WEST COAST EMT BLOCK 3 EXAM
COMPREHENSIVE PRACTICE EXAM
EDITION
Emergency Medical Technician (EMT-Basic) • National EMS Education Standards • NREMT Cognitive Exam Blueprint • 150
Questions • 8 Sections • Answers + Rationales
Candidate Name: ______________________________ Date: ____________ Score: ______ / 150
EXAM OVERVIEW & INSTRUCTIONS
Exam type Comprehensive block final — all foundational EMT knowledge and skills (Block 3)
Total questions 150 multiple-choice items, 4 options (A–D), one correct answer each
Aligned with National EMS Education Standards and the current NREMT cognitive exam blueprint
Content areas Airway, patient assessment, medical, trauma, special populations, EMS operations,
pharmacology
Time suggested Approximately 2–2.5 hours (the NREMT exam allows about 2 hours for 70–120 items)
How to use Answers and rationales appear below each question; cover them, answer on paper, then
self-score
STUDY STRATEGY
• Block exams are cumulative: expect questions from every prior block, so review airway, assessment, medical, and trauma
together.
• The 2025 AHA Guidelines for CPR and ECC are reflected here (compression rate 100–120/min, depth 2–2.4 in, 30:2
before advanced airway, epinephrine after the first shock in shockable rhythms).
• Time yourself section by section; 150 questions should take no more than about 2.5 hours at exam pace.
• Every question you miss identifies a topic to review before the real exam — reread the rationale, then the textbook section.
• This is practice material, not an official West Coast EMT or NREMT publication.
EXAM AT A GLANCE
Section Content Area Questions
1 Airway Management, Respiration & Ventilation – Anatomy, adjuncts, oxygen, BVM, CPAP 25
2 Patient Assessment – Scene size-up, primary/secondary survey, history, vitals 25
3 Medical Emergencies – Respiratory, cardiac, diabetic, allergic, neuro, behavioral 25
4 Trauma Emergencies – Bleeding, shock, head/spine, chest, abdomen, burns 20
5 Special Populations – Obstetrics, pediatrics, geriatrics 15
6 EMS Operations & Safety – Ambulance, MCI, triage, rescue, hazmat, legal 20
7 Pharmacology & Medication Administration – Common drugs, routes, calculations 10
8 Integrated Scenarios – Complex multi-system emergencies 10
TOTAL 150
Practice material for study purposes only. Verify current protocols with your program, medical director, and the current AHA
Guidelines for CPR and ECC.
West Coast EMT Block 3 Exam – Comprehensive Practice (2026/2027 Edition) Page 1 of 35
, Section 1: Airway Management, Respiration & Ventilation – Anatomy, Adjuncts, Oxygen
Delivery, BVM, CPAP (25 questions)
Q1: Which of the following structures is part of the LOWER airway?
A. Bronchioles [CORRECT]
B. Oropharynx
C. Larynx
D. Nasopharynx
Correct Answer: A
Rationale: The bronchioles and alveoli are in the lower (conducting and respiratory) airway. The pharynx (naso- and
oropharynx) and the larynx are considered upper airway structures.
Q2: The primary purpose of the respiratory system is to -
A. filter and humidify inhaled air
B. exchange oxygen and carbon dioxide at the alveolar level [CORRECT]
C. produce sound for speech
D. regulate body temperature
Correct Answer: B
Rationale: Gas exchange of O2 and CO2 across the alveolar-capillary membrane is the respiratory system's main job.
Filtering/humidifying, phonation, and temperature control are secondary functions.
Q3: You find a 62-year-old female unresponsive, lying on the floor, with loud snoring respirations. There is no
evidence of trauma. The BEST way to open her airway is the -
A. modified jaw-thrust with head extension
B. insertion of a nasopharyngeal airway before opening the airway
C. head-tilt/chin-lift maneuver [CORRECT]
D. jaw-thrust maneuver
Correct Answer: C
Rationale: With no suspected trauma, head-tilt/chin-lift is the correct maneuver. Jaw-thrust is reserved for suspected spinal
injury, and airway adjuncts are placed after opening the airway, not before.
