West Coast EMT Block ACTUAL Exam 1 AND CORRECT
ANSWERS ALREADY GRADED A+ - 225 Questions and
Answers Already Graded A+ Premium Exam Tested And
Verified
Subject Area Emergency Medical Services - Didactic and Practical
Description This exam covers core concepts for West Coast EMT block 1, including patient
assessment, airway management, cardiac emergencies, trauma triage, medical
emergencies, and operational considerations. Questions require synthesis of
clinical guidelines and pathophysiology.
Expected Grade A+
Total Questions 225
Duration 3 hours
Learning Outcomes 1. Integrate pathophysiological principles to formulate differential diagnoses in
acute emergencies.
2. Select appropriate interventions based on evidence-based protocols and patient
status.
3. Analyze trauma mechanisms to predict injury patterns and prioritize spinal
motion restriction.
4. Apply legal and ethical frameworks to prehospital decision-making.
5. Interpret monitoring data (ECG, capnography) to guide advanced life support.
Accreditation Meets U.S. DOT National EMS Education Standards and CAAHEP accreditation
criteria for paramedic programs.
Page 1
,1. For a patient in pulseless electrical activity (PEA) with a heart rate of 40
bpm and a rhythm that is narrow-complex, which of the following
pharmacological interventions is most appropriate?
A. Amiodarone 300 mg IV push
B. Epinephrine 1 mg IV every 3-5 minutes
C. Atropine 0.5 mg IV every 3-5 minutes
D. Sodium bicarbonate 1 mEq/kg IV
Answer: B. Epinephrine 1 mg IV every 3-5 minutes
PEA, especially with a rate <60, is often due to hypoperfusion or a reversible
cause. Epinephrine is the first-line vasopressor per ACLS guidelines to increase
cardiac output. Atropine is not recommended in PEA. Amiodarone is for
shockable rhythms. Bicarbonate is reserved for specific causes like tricyclic
overdose.
2. A patient with a traumatic injury presents with asymmetrical chest
movement, hyperresonance to percussion on the affected side, and profound
hypoxia. Immediate decompression by needle thoracostomy is performed.
Despite correct placement, the patient's condition does not improve. Which of
the following best explains this scenario?
A. The decompression needle was inserted too laterally, entering lung tissue
B. A massive hemothorax is present, not a tension pneumothorax
C. The patient has a simple pneumothorax that does not require decompression
D. The needle was placed in the second intercostal space, midclavicular line, on the
wrong side
Answer: B. A massive hemothorax is present, not a tension pneumothorax
Tension pneumothorax decompression should improve hypoxia and chest
movement. If no improvement, consider a hemothorax, which causes dullness to
percussion (not hyperresonance) and requires tube thoracostomy. The question
states hyperresonance, so tension was suspected; but massive hemothorax can
present similarly if air and blood coexist. Option B is plausible.
Page 2
,3. During transport of a patient with suspected acute coronary syndrome, the
ECG shows ST elevation in leads II, III, and aVF. The patient has a history of
COPD and a heart rate of 110. Which of the following factors would most
contraindicate the administration of nitroglycerin?
A. Use of sildenafil within the past 48 hours
B. Systolic blood pressure of 110 mmHg
C. Heart rate of 110 bpm
D. History of COPD
Answer: A. Use of sildenafil within the past 48 hours
Sildenafil and similar PDE-5 inhibitors potentiate the hypotensive effect of
nitroglycerin, leading to severe hypotension. This is an absolute contraindication
within 24-48 hours. SBP 110 is borderline but not an absolute contraindication.
Tachycardia and COPD are relative but not absolute contraindications.
4. A patient with type 1 diabetes presents with polyuria, polydipsia, and
abdominal pain. Blood glucose is 450 mg/dL. Urine dipstick shows large
ketones. The patient is alert and has a patent airway. Which of the following
interventions should be initiated first?
A. Administer 1 amp D50W
B. Begin normal saline bolus
C. Give sodium bicarbonate IV
D. Start an insulin drip
Answer: B. Begin normal saline bolus
This is diabetic ketoacidosis (DKA). Fluid resuscitation with normal saline is the
priority to correct hypovolemia and improve tissue perfusion. Insulin therapy is
started after fluids. D50W is for hypoglycemia. Bicarbonate is not routinely given
in DKA unless severe acidosis persists.
Page 3
, 5. During delivery of a neonate, the umbilical cord is seen protruding from the
vagina. Which of the following actions is most appropriate?
A. Apply firm traction to the cord to dislodge the head
B. Place the mother in a knee-chest position
C. Clamp and cut the cord immediately
D. Administer oxytocin to hasten delivery
Answer: B. Place the mother in a knee-chest position
Umbilical cord prolapse requires interventions to relieve pressure on the cord
and preserve fetal oxygenation. The knee-chest or Trendelenburg position
reduces pressure. Traction or clamping may compromise the cord. Oxytocin is
given after delivery for hemostasis, not before.
6. A patient weighing 30 kg requires epinephrine for anaphylaxis. The
concentration available is 1:1000 (1 mg/mL). What volume of this
concentration should be administered intramuscularly?
A. 0.15 mL
B. 0.3 mL
C. 0.5 mL
D. 0.01 mL
Answer: B. 0.3 mL
The IM dose of epinephrine for anaphylaxis in children >30 kg is 0.3 mg (same as
adult). Using 1:1000 (1 mg/mL), volume = 0.3 mg / 1 mg/mL = 0.3 mL. Option A
is for <30 kg (0.15 mg). Option C is excessive (0.5 mg).
