EMT Certification Exam 2026/2027 | NREMT
Practice Questions & Answer Guide
1. A 45-year-old male is unresponsive with agonal respirations. What is the first action?
A) Insert a nasopharyngeal airway
B) Open the airway with a head-tilt/chin-lift
C) Start chest compressions
D) Apply oxygen via non-rebreather
Answer B: Open the airway with a head-tilt/chin-lift
Rationale: Airway is always the first priority. Open the airway before assessing breathing.
2. A patient with severe shortness of breath has a tracheostomy and thick secretions. What is the
most appropriate action?
A) Apply oxygen via face mask
B) Suction the tracheostomy
C) Insert an oropharyngeal airway
D) Assist with a bag-valve-mask
Answer B: Suction the tracheostomy
Rationale: Clear the airway of secretions first. Suctioning is the priority to restore airflow.
3. A 56-year-old male complains of crushing chest pain radiating to his jaw. He is diaphoretic and
nauseated. Which of the following is the most appropriate initial action?
A) Administer aspirin
B) Apply oxygen and obtain a 12-lead ECG
C) Give nitroglycerin
,D) Transport immediately without treatment
Answer B: Apply oxygen and obtain a 12-lead ECG
Rationale: Oxygen (if hypoxic) and ECG are priorities to evaluate for STEMI. Aspirin and nitro may follow
after ECG.
4. A 30-year-old female is 38 weeks pregnant with contractions 2 minutes apart. Which of the
following positions is most appropriate?
A) Supine with legs flat
B) Left lateral recumbent position
C) Right lateral recumbent
D) Trendelenburg
Answer B: Left lateral recumbent position
Rationale: The left lateral position prevents supine hypotensive syndrome by relieving aortocaval
compression.
5. A pediatric patient is in respiratory distress with stridor and a barking cough. Which condition is
most likely?
A) Epiglottitis
B) Croup
C) Bronchiolitis
D) Asthma
Answer B: Croup
Rationale: Croup (laryngotracheobronchitis) typically presents with a barking cough and stridor.
6. A patient involved in a motor vehicle crash has a flail chest segment. Which finding is most
concerning?
A) Pain on palpation
B) Paradoxical movement of the chest wall
,C) Bruising over the ribs
D) Subcutaneous emphysema
Answer B: Paradoxical movement of the chest wall
Rationale: Flail chest causes paradoxical chest wall movement, leading to inadequate ventilation and
hypoxia.
7. A 62-year-old diabetic is found unresponsive. The blood glucose is 45 mg/dL. What is the
immediate treatment?
A) Give oral glucose paste
B) Administer IV dextrose 50% (D50)
C) Glucagon IM
D) Start an insulin drip
Answer B: Administer IV dextrose 50% (D50)
Rationale: Unconscious hypoglycemic patient requires IV dextrose. Glucagon is an alternative if no IV
access.
8. A patient with a gunshot wound to the abdomen has hypotension and tachycardia. What type
of shock is most likely?
A) Cardiogenic shock
B) Hypovolemic shock
C) Neurogenic shock
D) Septic shock
Answer B: Hypovolemic shock
Rationale: Hemorrhage from trauma causes hypovolemic shock. Treat with fluid resuscitation and
hemorrhage control.
9. A 6-year-old child has a fever, stiff neck, and petechial rash. What should be the first step?
A) Administer acetaminophen
, B) Place a surgical mask on the patient and transport immediately
C) Start an IV
D) Perform a lumbar puncture
Answer B: Place a surgical mask on the patient and transport immediately
Rationale: Suspected meningitis requires droplet precautions and rapid transport.
10. A patient with a severe allergic reaction has stridor and hypotension. Which medication should
be administered first?
A) Diphenhydramine
B) Epinephrine IM
C) Albuterol nebulizer
D) Methylprednisolone IV
Answer B: Epinephrine IM
Rationale: Epinephrine is first-line for anaphylaxis to reverse bronchospasm and hypotension.
11. A 75-year-old female with a history of CHF has pulmonary edema. Which of the following is
the best position for this patient?
A) Supine
B) High-Fowler’s with legs dangling
C) Trendelenburg
D) Prone
Answer B: High-Fowler’s with legs dangling
Rationale: High-Fowler’s reduces venous return and pulmonary congestion. Legs dangling further
reduces preload.
12. A patient with a head injury has a Glasgow Coma Scale (GCS) score of 7. What is the best
airway management?
