JB Learning EMT Final Exam 2026 - Emergency Medical
Technician Program - Complete Exam Questions and
Answers with Expert Solutions - 120 Questions with Answers
Page 1
,Q1. A patient with severe metabolic acidosis presents with deep, rapid breathing.
Which acid-base disorder is most likely to cause this compensatory pattern, and what
is the primary physiological goal of the response?
A. Respiratory acidosis; increase CO2 elimination
B. Metabolic alkalosis; decrease CO2 elimination
C. Metabolic acidosis; increase CO2 elimination
D. Respiratory alkalosis; decrease CO2 elimination
Correct Answer: C. Metabolic acidosis; increase CO2 elimination
Rationale: Kussmaul breathing (deep, rapid) is a compensatory response to metabolic
acidosis, aiming to blow off CO2 to raise pH. The primary goal is to increase CO2
elimination to compensate for the acidotic state. Respiratory acidosis would be treated
with ventilation, but the pattern is not compensatory; metabolic alkalosis would cause
hypoventilation.
Why Wrong:
A - Respiratory acidosis leads to hypoventilation, not deep rapid breathing.
B - Metabolic alkalosis would cause hypoventilation to retain CO2.
D - Respiratory alkalosis is caused by hyperventilation, not a compensatory response
to metabolic acidosis.
Reference: Bledsoe, B. (2026). Anatomy and Physiology for Emergency Care, 4th Ed., Ch.
3
Q2. During a cardiac arrest resuscitation, the ECG shows a shockable rhythm. After
the third shock, amiodarone is administered. What is the recommended dose and
subsequent action?
A. 300 mg IV/IO, followed by a second dose of 150 mg if needed
B. 1 mg/kg IV/IO, repeated once after 5 minutes
C. 150 mg IV/IO, followed by a continuous infusion of 1 mg/min
D. 5 mg/kg IV/IO, repeated once after 10 minutes
Correct Answer: A. 300 mg IV/IO, followed by a second dose of 150 mg if needed
Rationale: Per the current AHA guidelines, for refractory VF/pulseless VT, amiodarone is
given as an initial 300 mg IV/IO push, followed by a second dose of 150 mg if the rhythm
persists. The other options represent incorrect dosing or routes.
Why Wrong:
B - 1 mg/kg is the dose for epinephrine, not amiodarone.
C - 150 mg is the second dose, not the initial dose.
D - 5 mg/kg is not the recommended amiodarone dose in cardiac arrest.
Reference: AHA (2025). Guidelines for CPR and ECC, Part 3: Adult Basic and Advanced
Life Support
Page 2
,Q3. A patient has a flail chest segment. Which of the following pathophysiological
consequences is the most immediate threat to life?
A. Paradoxical movement causing impaired ventilation
B. Rupture of the diaphragm
C. Contusion of the underlying lung tissue
D. Fracture of the sternum
Correct Answer: C. Contusion of the underlying lung tissue
Rationale: While paradoxical movement is characteristic, the most immediate life threat is
the associated pulmonary contusion, which leads to hypoxia and respiratory failure. The
underlying lung injury is often more dangerous than the chest wall instability.
Diaphragmatic rupture and sternal fracture are not direct consequences of flail chest.
Why Wrong:
A - Paradoxical movement impairs ventilation but is not the most immediate threat;
the contusion causes hypoxia.
B - Diaphragmatic rupture is a separate injury, not a consequence of flail chest.
D - Sternal fracture can occur with flail chest but is not the immediate life threat.
Reference: Mistovich, J. (2026). Prehospital Emergency Care, 12th Ed., Ch. 28
Q4. A patient with a history of COPD presents with increasing dyspnea and a
decreased level of consciousness. The family reports the patient has been using their
prescribed oxygen at 2 L/min. Which of the following best explains the patient's
deterioration?
A. Oxygen-induced hypoventilation due to loss of hypoxic drive
B. Carbon dioxide narcosis from overoxygenation
C. Acute bronchospasm triggered by oxygen therapy
D. Pulmonary embolism unrelated to oxygen use
Correct Answer: B. Carbon dioxide narcosis from overoxygenation
Rationale: In patients with chronic CO2 retention, high-flow oxygen can suppress the
hypoxic drive, but the primary issue is CO2 narcosis from the Haldane effect and reduced
minute ventilation, leading to increased PaCO2 and altered mental status. The question
specifies 2 L/min, which is low-flow; however, the patient's deterioration is most likely due
to CO2 narcosis. Oxygen-induced hypoventilation is a related but less precise term.
Why Wrong:
A - Oxygen-induced hypoventilation is a mechanism, but the clinical consequence is
CO2 narcosis.
