NYS EMT State Written Actual Exam
2026/2027 | Verified Questions
New York State Department of Health (NYSDOH) Bureau of
EMS | Verified Q&A | Professional Emergency Medical
Technician Candidates
100 Questions | 2026/2027 NYS EMT Written Certification Examination
Introduction
This 100-question original NYS EMT State Written Actual Exam 2026/2027 covers Airway, Respiration,
and Ventilation; Cardiology and Resuscitation; Trauma; and Medical, Obstetrics/Gynecology, and EMS
Operations, including NYS-specific protocol principles. The questions are designed to reinforce NYS
EMT certification objectives for actual exam readiness and clinical proficiency through evidence-based
prehospital assessment, treatment priorities, safety awareness, and patient-centred EMS operations.
Actual Questions
Domain: Airway, Respiration, and Ventilation
1. A responsive patient has gurgling respirations after vomiting. What should the EMT do
first?
A. Place the patient flat and wait for the gurgling to stop.
B. Give oral fluids to clear the throat.
C. Clear the airway with suction while maintaining appropriate airway positioning.
D. Insert an oropharyngeal airway immediately.
Correct Answer: C
Rationale: Gurgling suggests fluid in the airway and requires prompt airway clearance. Suction and
positioning address the immediate threat before other adjuncts or interventions are considered.
2. What suctioning approach best reduces interruption of oxygenation and airway
trauma?
A. Apply continuous suction for several minutes before reassessment.
B. Insert the catheter until resistance is felt and leave it in place.
C. Use suction only as needed, keep attempts brief, and reassess ventilation between attempts.
D. Suction every patient with shortness of breath.
Correct Answer: C
Rationale: Suction is used when secretions, blood, or emesis threaten the airway. Brief, purposeful
attempts with reassessment help preserve oxygenation and reduce trauma.
NYS EMT State Written Actual Exam 2026/2027 | Verified Questions
,3. When is an oropharyngeal airway most appropriate?
A. For a patient with an intact gag reflex who is vomiting.
B. For an unresponsive patient who has no gag reflex.
C. For every patient receiving oxygen by nasal cannula.
D. For an alert patient who can speak clearly.
Correct Answer: B
Rationale: An oropharyngeal airway is used for an unresponsive patient without a gag reflex. In a patient
with an intact gag reflex, it can provoke vomiting and worsen airway risk.
4. Which finding makes nasopharyngeal-airway placement a concern requiring caution or
an alternative airway plan?
A. A patient who is breathing through the mouth.
B. A patient who is seated upright.
C. Suspected basilar skull injury or significant facial trauma.
D. A patient with a normal gag reflex only.
Correct Answer: C
Rationale: Significant facial trauma or suspected basilar skull injury can make a nasopharyngeal airway
inappropriate. Airway-adjunct selection must reflect the patient's injuries and clinical condition.
5. How should an EMT judge whether a bag-valve-mask ventilation is effective?
A. Deliver breaths as rapidly as possible.
B. Observe for gentle visible chest rise without excessive force.
C. Use the largest bag available regardless of patient size.
D. Ventilate until the abdomen becomes distended.
Correct Answer: B
Rationale: Effective positive-pressure ventilation produces gentle visible chest rise. Excessive force or
speed can cause gastric inflation and impair ventilation.
6. For an uninjured adult who needs airway opening, which maneuver is generally
appropriate?
A. Traction on the tongue.
B. Abdominal thrusts.
C. Head-tilt chin-lift.
D. Blind finger sweep.
Correct Answer: C
Rationale: For an adult without concern for spinal trauma, head-tilt chin-lift is the standard basic
maneuver to open the airway. Other maneuvers are used only for specific indications.
7. How should an EMT position an infant's airway for ventilation?
A. Turn the head fully to one side during every ventilation.
B. Extend the head as far back as possible.
C. Maintain a neutral or slightly sniffing position and avoid excessive head extension.
D. Place a thick pad under the head only.
Correct Answer: C
Rationale: An infant's airway is easily obstructed by overextension. A neutral or slight sniffing position
supports airway patency while avoiding excessive head movement.
NYS EMT State Written Actual Exam 2026/2027 | Verified Questions
, 8. An uninjured patient is breathing adequately after a brief episode of vomiting but
remains drowsy. Which position can help protect the airway?
A. A standing position without support.
B. A lateral recovery position when no contraindication is present.
C. A prone position with the face downward.
D. A flat position with the head lower than the feet.
Correct Answer: B
Rationale: A lateral recovery position can help drain secretions and reduce aspiration risk in a
spontaneously breathing patient without a contraindication. Ongoing airway and breathing
reassessment remains necessary.
