NCOEMS PRACTICE EXAM 2026/2027 – NORTH
CAROLINA OFFICE OF EMERGENCY MEDICAL
SERVICES 100 Accurate Real Exam Questions with
Verified Correct Answers Just Released – Latest Edition
Question 1
A 45-year-old male is found unresponsive with agonal respirations at a rate of 6 breaths per
minute. What is the priority intervention?
A) Apply oxygen via non-rebreather mask at 15 L/min
B) Begin chest compressions immediately
C) Open the airway and begin ventilations with a bag-valve mask (BVM)
D) Check for a carotid pulse for 10 seconds
Correct Answer: C
Rationale: Agonal respirations are not effective breathing. Open the airway and provide BVM
ventilations. Pulselessness would require compressions, but the question does not state
absence of pulse.
Question 2
You are called to the scene of a motor vehicle collision. The patient is awake but confused, has
a patent airway, and is breathing 22 times per minute. Pulse is 120. What is the priority
intervention?
A) Administer high-flow oxygen
B) Perform a rapid trauma assessment
C) Immobilize the cervical spine
D) Transport immediately
Correct Answer: C
Rationale: In any trauma patient with a mechanism of injury suggesting spinal injury, manual
cervical spine immobilization is the first priority after ensuring ABCs. The airway is patent and
breathing is adequate.
Question 3
,A 60-year-old male complains of chest pain radiating to the left arm. He is diaphoretic and
nauseated. His pulse is 110 and blood pressure is 140/90. He has a history of hypertension.
What medication should the EMT administer?
A) Nitroglycerin 0.4 mg sublingual
B) Aspirin 324 mg chewed
C) Oxygen via nasal cannula
D) Morphine sulfate
Correct Answer: B
Rationale: Aspirin (324 mg chewed) is indicated for suspected acute coronary syndrome to
reduce platelet aggregation. Nitroglycerin requires a prescription and assessment of
hypotension. Oxygen if SpO2 <94%.
Question 4
Which of the following is the correct compression-to-ventilation ratio for a single rescuer
performing CPR on an adult cardiac arrest patient?
A) 30:2
B) 15:2
C) 30:1
D) 15:1
Correct Answer: A
Rationale: AHA guidelines recommend 30:2 for single-rescuer adult CPR (30 compressions, 2
breaths). For two-rescuer adult CPR, it remains 30:2.
Question 5
An unresponsive patient has a blood glucose reading of 45 mg/dL. The patient has an intact gag
reflex. What is the most appropriate treatment?
A) Oral glucose gel
B) IV dextrose 50%
C) Glucagon IM
D) Nothing by mouth
Correct Answer: A
Rationale: With an intact gag reflex and ability to protect airway, oral glucose is preferred. IV
dextrose is for unconscious patients with IV access; glucagon IM is for unconscious patients
without IV access.
,Question 6
A patient involved in a fall from 15 feet has a large laceration on the forearm with bright red
blood spurting. What is the immediate intervention?
A) Apply a tourniquet proximal to the wound
B) Apply direct pressure with a sterile gauze
C) Elevate the arm above the heart
D) Apply a pressure bandage
Correct Answer: A
Rationale: Spurting bright red blood indicates arterial hemorrhage. Direct pressure may not
control it; tourniquet is indicated for life-threatening extremity hemorrhage.
Question 7
Which of the following is a normal finding in a patient experiencing anaphylaxis?
A) Hypotension
B) Stridor
C) Urticaria (hives)
D) All of the above
Correct Answer: D
Rationale: Anaphylaxis includes multiple systems: hypotension (cardiovascular), stridor
(respiratory), and urticaria (skin). All are expected findings.
Question 8
A 30-year-old female complains of sudden onset of severe headache, neck stiffness, and
photophobia. What is the most likely diagnosis?
A) Migraine headache
B) Subarachnoid hemorrhage
C) Tension headache
D) Sinusitis
Correct Answer: B
Rationale: Sudden, severe "thunderclap" headache with nuchal rigidity (neck stiffness) and
photophobia is classic for subarachnoid hemorrhage from a ruptured aneurysm.
Question 9
You arrive at the scene of a school bus collision with multiple injured children. Which patient
should be transported first based on triage?
, A) A child with a broken arm and crying
B) A child who is unconscious with shallow respirations
C) A child with a small laceration on the forehead
D) A child who is walking and talking
Correct Answer: B
Rationale: In triage, unconsciousness with inadequate breathing indicates immediate (Priority 1)
transport. START triage identifies patients who are breathing but unconscious as immediate.
Question 10
A patient is in respiratory distress with audible wheezing. He has a history of asthma. Which
medication is most appropriate?
A) Albuterol metered-dose inhaler (MDI)
B) Oral albuterol tablet
C) Epinephrine auto-injector
D) Ipratropium bromide
Correct Answer: A
Rationale: Albuterol MDI (with spacer if available) is the first-line bronchodilator for asthma
exacerbation. Epinephrine is for anaphylaxis or severe asthma with altered mental status.
Question 11
What is the correct order of the primary assessment?
A) Airway, Breathing, Circulation, Disability, Exposure (ABCDE)
B) Breathing, Airway, Circulation, Disability, Exposure
C) Circulation, Airway, Breathing, Disability, Exposure
D) Disability, Airway, Breathing, Circulation, Exposure
Correct Answer: A
Rationale: The standard ABCDE approach: Airway, Breathing, Circulation, Disability (neurologic
status), Exposure/environmental control.
Question 12
A patient is found in cardiac arrest. After starting CPR and attaching an AED, the AED advises
"No shock advised." What should the EMT do next?