Q4: A 22-year-old male is unresponsive after a motorcycle crash. The BEST airway technique is the -
A. oral airway only
B. chin-lift maneuver only
C. head-tilt/chin-lift maneuver
D. jaw-thrust maneuver [CORRECT]
Correct Answer: D
Rationale: When spinal injury is suspected, the jaw-thrust is performed without head tilt to open the airway while minimizing
cervical spine movement. Head-tilt devices and methods are avoided in these patients.
Q5: In an unconscious patient, the MOST common cause of airway obstruction is the -
A. tongue [CORRECT]
B. epiglottis
C. tracheal mucosa
D. vocal cords
Correct Answer: A
Rationale: When unconscious, the tongue relaxes and falls backward, occluding the pharynx. This is the most common cause
of obstruction and is why opening the airway is the first step.
West Coast EMT Block 3 Exam – Comprehensive Practice (2026/2027 Edition) Page 2 of 35
,Q6: An oropharyngeal airway is correctly sized by measuring from the -
A. tip of the nose to the earlobe
B. corner of the mouth to the angle of the jaw [CORRECT]
C. center of the mouth to the sternal notch
D. lower incisor to the hyoid bone
Correct Answer: B
Rationale: The OPA is sized from the corner of the mouth to the angle of the jaw. Nose-to-earlobe sizing applies to the
nasopharyngeal airway.
Q7: When inserting an oropharyngeal airway into an adult, the proper technique is to -
A. insert it only after suctioning, regardless of the airway's condition
B. insert it right side up, following the curve of the tongue
C. insert it inverted and rotate it 180 degrees once it passes the tongue [CORRECT]
D. push the tongue down with a tongue blade and insert it sideways
Correct Answer: C
Rationale: Adults typically receive the OPA inverted (curved backward) and rotated 180 degrees once past the tongue (or
inserted over a tongue blade). Inserting it right side up may push the tongue further back.
Q8: An oropharyngeal airway is CONTRAINDICATED in a patient who -
A. has a patent airway and is breathing spontaneously
B. is unresponsive with no gag reflex
C. has a suspected spinal injury
D. is conscious or semiconscious with an intact gag reflex [CORRECT]
Correct Answer: D
Rationale: An intact gag reflex or any conscious state contraindicates the OPA because it can trigger vomiting, laryngospasm,
or airway trauma. The OPA is meant for unresponsive patients without a gag reflex.
Q9: A nasopharyngeal airway is correctly sized by measuring from the -
A. tip of the nose to the earlobe [CORRECT]
B. bridge of the nose to the chin
C. nostril to the thyroid cartilage
D. corner of the mouth to the angle of the jaw
Correct Answer: A
Rationale: NPA sizing runs from the tip of the nose to the earlobe (or tragus); the flange should rest at the nostril.
Q10: A nasopharyngeal airway is CONTRAINDICATED or should be avoided in a patient with -
A. an unresponsive state with no gag reflex
B. suspected basilar skull fracture or severe mid-face trauma [CORRECT]
C. a gag reflex
D. a suspected spinal injury
Correct Answer: B
Rationale: An NPA is avoided with suspected basilar skull fracture or mid-face trauma because it may enter the cranial vault. It
is actually the airway of choice when a gag reflex is present and for spinal injury patients.
West Coast EMT Block 3 Exam – Comprehensive Practice (2026/2027 Edition) Page 3 of 35
, Q11: A semiconscious patient with an intact gag reflex who needs an airway adjunct should receive a -
A. cricothyrotomy
B. oropharyngeal airway
C. nasopharyngeal airway [CORRECT]
D. tracheostomy tube
Correct Answer: C
Rationale: The NPA is better tolerated in patients with a gag reflex because it passes through the nose and does not stimulate
the posterior pharynx like the OPA does.
