EMT-I/85 – Emergency Medical Technician
Intermediate/85 Professional Exam Prep
Updated 2026 | 100+ Practice Questions &
Verified Answers | Advanced Emergency Medical
Services Certification Study Guide, Intermediate
EMT Test Bank, Patient Assessment, Airway &
Respiratory Care, Trauma Life Support, Cardiac
Emergencies, IV Access, Emergency
Pharmacology, Medical & Pediatric Emergencies,
Clinical Scenarios, Detailed Rationales
Question 1: A 34-year-old male is found unresponsive in a garage with a
running vehicle. His skin is flushed and dry, and his pupils are constricted.
Which of the following acid-base imbalances is most likely to be present
initially?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
CORRECT ANSWER: C. Respiratory acidosis
Rationale: Carbon monoxide poisoning, while often causing anoxia, does not directly
cause acidosis. The running vehicle indicates potential CO poisoning; however, the
flushed skin and constricted pupils are not classic for CO (which causes cherry-red skin
and normal pupils). This presentation is more consistent with severe hypoventilation
due to CNS depression (e.g., from carbon monoxide or other toxins) leading to CO2
retention, which causes a respiratory acidosis. The other options are less likely in the
immediate setting of acute exposure to a CNS depressant.
Question 2: An EMT-I/85 is performing a needle decompression on a patient
with a tension pneumothorax. Which anatomical landmark is the preferred
site for this procedure?
A. The 4th intercostal space at the anterior axillary line
B. The 2nd intercostal space at the midclavicular line
C. The 5th intercostal space at the midaxillary line
D. The 2nd intercostal space at the midaxillary line
CORRECT ANSWER: B. The 2nd intercostal space at the midclavicular line
Rationale: The standard and preferred site for needle thoracostomy to decompress a
tension pneumothorax is the 2nd intercostal space in the midclavicular line. This site
provides access to the pleural space above the diaphragm and away from major internal
thoracic vessels.
,Question 3: Which of the following ECG findings is MOST characteristic of an
acute anteroseptal myocardial infarction?
A. ST-segment elevation in leads II, III, and aVF
B. ST-segment depression in leads V1 and V2
C. ST-segment elevation in leads V1, V2, V3, and V4
D. Pathologic Q waves in leads I and aVL
CORRECT ANSWER: C. ST-segment elevation in leads V1, V2, V3, and V4
Rationale: The anteroseptal wall of the left ventricle is best viewed by the precordial
leads V1 through V4. ST-segment elevation in these leads is the hallmark of an acute
anteroseptal STEMI.
Question 4: A patient with a history of COPD presents with severe respiratory
distress. Which of the following findings would BEST support a diagnosis of
acute respiratory failure?
A. A respiratory rate of 28 breaths per minute
B. An SpO2 of 91% on room air
C. A PaCO2 of 58 mmHg with a pH of 7.31
D. The use of accessory muscles during inspiration
CORRECT ANSWER: C. A PaCO2 of 58 mmHg with a pH of 7.31
Rationale: Acute respiratory failure is defined by a PaO2 less than 60 mmHg or a
PaCO2 greater than 50 mmHg with a pH less than 7.35. Option C presents a
hypercapnic respiratory failure with associated acidemia.
Question 5: In the management of a patient with status epilepticus, which of
the following benzodiazepines is preferred for its rapid onset and high lipid
solubility, making it effective for intramuscular administration when IV access
is not available?
A. Diazepam
B. Lorazepam
C. Midazolam
D. Chlordiazepoxide
CORRECT ANSWER: C. Midazolam
Rationale: Midazolam is highly lipid-soluble, which allows for rapid absorption and
onset of action when given intramuscularly. It is the preferred agent for IM use in status
epilepticus when IV access is unobtainable, particularly in the prehospital setting.
, Question 6: A patient with a known history of Wolff-Parkinson-White (WPW)
syndrome presents with a wide-complex tachycardia. Which of the following
medications is CONTRAINDICATED in this situation because it may accelerate
conduction through the accessory pathway?
A. Amiodarone
B. Lidocaine
C. Adenosine
D. Magnesium
CORRECT ANSWER: C. Adenosine
Rationale: In WPW with atrial fibrillation, adenosine is contraindicated because it can
block the AV node, leading to increased conduction down the accessory pathway and
potentially causing ventricular fibrillation. It is not a first-line agent for wide-complex
tachycardia of unknown origin.
Question 7: During the primary assessment of a trauma patient, which of the
following findings indicates a potential life-threatening airway obstruction that
requires immediate intervention?
A. Snoring respirations
B. Gurgling sounds
C. Stridor
D. Hoarseness
CORRECT ANSWER: C. Stridor
Rationale: Stridor is a high-pitched, monophonic sound caused by turbulent airflow
through a partially obstructed upper airway. It is a key indicator of an impending, life-
threatening airway compromise, often at the level of the larynx or trachea.
Question 8: A 65-year-old male presents with severe chest pain and
diaphoresis. His blood pressure is 88/62 mmHg and his heart rate is 118 bpm.
If the patient is in cardiogenic shock, what is the primary pathophysiological
problem that distinguishes it from hypovolemic shock?
A. Loss of intravascular volume
B. Failure of the cardiac pump
C. Systemic vasodilation
D. Obstructive compression of the heart
CORRECT ANSWER: B. Failure of the cardiac pump
Rationale: Cardiogenic shock is defined by primary pump failure of the heart, leading to
inadequate tissue perfusion despite adequate or elevated filling pressures. Hypovolemic
shock results from a loss of intravascular volume.
