NYS EMT State Written Actual Exam – NYSDOH
Bureau of EMS Actual Exam 2026/2027 | Complete Exam-
Style Questions with Detailed Rationales | Graded A+
Verified – Pass Guaranteed
Preparatory Concepts and Airway Management
Q1: You are dispatched to a residence for an elderly patient who is confused and unable to
communicate clearly. The patient’s neighbor states the patient has a history of dementia.
How should you proceed regarding consent for care and transport?
A. Proceed with care under the doctrine of implied consent, as the patient lacks the capacity
to make an informed refusal. [CORRECT]
B. Wait for a family member to arrive and provide written consent before initiating any
assessment.
C. Restrain the patient immediately to prevent them from leaving the scene against medical
advice.
D. Assume the neighbor has legal authority to consent on the patient’s behalf and proceed
with treatment.
Correct Answer: A
Rationale: The best answer is to proceed under implied consent because the patient’s
altered mental status prevents them from understanding the risks of refusing care, making it
legally and ethically sound to provide necessary emergency treatment.
Q2: When preparing to lift a 250-pound patient from a bed using a draw sheet, which body
mechanics principle is most critical to prevent provider injury?
A. Keep your back straight and lift primarily with your leg muscles. [CORRECT]
B. Extend your arms fully away from your body to maximize leverage.
C. Twist your torso slightly to align with the direction of the stretcher.
D. Lift quickly and abruptly to overcome the patient’s inertia.
Correct Answer: A
Rationale: This choice is correct because keeping your back straight and using the powerful
muscles of your legs minimizes strain on the lumbar spine, which is the foundational
principle of safe patient lifting.
Q3: You are responding to a patient with a known history of active tuberculosis. Which
combination of personal protective equipment (PPE) is most appropriate for your initial
contact?
A. Surgical mask and standard gloves
B. N95 respirator, gloves, and eye protection [CORRECT]
C. N95 respirator and a full-body hazmat suit
D. Standard gloves and a face shield only
Correct Answer: B
,Rationale: This aligns with standard infection control protocols for airborne pathogens,
where an N95 respirator is required to filter airborne droplets, supplemented by gloves and
eye protection for comprehensive barrier defense.
Q4: You are preparing to insert an oropharyngeal airway (OPA) in an unresponsive adult
patient. What is the correct method for sizing the device?
A. Measure from the tip of the nose to the earlobe.
B. Measure from the corner of the mouth to the angle of the jaw. [CORRECT]
C. Measure from the center of the lips to the chin.
D. Select the size based solely on the patient’s estimated weight.
Correct Answer: B
Rationale: The best answer is measuring from the corner of the mouth to the angle of the
jaw, as this ensures the flange rests at the lips and the tip sits properly in the hypopharynx
without obstructing the airway.
Q5: You are ventilating an apneic adult patient with a bag-valve-mask (BVM) and
supplemental oxygen. What is the appropriate ventilation rate?
A. 10 to 12 breaths per minute
B. 20 to 24 breaths per minute
C. One breath every 2 to 3 seconds
D. One breath every 5 to 6 seconds [CORRECT]
Correct Answer: D
Rationale: This matches the principle that adult ventilation should occur at a rate of 10 to 12
breaths per minute, which translates to one breath every 5 to 6 seconds, preventing
hyperventilation and gastric distention.
Q6: A patient is visibly anxious and asking repetitive questions about their chest pain. Which
therapeutic communication technique is most effective in this scenario?
A. Interrupt the patient to quickly obtain the SAMPLE history.
B. Acknowledge their concern and answer their questions calmly and honestly. [CORRECT]
C. Tell the patient that worrying will only make their heart condition worse.
D. Avoid eye contact to maintain professional boundaries.
Correct Answer: B
Rationale: In the field, EMTs prioritize building rapport and reducing anxiety by
acknowledging the patient’s fears and providing clear, honest answers, which fosters
cooperation and trust.
Q7: A patient with minor abrasions refuses transport after a low-speed motor vehicle
collision. What is the most critical element to document in this situation?
A. The patient’s insurance information and vehicle damage.
B. Your personal opinion on why the patient is making a poor choice.
C. That the patient was alert, oriented, and fully informed of the risks of refusing care.
[CORRECT]
D. The names of any bystanders who witnessed the collision.
Correct Answer: C
, Rationale: This choice is correct because documenting the patient’s mental capacity and
your explicit explanation of the risks of refusal is the primary legal defense against future
claims of abandonment or negligence.