Q12: While suctioning an adult patient's airway, the TOTAL suction time should not exceed -
A. 5 seconds
B. 10 seconds
C. 15 seconds [CORRECT]
D. 30 seconds
Correct Answer: C
Rationale: Suctioning is limited to about 15 seconds in adults (shorter in children) because it removes air from the airway.
Suction must be interrupted to ventilate between attempts.
Q13: Which suction catheter is designed to remove larger particles and secretions from the oropharynx?
A. French catheter
B. Bulb syringe used in the nose
C. Soft, flexible whistle-tip catheter
D. Yankauer (rigid) tip catheter [CORRECT]
Correct Answer: D
Rationale: The rigid Yankauer tip is the standard oropharyngeal suctioning device because it clears the mouth and pharynx of
large debris, blood, and vomit without collapsing.
Q14: A patient vomits and aspirates during a seizure. The priority is to -
A. suction the airway before ventilating the patient [CORRECT]
B. place the patient in the recovery position and reassess in 5 minutes
C. give oxygen by non-rebreather mask and transport
D. insert an OPA and ventilate immediately
Correct Answer: A
Rationale: Visible blood, vomit, or debris in the airway must be suctioned BEFORE ventilating so it is not pushed deeper into
the lungs.
Q15: While ventilating an adult patient with a bag-valve mask, the correct ventilation rate is approximately -
A. 1 breath every 3 seconds
B. 1 breath every 6 seconds [CORRECT]
C. 1 breath every 2 seconds
D. 1 breath every 10 seconds
Correct Answer: B
Rationale: Adult BLS ventilation is 1 breath about every 6 seconds (about 10 breaths/min). At 1 breath every 3 seconds, the
patient would be hyperventilated.
West Coast EMT Block 3 Exam – Comprehensive Practice (2026/2027 Edition) Page 4 of 35
COMPREHENSIVE PRACTICE EXAM
EDITION
Emergency Medical Technician (EMT-Basic) • National EMS Education Standards • NREMT Cognitive Exam Blueprint • 150
Questions • 8 Sections • Answers + Rationales
Candidate Name: ______________________________ Date: ____________ Score: ______ / 150
EXAM OVERVIEW & INSTRUCTIONS
Exam type Comprehensive block final — all foundational EMT knowledge and skills (Block 3)
Total questions 150 multiple-choice items, 4 options (A–D), one correct answer each
Aligned with National EMS Education Standards and the current NREMT cognitive exam blueprint
Content areas Airway, patient assessment, medical, trauma, special populations, EMS operations,
pharmacology
Time suggested Approximately 2–2.5 hours (the NREMT exam allows about 2 hours for 70–120 items)
How to use Answers and rationales appear below each question; cover them, answer on paper, then
self-score
STUDY STRATEGY
• Block exams are cumulative: expect questions from every prior block, so review airway, assessment, medical, and trauma
together.
• The 2025 AHA Guidelines for CPR and ECC are reflected here (compression rate 100–120/min, depth 2–2.4 in, 30:2
before advanced airway, epinephrine after the first shock in shockable rhythms).
• Time yourself section by section; 150 questions should take no more than about 2.5 hours at exam pace.
• Every question you miss identifies a topic to review before the real exam — reread the rationale, then the textbook section.
• This is practice material, not an official West Coast EMT or NREMT publication.