A) Stop CPR and check for a pulse
B) Resume CPR immediately for 2 minutes
C) Re-analyze the rhythm immediately
CAROLINA OFFICE OF EMERGENCY MEDICAL
SERVICES 100 Accurate Real Exam Questions with
Verified Correct Answers Just Released – Latest Edition
Question 1
A 45-year-old male is found unresponsive with agonal respirations at a rate of 6 breaths per
minute. What is the priority intervention?
A) Apply oxygen via non-rebreather mask at 15 L/min
B) Begin chest compressions immediately
C) Open the airway and begin ventilations with a bag-valve mask (BVM)
D) Check for a carotid pulse for 10 seconds
Correct Answer: C
Rationale: Agonal respirations are not effective breathing. Open the airway and provide BVM
ventilations. Pulselessness would require compressions, but the question does not state
absence of pulse.
Question 2
You are called to the scene of a motor vehicle collision. The patient is awake but confused, has
a patent airway, and is breathing 22 times per minute. Pulse is 120. What is the priority
intervention?
A) Administer high-flow oxygen
B) Perform a rapid trauma assessment
C) Immobilize the cervical spine
D) Transport immediately
Correct Answer: C
Rationale: In any trauma patient with a mechanism of injury suggesting spinal injury, manual
cervical spine immobilization is the first priority after ensuring ABCs. The airway is patent and
breathing is adequate.
Question 3
,A 60-year-old male complains of chest pain radiating to the left arm. He is diaphoretic and
nauseated. His pulse is 110 and blood pressure is 140/90. He has a history of hypertension.
What medication should the EMT administer?
A) Nitroglycerin 0.4 mg sublingual
B) Aspirin 324 mg chewed
C) Oxygen via nasal cannula
D) Morphine sulfate
Correct Answer: B
Rationale: Aspirin (324 mg chewed) is indicated for suspected acute coronary syndrome to
reduce platelet aggregation. Nitroglycerin requires a prescription and assessment of
hypotension. Oxygen if SpO2 <94%.
Question 4
Which of the following is the correct compression-to-ventilation ratio for a single rescuer
performing CPR on an adult cardiac arrest patient?
A) 30:2
B) 15:2
C) 30:1
D) 15:1
Correct Answer: A
Rationale: AHA guidelines recommend 30:2 for single-rescuer adult CPR (30 compressions, 2
breaths). For two-rescuer adult CPR, it remains 30:2.
Question 5
An unresponsive patient has a blood glucose reading of 45 mg/dL. The patient has an intact gag
reflex. What is the most appropriate treatment?
A) Oral glucose gel
B) IV dextrose 50%
C) Glucagon IM
D) Nothing by mouth
Correct Answer: A
Rationale: With an intact gag reflex and ability to protect airway, oral glucose is preferred. IV
dextrose is for unconscious patients with IV access; glucagon IM is for unconscious patients
without IV access.
,Question 6
A patient involved in a fall from 15 feet has a large laceration on the forearm with bright red
blood spurting. What is the immediate intervention?
A) Apply a tourniquet proximal to the wound
B) Apply direct pressure with a sterile gauze
C) Elevate the arm above the heart
D) Apply a pressure bandage
Correct Answer: A
Rationale: Spurting bright red blood indicates arterial hemorrhage. Direct pressure may not
control it; tourniquet is indicated for life-threatening extremity hemorrhage.
Question 7
Which of the following is a normal finding in a patient experiencing anaphylaxis?
A) Hypotension
B) Stridor
C) Urticaria (hives)
D) All of the above
Correct Answer: D
Rationale: Anaphylaxis includes multiple systems: hypotension (cardiovascular), stridor
(respiratory), and urticaria (skin). All are expected findings.
Question 8
A 30-year-old female complains of sudden onset of severe headache, neck stiffness, and
photophobia. What is the most likely diagnosis?
A) Migraine headache
B) Subarachnoid hemorrhage
C) Tension headache
D) Sinusitis
Correct Answer: B
Rationale: Sudden, severe "thunderclap" headache with nuchal rigidity (neck stiffness) and
photophobia is classic for subarachnoid hemorrhage from a ruptured aneurysm.
Question 9
You arrive at the scene of a school bus collision with multiple injured children. Which patient
should be transported first based on triage?
, A) A child with a broken arm and crying
B) A child who is unconscious with shallow respirations
C) A child with a small laceration on the forehead
D) A child who is walking and talking
Correct Answer: B
Rationale: In triage, unconsciousness with inadequate breathing indicates immediate (Priority 1)
transport. START triage identifies patients who are breathing but unconscious as immediate.
Question 10
A patient is in respiratory distress with audible wheezing. He has a history of asthma. Which
medication is most appropriate?
A) Albuterol metered-dose inhaler (MDI)
B) Oral albuterol tablet
C) Epinephrine auto-injector
D) Ipratropium bromide
Correct Answer: A
Rationale: Albuterol MDI (with spacer if available) is the first-line bronchodilator for asthma
exacerbation. Epinephrine is for anaphylaxis or severe asthma with altered mental status.
Question 11
What is the correct order of the primary assessment?
A) Airway, Breathing, Circulation, Disability, Exposure (ABCDE)
B) Breathing, Airway, Circulation, Disability, Exposure
C) Circulation, Airway, Breathing, Disability, Exposure
D) Disability, Airway, Breathing, Circulation, Exposure
Correct Answer: A
Rationale: The standard ABCDE approach: Airway, Breathing, Circulation, Disability (neurologic
status), Exposure/environmental control.
Question 12
A patient is found in cardiac arrest. After starting CPR and attaching an AED, the AED advises
"No shock advised." What should the EMT do next?
A) Stop CPR and check for a pulse
B) Resume CPR immediately for 2 minutes
C) Re-analyze the rhythm immediately
