EMT-I/85 – Emergency Medical Technician
Intermediate/85 Master Certification Review Updated
2026 | 500+ Practice Questions & Verified Answers |
Complete Intermediate EMS Exam Study Guide,
Emergency Medical Technician Test Bank, Airway &
Ventilation, Trauma Assessment, Cardiology, Medical
Emergencies, IV Therapy, Emergency Pharmacology,
Pediatric & Obstetric Care, EMS Operations, Case-
Based Learning, Detailed Rationales
Question 1: A 45-year-old male is found unresponsive with a respiratory rate
of 6 breaths per minute and shallow effort. His SpO2 is 82% on room air. After
opening the airway and suctioning, what is the MOST appropriate immediate
action?
A. Assist ventilations with a bag-valve-mask and 100% oxygen
B. Insert a nasopharyngeal airway and administer oxygen via non-rebreather mask
C. Perform a head-tilt chin-lift and administer oxygen via nasal cannula at 6 L/min
D. Apply a continuous positive airway pressure (CPAP) device at 10 cm H2O
CORRECT ANSWER: A. Assist ventilations with a bag-valve-mask and 100%
oxygen
Rationale: The patient has profound bradypnea and hypoxia, indicating respiratory
failure. The immediate priority is to support ventilations with a BVM and high-flow
oxygen. A non-rebreather or nasal cannula would not provide adequate ventilatory
support for a patient with a respiratory rate of 6. CPAP requires spontaneous breathing
effort and is contraindicated in apnea or severe hypoventilation.
Question 2: Which of the following ECG findings is MOST consistent with an
acute anteroseptal myocardial infarction?
A. ST-segment elevation in leads II, III, and aVF
B. ST-segment elevation in leads V1, V2, V3, and V4
C. ST-segment depression in leads I and aVL
D. Deep Q waves in leads II, III, and aVF
CORRECT ANSWER: B. ST-segment elevation in leads V1, V2, V3, and V4
Rationale: Leads V1 through V4 represent the anterior and septal walls of the left
ventricle. ST-segment elevation in these leads is diagnostic of an anteroseptal STEMI.
Leads II, III, and aVF indicate an inferior wall MI. ST depression in I and aVL can
suggest reciprocal changes in a lateral MI.
Question 3: An EMT-I/85 is assessing a patient with chest pain. The patient
describes the pain as a "sharp" sensation that worsens with inspiration. Which
of the following conditions is MOST likely?
,A. Acute coronary syndrome
B. Pericarditis
C. Aortic dissection
D. Pulmonary embolism
CORRECT ANSWER: B. Pericarditis
Rationale: Pericarditis classically presents with sharp, pleuritic chest pain that worsens
with inspiration and is often relieved by leaning forward. While pulmonary embolism
can also cause pleuritic pain, the classic positional relief points more specifically to
pericarditis. ACS pain is typically pressure-like and not positional, while aortic dissection
presents with tearing pain.
Question 4: Which of the following is a PRIMARY indication for the
administration of activated charcoal in the prehospital setting?
A. Ingestion of a caustic acid
B. Ingestion of a petroleum-based hydrocarbon
C. Ingestion of a tricyclic antidepressant within 1 hour
D. Altered mental status with a gag reflex present
CORRECT ANSWER: C. Ingestion of a tricyclic antidepressant within 1 hour
Rationale: Activated charcoal is indicated for the adsorption of certain toxins, including
tricyclic antidepressants, if the patient presents within 1 to 2 hours of ingestion and has
a protected airway. It is contraindicated in caustic and hydrocarbon ingestions due to
the risk of aspiration and worsening injury. Altered mental status is a contraindication
without airway protection.
Question 5: In a patient with suspected tension pneumothorax, which of the
following physical exam findings is MOST specific?
A. Contralateral tracheal deviation
B. Tachycardia and hypertension
C. Bilateral crackles on auscultation
D. Jugular venous distention that is positional
CORRECT ANSWER: A. Contralateral tracheal deviation
Rationale: Tracheal deviation away from the affected side is a late but highly specific
sign of tension pneumothorax, indicating significant mediastinal shift. This is a critical
finding that necessitates immediate needle decompression. Hypertension is not typical;
hypotension is more common. Crackles are more associated with pulmonary edema.
Question 6: A 32-year-old female is experiencing a severe asthma attack. She
is tachypneic, using accessory muscles, and has diminished breath sounds.
What is the MOST important initial intervention?