C - Bronchospasm is not directly caused by oxygen therapy.
D - Pulmonary embolism is not indicated by the scenario.
Reference: Bledsoe, B. (2026). Paramedic Care: Principles & Practice, 6th Ed., Ch. 9
Page 3
, Q5. Which of the following best describes the physiological mechanism by which
positive pressure ventilation improves oxygenation in a patient with pulmonary
edema?
A. Increases venous return and preload
B. Decreases intrathoracic pressure, reducing afterload
C. Forces fluid back into the pulmonary capillaries and recruits alveoli
D. Increases pulmonary blood flow to the upper lobes
Correct Answer: C. Forces fluid back into the pulmonary capillaries and recruits
alveoli
Rationale: Positive pressure ventilation (e.g., CPAP) increases intrathoracic pressure,
which reduces venous return (preload) and pushes alveolar fluid back into the interstitium,
improving gas exchange. It also recruits collapsed alveoli and decreases afterload by
reducing transmural pressure. Option C captures the direct effect on edema.
Why Wrong:
A - Positive pressure ventilation decreases venous return, not increases.
B - It increases intrathoracic pressure, not decreases.
D - It does not selectively increase flow to the upper lobes.
Reference: American Heart Association (2025). Handbook of Emergency Cardiovascular
Care
Q6. A patient with a history of type 1 diabetes is found unresponsive. Blood glucose is
32 mg/dL. After administering oral glucose is impossible, what is the most
appropriate immediate intervention?
A. Administer 1 mg glucagon IM and transport
B. Start an IV and administer D50W 25 g
C. Administer 50 mL of D50W IV push
D. Administer 0.5 mg glucagon IM
Correct Answer: B. Start an IV and administer D50W 25 g
Rationale: For a hypoglycemic patient with no IV access, glucagon 1 mg IM is an option,
but the best immediate intervention when IV access is available is D50W. The question
does not specify IV access, but the options include both. Since the patient is unresponsive
and cannot take oral glucose, the EMT (if allowed) or ALS should give IV dextrose. Among
the options, B is the most appropriate because it includes starting an IV and administering
D50W.
Why Wrong:
A - Glucagon is effective but slower and less preferred when IV access is available.
C - 50 mL of D50W is 25 g, but this option does not mention IV access.
D - 0.5 mg is a pediatric dose; adult dose is 1 mg.
Page 4
Technician Program - Complete Exam Questions and
Answers with Expert Solutions - 120 Questions with Answers
Page 1
,Q1. A patient with severe metabolic acidosis presents with deep, rapid breathing.
Which acid-base disorder is most likely to cause this compensatory pattern, and what
is the primary physiological goal of the response?
A. Respiratory acidosis; increase CO2 elimination
B. Metabolic alkalosis; decrease CO2 elimination
C. Metabolic acidosis; increase CO2 elimination
D. Respiratory alkalosis; decrease CO2 elimination
Correct Answer: C. Metabolic acidosis; increase CO2 elimination
Rationale: Kussmaul breathing (deep, rapid) is a compensatory response to metabolic
acidosis, aiming to blow off CO2 to raise pH. The primary goal is to increase CO2
elimination to compensate for the acidotic state. Respiratory acidosis would be treated
with ventilation, but the pattern is not compensatory; metabolic alkalosis would cause
hypoventilation.
Why Wrong:
A - Respiratory acidosis leads to hypoventilation, not deep rapid breathing.
B - Metabolic alkalosis would cause hypoventilation to retain CO2.
D - Respiratory alkalosis is caused by hyperventilation, not a compensatory response
to metabolic acidosis.
Reference: Bledsoe, B. (2026). Anatomy and Physiology for Emergency Care, 4th Ed., Ch.
3
Q2. During a cardiac arrest resuscitation, the ECG shows a shockable rhythm. After
the third shock, amiodarone is administered. What is the recommended dose and
subsequent action?
A. 300 mg IV/IO, followed by a second dose of 150 mg if needed
B. 1 mg/kg IV/IO, repeated once after 5 minutes
C. 150 mg IV/IO, followed by a continuous infusion of 1 mg/min
D. 5 mg/kg IV/IO, repeated once after 10 minutes
Correct Answer: A. 300 mg IV/IO, followed by a second dose of 150 mg if needed
Rationale: Per the current AHA guidelines, for refractory VF/pulseless VT, amiodarone is
given as an initial 300 mg IV/IO push, followed by a second dose of 150 mg if the rhythm
persists. The other options represent incorrect dosing or routes.
Why Wrong:
B - 1 mg/kg is the dose for epinephrine, not amiodarone.
C - 150 mg is the second dose, not the initial dose.