EXAM AT A GLANCE
Section Content Area Questions
1 Airway Management, Respiration & Ventilation – Anatomy, adjuncts, oxygen, BVM, CPAP 25
2 Patient Assessment – Scene size-up, primary/secondary survey, history, vitals 25
3 Medical Emergencies – Respiratory, cardiac, diabetic, allergic, neuro, behavioral 25
4 Trauma Emergencies – Bleeding, shock, head/spine, chest, abdomen, burns 20
5 Special Populations – Obstetrics, pediatrics, geriatrics 15
6 EMS Operations & Safety – Ambulance, MCI, triage, rescue, hazmat, legal 20
7 Pharmacology & Medication Administration – Common drugs, routes, calculations 10
8 Integrated Scenarios – Complex multi-system emergencies 10
TOTAL 150
Practice material for study purposes only. Verify current protocols with your program, medical director, and the current AHA
Guidelines for CPR and ECC.
West Coast EMT Block 3 Exam – Comprehensive Practice (2026/2027 Edition) Page 1 of 35
, Section 1: Airway Management, Respiration & Ventilation – Anatomy, Adjuncts, Oxygen
Delivery, BVM, CPAP (25 questions)
Q1: Which of the following structures is part of the LOWER airway?
A. Bronchioles [CORRECT]
B. Oropharynx
C. Larynx
D. Nasopharynx
Correct Answer: A
Rationale: The bronchioles and alveoli are in the lower (conducting and respiratory) airway. The pharynx (naso- and
oropharynx) and the larynx are considered upper airway structures.
Q2: The primary purpose of the respiratory system is to -
A. filter and humidify inhaled air
B. exchange oxygen and carbon dioxide at the alveolar level [CORRECT]
C. produce sound for speech
D. regulate body temperature
Correct Answer: B
Rationale: Gas exchange of O2 and CO2 across the alveolar-capillary membrane is the respiratory system's main job.
Filtering/humidifying, phonation, and temperature control are secondary functions.
Q3: You find a 62-year-old female unresponsive, lying on the floor, with loud snoring respirations. There is no
evidence of trauma. The BEST way to open her airway is the -
A. modified jaw-thrust with head extension
B. insertion of a nasopharyngeal airway before opening the airway
C. head-tilt/chin-lift maneuver [CORRECT]
D. jaw-thrust maneuver
Correct Answer: C
Rationale: With no suspected trauma, head-tilt/chin-lift is the correct maneuver. Jaw-thrust is reserved for suspected spinal
injury, and airway adjuncts are placed after opening the airway, not before.
Q4: A 22-year-old male is unresponsive after a motorcycle crash. The BEST airway technique is the -
A. oral airway only
B. chin-lift maneuver only
C. head-tilt/chin-lift maneuver
D. jaw-thrust maneuver [CORRECT]
Correct Answer: D
Rationale: When spinal injury is suspected, the jaw-thrust is performed without head tilt to open the airway while minimizing
cervical spine movement. Head-tilt devices and methods are avoided in these patients.
Q5: In an unconscious patient, the MOST common cause of airway obstruction is the -
A. tongue [CORRECT]
B. epiglottis
C. tracheal mucosa
D. vocal cords
Correct Answer: A
Rationale: When unconscious, the tongue relaxes and falls backward, occluding the pharynx. This is the most common cause
of obstruction and is why opening the airway is the first step.
West Coast EMT Block 3 Exam – Comprehensive Practice (2026/2027 Edition) Page 2 of 35
,Q6: An oropharyngeal airway is correctly sized by measuring from the -
A. tip of the nose to the earlobe
B. corner of the mouth to the angle of the jaw [CORRECT]
C. center of the mouth to the sternal notch
D. lower incisor to the hyoid bone
Correct Answer: B
Rationale: The OPA is sized from the corner of the mouth to the angle of the jaw. Nose-to-earlobe sizing applies to the
nasopharyngeal airway.
Q7: When inserting an oropharyngeal airway into an adult, the proper technique is to -
A. insert it only after suctioning, regardless of the airway's condition
B. insert it right side up, following the curve of the tongue
C. insert it inverted and rotate it 180 degrees once it passes the tongue [CORRECT]
D. push the tongue down with a tongue blade and insert it sideways
Correct Answer: C
Rationale: Adults typically receive the OPA inverted (curved backward) and rotated 180 degrees once past the tongue (or
inserted over a tongue blade). Inserting it right side up may push the tongue further back.
