1. A 58-year-old man is clutching his chest and says, "It feels like an elephant is sitting on me." As
an EMR, what is your priority action after ensuring scene safety?
A) Apply high-flow oxygen via non-rebreather mask
B) Immediately drive him to the hospital in your personal vehicle
C) Ask him if he has a history of heartburn
D) Have him drink a glass of water to rule out indigestion
Correct Answer: A) Apply high-flow oxygen via non-rebreather mask
.Rationale: Chest pressure suggests a myocardial infarction; oxygen helps reduce heart muscle
damage by increasing perfusion to ischemic tissue; wait for ALS transport.
2. You arrive at a scene where a patient has a small knife impaled in their thigh. The blade is still in
place. What should you do?
A) Remove the knife to assess the depth of the wound
B) Stabilize the knife with bulky dressings and control bleeding around it
C) Irrigate the wound vigorously with saline
D) Apply a tourniquet directly over the knife
Correct Answer: B) Stabilize the knife with bulky dressings and control bleeding around it
.Rationale: Removing an impaled object can worsen bleeding or cause further internal damage;
stabilize it in place and apply pressure around it.
3. During your primary assessment, an unresponsive 6-year-old child has agonal breathing with a
weak pulse of 30 beats per minute. What is your most immediate action?
A) Begin chest compressions immediately
B) Place the child in the recovery position
C) Listen for breath sounds for 20 seconds
D) Search for a medical alert bracelet
Correct Answer: A) Begin chest compressions immediately
.Rationale: A pulse less than 60 bpm with poor perfusion in a child indicates cardiac arrest; start
CPR immediately with a 30:2 ratio for single rescuer.
,4. A woman is stung by a bee and immediately develops hives, difficulty breathing, and stridor.
She has an epinephrine auto-injector but cannot use it herself. You should:
A) Administer the epinephrine into her thigh muscle
B) Administer the epinephrine into her heart
C) Wait 10 minutes to see if symptoms worsen
D) Give her an oral antihistamine from her purse
Correct Answer: A) Administer the epinephrine into her thigh muscle
.Rationale: Epinephrine reverses anaphylactic shock by bronchodilation and vasoconstriction;
administer into the vastus lateralis muscle (mid-thigh outer side).
5. At a motor vehicle collision, a patient is trapped in the driver's seat with the steering wheel
pushed into their chest. They have absent breath sounds on the left side and jugular vein
distension. You suspect:
A) Simple pneumothorax
B) Tension pneumothorax
C) Cardiac tamponade
D) Hemothorax
Correct Answer: B) Tension pneumothorax
.Rationale: Trapped air in the pleural space collapses the lung and shifts the heart; absent breath
sounds plus distended neck veins are classic tension pneumothorax signs.
6. You are caring for a 70-year-old female who fell and cannot move her left arm or leg. Her speech
is slurred. What is the time-sensitive condition you should suspect?
A) Hypoglycemia
B) Stroke (CVA)
C) Broken humerus
D) Seizure postictal state
Correct Answer: B) Stroke (CVA)
.Rationale: Sudden unilateral weakness and slurred speech indicate an ischemic or hemorrhagic
stroke; note the time of symptom onset for thrombolytic therapy eligibility.
7. While using a bag-valve-mask (BVM) on an adult patient, you see the stomach rising instead of
the chest. This is called gastric distention and is caused by:
A) Ventilating too slowly
B) Using 100% oxygen
,C) Ventilating with too much force or volume
D) Having the patient supine
Correct Answer: C) Ventilating with too much force or volume
.Rationale: Excessive pressure overcomes the lower esophageal sphincter; air enters the stomach,
increasing vomit risk; give each breath over 1 second just until chest rises.
8. A patient with a history of diabetes is confused, sweating profusely, and has a rapid pulse. You
cannot obtain a glucometer reading. What should you do if the patient can swallow?
A) Administer insulin
B) Give oral glucose or a sugary drink
C) Withhold all fluids
D) Have them exercise to burn off sugar
Correct Answer: B) Give oral glucose or a sugary drink
.Rationale: These are signs of hypoglycemia (low blood sugar); oral sugar is a life-saving
treatment; do not give anything if patient cannot swallow safely.
9. You find a patient face-down on the floor not moving. Before rolling them over, you must check
for:
A) A medical alert bracelet
B) The patient's age
C) Whether they are breathing normally
D) The patient's wallet for ID
Correct Answer: C) Whether they are breathing normally
.Rationale: If the patient is in cardiac arrest, immediate CPR is needed; log roll only after
confirming unresponsiveness and abnormal breathing to protect the spine.