Intermediate/85 Professional Exam Prep
Updated 2026 | 100+ Practice Questions &
Verified Answers | Advanced Emergency Medical
Services Certification Study Guide, Intermediate
EMT Test Bank, Patient Assessment, Airway &
Respiratory Care, Trauma Life Support, Cardiac
Emergencies, IV Access, Emergency
Pharmacology, Medical & Pediatric Emergencies,
Clinical Scenarios, Detailed Rationales
Question 1: A 34-year-old male is found unresponsive in a garage with a
running vehicle. His skin is flushed and dry, and his pupils are constricted.
Which of the following acid-base imbalances is most likely to be present
initially?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
CORRECT ANSWER: C. Respiratory acidosis
Rationale: Carbon monoxide poisoning, while often causing anoxia, does not directly
cause acidosis. The running vehicle indicates potential CO poisoning; however, the
flushed skin and constricted pupils are not classic for CO (which causes cherry-red skin
and normal pupils). This presentation is more consistent with severe hypoventilation
due to CNS depression (e.g., from carbon monoxide or other toxins) leading to CO2
retention, which causes a respiratory acidosis. The other options are less likely in the
immediate setting of acute exposure to a CNS depressant.
Question 2: An EMT-I/85 is performing a needle decompression on a patient
with a tension pneumothorax. Which anatomical landmark is the preferred
site for this procedure?
A. The 4th intercostal space at the anterior axillary line
B. The 2nd intercostal space at the midclavicular line
C. The 5th intercostal space at the midaxillary line
D. The 2nd intercostal space at the midaxillary line
CORRECT ANSWER: B. The 2nd intercostal space at the midclavicular line
Rationale: The standard and preferred site for needle thoracostomy to decompress a
tension pneumothorax is the 2nd intercostal space in the midclavicular line. This site
provides access to the pleural space above the diaphragm and away from major internal
thoracic vessels.
,Question 3: Which of the following ECG findings is MOST characteristic of an
acute anteroseptal myocardial infarction?
A. ST-segment elevation in leads II, III, and aVF
B. ST-segment depression in leads V1 and V2
C. ST-segment elevation in leads V1, V2, V3, and V4
D. Pathologic Q waves in leads I and aVL
CORRECT ANSWER: C. ST-segment elevation in leads V1, V2, V3, and V4
Rationale: The anteroseptal wall of the left ventricle is best viewed by the precordial
leads V1 through V4. ST-segment elevation in these leads is the hallmark of an acute
anteroseptal STEMI.
Question 4: A patient with a history of COPD presents with severe respiratory
distress. Which of the following findings would BEST support a diagnosis of
acute respiratory failure?
A. A respiratory rate of 28 breaths per minute
B. An SpO2 of 91% on room air
C. A PaCO2 of 58 mmHg with a pH of 7.31
D. The use of accessory muscles during inspiration
CORRECT ANSWER: C. A PaCO2 of 58 mmHg with a pH of 7.31
Rationale: Acute respiratory failure is defined by a PaO2 less than 60 mmHg or a
PaCO2 greater than 50 mmHg with a pH less than 7.35. Option C presents a
hypercapnic respiratory failure with associated acidemia.
Question 5: In the management of a patient with status epilepticus, which of
the following benzodiazepines is preferred for its rapid onset and high lipid
solubility, making it effective for intramuscular administration when IV access
is not available?
A. Diazepam
B. Lorazepam
C. Midazolam
D. Chlordiazepoxide
CORRECT ANSWER: C. Midazolam
Rationale: Midazolam is highly lipid-soluble, which allows for rapid absorption and
onset of action when given intramuscularly. It is the preferred agent for IM use in status
epilepticus when IV access is unobtainable, particularly in the prehospital setting.
, Question 6: A patient with a known history of Wolff-Parkinson-White (WPW)
syndrome presents with a wide-complex tachycardia. Which of the following
medications is CONTRAINDICATED in this situation because it may accelerate
conduction through the accessory pathway?
A. Amiodarone
B. Lidocaine
C. Adenosine
D. Magnesium
CORRECT ANSWER: C. Adenosine
Rationale: In WPW with atrial fibrillation, adenosine is contraindicated because it can
block the AV node, leading to increased conduction down the accessory pathway and
potentially causing ventricular fibrillation. It is not a first-line agent for wide-complex
tachycardia of unknown origin.
Question 7: During the primary assessment of a trauma patient, which of the
following findings indicates a potential life-threatening airway obstruction that
requires immediate intervention?
A. Snoring respirations
B. Gurgling sounds
C. Stridor
D. Hoarseness
CORRECT ANSWER: C. Stridor
Rationale: Stridor is a high-pitched, monophonic sound caused by turbulent airflow
through a partially obstructed upper airway. It is a key indicator of an impending, life-
threatening airway compromise, often at the level of the larynx or trachea.
Question 8: A 65-year-old male presents with severe chest pain and
diaphoresis. His blood pressure is 88/62 mmHg and his heart rate is 118 bpm.
If the patient is in cardiogenic shock, what is the primary pathophysiological
problem that distinguishes it from hypovolemic shock?
A. Loss of intravascular volume
B. Failure of the cardiac pump
C. Systemic vasodilation
D. Obstructive compression of the heart
CORRECT ANSWER: B. Failure of the cardiac pump
Rationale: Cardiogenic shock is defined by primary pump failure of the heart, leading to
inadequate tissue perfusion despite adequate or elevated filling pressures. Hypovolemic
shock results from a loss of intravascular volume.
