NAEMT AMLS | Advanced Medical Life Support - Pretest 2026/2027 | All Correct - Verified Rationales
AMLS Pretest - Questions & Answers (All Correct)
NAEMT Advanced Medical Life Support - 2026/2027
Aligned with the 2026/2027 NAEMT AMLS Provider Manual and current AMLS algorithms
Total Questions: 50 (multiple choice, single best answer)
Cognitive Mix: 30% Recall | 50% Application | 20% Analysis
Format: 80% scenario-based | 20% direct recall
Sections: 6 AMLS pretest content domains
Time Allotted: 75 minutes (average ~90 sec per question)
Passing Standard: NAEMT AMLS pretest baseline - 80% correct
Examination Instructions
1. Each question has four response options (A, B, C, D). Select the single best answer.
2. Scenario questions present vital signs, presentation, and history - apply the AMLS assessment pathway systematically
(scene size-up, primary survey, secondary survey, ongoing assessment).
3. The Correct Answer and a Rationale are provided immediately beneath each question for self-study review.
4. Rationales include pathophysiology, AMLS algorithm application, clinical reasoning principles, and evidence-based
treatment standards. Distractors represent common AMLS pretest pitfalls.
5. The bolded amber accent line marks the correct option. All other options are plausible distractors that reflect common
AMLS pretest errors.
SECTION 1 | AMLS Assessment Pathway and Clinical
Q1 - Q8
Reasoning
Q1. EMS responds to a 68-year-old male with acute dyspnea in a second-floor apartment. On arrival the
patient is sitting upright in tripod position, conscious and oriented, with audible wheezing and labored
respirations. Which component of the AMLS scene size-up is most critical to complete before patient
contact?
A. Determining the patient's insurance status
B. Ensuring scene safety (including environmental hazards, hostile environment, number of patients,
mechanism of illness/injury), and considering the need for additional resources [CORRECT]
C. Obtaining a complete medication list from family
D. Beginning the secondary survey immediately
Correct Answer: B
Rationale: The AMLS scene size-up is the first step in the assessment pathway: ensure scene safety, identify
environmental hazards (smoke, CO, oxygen tubing with smoking, hostile environment, hoarding, agitated pets),
determine the number of patients, identify the mechanism of illness or injury, and consider the need for additional
resources (extrication, HazMat, police, additional ambulances). Approaching the patient before scene safety is ensured
risks creating additional patients (rescuers becoming victims). AMLS algorithm: scene size-up precedes the primary
survey.
AMLS Pretest - 50 Questions Page 1
,NAEMT AMLS | Advanced Medical Life Support - Pretest 2026/2027 | All Correct - Verified Rationales
Q2. A 56-year-old female is found unresponsive on the floor of her home. She has sonorous respirations at
6 breaths per minute, radial pulse is 50 and weak, and her skin is cool and clammy. Her SpO2 is 78% on
room air. Using the AMLS primary survey, what is the priority intervention?
A. Obtain a 12-lead ECG
B. Establish an IV and administer 250 mL fluid bolus
C. Open the airway with a head tilt-chin lift (no trauma suspected) and ventilate with a bag-mask at
10-12 breaths/min, then suction secretions as needed; oxygen to maintain SpO2 94-99% [CORRECT]
D. Administer naloxone 0.4 mg IM
Correct Answer: C
Rationale: The AMLS primary survey follows Airway, Breathing, Circulation, Disability, Exposure (ABCDE). The
patient has sonorous respirations (upper airway obstruction by the tongue) and a respiratory rate of 6 (severe
hypoventilation). Per AMLS algorithms, the priority is to OPEN and MAINTAIN the airway and provide
positive-pressure ventilation with a bag-mask device at 10-12 breaths/min for an adult. ECG (A) and IV fluids (B) come
after airway/breathing stabilization. Naloxone (D) would be appropriate if opioid overdose is suspected, but airway
management remains the first priority and does not require waiting for naloxone to take effect.
Q3. After stabilization of a 72-year-old male with chest pain, the AMLS provider is preparing to take a
focused history. Which standardized framework is most appropriate for organizing the history of present
illness?
A. APGAR scoring
B. SAMPLE (Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, Events leading)
combined with OPQRST (Onset, Provocation, Quality, Radiation, Severity, Time) for symptom
characterization [CORRECT]
C. Glasgow Coma Scale
D. Cincinnati Prehospital Stroke Scale
Correct Answer: B
Rationale: SAMPLE captures the essentials of a complete medical history (Symptoms, Allergies, Medications, Past
history, Last oral intake, Events leading up), and OPQRST characterizes a single symptom in detail (Onset,
Provocation/Palliation, Quality, Radiation/Region, Severity, Time). Together they form the AMLS standard for the
focused history. APGAR is for newborn assessment; GCS is for level of consciousness; the Cincinnati Stroke Scale is a
focused neurological screen for stroke. AMLS algorithm: SAMPLE + OPQRST together provide a comprehensive yet
efficient history.
