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NCOEMS Practice Exam 2026/2027 (North Carolina Office of
Emergency Medical Services) Accurate Real Exam 150 Questions
and Verified Correct Answers (MOST RECENT!!!)
1. EMTs should wear high-efficiency particulate air (HEPA) respirators when they are in contact with patients who
have which of the following conditions?
A. HIV or AIDS
B. Tuberculosis (TB)
C. Open wounds
D. Hepatitis B
Answer: B
Tuberculosis is transmitted via airborne droplets requiring HEPA respirators (N95 or higher); HIV, hepatitis B
require standard precautions but not respiratory isolation.
2. You are called to assist a 60-year-old female complaining of a severe headache. Upon entering the home, you
smell a strong odor of natural gas. What is your first action?
A. Check the patient's airway, breathing, and circulation
B. Insert a nasopharyngeal airway and assess vital signs
C. Remove the patient from the house to your ambulance
D. Open all windows and determine the source of the gas leak
Answer: C
Scene safety is paramount; natural gas poses explosion and inhalation risks, so the patient must be removed
immediately before assessment.
3. The most common electrical rhythm disturbance that results in sudden cardiac arrest is called:
A. Pulseless electrical activity (PEA)
B. Ventricular fibrillation (V-fib)
C. Ventricular tachycardia (V-tach)
D. Asystole
Answer: B
Ventricular fibrillation is the most common initial rhythm in sudden cardiac arrest, characterized by chaotic
electrical activity without mechanical contraction.
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4. A non-trauma patient was pulseless and apneic. Assisted ventilation was attempted but unsuccessful. After
repositioning the head, a repeat ventilation is also unsuccessful. Which is the next most appropriate step?
A. Check for an airway obstruction
B. Continue with chest compressions only
C. Attempt ventilations using an alternative method
D. Continue repositioning the head until ventilations succeed
Answer: A
After confirming correct head positioning, unsuccessful ventilation indicates airway obstruction requiring
immediate assessment and clearance.
5. During cardiac arrest management, the AED gives a "no shock advised" message. Which condition most likely
prompted this message?
A. The patient is in V-tach
B. The patient is hypothermic
C. The patient is in V-fib
D. The patient's rhythm is asystole
Answer: D
Asystole and PEA are non-shockable rhythms; the AED will not advise defibrillation for these despite continued
cardiac arrest.
6. ALS providers are hyperventilating a patient with suspected brainstem herniation. What should be the target
end-tidal CO2 level during hyperventilation?
A. 20-25 mmHg
B. 60-70 mmHg
C. 30-35 mmHg
D. 40-45 mmHg
Answer: C
*Target ETCO2 of 30-35 mmHg causes cerebral vasoconstriction reducing intracranial pressure; lower levels risk
cerebral ischemia.*
7. Which of the following patients has the highest priority for transport?
A. 57-year-old male with chest pain and systolic BP of 80
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B. 40-year-old female with moderate leg pain
C. 75-year-old male who appears confused but responds to commands
D. 25-year-old female in labor with contractions six minutes apart
Answer: A
Hypotension with chest pain indicates cardiogenic shock, a life-threatening emergency requiring immediate
transport.
8. Of the following, which body fluid has the most potential to transmit bloodborne diseases?
A. Nasal discharge
B. Vomitus
C. Amniotic fluid
D. Feces
Answer: C
Amniotic fluid is considered high-risk for bloodborne pathogens, especially hepatitis B and HIV, requiring full PPE
precautions.
9. Your patient is an 11-month-old female. How can you determine if she has a decreased mental status and
responds to verbal stimuli?
A. She will be upset when you take her from her mother's arms
B. She will be unable to tell you her age if asked
C. She will attempt to locate her parents' voices when they speak
D. She will try to pull away from a painful stimulus on her toe
Answer: C
An infant responding to voice by turning toward the sound indicates appropriate responsiveness to verbal stimuli.
10. A 45-year-old male is experiencing chest discomfort. After placing him in a position of comfort, your next
action should be:
A. Ventilate with a nonrebreather mask at 15 L/min
B. Ventilate with a bag-valve mask at 15 L/min
C. Administer oxygen by nonrebreather mask at 15 L/min
D. Administer oxygen by nasal cannula at 6 L/min
Answer: C
3|Page SUCCESS!!!