D - 5 mg/kg is not the recommended amiodarone dose in cardiac arrest.
Reference: AHA (2025). Guidelines for CPR and ECC, Part 3: Adult Basic and Advanced
Life Support
Page 2
,Q3. A patient has a flail chest segment. Which of the following pathophysiological
consequences is the most immediate threat to life?
A. Paradoxical movement causing impaired ventilation
B. Rupture of the diaphragm
C. Contusion of the underlying lung tissue
D. Fracture of the sternum
Correct Answer: C. Contusion of the underlying lung tissue
Rationale: While paradoxical movement is characteristic, the most immediate life threat is
the associated pulmonary contusion, which leads to hypoxia and respiratory failure. The
underlying lung injury is often more dangerous than the chest wall instability.
Diaphragmatic rupture and sternal fracture are not direct consequences of flail chest.
Why Wrong:
A - Paradoxical movement impairs ventilation but is not the most immediate threat;
the contusion causes hypoxia.
B - Diaphragmatic rupture is a separate injury, not a consequence of flail chest.
D - Sternal fracture can occur with flail chest but is not the immediate life threat.
Reference: Mistovich, J. (2026). Prehospital Emergency Care, 12th Ed., Ch. 28
Q4. A patient with a history of COPD presents with increasing dyspnea and a
decreased level of consciousness. The family reports the patient has been using their
prescribed oxygen at 2 L/min. Which of the following best explains the patient's
deterioration?
A. Oxygen-induced hypoventilation due to loss of hypoxic drive
B. Carbon dioxide narcosis from overoxygenation
C. Acute bronchospasm triggered by oxygen therapy
D. Pulmonary embolism unrelated to oxygen use
Correct Answer: B. Carbon dioxide narcosis from overoxygenation
Rationale: In patients with chronic CO2 retention, high-flow oxygen can suppress the
hypoxic drive, but the primary issue is CO2 narcosis from the Haldane effect and reduced
minute ventilation, leading to increased PaCO2 and altered mental status. The question
specifies 2 L/min, which is low-flow; however, the patient's deterioration is most likely due
to CO2 narcosis. Oxygen-induced hypoventilation is a related but less precise term.
Why Wrong:
A - Oxygen-induced hypoventilation is a mechanism, but the clinical consequence is
CO2 narcosis.
C - Bronchospasm is not directly caused by oxygen therapy.
D - Pulmonary embolism is not indicated by the scenario.
Reference: Bledsoe, B. (2026). Paramedic Care: Principles & Practice, 6th Ed., Ch. 9
Page 3
, Q5. Which of the following best describes the physiological mechanism by which
positive pressure ventilation improves oxygenation in a patient with pulmonary
edema?
A. Increases venous return and preload
B. Decreases intrathoracic pressure, reducing afterload
C. Forces fluid back into the pulmonary capillaries and recruits alveoli
D. Increases pulmonary blood flow to the upper lobes
Correct Answer: C. Forces fluid back into the pulmonary capillaries and recruits
alveoli
Rationale: Positive pressure ventilation (e.g., CPAP) increases intrathoracic pressure,
which reduces venous return (preload) and pushes alveolar fluid back into the interstitium,
improving gas exchange. It also recruits collapsed alveoli and decreases afterload by
reducing transmural pressure. Option C captures the direct effect on edema.
Why Wrong:
A - Positive pressure ventilation decreases venous return, not increases.
B - It increases intrathoracic pressure, not decreases.
D - It does not selectively increase flow to the upper lobes.
Reference: American Heart Association (2025). Handbook of Emergency Cardiovascular
Care
Q6. A patient with a history of type 1 diabetes is found unresponsive. Blood glucose is
32 mg/dL. After administering oral glucose is impossible, what is the most
appropriate immediate intervention?
A. Administer 1 mg glucagon IM and transport
B. Start an IV and administer D50W 25 g
C. Administer 50 mL of D50W IV push
D. Administer 0.5 mg glucagon IM
Correct Answer: B. Start an IV and administer D50W 25 g
Rationale: For a hypoglycemic patient with no IV access, glucagon 1 mg IM is an option,
but the best immediate intervention when IV access is available is D50W. The question
does not specify IV access, but the options include both. Since the patient is unresponsive
and cannot take oral glucose, the EMT (if allowed) or ALS should give IV dextrose. Among
the options, B is the most appropriate because it includes starting an IV and administering
D50W.
Why Wrong:
A - Glucagon is effective but slower and less preferred when IV access is available.
C - 50 mL of D50W is 25 g, but this option does not mention IV access.
D - 0.5 mg is a pediatric dose; adult dose is 1 mg.
Page 4