AMLS Pretest - 50 Questions Page 2
, NAEMT AMLS | Advanced Medical Life Support - Pretest 2026/2027 | All Correct - Verified Rationales
Q4. A 45-year-old female presents with sudden onset severe tearing chest pain radiating to the back, blood
pressure 180/110 in the right arm and 145/85 in the left arm, with a new diastolic murmur. Using AMLS
clinical reasoning, which hypothesis generation strategy is most appropriate, and what is the priority
differential diagnosis?
A. Pattern recognition to ACS; plan for aspirin and nitroglycerin
B. Generate a differential including ACS, aortic dissection, pulmonary embolism, pneumothorax,
esophageal rupture, and musculoskeletal pain; prioritize aortic dissection as the most dangerous
given the tearing pain, blood pressure differential, and new murmur [CORRECT]
C. Treat empirically for GERD with antacids
D. Assume pericarditis and treat with NSAIDs
Correct Answer: B
Rationale: AMLS clinical reasoning uses both hypothesis generation (broad differential) AND pattern recognition
(matching to specific conditions). Tearing chest pain radiating to the back, blood pressure differential >20 mmHg
between arms, and a new diastolic murmur are classic for aortic dissection - a life-threatening emergency. Treatment
for ACS (aspirin, nitroglycerin) could worsen dissection. AMLS principle: generate the broad differential first, then
prioritize the most dangerous condition. The most likely vs. most dangerous distinction is a core AMLS reasoning
framework.
Q5. A 38-year-old male presents with acute onset severe scrotal pain after lifting a heavy object, with
abdominal distension and vomiting. The pain started in the lower abdomen and now radiates to the
testicle. What is the most likely diagnosis, and what is the most dangerous condition on the differential
that must be excluded?
A. Most likely: testicular torsion (sudden onset, lifting, radiation to testicle). Most dangerous:
testicular torsion (requires surgical detorsion within 6 hours to save the testicle); also consider
incarcerated inguinal hernia [CORRECT]
B. Most likely: epididymitis; most dangerous: testicular cancer
C. Most likely: kidney stone; most dangerous: appendicitis
D. Most likely: UTI; most dangerous: prostatitis
Correct Answer: A
Rationale: Sudden onset severe scrotal pain after lifting (which increases intra-abdominal pressure) with radiation to
the testicle is the classic presentation of testicular torsion. The time window for surgical detorsion to save the testicle is 6
hours - any delay risks testicular loss. Incarcerated inguinal hernia is the second most dangerous differential (also
requires urgent surgery). Epididymitis is more gradual and accompanied by fever and dysuria. AMLS reasoning:
identify BOTH the most likely AND the most dangerous condition - they may be the same, but the priority is to exclude
life/organ-threatening conditions first.
AMLS Pretest - 50 Questions Page 3
AMLS Pretest - Questions & Answers (All Correct)
NAEMT Advanced Medical Life Support - 2026/2027
Aligned with the 2026/2027 NAEMT AMLS Provider Manual and current AMLS algorithms
Total Questions: 50 (multiple choice, single best answer)
Cognitive Mix: 30% Recall | 50% Application | 20% Analysis
Format: 80% scenario-based | 20% direct recall
Sections: 6 AMLS pretest content domains
Time Allotted: 75 minutes (average ~90 sec per question)
Passing Standard: NAEMT AMLS pretest baseline - 80% correct
Examination Instructions
1. Each question has four response options (A, B, C, D). Select the single best answer.
2. Scenario questions present vital signs, presentation, and history - apply the AMLS assessment pathway systematically
(scene size-up, primary survey, secondary survey, ongoing assessment).
3. The Correct Answer and a Rationale are provided immediately beneath each question for self-study review.
4. Rationales include pathophysiology, AMLS algorithm application, clinical reasoning principles, and evidence-based
treatment standards. Distractors represent common AMLS pretest pitfalls.
5. The bolded amber accent line marks the correct option. All other options are plausible distractors that reflect common
AMLS pretest errors.
SECTION 1 | AMLS Assessment Pathway and Clinical
Q1 - Q8
Reasoning
Q1. EMS responds to a 68-year-old male with acute dyspnea in a second-floor apartment. On arrival the
patient is sitting upright in tripod position, conscious and oriented, with audible wheezing and labored
respirations. Which component of the AMLS scene size-up is most critical to complete before patient
contact?
A. Determining the patient's insurance status
B. Ensuring scene safety (including environmental hazards, hostile environment, number of patients,
mechanism of illness/injury), and considering the need for additional resources [CORRECT]
C. Obtaining a complete medication list from family
D. Beginning the secondary survey immediately
Correct Answer: B
Rationale: The AMLS scene size-up is the first step in the assessment pathway: ensure scene safety, identify
environmental hazards (smoke, CO, oxygen tubing with smoking, hostile environment, hoarding, agitated pets),
determine the number of patients, identify the mechanism of illness or injury, and consider the need for additional
resources (extrication, HazMat, police, additional ambulances). Approaching the patient before scene safety is ensured
risks creating additional patients (rescuers becoming victims). AMLS algorithm: scene size-up precedes the primary
survey.