9. Why can pulse-oximeter readings be unreliable in a poorly perfused patient?
A. It always reads high after oxygen is applied.
B. It replaces respiratory assessment.
C. The device measures only blood pressure.
D. Poor peripheral blood flow can interfere with the device's ability to obtain an accurate signal.
Correct Answer: D
Rationale: Pulse oximetry is a useful adjunct, but poor perfusion, motion, and other factors can impair the
signal. The EMT must integrate the reading with respiratory effort, mental status, skin signs, and overall
assessment.
10. What does cyanosis generally indicate in a patient with respiratory compromise?
A. A finding that proves a patient has a fever.
B. A reason to withhold oxygen.
C. A reliable early sign that breathing is normal.
D. A potentially late sign of inadequate oxygenation requiring urgent assessment and support.
Correct Answer: D
Rationale: Cyanosis may be a late and concerning sign of inadequate oxygenation. Airway, breathing,
ventilation, and perfusion require immediate attention.
11. Which breath-sound pattern is commonly associated with lower-airway narrowing
such as bronchospasm?
A. Gurgling caused by fluid in the upper airway.
B. Wheezing with prolonged exhalation.
C. Absent speech with no respiratory effort.
D. High-pitched stridor only on inspiration.
Correct Answer: B
Rationale: Wheezing and prolonged exhalation suggest lower-airway narrowing. The EMT assesses work
of breathing, oxygenation, response to care, and the need for additional resources.
12. A patient with chronic obstructive lung disease is in obvious respiratory distress and
appears hypoxemic. What is the most appropriate oxygen principle?
A. Provide oxygen as indicated and reassess rather than withholding needed oxygen because of the
diagnosis.
B. Withhold oxygen from every patient with chronic lung disease.
C. Use only room air until cyanosis resolves.
D. Give oral medication before assessing breathing.
Correct Answer: A
Rationale: A chronic lung diagnosis is not a reason to withhold needed oxygen. Oxygen delivery and
ventilation support should follow patient condition, protocol, and ongoing reassessment.
NYS EMT State Written Actual Exam 2026/2027 | Verified Questions
2026/2027 | Verified Questions
New York State Department of Health (NYSDOH) Bureau of
EMS | Verified Q&A | Professional Emergency Medical
Technician Candidates
100 Questions | 2026/2027 NYS EMT Written Certification Examination
Introduction
This 100-question original NYS EMT State Written Actual Exam 2026/2027 covers Airway, Respiration,
and Ventilation; Cardiology and Resuscitation; Trauma; and Medical, Obstetrics/Gynecology, and EMS
Operations, including NYS-specific protocol principles. The questions are designed to reinforce NYS
EMT certification objectives for actual exam readiness and clinical proficiency through evidence-based
prehospital assessment, treatment priorities, safety awareness, and patient-centred EMS operations.
Actual Questions
Domain: Airway, Respiration, and Ventilation
1. A responsive patient has gurgling respirations after vomiting. What should the EMT do
first?
A. Place the patient flat and wait for the gurgling to stop.
B. Give oral fluids to clear the throat.
C. Clear the airway with suction while maintaining appropriate airway positioning.
D. Insert an oropharyngeal airway immediately.
Correct Answer: C
Rationale: Gurgling suggests fluid in the airway and requires prompt airway clearance. Suction and
positioning address the immediate threat before other adjuncts or interventions are considered.
2. What suctioning approach best reduces interruption of oxygenation and airway
trauma?
A. Apply continuous suction for several minutes before reassessment.
B. Insert the catheter until resistance is felt and leave it in place.
C. Use suction only as needed, keep attempts brief, and reassess ventilation between attempts.
D. Suction every patient with shortness of breath.
Correct Answer: C
Rationale: Suction is used when secretions, blood, or emesis threaten the airway. Brief, purposeful
attempts with reassessment help preserve oxygenation and reduce trauma.
NYS EMT State Written Actual Exam 2026/2027 | Verified Questions
,3. When is an oropharyngeal airway most appropriate?
A. For a patient with an intact gag reflex who is vomiting.
B. For an unresponsive patient who has no gag reflex.
C. For every patient receiving oxygen by nasal cannula.
D. For an alert patient who can speak clearly.
Correct Answer: B
Rationale: An oropharyngeal airway is used for an unresponsive patient without a gag reflex. In a patient
with an intact gag reflex, it can provoke vomiting and worsen airway risk.
