factors is classic
for pulmonary embolism.
12. A 70-year-old patient complains of a sudden, severe headache described as "the worst of
my life," followed by nausea, vomiting, and neck stiffness. The patient is confused. The EMT
should suspect:
A) Migraine headache
B) Subarachnoid hemorrhage
C) Meningitis
D) Tension headache
Correct Answer: B
Rationale: A thunderclap headache with nuchal rigidity and altered mental status suggests a
ruptured cerebral aneurysm causing subarachnoid hemorrhage.
13. A patient with a known seizure disorder is actively seizing. The EMT should:
A) Insert a bite block between the teeth
