JB Learning EMT Paramedic All Chapter Exams
(2026) Actual Questions and Verified Answers 300
Practice Questions and Correct Answers with
Detailed Rationales 2026|2027|Latest Update
MULTICHOICE QUESTIONS
1. A 45-year-old male is found unresponsive with agonal respirations. His pulse is
weak and thready at 110 bpm. What is the first action you should take?
A) Insert an oropharyngeal airway
B) Begin chest compressions
C) Open the airway with a head-tilt/chin-lift
D) Apply a non-rebreather mask at 15 LPM
Answer: C
Rationale: Airway management is the first priority in any unresponsive patient.
Opening the airway with a head-tilt/chin-lift allows for assessment of breathing
and delivery of ventilations. Compressions are indicated only after confirming
cardiac arrest.
2. Which of the following is the most reliable indicator of adequate ventilation in
an intubated patient?
A) Symmetrical chest rise
B) Pulse oximetry reading of 95%
C) End-tidal CO₂ between 35-45 mmHg
D) Absence of breath sounds over the epigastrium
Answer: C
Rationale: End-tidal CO₂ (Eco₂) waveform and value between 35-45 mmHg is the
most reliable indicator of proper endotracheal tube placement and adequate
ventilation. While chest rise and pulse oximetry are useful, Eco₂ is the gold
standard.
,3. A 68-year-old male with a history of COPD is in respiratory distress. He is using
accessory muscles and has a barrel-shaped chest. His SpO₂ is 88% on room air.
What is the most appropriate initial oxygen delivery device?
A) Non-rebreather mask at 15 LPM
B) Nasal cannula at 2-4 LPM
C) Simple face mask at 6-10 LPM
D) Venturi mask at 24-28% Fiol₂
Answer: B
Rationale: COPD patients are at risk for oxygen-induced hypercapnia due to loss
of hypoxic drive. A nasal cannula at 2-4 LPM is the preferred initial delivery
method to achieve an SpO₂ target of 88-92% without suppressing respiratory drive.
4. A 32-year-old female is in cardiac arrest. The cardiac monitor shows ventricular
fibrillation. What is the first-line treatment?
A) Amiodarone 300 mg IV push
B) Defibrillation at 200 joules (biphasic)
C) Epinephrine 1 mg IV push
D) Synchronized cardioversion
Answer: B
Rationale: Ventricular fibrillation is a shockable rhythm. The immediate treatment
is defibrillation with a biphasic defibrillator at 200 joules. Epinephrine and
amiodarone are administered after defibrillation and CPR cycles.
5. A paramedic is assessing a patient with chest pain. The 12-lead EKG shows ST-
segment elevation in leads V1-V4. Which coronary artery is most likely occluded?
A) Right coronary artery
B) Left anterior descending artery
C) Left circumflex artery
D) Posterior descending artery
Answer: B
Rationale: ST-segment elevation in the anterior leads (V1-V4) indicates an
anterior wall myocardial infarction, most commonly caused by occlusion of the left
,anterior descending (LAD) artery. This is often referred to as the "widow-maker"
MI.
6. A 58-year-old male presents with chest pressure radiating to his jaw, diaphoresis,
and nausea. Vital signs: BP 148/92, HR 108, RR 22, SpO₂ 96%. A 12-lead ECG
reveals ST-segment elevation of 2 mm in leads II, III, and if. Which intervention is
the highest priority?
A) Administer nitroglycerin 0.4 mg sublingual
B) Administer aspirin 324 mg chewed
C) Obtain intravenous access and administer fentanyl for pain
D) Apply supplemental oxygen via non-rebreather mask
Answer: B
Rationale: Aspirin inhibits platelet aggregation by blocking thromboxane A2,
reducing mortality in acute myocardial infarction. In inferior STEMI, right
ventricular involvement is possible, making nitroglycerin relatively contraindicated
due to preload reduction and hypotension risk. Oxygen is not indicated with SpO₂
96%.
7. A paramedic is intubating a patient in cardiac arrest. After passing the
endotracheal tube, capnography shows a flat waveform with no detectable CO₂.