4. Which finding makes nasopharyngeal-airway placement a concern requiring caution or
an alternative airway plan?
A. A patient who is breathing through the mouth.
B. A patient who is seated upright.
C. Suspected basilar skull injury or significant facial trauma.
D. A patient with a normal gag reflex only.
Correct Answer: C
Rationale: Significant facial trauma or suspected basilar skull injury can make a nasopharyngeal airway
inappropriate. Airway-adjunct selection must reflect the patient's injuries and clinical condition.
5. How should an EMT judge whether a bag-valve-mask ventilation is effective?
A. Deliver breaths as rapidly as possible.
B. Observe for gentle visible chest rise without excessive force.
C. Use the largest bag available regardless of patient size.
D. Ventilate until the abdomen becomes distended.
Correct Answer: B
Rationale: Effective positive-pressure ventilation produces gentle visible chest rise. Excessive force or
speed can cause gastric inflation and impair ventilation.
6. For an uninjured adult who needs airway opening, which maneuver is generally
appropriate?
A. Traction on the tongue.
B. Abdominal thrusts.
C. Head-tilt chin-lift.
D. Blind finger sweep.
Correct Answer: C
Rationale: For an adult without concern for spinal trauma, head-tilt chin-lift is the standard basic
maneuver to open the airway. Other maneuvers are used only for specific indications.
7. How should an EMT position an infant's airway for ventilation?
A. Turn the head fully to one side during every ventilation.
B. Extend the head as far back as possible.
C. Maintain a neutral or slightly sniffing position and avoid excessive head extension.
D. Place a thick pad under the head only.
Correct Answer: C
Rationale: An infant's airway is easily obstructed by overextension. A neutral or slight sniffing position
supports airway patency while avoiding excessive head movement.
NYS EMT State Written Actual Exam 2026/2027 | Verified Questions
, 8. An uninjured patient is breathing adequately after a brief episode of vomiting but
remains drowsy. Which position can help protect the airway?
A. A standing position without support.
B. A lateral recovery position when no contraindication is present.
C. A prone position with the face downward.
D. A flat position with the head lower than the feet.
Correct Answer: B
Rationale: A lateral recovery position can help drain secretions and reduce aspiration risk in a
spontaneously breathing patient without a contraindication. Ongoing airway and breathing
reassessment remains necessary.
9. Why can pulse-oximeter readings be unreliable in a poorly perfused patient?
A. It always reads high after oxygen is applied.
B. It replaces respiratory assessment.
C. The device measures only blood pressure.
D. Poor peripheral blood flow can interfere with the device's ability to obtain an accurate signal.
Correct Answer: D
Rationale: Pulse oximetry is a useful adjunct, but poor perfusion, motion, and other factors can impair the
signal. The EMT must integrate the reading with respiratory effort, mental status, skin signs, and overall
assessment.
10. What does cyanosis generally indicate in a patient with respiratory compromise?
A. A finding that proves a patient has a fever.
B. A reason to withhold oxygen.
C. A reliable early sign that breathing is normal.
D. A potentially late sign of inadequate oxygenation requiring urgent assessment and support.
Correct Answer: D
Rationale: Cyanosis may be a late and concerning sign of inadequate oxygenation. Airway, breathing,
ventilation, and perfusion require immediate attention.
11. Which breath-sound pattern is commonly associated with lower-airway narrowing
such as bronchospasm?
A. Gurgling caused by fluid in the upper airway.
B. Wheezing with prolonged exhalation.
C. Absent speech with no respiratory effort.
D. High-pitched stridor only on inspiration.
Correct Answer: B
Rationale: Wheezing and prolonged exhalation suggest lower-airway narrowing. The EMT assesses work
of breathing, oxygenation, response to care, and the need for additional resources.
12. A patient with chronic obstructive lung disease is in obvious respiratory distress and
appears hypoxemic. What is the most appropriate oxygen principle?
A. Provide oxygen as indicated and reassess rather than withholding needed oxygen because of the
diagnosis.
B. Withhold oxygen from every patient with chronic lung disease.
C. Use only room air until cyanosis resolves.
D. Give oral medication before assessing breathing.
Correct Answer: A
Rationale: A chronic lung diagnosis is not a reason to withhold needed oxygen. Oxygen delivery and
ventilation support should follow patient condition, protocol, and ongoing reassessment.
NYS EMT State Written Actual Exam 2026/2027 | Verified Questions