A. Administer subcutaneous epinephrine
B. Administer albuterol via nebulizer
,C. Administer high-flow oxygen
D. Insert an oropharyngeal airway
CORRECT ANSWER: C. Administer high-flow oxygen
Rationale: The immediate priority for any patient in respiratory distress is to correct
hypoxia. High-flow oxygen should be applied first. While albuterol and epinephrine are
bronchodilators, oxygen administration takes precedence in the initial management to
ensure adequate oxygenation while the bronchodilator takes effect.
Question 7: Which of the following rhythms is characterized by a chaotic,
irregular baseline without discernible P waves or QRS complexes?
A. Atrial fibrillation
B. Ventricular fibrillation
C. Asystole
D. Torsades de pointes
CORRECT ANSWER: B. Ventricular fibrillation
Rationale: Ventricular fibrillation (V-fib) is a lethal rhythm marked by no organized
electrical activity, resulting in a chaotic waveform on ECG with no identifiable P waves,
QRS complexes, or T waves. Atrial fibrillation has an irregularly irregular rhythm with
QRS complexes present. Asystole is a straight line. Torsades is a polymorphic
ventricular tachycardia.
Question 8: In a patient with cardiogenic shock, which of the following
hemodynamic parameters is MOST likely present?
A. Elevated cardiac output and decreased systemic vascular resistance
B. Decreased cardiac output and elevated systemic vascular resistance
C. Decreased cardiac output and decreased systemic vascular resistance
D. Elevated cardiac output and elevated systemic vascular resistance
CORRECT ANSWER: B. Decreased cardiac output and elevated systemic
vascular resistance
Rationale: In cardiogenic shock, the heart fails to pump effectively, leading to
decreased cardiac output. As a compensatory mechanism, the body increases systemic
vascular resistance (SVR) to maintain blood pressure and perfusion to vital organs. This
differentiates it from distributive shock where SVR is low.
Question 9: A 25-year-old male sustains a blunt injury to the right side of his
chest. He is tachypneic with absent breath sounds on the right. Which of the
following should the EMT-I/85 suspect?
A. Tension pneumothorax
B. Hemothorax
C. Spontaneous pneumothorax
D. Rib fracture without complications
, CORRECT ANSWER: B. Hemothorax
Rationale: Blunt trauma to the chest frequently causes a hemothorax, where blood
accumulates in the pleural space. This causes tachypnea and diminished breath sounds
on the affected side. While a pneumothorax is possible, the presence of trauma with
likely bleeding makes hemothorax a primary concern. Tension pneumothorax involves
tracheal deviation and hypotension, not isolated absent breath sounds.
Question 10: A patient has a blood pressure of 88/52, heart rate of 118, and
pale, cool, and clammy skin. This presentation is MOST consistent with:
A. Neurogenic shock
B. Hypovolemic shock
C. Anaphylactic shock
D. Psychogenic shock
CORRECT ANSWER: B. Hypovolemic shock
Rationale: Hypotension, tachycardia, and pale, cool, clammy skin are classic signs of
hypovolemic shock. This occurs due to a significant loss of intravascular volume.
Neurogenic shock presents with bradycardia and warm skin. Anaphylactic shock
involves urticaria and respiratory distress. Psychogenic shock is a fainting episode.
Question 11: Which of the following assessment findings would be MOST
indicative of a tension pneumothorax developing in a mechanically ventilated
patient?
A. Sudden onset of hypertension and tachycardia
B. Decreased breath sounds on the contralateral side
C. Increasing peak airway pressures and hypotension
D. Subcutaneous emphysema localized to the site of injury
CORRECT ANSWER: C. Increasing peak airway pressures and hypotension
Rationale: In mechanically ventilated patients, a developing tension pneumothorax
traps air in the pleural space. This leads to increasing peak inspiratory pressures due to
decreased lung compliance and is often accompanied by sudden hypotension (pulsus
paradoxus). Hypertension is not a feature.
Question 12: In a patient with suspected acute ischemic stroke, the MAIN goal
of prehospital management is to:
A. Administer a bolus of normal saline to increase perfusion
B. Identify the time of symptom onset
C. Administer aspirin sublingually
D. Lower the blood pressure to below 120/80
CORRECT ANSWER: B. Identify the time of symptom onset
Rationale: The time of symptom onset is critical for determining if the patient is a
candidate for thrombolytic therapy (tPA) which has a strict 3- to 4.5-hour window.