Page 4
ANSWERS ALREADY GRADED A+ - 225 Questions and
Answers Already Graded A+ Premium Exam Tested And
Verified
Subject Area Emergency Medical Services - Didactic and Practical
Description This exam covers core concepts for West Coast EMT block 1, including patient
assessment, airway management, cardiac emergencies, trauma triage, medical
emergencies, and operational considerations. Questions require synthesis of
clinical guidelines and pathophysiology.
Expected Grade A+
Total Questions 225
Duration 3 hours
Learning Outcomes 1. Integrate pathophysiological principles to formulate differential diagnoses in
acute emergencies.
2. Select appropriate interventions based on evidence-based protocols and patient
status.
3. Analyze trauma mechanisms to predict injury patterns and prioritize spinal
motion restriction.
4. Apply legal and ethical frameworks to prehospital decision-making.
5. Interpret monitoring data (ECG, capnography) to guide advanced life support.
Accreditation Meets U.S. DOT National EMS Education Standards and CAAHEP accreditation
criteria for paramedic programs.
Page 1
,1. For a patient in pulseless electrical activity (PEA) with a heart rate of 40
bpm and a rhythm that is narrow-complex, which of the following
pharmacological interventions is most appropriate?
A. Amiodarone 300 mg IV push
B. Epinephrine 1 mg IV every 3-5 minutes
C. Atropine 0.5 mg IV every 3-5 minutes
D. Sodium bicarbonate 1 mEq/kg IV
Answer: B. Epinephrine 1 mg IV every 3-5 minutes
PEA, especially with a rate <60, is often due to hypoperfusion or a reversible
cause. Epinephrine is the first-line vasopressor per ACLS guidelines to increase
cardiac output. Atropine is not recommended in PEA. Amiodarone is for
shockable rhythms. Bicarbonate is reserved for specific causes like tricyclic
overdose.
2. A patient with a traumatic injury presents with asymmetrical chest
movement, hyperresonance to percussion on the affected side, and profound
hypoxia. Immediate decompression by needle thoracostomy is performed.
Despite correct placement, the patient's condition does not improve. Which of
the following best explains this scenario?
A. The decompression needle was inserted too laterally, entering lung tissue
B. A massive hemothorax is present, not a tension pneumothorax
C. The patient has a simple pneumothorax that does not require decompression
D. The needle was placed in the second intercostal space, midclavicular line, on the
wrong side
Answer: B. A massive hemothorax is present, not a tension pneumothorax
Tension pneumothorax decompression should improve hypoxia and chest
movement. If no improvement, consider a hemothorax, which causes dullness to
percussion (not hyperresonance) and requires tube thoracostomy. The question
states hyperresonance, so tension was suspected; but massive hemothorax can
present similarly if air and blood coexist. Option B is plausible.
Page 2
,3. During transport of a patient with suspected acute coronary syndrome, the
ECG shows ST elevation in leads II, III, and aVF. The patient has a history of
COPD and a heart rate of 110. Which of the following factors would most
contraindicate the administration of nitroglycerin?
A. Use of sildenafil within the past 48 hours
B. Systolic blood pressure of 110 mmHg
C. Heart rate of 110 bpm
D. History of COPD
Answer: A. Use of sildenafil within the past 48 hours
Sildenafil and similar PDE-5 inhibitors potentiate the hypotensive effect of
nitroglycerin, leading to severe hypotension. This is an absolute contraindication
within 24-48 hours. SBP 110 is borderline but not an absolute contraindication.
Tachycardia and COPD are relative but not absolute contraindications.
4. A patient with type 1 diabetes presents with polyuria, polydipsia, and
abdominal pain. Blood glucose is 450 mg/dL. Urine dipstick shows large
ketones. The patient is alert and has a patent airway. Which of the following
interventions should be initiated first?
A. Administer 1 amp D50W
B. Begin normal saline bolus
C. Give sodium bicarbonate IV
D. Start an insulin drip
Answer: B. Begin normal saline bolus
This is diabetic ketoacidosis (DKA). Fluid resuscitation with normal saline is the
priority to correct hypovolemia and improve tissue perfusion. Insulin therapy is
started after fluids. D50W is for hypoglycemia. Bicarbonate is not routinely given
in DKA unless severe acidosis persists.
Page 3
, 5. During delivery of a neonate, the umbilical cord is seen protruding from the
vagina. Which of the following actions is most appropriate?
A. Apply firm traction to the cord to dislodge the head
B. Place the mother in a knee-chest position
C. Clamp and cut the cord immediately
D. Administer oxytocin to hasten delivery
Answer: B. Place the mother in a knee-chest position
Umbilical cord prolapse requires interventions to relieve pressure on the cord
and preserve fetal oxygenation. The knee-chest or Trendelenburg position
reduces pressure. Traction or clamping may compromise the cord. Oxytocin is
given after delivery for hemostasis, not before.
6. A patient weighing 30 kg requires epinephrine for anaphylaxis. The
concentration available is 1:1000 (1 mg/mL). What volume of this
concentration should be administered intramuscularly?
A. 0.15 mL
B. 0.3 mL
C. 0.5 mL
D. 0.01 mL
Answer: B. 0.3 mL
The IM dose of epinephrine for anaphylaxis in children >30 kg is 0.3 mg (same as
adult). Using 1:1000 (1 mg/mL), volume = 0.3 mg / 1 mg/mL = 0.3 mL. Option A
is for <30 kg (0.15 mg). Option C is excessive (0.5 mg).
Page 4