NCOEMS Practice Exam 2026/2027 (North Carolina Office of
Emergency Medical Services) Accurate Real Exam 150 Questions
and Verified Correct Answers (MOST RECENT!!!)
1. EMTs should wear high-efficiency particulate air (HEPA) respirators when they are in contact with patients who
have which of the following conditions?
A. HIV or AIDS
B. Tuberculosis (TB)
C. Open wounds
D. Hepatitis B
Answer: B
Tuberculosis is transmitted via airborne droplets requiring HEPA respirators (N95 or higher); HIV, hepatitis B
require standard precautions but not respiratory isolation.
2. You are called to assist a 60-year-old female complaining of a severe headache. Upon entering the home, you
smell a strong odor of natural gas. What is your first action?
A. Check the patient's airway, breathing, and circulation
B. Insert a nasopharyngeal airway and assess vital signs
C. Remove the patient from the house to your ambulance
D. Open all windows and determine the source of the gas leak
Answer: C
Scene safety is paramount; natural gas poses explosion and inhalation risks, so the patient must be removed
immediately before assessment.
3. The most common electrical rhythm disturbance that results in sudden cardiac arrest is called:
A. Pulseless electrical activity (PEA)
B. Ventricular fibrillation (V-fib)
C. Ventricular tachycardia (V-tach)
D. Asystole
Answer: B
Ventricular fibrillation is the most common initial rhythm in sudden cardiac arrest, characterized by chaotic
electrical activity without mechanical contraction.
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4. A non-trauma patient was pulseless and apneic. Assisted ventilation was attempted but unsuccessful. After
repositioning the head, a repeat ventilation is also unsuccessful. Which is the next most appropriate step?
A. Check for an airway obstruction
B. Continue with chest compressions only
C. Attempt ventilations using an alternative method
D. Continue repositioning the head until ventilations succeed
Answer: A
After confirming correct head positioning, unsuccessful ventilation indicates airway obstruction requiring
immediate assessment and clearance.
5. During cardiac arrest management, the AED gives a "no shock advised" message. Which condition most likely
prompted this message?
A. The patient is in V-tach
B. The patient is hypothermic
C. The patient is in V-fib
D. The patient's rhythm is asystole
Answer: D
Asystole and PEA are non-shockable rhythms; the AED will not advise defibrillation for these despite continued
cardiac arrest.
6. ALS providers are hyperventilating a patient with suspected brainstem herniation. What should be the target
end-tidal CO2 level during hyperventilation?
A. 20-25 mmHg
B. 60-70 mmHg
C. 30-35 mmHg
D. 40-45 mmHg
Answer: C
*Target ETCO2 of 30-35 mmHg causes cerebral vasoconstriction reducing intracranial pressure; lower levels risk
cerebral ischemia.*
7. Which of the following patients has the highest priority for transport?
A. 57-year-old male with chest pain and systolic BP of 80
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B. 40-year-old female with moderate leg pain
C. 75-year-old male who appears confused but responds to commands
D. 25-year-old female in labor with contractions six minutes apart
Answer: A
Hypotension with chest pain indicates cardiogenic shock, a life-threatening emergency requiring immediate
transport.
8. Of the following, which body fluid has the most potential to transmit bloodborne diseases?
A. Nasal discharge
B. Vomitus
C. Amniotic fluid
D. Feces
Answer: C
Amniotic fluid is considered high-risk for bloodborne pathogens, especially hepatitis B and HIV, requiring full PPE
precautions.
9. Your patient is an 11-month-old female. How can you determine if she has a decreased mental status and
responds to verbal stimuli?
A. She will be upset when you take her from her mother's arms
B. She will be unable to tell you her age if asked
C. She will attempt to locate her parents' voices when they speak
D. She will try to pull away from a painful stimulus on her toe
Answer: C
An infant responding to voice by turning toward the sound indicates appropriate responsiveness to verbal stimuli.
10. A 45-year-old male is experiencing chest discomfort. After placing him in a position of comfort, your next
action should be:
A. Ventilate with a nonrebreather mask at 15 L/min
B. Ventilate with a bag-valve mask at 15 L/min
C. Administer oxygen by nonrebreather mask at 15 L/min
D. Administer oxygen by nasal cannula at 6 L/min
Answer: C
3|Page SUCCESS!!!