Intermediate/85 Master Certification Review Updated
2026 | 500+ Practice Questions & Verified Answers |
Complete Intermediate EMS Exam Study Guide,
Emergency Medical Technician Test Bank, Airway &
Ventilation, Trauma Assessment, Cardiology, Medical
Emergencies, IV Therapy, Emergency Pharmacology,
Pediatric & Obstetric Care, EMS Operations, Case-
Based Learning, Detailed Rationales
Question 1: A 45-year-old male is found unresponsive with a respiratory rate
of 6 breaths per minute and shallow effort. His SpO2 is 82% on room air. After
opening the airway and suctioning, what is the MOST appropriate immediate
action?
A. Assist ventilations with a bag-valve-mask and 100% oxygen
B. Insert a nasopharyngeal airway and administer oxygen via non-rebreather mask
C. Perform a head-tilt chin-lift and administer oxygen via nasal cannula at 6 L/min
D. Apply a continuous positive airway pressure (CPAP) device at 10 cm H2O
CORRECT ANSWER: A. Assist ventilations with a bag-valve-mask and 100%
oxygen
Rationale: The patient has profound bradypnea and hypoxia, indicating respiratory
failure. The immediate priority is to support ventilations with a BVM and high-flow
oxygen. A non-rebreather or nasal cannula would not provide adequate ventilatory
support for a patient with a respiratory rate of 6. CPAP requires spontaneous breathing
effort and is contraindicated in apnea or severe hypoventilation.
Question 2: Which of the following ECG findings is MOST consistent with an
acute anteroseptal myocardial infarction?
A. ST-segment elevation in leads II, III, and aVF
B. ST-segment elevation in leads V1, V2, V3, and V4
C. ST-segment depression in leads I and aVL
D. Deep Q waves in leads II, III, and aVF
CORRECT ANSWER: B. ST-segment elevation in leads V1, V2, V3, and V4
Rationale: Leads V1 through V4 represent the anterior and septal walls of the left
ventricle. ST-segment elevation in these leads is diagnostic of an anteroseptal STEMI.
Leads II, III, and aVF indicate an inferior wall MI. ST depression in I and aVL can
suggest reciprocal changes in a lateral MI.
Question 3: An EMT-I/85 is assessing a patient with chest pain. The patient
describes the pain as a "sharp" sensation that worsens with inspiration. Which
of the following conditions is MOST likely?
,A. Acute coronary syndrome
B. Pericarditis
C. Aortic dissection
D. Pulmonary embolism
CORRECT ANSWER: B. Pericarditis
Rationale: Pericarditis classically presents with sharp, pleuritic chest pain that worsens
with inspiration and is often relieved by leaning forward. While pulmonary embolism
can also cause pleuritic pain, the classic positional relief points more specifically to
pericarditis. ACS pain is typically pressure-like and not positional, while aortic dissection
presents with tearing pain.
Question 4: Which of the following is a PRIMARY indication for the
administration of activated charcoal in the prehospital setting?
A. Ingestion of a caustic acid
B. Ingestion of a petroleum-based hydrocarbon
C. Ingestion of a tricyclic antidepressant within 1 hour
D. Altered mental status with a gag reflex present
CORRECT ANSWER: C. Ingestion of a tricyclic antidepressant within 1 hour
Rationale: Activated charcoal is indicated for the adsorption of certain toxins, including
tricyclic antidepressants, if the patient presents within 1 to 2 hours of ingestion and has
a protected airway. It is contraindicated in caustic and hydrocarbon ingestions due to
the risk of aspiration and worsening injury. Altered mental status is a contraindication
without airway protection.
Question 5: In a patient with suspected tension pneumothorax, which of the
following physical exam findings is MOST specific?
A. Contralateral tracheal deviation
B. Tachycardia and hypertension
C. Bilateral crackles on auscultation
D. Jugular venous distention that is positional
CORRECT ANSWER: A. Contralateral tracheal deviation
Rationale: Tracheal deviation away from the affected side is a late but highly specific
sign of tension pneumothorax, indicating significant mediastinal shift. This is a critical
finding that necessitates immediate needle decompression. Hypertension is not typical;
hypotension is more common. Crackles are more associated with pulmonary edema.
Question 6: A 32-year-old female is experiencing a severe asthma attack. She
is tachypneic, using accessory muscles, and has diminished breath sounds.
What is the MOST important initial intervention?