10. A 16-year-old ingested an unknown amount of Tylenol (acetaminophen) 30 minutes ago and is
now nauseous but alert. What is your priority action?
A) Induce vomiting with ipecac
B) Give activated charcoal orally
C) Call poison control and transport
D) Have them drink milk to coat the stomach
Correct Answer: C) Call poison control and transport
.Rationale: Acetaminophen overdose causes delayed liver failure; do not induce vomiting unless
directed; transport for potential N-acetylcysteine treatment.
, 11. You are the first responder at a house fire. A firefighter brings out a child who is not breathing
but has a pulse. What is your first action for this child?
A) Start chest compressions
B) Attach an AED
C) Open the airway and give two rescue breaths
D) Perform a finger sweep of the mouth
Correct Answer: C) Open the airway and give two rescue breaths
.Rationale: .Respiratory arrest with a pulse requires ventilations; the likely cause is smoke
inhalation; give 1 breath every 3-5 seconds for a child with a pulse..
12. What does the "P" stand for in the SAMPLE history mnemonic?
A) Pain level
B) Past pertinent medical history
C) Present illness
D) Position of comfort
Correct Answer: B) Past pertinent medical history
.Rationale: SAMPLE helps gather critical history: Signs/Symptoms, Allergies, Medications, Past
history, Last oral intake, Events leading to injury/illness.
13. A patient has a deep gash on their forearm with bright red blood spurting in time with the
pulse. This indicates:
A) Venous bleeding
B) Capillary bleeding
C) Arterial bleeding
D) Superficial bleeding
Correct Answer: C) Arterial bleeding
.Rationale: Bright red, pulsatile spurting is high-pressure arterial bleeding; requires immediate
direct pressure and pressure bandage as it is life-threatening.
14. During a mass casualty incident, you find a patient who is not breathing. After opening the
airway, they still do not breathe. You should:
A) Tag them as black (deceased) and move on
B) Tag them as red (immediate) and begin rescue breaths
C) Tag them as yellow (delayed) and reassess in 10 minutes
D) Transport them immediately alone
an EMR, what is your priority action after ensuring scene safety?
A) Apply high-flow oxygen via non-rebreather mask
B) Immediately drive him to the hospital in your personal vehicle
C) Ask him if he has a history of heartburn
D) Have him drink a glass of water to rule out indigestion
Correct Answer: A) Apply high-flow oxygen via non-rebreather mask
.Rationale: Chest pressure suggests a myocardial infarction; oxygen helps reduce heart muscle
damage by increasing perfusion to ischemic tissue; wait for ALS transport.
2. You arrive at a scene where a patient has a small knife impaled in their thigh. The blade is still in
place. What should you do?
A) Remove the knife to assess the depth of the wound
B) Stabilize the knife with bulky dressings and control bleeding around it
C) Irrigate the wound vigorously with saline
D) Apply a tourniquet directly over the knife
Correct Answer: B) Stabilize the knife with bulky dressings and control bleeding around it
.Rationale: Removing an impaled object can worsen bleeding or cause further internal damage;
stabilize it in place and apply pressure around it.
3. During your primary assessment, an unresponsive 6-year-old child has agonal breathing with a
weak pulse of 30 beats per minute. What is your most immediate action?
A) Begin chest compressions immediately
B) Place the child in the recovery position
C) Listen for breath sounds for 20 seconds
D) Search for a medical alert bracelet
Correct Answer: A) Begin chest compressions immediately
.Rationale: A pulse less than 60 bpm with poor perfusion in a child indicates cardiac arrest; start
CPR immediately with a 30:2 ratio for single rescuer.
,4. A woman is stung by a bee and immediately develops hives, difficulty breathing, and stridor.
She has an epinephrine auto-injector but cannot use it herself. You should:
A) Administer the epinephrine into her thigh muscle
B) Administer the epinephrine into her heart
C) Wait 10 minutes to see if symptoms worsen
D) Give her an oral antihistamine from her purse
Correct Answer: A) Administer the epinephrine into her thigh muscle
.Rationale: Epinephrine reverses anaphylactic shock by bronchodilation and vasoconstriction;
administer into the vastus lateralis muscle (mid-thigh outer side).