A) Nasopharyngeal airway
Practice Questions & Answer Guide
1. A 45-year-old male is unresponsive with agonal respirations. What is the first action?
A) Insert a nasopharyngeal airway
B) Open the airway with a head-tilt/chin-lift
C) Start chest compressions
D) Apply oxygen via non-rebreather
Answer B: Open the airway with a head-tilt/chin-lift
Rationale: Airway is always the first priority. Open the airway before assessing breathing.
2. A patient with severe shortness of breath has a tracheostomy and thick secretions. What is the
most appropriate action?
A) Apply oxygen via face mask
B) Suction the tracheostomy
C) Insert an oropharyngeal airway
D) Assist with a bag-valve-mask
Answer B: Suction the tracheostomy
Rationale: Clear the airway of secretions first. Suctioning is the priority to restore airflow.
3. A 56-year-old male complains of crushing chest pain radiating to his jaw. He is diaphoretic and
nauseated. Which of the following is the most appropriate initial action?
A) Administer aspirin
B) Apply oxygen and obtain a 12-lead ECG
C) Give nitroglycerin
,D) Transport immediately without treatment
Answer B: Apply oxygen and obtain a 12-lead ECG
Rationale: Oxygen (if hypoxic) and ECG are priorities to evaluate for STEMI. Aspirin and nitro may follow
after ECG.
4. A 30-year-old female is 38 weeks pregnant with contractions 2 minutes apart. Which of the
following positions is most appropriate?
A) Supine with legs flat
B) Left lateral recumbent position
C) Right lateral recumbent
D) Trendelenburg
Answer B: Left lateral recumbent position
Rationale: The left lateral position prevents supine hypotensive syndrome by relieving aortocaval
compression.
5. A pediatric patient is in respiratory distress with stridor and a barking cough. Which condition is
most likely?
A) Epiglottitis
B) Croup
C) Bronchiolitis
D) Asthma
Answer B: Croup
Rationale: Croup (laryngotracheobronchitis) typically presents with a barking cough and stridor.
6. A patient involved in a motor vehicle crash has a flail chest segment. Which finding is most
concerning?
A) Pain on palpation
B) Paradoxical movement of the chest wall
,C) Bruising over the ribs
D) Subcutaneous emphysema
Answer B: Paradoxical movement of the chest wall
Rationale: Flail chest causes paradoxical chest wall movement, leading to inadequate ventilation and
hypoxia.
7. A 62-year-old diabetic is found unresponsive. The blood glucose is 45 mg/dL. What is the
immediate treatment?
A) Give oral glucose paste
B) Administer IV dextrose 50% (D50)
C) Glucagon IM
D) Start an insulin drip
Answer B: Administer IV dextrose 50% (D50)
Rationale: Unconscious hypoglycemic patient requires IV dextrose. Glucagon is an alternative if no IV
access.
8. A patient with a gunshot wound to the abdomen has hypotension and tachycardia. What type
of shock is most likely?
A) Cardiogenic shock
B) Hypovolemic shock
C) Neurogenic shock
D) Septic shock
Answer B: Hypovolemic shock
Rationale: Hemorrhage from trauma causes hypovolemic shock. Treat with fluid resuscitation and
hemorrhage control.
9. A 6-year-old child has a fever, stiff neck, and petechial rash. What should be the first step?
A) Administer acetaminophen
, B) Place a surgical mask on the patient and transport immediately
C) Start an IV
D) Perform a lumbar puncture
Answer B: Place a surgical mask on the patient and transport immediately
Rationale: Suspected meningitis requires droplet precautions and rapid transport.
10. A patient with a severe allergic reaction has stridor and hypotension. Which medication should
be administered first?
A) Diphenhydramine
B) Epinephrine IM
C) Albuterol nebulizer
D) Methylprednisolone IV
Answer B: Epinephrine IM
Rationale: Epinephrine is first-line for anaphylaxis to reverse bronchospasm and hypotension.
11. A 75-year-old female with a history of CHF has pulmonary edema. Which of the following is
the best position for this patient?
A) Supine
B) High-Fowler’s with legs dangling
C) Trendelenburg
D) Prone
Answer B: High-Fowler’s with legs dangling
Rationale: High-Fowler’s reduces venous return and pulmonary congestion. Legs dangling further
reduces preload.
12. A patient with a head injury has a Glasgow Coma Scale (GCS) score of 7. What is the best
airway management?
A) Nasopharyngeal airway