Q8: Which of the following actions by an EMT would legally constitute abandonment?
A. Transferring care to a paramedic who has a higher scope of practice.
B. Leaving a patient in the emergency department waiting room without notifying triage
staff. [CORRECT]
C. Terminating resuscitation efforts in the field under a valid NYS MOLST order.
D. Refusing to transport a patient who is verbally abusive but medically stable.
Correct Answer: B
Rationale: This aligns with the legal definition of abandonment, which occurs when a
provider unilaterally terminates the provider-patient relationship without ensuring the
patient is transferred to an equally or more qualified healthcare professional.
Q9: When suctioning the oropharynx of an adult patient, what is the maximum
recommended duration for a single suction pass?
A. 5 seconds
B. 10 seconds [CORRECT]
C. 15 seconds
D. 30 seconds
Correct Answer: B
Rationale: The best answer is 10 seconds, as prolonged suctioning can rapidly deplete the
patient’s oxygen reserves and induce hypoxia or vagal stimulation leading to bradycardia.
Q10: You are treating a patient with a known history of severe COPD who is experiencing
mild respiratory distress. What is the most appropriate initial oxygen therapy approach?
A. Withhold oxygen entirely to avoid suppressing the hypoxic drive.
B. Administer high-flow oxygen via a non-rebreather mask at 15 L/min.
C. Titrate oxygen via a nasal cannula to maintain an SpO2 of 88% to 92%. [CORRECT]
D. Assist ventilations with a BVM at a rate of 20 breaths per minute.
Correct Answer: C
Rationale: This matches the principle that while the "hypoxic drive" theory is often
overstated, current best practice for COPD patients is to titrate oxygen to a target SpO2 of
88% to 92% to avoid potential hypercapnia while still treating hypoxia.
Q11: Which anatomical structure serves as the primary landmark separating the upper
airway from the lower airway?
A. Epiglottis
B. Vocal cords [CORRECT]
C. Carina
D. Thyroid cartilage
Correct Answer: B
Rationale: This choice is correct because the vocal cords (glottis) are the universally
accepted anatomical boundary dividing the upper and lower respiratory tracts in prehospital
medicine.
Bureau of EMS Actual Exam 2026/2027 | Complete Exam-
Style Questions with Detailed Rationales | Graded A+
Verified – Pass Guaranteed
Preparatory Concepts and Airway Management
Q1: You are dispatched to a residence for an elderly patient who is confused and unable to
communicate clearly. The patient’s neighbor states the patient has a history of dementia.
How should you proceed regarding consent for care and transport?
A. Proceed with care under the doctrine of implied consent, as the patient lacks the capacity
to make an informed refusal. [CORRECT]
B. Wait for a family member to arrive and provide written consent before initiating any
assessment.
C. Restrain the patient immediately to prevent them from leaving the scene against medical
advice.
D. Assume the neighbor has legal authority to consent on the patient’s behalf and proceed
with treatment.
Correct Answer: A
Rationale: The best answer is to proceed under implied consent because the patient’s
altered mental status prevents them from understanding the risks of refusing care, making it
legally and ethically sound to provide necessary emergency treatment.
Q2: When preparing to lift a 250-pound patient from a bed using a draw sheet, which body
mechanics principle is most critical to prevent provider injury?
A. Keep your back straight and lift primarily with your leg muscles. [CORRECT]
B. Extend your arms fully away from your body to maximize leverage.
C. Twist your torso slightly to align with the direction of the stretcher.
D. Lift quickly and abruptly to overcome the patient’s inertia.
Correct Answer: A
Rationale: This choice is correct because keeping your back straight and using the powerful
muscles of your legs minimizes strain on the lumbar spine, which is the foundational
principle of safe patient lifting.
Q3: You are responding to a patient with a known history of active tuberculosis. Which
combination of personal protective equipment (PPE) is most appropriate for your initial
contact?
A. Surgical mask and standard gloves
B. N95 respirator, gloves, and eye protection [CORRECT]
C. N95 respirator and a full-body hazmat suit
D. Standard gloves and a face shield only
Correct Answer: B
,Rationale: This aligns with standard infection control protocols for airborne pathogens,
where an N95 respirator is required to filter airborne droplets, supplemented by gloves and
eye protection for comprehensive barrier defense.