Chest rise is minimal. Which action should be taken immediately?
A) Advance the tube 2 cm and reassess
B) Remove the tube and ventilate with a bag-valve mask
C) Inflate the cuff with an additional 5 mL of air
D) Perform needle cricothyrotomy
Answer: B
Rationale: Absence of waveform capnography in a perfusing rhythm or after
initial placement indicates esophageal intubation until proven otherwise.
Immediate removal and bag-valve-mask ventilation prevent hypoxia and gastric
insufflation.
8. A 20-year-old male sustains a gunshot wound to the left chest. He is agitated,
tachypneic, and has distended neck veins. Breath sounds are absent on the left, and
, the trachea is shifted to the right. Heart sounds are muffled. What is the most likely
diagnosis?
A) Simple pneumothorax
B) Pericardial tamponade
C) Tension pneumothorax
D) Massive hemothorax
Answer: C
Rationale: The triad of unilateral breath sounds, tracheal deviation away from the
affected side, and distended neck veins in a hypotensive patient indicates tension
pneumothorax. This is a life-threatening condition requiring immediate needle
decompression.
9. During a pediatric respiratory arrest, an 8-year-old child is intubated with a 6.0
mm cuffed endotracheal tube. Proper placement is confirmed. The cuff pressure
should be maintained at what maximum level?
A) 15 cm H₂O
B) 20 cm H₂O
C) 30 cm H₂O
D) 40 cm H₂O
Answer: B
Rationale: Cuff pressure should be kept below 20 cm H₂O in children to prevent
tracheal mucosal ischemia. Pediatric tracheal cartilage is softer and more
susceptible to pressure necrosis.
10. A patient with a history of COPD is found unresponsive. ECG shows sinus
bradycardia at 38 bpm, BP 68/40. Capnography shows ETCO₂ 55 mmHg. The
patient is intubated and being ventilated at 10 breaths/min. What should you do?
A) Increase ventilation rate to 20 breaths/min
B) Decrease ventilation rate to 6 breaths/min
C) Maintain current ventilation rate and monitor
D) Administer epinephrine 1 mg IV push
Answer: B
(2026) Actual Questions and Verified Answers 300
Practice Questions and Correct Answers with
Detailed Rationales 2026|2027|Latest Update
MULTICHOICE QUESTIONS
1. A 45-year-old male is found unresponsive with agonal respirations. His pulse is
weak and thready at 110 bpm. What is the first action you should take?
A) Insert an oropharyngeal airway
B) Begin chest compressions
C) Open the airway with a head-tilt/chin-lift
D) Apply a non-rebreather mask at 15 LPM
Answer: C
Rationale: Airway management is the first priority in any unresponsive patient.
Opening the airway with a head-tilt/chin-lift allows for assessment of breathing
and delivery of ventilations. Compressions are indicated only after confirming
cardiac arrest.
2. Which of the following is the most reliable indicator of adequate ventilation in
an intubated patient?
A) Symmetrical chest rise
B) Pulse oximetry reading of 95%
C) End-tidal CO₂ between 35-45 mmHg
D) Absence of breath sounds over the epigastrium
Answer: C
Rationale: End-tidal CO₂ (Eco₂) waveform and value between 35-45 mmHg is the
most reliable indicator of proper endotracheal tube placement and adequate
ventilation. While chest rise and pulse oximetry are useful, Eco₂ is the gold
standard.
,3. A 68-year-old male with a history of COPD is in respiratory distress. He is using
accessory muscles and has a barrel-shaped chest. His SpO₂ is 88% on room air.
What is the most appropriate initial oxygen delivery device?
A) Non-rebreather mask at 15 LPM
B) Nasal cannula at 2-4 LPM
C) Simple face mask at 6-10 LPM
D) Venturi mask at 24-28% Fiol₂
Answer: B
Rationale: COPD patients are at risk for oxygen-induced hypercapnia due to loss
of hypoxic drive. A nasal cannula at 2-4 LPM is the preferred initial delivery
method to achieve an SpO₂ target of 88-92% without suppressing respiratory drive.
4. A 32-year-old female is in cardiac arrest. The cardiac monitor shows ventricular
fibrillation. What is the first-line treatment?
