EMR Final Exam (1-100) Questions and Answers.
INTRODUCTION.
Emergency Medical Responder (EMR) Final Exam preparation package is designed to assess
comprehensive knowledge and readiness for national certification. The 100 questions cover the full
scope of the National EMS Education Standards for EMR, including patient assessment, medical
emergencies, trauma management, EMS operations, and foundational medical knowledge. All content
aligns with current American Heart Association (AHA) guidelines, NAEMT position statements, and
evidence-based prehospital care protocols.
1. What is the FIRST action an EMR should take upon arriving at the scene of a motor vehicle collision?
A. Begin triage of all patients
B. Perform a primary assessment on the closest patient
C. Ensure scene safety and body substance isolation (BSI)
D. Request additional resources immediately
Answer: C
Rationale: Scene safety and BSI are the absolute first priorities in the EMR's order of operations. No
patient care can be safely initiated until the scene is secured for the responder and the risk of
communicable disease transmission is minimized.
2. An alert adult patient is experiencing chest pain radiating to their left arm. They have a known history
of angina. Their skin is pale and clammy. After administering their prescribed nitroglycerin, their pain
decreases but their blood pressure is now 88/50 mmHg. What is the most appropriate next action?
A. Administer a second dose of nitroglycerin as prescribed
B. Place the patient in a supine position and elevate their legs
C. Administer high-concentration oxygen via non-rebreather mask
D. Assist the patient in taking their own aspirin
Answer: B
Rationale: Nitroglycerin is a vasodilator and can cause hypotension (SBP <90 mmHg is a contraindication
for further doses). Placing the patient supine with legs elevated improves venous return and blood
pressure (Trendelenburg position). Oxygen (C) is indicated but does not address the hypotension. Aspirin
(D) is indicated for suspected MI but is secondary to managing the life-threatening hypotension.
3. During the primary assessment of an unresponsive trauma patient, the EMR notes the patient has
snoring respirations. What is the immediate intervention?
A. Begin chest compressions
,B. Insert an oropharyngeal airway (OPA)
C. Perform a jaw-thrust maneuver
D. Suction the airway
Answer: C
Rationale: Snoring respirations indicate a partial airway obstruction, typically by the tongue. The
immediate, manual intervention is a jaw-thrust maneuver (or head-tilt/chin-lift if no spinal injury is
suspected) to open the airway. An OPA (B) is inserted only if the patient is unconscious and has no gag
reflex, but manual opening comes first. Suctioning (D) is for liquid obstructions.
4. What is the correct ratio of chest compressions to ventilations for a single rescuer performing adult
CPR?
A. 15 compressions to 2 ventilations
B. 30 compressions to 2 ventilations
C. 15 compressions to 1 ventilation
D. 30 compressions to 1 ventilation
Answer: B
Rationale: According to current American Heart Association (AHA) guidelines, the ratio for single-
rescuer adult CPR is 30 chest compressions to 2 ventilations.
5. An adult patient with a suspected opioid overdose has a respiratory rate of 6 breaths per minute and
pinpoint pupils. The patient has a pulse. What is the immediate priority?
A. Administer naloxone immediately
B. Begin bag-valve-mask ventilation
C. Start chest compressions
D. Place the patient in the recovery position
Answer: B
Rationale: According to AHA guidelines, rescue breathing (or BVM ventilation) is the immediate priority
for an apneic or severely bradypneic patient with a pulse. Ventilations take precedence over naloxone
administration because the primary life threat is respiratory failure leading to hypoxia and cardiac arrest.
6. When assessing a pediatric patient (2 years old) using the Pediatric Assessment Triangle (PAT), which
of the following is NOT a component?
A. Appearance (muscle tone/interactiveness)
B. Work of breathing
C. Circulation to the skin
,D. Blood pressure measurement
Answer: D
Rationale: The Pediatric Assessment Triangle consists of three elements assessed from across the
room: Appearance, Work of breathing, and Circulation to the skin. Blood pressure measurement is part
of the primary survey (and vital signs) but is not part of the initial PAT performed before touching the
child.