Q4: You are preparing to insert an oropharyngeal airway (OPA) in an unresponsive adult
patient. What is the correct method for sizing the device?
A. Measure from the tip of the nose to the earlobe.
B. Measure from the corner of the mouth to the angle of the jaw. [CORRECT]
C. Measure from the center of the lips to the chin.
D. Select the size based solely on the patient’s estimated weight.
Correct Answer: B
Rationale: The best answer is measuring from the corner of the mouth to the angle of the
jaw, as this ensures the flange rests at the lips and the tip sits properly in the hypopharynx
without obstructing the airway.
Q5: You are ventilating an apneic adult patient with a bag-valve-mask (BVM) and
supplemental oxygen. What is the appropriate ventilation rate?
A. 10 to 12 breaths per minute
B. 20 to 24 breaths per minute
C. One breath every 2 to 3 seconds
D. One breath every 5 to 6 seconds [CORRECT]
Correct Answer: D
Rationale: This matches the principle that adult ventilation should occur at a rate of 10 to 12
breaths per minute, which translates to one breath every 5 to 6 seconds, preventing
hyperventilation and gastric distention.
Q6: A patient is visibly anxious and asking repetitive questions about their chest pain. Which
therapeutic communication technique is most effective in this scenario?
A. Interrupt the patient to quickly obtain the SAMPLE history.
B. Acknowledge their concern and answer their questions calmly and honestly. [CORRECT]
C. Tell the patient that worrying will only make their heart condition worse.
D. Avoid eye contact to maintain professional boundaries.
Correct Answer: B
Rationale: In the field, EMTs prioritize building rapport and reducing anxiety by
acknowledging the patient’s fears and providing clear, honest answers, which fosters
cooperation and trust.
Q7: A patient with minor abrasions refuses transport after a low-speed motor vehicle
collision. What is the most critical element to document in this situation?
A. The patient’s insurance information and vehicle damage.
B. Your personal opinion on why the patient is making a poor choice.
C. That the patient was alert, oriented, and fully informed of the risks of refusing care.
[CORRECT]
D. The names of any bystanders who witnessed the collision.
Correct Answer: C
, Rationale: This choice is correct because documenting the patient’s mental capacity and
your explicit explanation of the risks of refusal is the primary legal defense against future
claims of abandonment or negligence.
Q8: Which of the following actions by an EMT would legally constitute abandonment?
A. Transferring care to a paramedic who has a higher scope of practice.
B. Leaving a patient in the emergency department waiting room without notifying triage
staff. [CORRECT]
C. Terminating resuscitation efforts in the field under a valid NYS MOLST order.
D. Refusing to transport a patient who is verbally abusive but medically stable.
Correct Answer: B
Rationale: This aligns with the legal definition of abandonment, which occurs when a
provider unilaterally terminates the provider-patient relationship without ensuring the
patient is transferred to an equally or more qualified healthcare professional.
Q9: When suctioning the oropharynx of an adult patient, what is the maximum
recommended duration for a single suction pass?
A. 5 seconds
B. 10 seconds [CORRECT]
C. 15 seconds
D. 30 seconds
Correct Answer: B
Rationale: The best answer is 10 seconds, as prolonged suctioning can rapidly deplete the
patient’s oxygen reserves and induce hypoxia or vagal stimulation leading to bradycardia.
Q10: You are treating a patient with a known history of severe COPD who is experiencing
mild respiratory distress. What is the most appropriate initial oxygen therapy approach?
A. Withhold oxygen entirely to avoid suppressing the hypoxic drive.
B. Administer high-flow oxygen via a non-rebreather mask at 15 L/min.
C. Titrate oxygen via a nasal cannula to maintain an SpO2 of 88% to 92%. [CORRECT]
D. Assist ventilations with a BVM at a rate of 20 breaths per minute.
Correct Answer: C
Rationale: This matches the principle that while the "hypoxic drive" theory is often
overstated, current best practice for COPD patients is to titrate oxygen to a target SpO2 of
88% to 92% to avoid potential hypercapnia while still treating hypoxia.
Q11: Which anatomical structure serves as the primary landmark separating the upper
airway from the lower airway?
A. Epiglottis
B. Vocal cords [CORRECT]
C. Carina
D. Thyroid cartilage
Correct Answer: B
Rationale: This choice is correct because the vocal cords (glottis) are the universally
accepted anatomical boundary dividing the upper and lower respiratory tracts in prehospital
medicine.