5. At a motor vehicle collision, a patient is trapped in the driver's seat with the steering wheel
pushed into their chest. They have absent breath sounds on the left side and jugular vein
distension. You suspect:
A) Simple pneumothorax
B) Tension pneumothorax
C) Cardiac tamponade
D) Hemothorax
Correct Answer: B) Tension pneumothorax
.Rationale: Trapped air in the pleural space collapses the lung and shifts the heart; absent breath
sounds plus distended neck veins are classic tension pneumothorax signs.
6. You are caring for a 70-year-old female who fell and cannot move her left arm or leg. Her speech
is slurred. What is the time-sensitive condition you should suspect?
A) Hypoglycemia
B) Stroke (CVA)
C) Broken humerus
D) Seizure postictal state
Correct Answer: B) Stroke (CVA)
.Rationale: Sudden unilateral weakness and slurred speech indicate an ischemic or hemorrhagic
stroke; note the time of symptom onset for thrombolytic therapy eligibility.
7. While using a bag-valve-mask (BVM) on an adult patient, you see the stomach rising instead of
the chest. This is called gastric distention and is caused by:
A) Ventilating too slowly
B) Using 100% oxygen
,C) Ventilating with too much force or volume
D) Having the patient supine
Correct Answer: C) Ventilating with too much force or volume
.Rationale: Excessive pressure overcomes the lower esophageal sphincter; air enters the stomach,
increasing vomit risk; give each breath over 1 second just until chest rises.
8. A patient with a history of diabetes is confused, sweating profusely, and has a rapid pulse. You
cannot obtain a glucometer reading. What should you do if the patient can swallow?
A) Administer insulin
B) Give oral glucose or a sugary drink
C) Withhold all fluids
D) Have them exercise to burn off sugar
Correct Answer: B) Give oral glucose or a sugary drink
.Rationale: These are signs of hypoglycemia (low blood sugar); oral sugar is a life-saving
treatment; do not give anything if patient cannot swallow safely.
9. You find a patient face-down on the floor not moving. Before rolling them over, you must check
for:
A) A medical alert bracelet
B) The patient's age
C) Whether they are breathing normally
D) The patient's wallet for ID
Correct Answer: C) Whether they are breathing normally
.Rationale: If the patient is in cardiac arrest, immediate CPR is needed; log roll only after
confirming unresponsiveness and abnormal breathing to protect the spine.
10. A 16-year-old ingested an unknown amount of Tylenol (acetaminophen) 30 minutes ago and is
now nauseous but alert. What is your priority action?
A) Induce vomiting with ipecac
B) Give activated charcoal orally
C) Call poison control and transport
D) Have them drink milk to coat the stomach
Correct Answer: C) Call poison control and transport
.Rationale: Acetaminophen overdose causes delayed liver failure; do not induce vomiting unless
directed; transport for potential N-acetylcysteine treatment.
, 11. You are the first responder at a house fire. A firefighter brings out a child who is not breathing
but has a pulse. What is your first action for this child?
A) Start chest compressions
B) Attach an AED
C) Open the airway and give two rescue breaths
D) Perform a finger sweep of the mouth
Correct Answer: C) Open the airway and give two rescue breaths
.Rationale: .Respiratory arrest with a pulse requires ventilations; the likely cause is smoke
inhalation; give 1 breath every 3-5 seconds for a child with a pulse..
12. What does the "P" stand for in the SAMPLE history mnemonic?
A) Pain level
B) Past pertinent medical history
C) Present illness
D) Position of comfort
Correct Answer: B) Past pertinent medical history
.Rationale: SAMPLE helps gather critical history: Signs/Symptoms, Allergies, Medications, Past
history, Last oral intake, Events leading to injury/illness.
13. A patient has a deep gash on their forearm with bright red blood spurting in time with the
pulse. This indicates:
A) Venous bleeding
B) Capillary bleeding
C) Arterial bleeding
D) Superficial bleeding
Correct Answer: C) Arterial bleeding
.Rationale: Bright red, pulsatile spurting is high-pressure arterial bleeding; requires immediate
direct pressure and pressure bandage as it is life-threatening.
14. During a mass casualty incident, you find a patient who is not breathing. After opening the
airway, they still do not breathe. You should:
A) Tag them as black (deceased) and move on
B) Tag them as red (immediate) and begin rescue breaths
C) Tag them as yellow (delayed) and reassess in 10 minutes
D) Transport them immediately alone