7. A construction worker fell approximately 12 feet from a scaffold, landing on their feet. They are
complaining of severe ankle pain but deny back pain. They are ambulatory at the scene. What is the MOST
appropriate action regarding spinal motion restriction?
A. Apply a rigid cervical collar only since they are ambulatory
B. No spinal motion restriction is needed since they deny back pain
C. Maintain manual stabilization and apply full spinal motion restriction precautions
D. Allow the patient to self-extricate since they are walking
Answer: C
Rationale: Falls greater than three times the patient's height (or approximately 10 feet for adults) are
significant mechanisms of injury for spinal injury. Even ambulatory patients with significant mechanisms
require spinal precautions. The energy transmitted through the feet/ankles can travel up the axial
skeleton, causing spinal fractures even without immediate pain.
8. What is the proper compression depth for adult CPR according to current AHA guidelines?
A. At least 1 inch (2.5 cm)
B. At least 2 inches (5 cm) but not more than 2.4 inches (6 cm)
C. Exactly 2 inches (5 cm)
D. One-third the depth of the chest
Answer: B
Rationale: Current AHA guidelines specify compressing the adult chest at least 2 inches (5 cm) but
avoiding depths greater than 2.4 inches (6 cm) to minimize risk of injury while maintaining adequate
perfusion. "One-third the depth of the chest" applies to infant and child CPR.
9. An unresponsive adult patient is found lying supine. You are alone and have just activated EMS. The
patient's airway appears open, but you notice minimal chest rise and fall. What should you do NEXT?
A. Check the carotid pulse for no more than 10 seconds
B. Immediately begin rescue breathing
C. Deliver two rescue breaths before checking circulation
D. Open the airway using head-tilt/chin-lift
, Answer: A
Rationale: The 2020 AHA guidelines emphasize circulation assessment immediately after airway
assessment for unresponsive adults. Check the carotid pulse for no more than 10 seconds. If there is no
pulse or you are unsure, begin CPR. If there is a pulse but no normal breathing, provide rescue breathing.
10. A patient with a history of asthma is experiencing a severe exacerbation. They are sitting upright, using
accessory muscles, and able to speak only in single words. Vital signs: HR 128, RR 32, SpO2 88% on room
air. What is the priority intervention?
A. Immediate transport to the nearest emergency department
B. Administration of the patient's prescribed albuterol inhaler
C. Administration of high-concentration oxygen
D. Positioning the patient supine for better lung expansion
Answer: C
Rationale: An SpO2 of 88% indicates severe hypoxemia and is the immediate life threat. High-
concentration oxygen (15 LPM via non-rebreather or 10-15 LPM via nebulizer) takes priority. While
albuterol (B) is indicated for bronchodilation, correcting hypoxemia is the first priority. The patient should
remain upright (D is incorrect) to maximize diaphragmatic excursion.
11. During the primary assessment, you find an unresponsive patient with agonal gasping respirations and
no carotid pulse. What is your FIRST action?
A. Give two rescue breaths
B. Begin high-quality CPR starting with chest compressions
C. Apply the AED immediately
D. Insert an oropharyngeal airway
Answer: B
Rationale: Agonal gasps are not considered normal breathing. In an unresponsive, pulseless patient with
agonal respirations, immediate CPR is indicated starting with chest compressions (C-A-B sequence).
Rescue breaths alone are insufficient for cardiac arrest. The AED should be applied as soon as available
but does not supersede immediate compressions.
12. A patient was struck in the abdomen during an assault and is presenting with signs of shock
(tachycardia, hypotension, cool/clammy skin) but no external bleeding. What is the most likely cause of
their shock?
A. Cardiogenic shock
B. Neurogenic shock
C. Hemorrhagic shock
D. Anaphylactic shock
INTRODUCTION.
