EMT ADVANCED REVIEW 2026-2027
QUESTIONS AND VERIFIED ANSWERS|
GRADE A+
1. A 68-year-old female presents with sudden onset of dyspnea and sharp chest pain that
worsens with deep inspiration. She recently underwent hip replacement surgery. What is the
most likely pathophysiological mechanism?
A. Alveolar collapse due to surfactant deficiency
B. Bronchoconstriction resulting from an exaggerated immune response
C. Increase in pulmonary vascular resistance due to left-sided heart failure
D. Ventilation-perfusion mismatch caused by a pulmonary embolus
Answer: D
Conceptual Explanation: Sudden onset dyspnea, pleuritic chest pain, and recent surgery
are classic signs of a pulmonary embolism, which causes a perfusion defect despite
adequate ventilation (V/Q mismatch).
2. Which of the following findings is the most reliable indicator of decompensated shock in a
4-year-old child?
A. Capillary refill time of 3 seconds
B. Systolic blood pressure of 70 mmHg
,C. Tachycardia exceeding 140 beats/min
D. Altered mental status and irritability
Answer: B
Conceptual Explanation: In pediatrics, blood pressure is maintained until the very late
stages of shock. Hypotension (SBP < 70 + 2x age) marks the transition from compensated
to decompensated shock.
3. A patient with a suspected spinal cord injury presents with hypotension, bradycardia, and
warm, dry skin. Which type of shock should you suspect?
A. Hypovolemic shock
B. Cardiogenic shock
C. Septic shock
D. Neurogenic shock
Answer: D
Conceptual Explanation: Neurogenic shock is characterized by the loss of sympathetic
nervous system tone, leading to vasodilation (warm/dry skin) and a lack of compensatory
tachycardia (bradycardia).
4. While ventilating an apneic patient with a BVM, you notice the chest is not rising
adequately. Your first action should be to:
A. Increase the force of ventilations
, B. Switch to a demand valve ventilator
C. Immediately insert an oropharyngeal airway
D. Reposition the head and ensure a proper mask seal
Answer: D
Conceptual Explanation: The most common causes of inadequate BVM ventilation are
improper head positioning or a poor seal. These should be addressed before other
interventions.
5. A 55-year-old male complains of crushing chest pain and diaphoresis. He has a history of
angina and takes nitroglycerin. After checking his BP (130/80), you should:
A. Assist him with his nitroglycerin immediately
B. Administer 324mg of aspirin if not contraindicated
C. Place him in a prone position to aid breathing
D. Wait for ALS to arrive before administering medications
Answer: B
Conceptual Explanation: Aspirin is the priority for suspected ACS to prevent further
platelet aggregation, often administered before or concurrently with nitroglycerin
depending on local protocols.
QUESTIONS AND VERIFIED ANSWERS|
GRADE A+
1. A 68-year-old female presents with sudden onset of dyspnea and sharp chest pain that
worsens with deep inspiration. She recently underwent hip replacement surgery. What is the
most likely pathophysiological mechanism?
A. Alveolar collapse due to surfactant deficiency
B. Bronchoconstriction resulting from an exaggerated immune response
C. Increase in pulmonary vascular resistance due to left-sided heart failure
D. Ventilation-perfusion mismatch caused by a pulmonary embolus
Answer: D
Conceptual Explanation: Sudden onset dyspnea, pleuritic chest pain, and recent surgery
are classic signs of a pulmonary embolism, which causes a perfusion defect despite
adequate ventilation (V/Q mismatch).
2. Which of the following findings is the most reliable indicator of decompensated shock in a
4-year-old child?
A. Capillary refill time of 3 seconds
B. Systolic blood pressure of 70 mmHg
,C. Tachycardia exceeding 140 beats/min
D. Altered mental status and irritability
Answer: B
Conceptual Explanation: In pediatrics, blood pressure is maintained until the very late
stages of shock. Hypotension (SBP < 70 + 2x age) marks the transition from compensated
to decompensated shock.
3. A patient with a suspected spinal cord injury presents with hypotension, bradycardia, and
warm, dry skin. Which type of shock should you suspect?
A. Hypovolemic shock
B. Cardiogenic shock
C. Septic shock
D. Neurogenic shock
Answer: D
Conceptual Explanation: Neurogenic shock is characterized by the loss of sympathetic
nervous system tone, leading to vasodilation (warm/dry skin) and a lack of compensatory
tachycardia (bradycardia).
4. While ventilating an apneic patient with a BVM, you notice the chest is not rising
adequately. Your first action should be to:
A. Increase the force of ventilations
, B. Switch to a demand valve ventilator
C. Immediately insert an oropharyngeal airway
D. Reposition the head and ensure a proper mask seal
Answer: D
Conceptual Explanation: The most common causes of inadequate BVM ventilation are
improper head positioning or a poor seal. These should be addressed before other
interventions.
5. A 55-year-old male complains of crushing chest pain and diaphoresis. He has a history of
angina and takes nitroglycerin. After checking his BP (130/80), you should:
A. Assist him with his nitroglycerin immediately
B. Administer 324mg of aspirin if not contraindicated
C. Place him in a prone position to aid breathing
D. Wait for ALS to arrive before administering medications
Answer: B
Conceptual Explanation: Aspirin is the priority for suspected ACS to prevent further
platelet aggregation, often administered before or concurrently with nitroglycerin
depending on local protocols.