A. Administer subcutaneous epinephrine
B. Administer albuterol via nebulizer
,C. Administer high-flow oxygen
D. Insert an oropharyngeal airway
CORRECT ANSWER: C. Administer high-flow oxygen
Rationale: The immediate priority for any patient in respiratory distress is to correct
hypoxia. High-flow oxygen should be applied first. While albuterol and epinephrine are
bronchodilators, oxygen administration takes precedence in the initial management to
ensure adequate oxygenation while the bronchodilator takes effect.
Question 7: Which of the following rhythms is characterized by a chaotic,
irregular baseline without discernible P waves or QRS complexes?
A. Atrial fibrillation
B. Ventricular fibrillation
C. Asystole
D. Torsades de pointes
CORRECT ANSWER: B. Ventricular fibrillation
Rationale: Ventricular fibrillation (V-fib) is a lethal rhythm marked by no organized
electrical activity, resulting in a chaotic waveform on ECG with no identifiable P waves,
QRS complexes, or T waves. Atrial fibrillation has an irregularly irregular rhythm with
QRS complexes present. Asystole is a straight line. Torsades is a polymorphic
ventricular tachycardia.
Question 8: In a patient with cardiogenic shock, which of the following
hemodynamic parameters is MOST likely present?
A. Elevated cardiac output and decreased systemic vascular resistance
B. Decreased cardiac output and elevated systemic vascular resistance
C. Decreased cardiac output and decreased systemic vascular resistance
D. Elevated cardiac output and elevated systemic vascular resistance
CORRECT ANSWER: B. Decreased cardiac output and elevated systemic
vascular resistance
Rationale: In cardiogenic shock, the heart fails to pump effectively, leading to
decreased cardiac output. As a compensatory mechanism, the body increases systemic
vascular resistance (SVR) to maintain blood pressure and perfusion to vital organs. This
differentiates it from distributive shock where SVR is low.
Question 9: A 25-year-old male sustains a blunt injury to the right side of his
chest. He is tachypneic with absent breath sounds on the right. Which of the
following should the EMT-I/85 suspect?
A. Tension pneumothorax
B. Hemothorax
C. Spontaneous pneumothorax
D. Rib fracture without complications
, CORRECT ANSWER: B. Hemothorax
Rationale: Blunt trauma to the chest frequently causes a hemothorax, where blood
accumulates in the pleural space. This causes tachypnea and diminished breath sounds
on the affected side. While a pneumothorax is possible, the presence of trauma with
likely bleeding makes hemothorax a primary concern. Tension pneumothorax involves
tracheal deviation and hypotension, not isolated absent breath sounds.
Question 10: A patient has a blood pressure of 88/52, heart rate of 118, and
pale, cool, and clammy skin. This presentation is MOST consistent with:
A. Neurogenic shock
B. Hypovolemic shock
C. Anaphylactic shock
D. Psychogenic shock
CORRECT ANSWER: B. Hypovolemic shock
Rationale: Hypotension, tachycardia, and pale, cool, clammy skin are classic signs of
hypovolemic shock. This occurs due to a significant loss of intravascular volume.
Neurogenic shock presents with bradycardia and warm skin. Anaphylactic shock
involves urticaria and respiratory distress. Psychogenic shock is a fainting episode.
Question 11: Which of the following assessment findings would be MOST
indicative of a tension pneumothorax developing in a mechanically ventilated
patient?
A. Sudden onset of hypertension and tachycardia
B. Decreased breath sounds on the contralateral side
C. Increasing peak airway pressures and hypotension
D. Subcutaneous emphysema localized to the site of injury
CORRECT ANSWER: C. Increasing peak airway pressures and hypotension
Rationale: In mechanically ventilated patients, a developing tension pneumothorax
traps air in the pleural space. This leads to increasing peak inspiratory pressures due to
decreased lung compliance and is often accompanied by sudden hypotension (pulsus
paradoxus). Hypertension is not a feature.
Question 12: In a patient with suspected acute ischemic stroke, the MAIN goal
of prehospital management is to:
A. Administer a bolus of normal saline to increase perfusion
B. Identify the time of symptom onset
C. Administer aspirin sublingually
D. Lower the blood pressure to below 120/80
CORRECT ANSWER: B. Identify the time of symptom onset
Rationale: The time of symptom onset is critical for determining if the patient is a
candidate for thrombolytic therapy (tPA) which has a strict 3- to 4.5-hour window.