Emergency Medical Responder (EMR) Final Exam preparation package is designed to assess
comprehensive knowledge and readiness for national certification. The 100 questions cover the full
scope of the National EMS Education Standards for EMR, including patient assessment, medical
emergencies, trauma management, EMS operations, and foundational medical knowledge. All content
aligns with current American Heart Association (AHA) guidelines, NAEMT position statements, and
evidence-based prehospital care protocols.
1. What is the FIRST action an EMR should take upon arriving at the scene of a motor vehicle collision?
A. Begin triage of all patients
B. Perform a primary assessment on the closest patient
C. Ensure scene safety and body substance isolation (BSI)
D. Request additional resources immediately
Answer: C
Rationale: Scene safety and BSI are the absolute first priorities in the EMR's order of operations. No
patient care can be safely initiated until the scene is secured for the responder and the risk of
communicable disease transmission is minimized.
2. An alert adult patient is experiencing chest pain radiating to their left arm. They have a known history
of angina. Their skin is pale and clammy. After administering their prescribed nitroglycerin, their pain
decreases but their blood pressure is now 88/50 mmHg. What is the most appropriate next action?
A. Administer a second dose of nitroglycerin as prescribed
B. Place the patient in a supine position and elevate their legs
C. Administer high-concentration oxygen via non-rebreather mask
D. Assist the patient in taking their own aspirin
Answer: B
Rationale: Nitroglycerin is a vasodilator and can cause hypotension (SBP <90 mmHg is a contraindication
for further doses). Placing the patient supine with legs elevated improves venous return and blood
pressure (Trendelenburg position). Oxygen (C) is indicated but does not address the hypotension. Aspirin
(D) is indicated for suspected MI but is secondary to managing the life-threatening hypotension.
3. During the primary assessment of an unresponsive trauma patient, the EMR notes the patient has
snoring respirations. What is the immediate intervention?
A. Begin chest compressions
,B. Insert an oropharyngeal airway (OPA)
C. Perform a jaw-thrust maneuver
D. Suction the airway
Answer: C
Rationale: Snoring respirations indicate a partial airway obstruction, typically by the tongue. The
immediate, manual intervention is a jaw-thrust maneuver (or head-tilt/chin-lift if no spinal injury is
suspected) to open the airway. An OPA (B) is inserted only if the patient is unconscious and has no gag
reflex, but manual opening comes first. Suctioning (D) is for liquid obstructions.
4. What is the correct ratio of chest compressions to ventilations for a single rescuer performing adult
CPR?
A. 15 compressions to 2 ventilations
B. 30 compressions to 2 ventilations
C. 15 compressions to 1 ventilation
D. 30 compressions to 1 ventilation
Answer: B
Rationale: According to current American Heart Association (AHA) guidelines, the ratio for single-
rescuer adult CPR is 30 chest compressions to 2 ventilations.
5. An adult patient with a suspected opioid overdose has a respiratory rate of 6 breaths per minute and
pinpoint pupils. The patient has a pulse. What is the immediate priority?
A. Administer naloxone immediately
B. Begin bag-valve-mask ventilation
C. Start chest compressions
D. Place the patient in the recovery position
Answer: B
Rationale: According to AHA guidelines, rescue breathing (or BVM ventilation) is the immediate priority
for an apneic or severely bradypneic patient with a pulse. Ventilations take precedence over naloxone
administration because the primary life threat is respiratory failure leading to hypoxia and cardiac arrest.
6. When assessing a pediatric patient (2 years old) using the Pediatric Assessment Triangle (PAT), which
of the following is NOT a component?
A. Appearance (muscle tone/interactiveness)
B. Work of breathing
C. Circulation to the skin
,D. Blood pressure measurement
Answer: D
Rationale: The Pediatric Assessment Triangle consists of three elements assessed from across the
room: Appearance, Work of breathing, and Circulation to the skin. Blood pressure measurement is part
of the primary survey (and vital signs) but is not part of the initial PAT performed before touching the
child.
