WEST COAST EMT FINAL EXAM
QUESTIONS AND ANSWERS 100%
VERIFIED BY EXPERTS. 2026/2027
1. A 68-year-old male presents with sudden onset of substernal chest pressure, diaphoresis,
and nausea. He has a history of erectile dysfunction and took sildenafil 12 hours ago. Which
of the following is the most appropriate action regarding his chest pain?
A. Administer 324mg of Aspirin and withhold Nitroglycerin.
B. Administer 0.4mg Nitroglycerin sublingually immediately.
C. Administer half the dose (0.2mg) of Nitroglycerin.
D. Wait 24 hours from his last dose of sildenafil to give Nitroglycerin.
Answer: A
Conceptual Explanation: Nitroglycerin is strictly contraindicated within 24-48 hours of
phosphodiesterase inhibitors (like sildenafil) due to the risk of life-threatening
hypotension. Aspirin remains indicated for suspected ACS.
,2. Which of the following findings is most characteristic of a tension pneumothorax compared
to a simple pneumothorax?
A. Jugular Venous Distension (JVD) and tracheal deviation.
B. Decreased breath sounds on the affected side.
C. Sharp, pleuritic chest pain.
D. Oxygen saturation of 92% on room air.
Answer: A
Conceptual Explanation: While both cause decreased breath sounds, JVD and tracheal
deviation (a late sign) indicate increased intrathoracic pressure obstructing venous return,
defining a tension pneumothorax.
3. You are treating a 4-year-old patient in respiratory distress. Using the Pediatric Assessment
Triangle (PAT), you notice the child is tripodding, has audible stridor, but is alert and has pink
skin. What is your primary impression?
A. Respiratory distress
B. Cardiopulmonary arrest
C. Respiratory failure
D. Compensated shock
Answer: A
, Conceptual Explanation: In the PAT, if only the ‘Work of Breathing’ is abnormal while
‘Appearance’ and ‘Circulation’ are normal, the child is in respiratory distress. If appearance
or circulation were affected, it would suggest failure.
4. During the delivery of a newborn, you notice the umbilical cord is wrapped tightly around
the baby’s neck. What is your first action?
A. Immediately clamp and cut the cord.
B. Apply high-flow oxygen to the mother.
C. Instruct the mother to stop pushing and transport immediately.
D. Attempt to gently slip the cord over the baby’s head.
Answer: D
Conceptual Explanation: A nuchal cord should first be managed by attempting to gently
slip it over the head. If it is too tight to slip, only then should it be clamped and cut to allow
delivery.
5. A 22-year-old female is found unresponsive in an alley. Her respirations are 4 breaths/min
and shallow, and her pupils are pinpoint. What is the physiological mechanism of the drug
most likely responsible for this?
A. Sympathetic nervous system stimulation
B. Cholinergic crisis
C. Anticholinergic toxidrome
QUESTIONS AND ANSWERS 100%
VERIFIED BY EXPERTS. 2026/2027
1. A 68-year-old male presents with sudden onset of substernal chest pressure, diaphoresis,
and nausea. He has a history of erectile dysfunction and took sildenafil 12 hours ago. Which
of the following is the most appropriate action regarding his chest pain?
A. Administer 324mg of Aspirin and withhold Nitroglycerin.
B. Administer 0.4mg Nitroglycerin sublingually immediately.
C. Administer half the dose (0.2mg) of Nitroglycerin.
D. Wait 24 hours from his last dose of sildenafil to give Nitroglycerin.
Answer: A
Conceptual Explanation: Nitroglycerin is strictly contraindicated within 24-48 hours of
phosphodiesterase inhibitors (like sildenafil) due to the risk of life-threatening
hypotension. Aspirin remains indicated for suspected ACS.
,2. Which of the following findings is most characteristic of a tension pneumothorax compared
to a simple pneumothorax?
A. Jugular Venous Distension (JVD) and tracheal deviation.
B. Decreased breath sounds on the affected side.
C. Sharp, pleuritic chest pain.
D. Oxygen saturation of 92% on room air.
Answer: A
Conceptual Explanation: While both cause decreased breath sounds, JVD and tracheal
deviation (a late sign) indicate increased intrathoracic pressure obstructing venous return,
defining a tension pneumothorax.
3. You are treating a 4-year-old patient in respiratory distress. Using the Pediatric Assessment
Triangle (PAT), you notice the child is tripodding, has audible stridor, but is alert and has pink
skin. What is your primary impression?
A. Respiratory distress
B. Cardiopulmonary arrest
C. Respiratory failure
D. Compensated shock
Answer: A
, Conceptual Explanation: In the PAT, if only the ‘Work of Breathing’ is abnormal while
‘Appearance’ and ‘Circulation’ are normal, the child is in respiratory distress. If appearance
or circulation were affected, it would suggest failure.
4. During the delivery of a newborn, you notice the umbilical cord is wrapped tightly around
the baby’s neck. What is your first action?
A. Immediately clamp and cut the cord.
B. Apply high-flow oxygen to the mother.
C. Instruct the mother to stop pushing and transport immediately.
D. Attempt to gently slip the cord over the baby’s head.
Answer: D
Conceptual Explanation: A nuchal cord should first be managed by attempting to gently
slip it over the head. If it is too tight to slip, only then should it be clamped and cut to allow
delivery.
5. A 22-year-old female is found unresponsive in an alley. Her respirations are 4 breaths/min
and shallow, and her pupils are pinpoint. What is the physiological mechanism of the drug
most likely responsible for this?
A. Sympathetic nervous system stimulation
B. Cholinergic crisis
C. Anticholinergic toxidrome