A) Amiodarone 300 mg IV push
B) Defibrillation at 200 joules (biphasic)
C) Epinephrine 1 mg IV push
D) Synchronized cardioversion
Answer: B
Rationale: Ventricular fibrillation is a shockable rhythm. The immediate treatment
is defibrillation with a biphasic defibrillator at 200 joules. Epinephrine and
amiodarone are administered after defibrillation and CPR cycles.
5. A paramedic is assessing a patient with chest pain. The 12-lead EKG shows ST-
segment elevation in leads V1-V4. Which coronary artery is most likely occluded?
A) Right coronary artery
B) Left anterior descending artery
C) Left circumflex artery
D) Posterior descending artery
Answer: B
Rationale: ST-segment elevation in the anterior leads (V1-V4) indicates an
anterior wall myocardial infarction, most commonly caused by occlusion of the left
,anterior descending (LAD) artery. This is often referred to as the "widow-maker"
MI.
6. A 58-year-old male presents with chest pressure radiating to his jaw, diaphoresis,
and nausea. Vital signs: BP 148/92, HR 108, RR 22, SpO₂ 96%. A 12-lead ECG
reveals ST-segment elevation of 2 mm in leads II, III, and if. Which intervention is
the highest priority?
A) Administer nitroglycerin 0.4 mg sublingual
B) Administer aspirin 324 mg chewed
C) Obtain intravenous access and administer fentanyl for pain
D) Apply supplemental oxygen via non-rebreather mask
Answer: B
Rationale: Aspirin inhibits platelet aggregation by blocking thromboxane A2,
reducing mortality in acute myocardial infarction. In inferior STEMI, right
ventricular involvement is possible, making nitroglycerin relatively contraindicated
due to preload reduction and hypotension risk. Oxygen is not indicated with SpO₂
96%.
7. A paramedic is intubating a patient in cardiac arrest. After passing the
endotracheal tube, capnography shows a flat waveform with no detectable CO₂.
Chest rise is minimal. Which action should be taken immediately?
A) Advance the tube 2 cm and reassess
B) Remove the tube and ventilate with a bag-valve mask
C) Inflate the cuff with an additional 5 mL of air
D) Perform needle cricothyrotomy
Answer: B
Rationale: Absence of waveform capnography in a perfusing rhythm or after
initial placement indicates esophageal intubation until proven otherwise.
Immediate removal and bag-valve-mask ventilation prevent hypoxia and gastric
insufflation.
8. A 20-year-old male sustains a gunshot wound to the left chest. He is agitated,
tachypneic, and has distended neck veins. Breath sounds are absent on the left, and
, the trachea is shifted to the right. Heart sounds are muffled. What is the most likely
diagnosis?
A) Simple pneumothorax
B) Pericardial tamponade
C) Tension pneumothorax
D) Massive hemothorax
Answer: C
Rationale: The triad of unilateral breath sounds, tracheal deviation away from the
affected side, and distended neck veins in a hypotensive patient indicates tension
pneumothorax. This is a life-threatening condition requiring immediate needle
decompression.
9. During a pediatric respiratory arrest, an 8-year-old child is intubated with a 6.0
mm cuffed endotracheal tube. Proper placement is confirmed. The cuff pressure
should be maintained at what maximum level?
A) 15 cm H₂O
B) 20 cm H₂O
C) 30 cm H₂O
D) 40 cm H₂O
Answer: B
Rationale: Cuff pressure should be kept below 20 cm H₂O in children to prevent
tracheal mucosal ischemia. Pediatric tracheal cartilage is softer and more
susceptible to pressure necrosis.
10. A patient with a history of COPD is found unresponsive. ECG shows sinus
bradycardia at 38 bpm, BP 68/40. Capnography shows ETCO₂ 55 mmHg. The
patient is intubated and being ventilated at 10 breaths/min. What should you do?
A) Increase ventilation rate to 20 breaths/min
B) Decrease ventilation rate to 6 breaths/min
C) Maintain current ventilation rate and monitor
D) Administer epinephrine 1 mg IV push
Answer: B
