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LATEST EXAM UPDATE 2026/2027
Core Domains:
Airway Management and Respiratory Emergencies
Cardiovascular Emergencies and Resuscitation
Medical Emergencies and Toxicology
Trauma and Shock Management
Obstetrics, Gynecology, and Pediatrics
EMS Operations, Safety, and Incident Command
Legal, Ethical, and Professional Standards in EMS
Behavioral Health and Crisis Intervention
Introduction
This comprehensive assessment is designed to rigorously evaluate the cognitive
knowledge and critical decision-making skills essential for successful entry into the
Loyola EMS System. The examination encompasses a broad spectrum of
foundational theory and applied professional knowledge, reflecting the dynamic
and demanding nature of prehospital emergency care. Candidates will encounter a
variety of multiple-choice questions, including scenario-based items that emphasize
real-world application, clinical reasoning, and the ability to prioritize patient care
under pressure. Success on this exam indicates a candidate's readiness to function
effectively within the Loyola EMS System, demonstrating a commitment to clinical
excellence, patient safety, and professional integrity. This document serves as a
definitive study resource, providing verified answers and detailed rationales to
facilitate a deep understanding of the core concepts.
,SECTION ONE: QUESTIONS 1 – 50
1. A 45-year-old male is found unresponsive with a respiratory rate of 6 breaths
per minute and an oxygen saturation of 82% on room air. What is the MOST
appropriate initial airway intervention?
A. Insert an oropharyngeal airway and administer oxygen via non-rebreather
mask at 15 LPM.
B. Perform a head-tilt, chin-lift maneuver and begin positive pressure ventilation
with a bag-valve-mask (BVM) device.
C. Place the patient in the recovery position and administer high-flow nasal
cannula at 15 LPM.
D. Suction the oropharynx and administer oxygen via a simple face mask at 10
LPM.
🟢 Correct Answer: B. Perform a head-tilt, chin-lift maneuver and begin positive
pressure ventilation with a bag-valve-mask (BVM) device.
🔴 Explanation: The patient is in respiratory failure with a critically low respiratory
rate and severe hypoxia. The priority is to open the airway and provide immediate
positive pressure ventilation. A BVM with supplemental oxygen is indicated. An
oropharyngeal airway may be used as an adjunct after the BVM is being utilized,
but ventilation is the primary need.
2. Which of the following findings is the MOST reliable indicator of adequate
perfusion in a 4-year-old child following a febrile seizure?
,A. Capillary refill time of 3 seconds
B. Strong, palpable radial pulses
C. Warm, dry skin
D. A blood pressure of 90/60 mmHg
🟢 Correct Answer: B. Strong, palpable radial pulses
🔴 Explanation: In children, the presence of strong central (carotid/femoral) and
peripheral (radial) pulses is a very reliable indicator of adequate cardiac output
and perfusion. While normal capillary refill is less than 2 seconds, a time of 3
seconds can be a sign of peripheral vasoconstriction. Warm, dry skin is a late sign
of good perfusion and can be misleading.
3. A patient presents with a sudden onset of severe, tearing chest pain radiating
to the back, with a 20 mmHg difference in systolic blood pressure between the
right and left arms. Which of the following diagnoses is MOST likely?
A. Myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
🟢 Correct Answer: C. Aortic dissection
🔴 Explanation: Aortic dissection classically presents with sudden, severe tearing
or ripping chest pain that radiates to the back or neck. A discrepancy in blood
pressure between arms is a key clinical sign due to the involvement of the
subclavian arteries. This differentiates it from the other choices. Myocardial
infarction pain is often crushing, pulmonary embolism presents with pleuritic
chest pain and dyspnea, and pericarditis pain is typically positional and relieved
by leaning forward.
, 4. According to the American Heart Association (AHA) guidelines, what is the
compression-to-ventilation ratio for a single rescuer performing CPR on a 6-
month-old infant?
A. 15:2
B. 30:2
C. 15:1
D. 30:1
🟢 Correct Answer: B. 30:2
🔴 Explanation: For a single rescuer performing CPR on an infant (under 1 year of
age) or child (1 year to puberty), the recommended compression-to-ventilation
ratio is 30:2. This is the same as for adults to ensure adequate oxygenation and
circulation. Healthcare providers performing two-rescuer CPR on an infant/child
should use a ratio of 15:2.
5. You are called to a scene where a patient has sustained a chemical splash to
the eyes and face. What is the MOST important immediate action?
A. Identify the chemical agent by asking the patient.
B. Neutralize the chemical with a weak acid or base.
C. Irrigate the eyes and face with copious amounts of saline or water.
D. Cover the eyes with a sterile dressing to prevent contamination.
🟢 Correct Answer: C. Irrigate the eyes and face with copious amounts of saline
or water.
🔴 Explanation: Immediate and prolonged irrigation with a large volume of water
or saline is the single most important intervention to remove the chemical and
minimize tissue damage. Neutralization reactions are exothermic and can cause