7. A construction worker fell approximately 12 feet from a scaffold, landing on their feet. They are
complaining of severe ankle pain but deny back pain. They are ambulatory at the scene. What is the MOST
appropriate action regarding spinal motion restriction?
A. Apply a rigid cervical collar only since they are ambulatory
B. No spinal motion restriction is needed since they deny back pain
C. Maintain manual stabilization and apply full spinal motion restriction precautions
D. Allow the patient to self-extricate since they are walking
Answer: C
Rationale: Falls greater than three times the patient's height (or approximately 10 feet for adults) are
significant mechanisms of injury for spinal injury. Even ambulatory patients with significant mechanisms
require spinal precautions. The energy transmitted through the feet/ankles can travel up the axial
skeleton, causing spinal fractures even without immediate pain.
8. What is the proper compression depth for adult CPR according to current AHA guidelines?
A. At least 1 inch (2.5 cm)
B. At least 2 inches (5 cm) but not more than 2.4 inches (6 cm)
C. Exactly 2 inches (5 cm)
D. One-third the depth of the chest
Answer: B
Rationale: Current AHA guidelines specify compressing the adult chest at least 2 inches (5 cm) but
avoiding depths greater than 2.4 inches (6 cm) to minimize risk of injury while maintaining adequate
perfusion. "One-third the depth of the chest" applies to infant and child CPR.
9. An unresponsive adult patient is found lying supine. You are alone and have just activated EMS. The
patient's airway appears open, but you notice minimal chest rise and fall. What should you do NEXT?
A. Check the carotid pulse for no more than 10 seconds
B. Immediately begin rescue breathing
C. Deliver two rescue breaths before checking circulation
D. Open the airway using head-tilt/chin-lift
, Answer: A
Rationale: The 2020 AHA guidelines emphasize circulation assessment immediately after airway
assessment for unresponsive adults. Check the carotid pulse for no more than 10 seconds. If there is no
pulse or you are unsure, begin CPR. If there is a pulse but no normal breathing, provide rescue breathing.
10. A patient with a history of asthma is experiencing a severe exacerbation. They are sitting upright, using
accessory muscles, and able to speak only in single words. Vital signs: HR 128, RR 32, SpO2 88% on room
air. What is the priority intervention?
A. Immediate transport to the nearest emergency department
B. Administration of the patient's prescribed albuterol inhaler
C. Administration of high-concentration oxygen
D. Positioning the patient supine for better lung expansion
Answer: C
Rationale: An SpO2 of 88% indicates severe hypoxemia and is the immediate life threat. High-
concentration oxygen (15 LPM via non-rebreather or 10-15 LPM via nebulizer) takes priority. While
albuterol (B) is indicated for bronchodilation, correcting hypoxemia is the first priority. The patient should
remain upright (D is incorrect) to maximize diaphragmatic excursion.
11. During the primary assessment, you find an unresponsive patient with agonal gasping respirations and
no carotid pulse. What is your FIRST action?
A. Give two rescue breaths
B. Begin high-quality CPR starting with chest compressions
C. Apply the AED immediately
D. Insert an oropharyngeal airway
Answer: B
Rationale: Agonal gasps are not considered normal breathing. In an unresponsive, pulseless patient with
agonal respirations, immediate CPR is indicated starting with chest compressions (C-A-B sequence).
Rescue breaths alone are insufficient for cardiac arrest. The AED should be applied as soon as available
but does not supersede immediate compressions.
12. A patient was struck in the abdomen during an assault and is presenting with signs of shock
(tachycardia, hypotension, cool/clammy skin) but no external bleeding. What is the most likely cause of
their shock?
A. Cardiogenic shock
B. Neurogenic shock
C. Hemorrhagic shock
D. Anaphylactic shock