Q8: An oropharyngeal airway is CONTRAINDICATED in a patient who -
A. has a patent airway and is breathing spontaneously
B. is unresponsive with no gag reflex
C. has a suspected spinal injury
D. is conscious or semiconscious with an intact gag reflex [CORRECT]
Correct Answer: D
Rationale: An intact gag reflex or any conscious state contraindicates the OPA because it can trigger vomiting, laryngospasm,
or airway trauma. The OPA is meant for unresponsive patients without a gag reflex.
Q9: A nasopharyngeal airway is correctly sized by measuring from the -
A. tip of the nose to the earlobe [CORRECT]
B. bridge of the nose to the chin
C. nostril to the thyroid cartilage
D. corner of the mouth to the angle of the jaw
Correct Answer: A
Rationale: NPA sizing runs from the tip of the nose to the earlobe (or tragus); the flange should rest at the nostril.
Q10: A nasopharyngeal airway is CONTRAINDICATED or should be avoided in a patient with -
A. an unresponsive state with no gag reflex
B. suspected basilar skull fracture or severe mid-face trauma [CORRECT]
C. a gag reflex
D. a suspected spinal injury
Correct Answer: B
Rationale: An NPA is avoided with suspected basilar skull fracture or mid-face trauma because it may enter the cranial vault. It
is actually the airway of choice when a gag reflex is present and for spinal injury patients.
West Coast EMT Block 3 Exam – Comprehensive Practice (2026/2027 Edition) Page 3 of 35
, Q11: A semiconscious patient with an intact gag reflex who needs an airway adjunct should receive a -
A. cricothyrotomy
B. oropharyngeal airway
C. nasopharyngeal airway [CORRECT]
D. tracheostomy tube
Correct Answer: C
Rationale: The NPA is better tolerated in patients with a gag reflex because it passes through the nose and does not stimulate
the posterior pharynx like the OPA does.
Q12: While suctioning an adult patient's airway, the TOTAL suction time should not exceed -
A. 5 seconds
B. 10 seconds
C. 15 seconds [CORRECT]
D. 30 seconds
Correct Answer: C
Rationale: Suctioning is limited to about 15 seconds in adults (shorter in children) because it removes air from the airway.
Suction must be interrupted to ventilate between attempts.
Q13: Which suction catheter is designed to remove larger particles and secretions from the oropharynx?
A. French catheter
B. Bulb syringe used in the nose
C. Soft, flexible whistle-tip catheter
D. Yankauer (rigid) tip catheter [CORRECT]
Correct Answer: D
Rationale: The rigid Yankauer tip is the standard oropharyngeal suctioning device because it clears the mouth and pharynx of
large debris, blood, and vomit without collapsing.
Q14: A patient vomits and aspirates during a seizure. The priority is to -
A. suction the airway before ventilating the patient [CORRECT]
B. place the patient in the recovery position and reassess in 5 minutes
C. give oxygen by non-rebreather mask and transport
D. insert an OPA and ventilate immediately
Correct Answer: A
Rationale: Visible blood, vomit, or debris in the airway must be suctioned BEFORE ventilating so it is not pushed deeper into
the lungs.
Q15: While ventilating an adult patient with a bag-valve mask, the correct ventilation rate is approximately -
A. 1 breath every 3 seconds
B. 1 breath every 6 seconds [CORRECT]
C. 1 breath every 2 seconds
D. 1 breath every 10 seconds
Correct Answer: B
Rationale: Adult BLS ventilation is 1 breath about every 6 seconds (about 10 breaths/min). At 1 breath every 3 seconds, the
patient would be hyperventilated.
West Coast EMT Block 3 Exam – Comprehensive Practice (2026/2027 Edition) Page 4 of 35