AMLS Pretest - 50 Questions Page 1
,NAEMT AMLS | Advanced Medical Life Support - Pretest 2026/2027 | All Correct - Verified Rationales
Q2. A 56-year-old female is found unresponsive on the floor of her home. She has sonorous respirations at
6 breaths per minute, radial pulse is 50 and weak, and her skin is cool and clammy. Her SpO2 is 78% on
room air. Using the AMLS primary survey, what is the priority intervention?
A. Obtain a 12-lead ECG
B. Establish an IV and administer 250 mL fluid bolus
C. Open the airway with a head tilt-chin lift (no trauma suspected) and ventilate with a bag-mask at
10-12 breaths/min, then suction secretions as needed; oxygen to maintain SpO2 94-99% [CORRECT]
D. Administer naloxone 0.4 mg IM
Correct Answer: C
Rationale: The AMLS primary survey follows Airway, Breathing, Circulation, Disability, Exposure (ABCDE). The
patient has sonorous respirations (upper airway obstruction by the tongue) and a respiratory rate of 6 (severe
hypoventilation). Per AMLS algorithms, the priority is to OPEN and MAINTAIN the airway and provide
positive-pressure ventilation with a bag-mask device at 10-12 breaths/min for an adult. ECG (A) and IV fluids (B) come
after airway/breathing stabilization. Naloxone (D) would be appropriate if opioid overdose is suspected, but airway
management remains the first priority and does not require waiting for naloxone to take effect.
Q3. After stabilization of a 72-year-old male with chest pain, the AMLS provider is preparing to take a
focused history. Which standardized framework is most appropriate for organizing the history of present
illness?
A. APGAR scoring
B. SAMPLE (Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, Events leading)
combined with OPQRST (Onset, Provocation, Quality, Radiation, Severity, Time) for symptom
characterization [CORRECT]
C. Glasgow Coma Scale
D. Cincinnati Prehospital Stroke Scale
Correct Answer: B
Rationale: SAMPLE captures the essentials of a complete medical history (Symptoms, Allergies, Medications, Past
history, Last oral intake, Events leading up), and OPQRST characterizes a single symptom in detail (Onset,
Provocation/Palliation, Quality, Radiation/Region, Severity, Time). Together they form the AMLS standard for the
focused history. APGAR is for newborn assessment; GCS is for level of consciousness; the Cincinnati Stroke Scale is a
focused neurological screen for stroke. AMLS algorithm: SAMPLE + OPQRST together provide a comprehensive yet
efficient history.
AMLS Pretest - 50 Questions Page 2
, NAEMT AMLS | Advanced Medical Life Support - Pretest 2026/2027 | All Correct - Verified Rationales
Q4. A 45-year-old female presents with sudden onset severe tearing chest pain radiating to the back, blood
pressure 180/110 in the right arm and 145/85 in the left arm, with a new diastolic murmur. Using AMLS
clinical reasoning, which hypothesis generation strategy is most appropriate, and what is the priority
differential diagnosis?
A. Pattern recognition to ACS; plan for aspirin and nitroglycerin
B. Generate a differential including ACS, aortic dissection, pulmonary embolism, pneumothorax,
esophageal rupture, and musculoskeletal pain; prioritize aortic dissection as the most dangerous
given the tearing pain, blood pressure differential, and new murmur [CORRECT]
C. Treat empirically for GERD with antacids
D. Assume pericarditis and treat with NSAIDs
Correct Answer: B
Rationale: AMLS clinical reasoning uses both hypothesis generation (broad differential) AND pattern recognition
(matching to specific conditions). Tearing chest pain radiating to the back, blood pressure differential >20 mmHg
between arms, and a new diastolic murmur are classic for aortic dissection - a life-threatening emergency. Treatment
for ACS (aspirin, nitroglycerin) could worsen dissection. AMLS principle: generate the broad differential first, then
prioritize the most dangerous condition. The most likely vs. most dangerous distinction is a core AMLS reasoning
framework.
Q5. A 38-year-old male presents with acute onset severe scrotal pain after lifting a heavy object, with
abdominal distension and vomiting. The pain started in the lower abdomen and now radiates to the
testicle. What is the most likely diagnosis, and what is the most dangerous condition on the differential
that must be excluded?
A. Most likely: testicular torsion (sudden onset, lifting, radiation to testicle). Most dangerous:
testicular torsion (requires surgical detorsion within 6 hours to save the testicle); also consider
incarcerated inguinal hernia [CORRECT]
B. Most likely: epididymitis; most dangerous: testicular cancer
C. Most likely: kidney stone; most dangerous: appendicitis
D. Most likely: UTI; most dangerous: prostatitis
Correct Answer: A
Rationale: Sudden onset severe scrotal pain after lifting (which increases intra-abdominal pressure) with radiation to
the testicle is the classic presentation of testicular torsion. The time window for surgical detorsion to save the testicle is 6
hours - any delay risks testicular loss. Incarcerated inguinal hernia is the second most dangerous differential (also
requires urgent surgery). Epididymitis is more gradual and accompanied by fever and dysuria. AMLS reasoning:
identify BOTH the most likely AND the most dangerous condition - they may be the same, but the priority is to exclude
life/organ-threatening conditions first.
AMLS Pretest - 50 Questions Page 3
