EMT-I/85 – Emergency Medical Technician
Intermediate/85 National Certification Review
Updated 2026 | 500+ Practice Questions & Verified
Answers | Advanced EMS Exam Prep Study Guide,
Prehospital Emergency Care Test Bank, Trauma
Management, Airway & Ventilation, Cardiology,
Medical Emergencies, IV Therapy, Pharmacology,
Pediatric & Geriatric Care, Detailed Rationales
Question 1: A 45-year-old male presents with confusion, diaphoresis, and
tachycardia. His blood glucose is 42 mg/dL. After establishing IV access,
which of the following is the MOST appropriate initial pharmacologic
intervention if the patient is unable to protect his airway?
A. Oral glucose paste administered buccally
B. 1 mg of Glucagon administered intramuscularly
C. 25 grams of 50% Dextrose administered intravenously
D. 1 amp of D50W administered via endotracheal tube
CORRECT ANSWER: C. 25 grams of 50% Dextrose administered intravenously
Rationale: For a patient with severe hypoglycemia who is unable to protect their airway
(altered mental status), IV access should be utilized to administer D50W. Glucagon is a
second-line agent when IV access cannot be established and is less predictable in its
effect.
Question 2: In the context of the EMT-I/85 scope of practice, which of the
following dysrhythmias would be the MOST appropriate indication for the
administration of Atropine?
A. Symptomatic sinus bradycardia with a rate of 42 and hypotension
B. Asystole confirmed in two leads
C. Third-degree heart block with a wide-complex escape rhythm
D. Pulseless electrical activity (PEA) with a rate of 30
CORRECT ANSWER: A. Symptomatic sinus bradycardia with a rate of 42 and
hypotension
Rationale: Atropine is indicated for symptomatic bradycardias, particularly sinus
bradycardia. It increases the heart rate by blocking the parasympathetic nervous system.
It is not effective for asystole, high-degree blocks with wide complexes (which often
require pacing), or PEA where the primary issue is mechanical.
Question 3: During the assessment of a trauma patient with a suspected pelvic
fracture, you note a significant drop in blood pressure and an increase in heart
rate. Which of the following classifications of shock is MOST consistent with
these findings?
,A. Neurogenic shock
B. Cardiogenic shock
C. Hypovolemic shock
D. Obstructive shock
CORRECT ANSWER: C. Hypovolemic shock
Rationale: Pelvic fractures can cause significant internal blood loss into the
retroperitoneal space, leading to hypovolemic shock. The classic signs of hypovolemic
shock include hypotension, tachycardia, pale/cool skin, and delayed capillary refill.
Question 4: A 60-year-old male with a history of COPD presents with severe
respiratory distress and a diminished level of consciousness. His SpO2 is 78%
on room air. You are unable to obtain an ETCO2 reading due to the small tidal
volume. After assisting ventilations with a BVM, the patient’s gastric
distention increases, compromising the ability to ventilate. What is the MOST
appropriate next step?
A. Continue BVM ventilations and apply cricoid pressure
B. Insert an oropharyngeal airway and continue ventilating
C. Perform a needle decompression of the stomach
D. Insert a nasogastric tube to decompress the stomach
CORRECT ANSWER: D. Insert a nasogastric tube to decompress the stomach
Rationale: Gastric distention from BVM ventilations can elevate the diaphragm and
restrict lung expansion. While cricoid pressure can help prevent this initially, the best
remedy for an already distended stomach in a patient with an advanced airway or who is
obtunded is the insertion of an NG tube to relieve the pressure.
Question 5: You are on the scene of a motor vehicle collision. The driver
complains of neck pain and has a contusion on his forehead from striking the
windshield. He has a patent airway and is breathing 20 times per minute with
good tidal volume. Which of the following is the MOST appropriate initial
spinal motion restriction protocol for this patient?
A. Apply a rigid cervical collar only.
B. Apply a rigid cervical collar and secure to a long spine board.
C. Place the patient in a supine position on the stretcher with a cervical collar and head
blocks.
D. Allow the patient to self-extricate and sit upright on the stretcher.
CORRECT ANSWER: C. Place the patient in a supine position on the stretcher
with a cervical collar and head blocks.
Rationale: Current evidence-based guidelines suggest spinal motion restriction (SMR)
rather than immobilization. Unless the patient is critically unstable, it is preferred to
place the patient supine on the ambulance stretcher with a cervical collar and head
,blocks (or a vacuum splint) rather than a rigid long spine board, which is associated with
discomfort and respiratory compromise.
Question 6: Which of the following is the MOST reliable indicator of adequate
artificial ventilation in an adult patient?
A. The presence of bilateral breath sounds
B. The visible rise and fall of the chest
C. An ETCO2 reading of 35-45 mmHg
D. A SpO2 reading of 95%
CORRECT ANSWER: C. An ETCO2 reading of 35-45 mmHg
Rationale: While visible chest rise and bilateral breath sounds are essential, ETCO2
(end-tidal carbon dioxide) is the most reliable indicator of effective ventilation because it
directly measures the elimination of CO2 from the lungs, reflecting that gas exchange is
occurring. A normal ETCO2 range is 35-45 mmHg.
Question 7: A patient with a history of congestive heart failure is experiencing
acute pulmonary edema. You have applied CPAP and administered
Nitroglycerin. His blood pressure is 170/98. Which of the following is the
NEXT pharmacologic agent of choice for this patient as per standard
protocols?
A. Furosemide (Lasix)
B. Morphine
C. Dobutamine
D. Epinephrine
CORRECT ANSWER: A. Furosemide (Lasix)
Rationale: While CPAP and Nitroglycerin are front-line treatments for acute pulmonary
edema due to preload reduction, Furosemide is the next significant step to reduce fluid
volume by promoting diuresis, thereby reducing preload further. Morphine is considered
an adjunctive therapy for anxiety and preload reduction but is used less frequently now.
Question 8: You are transporting a patient who is in cardiac arrest. You are
performing CPR with an advanced airway in place. According to the 2020 AHA
guidelines, what compression-to-ventilation ratio should be used?
A. 30 compressions to 2 ventilations
B. 15 compressions to 2 ventilations
C. Continuous compressions at a rate of 100-120/min with 1 breath every 6 seconds
D. Continuous compressions at a rate of 80-100/min with 1 breath every 8 seconds
CORRECT ANSWER: C. Continuous compressions at a rate of 100-120/min
with 1 breath every 6 seconds
Rationale: Once an advanced airway (e.g., endotracheal tube or supraglottic airway) is
in place during CPR, the rescuers should provide continuous chest compressions at a
, rate of 100-120 per minute without pauses for ventilations, and deliver one breath every
6 seconds (10 breaths per minute).
Question 9: A 55-year-old female complains of chest pain that radiates to her
jaw. She is nauseated and pale. Her vital signs are BP 108/70, HR 110, RR 20.
What is the MOST important immediate action regarding her chest pain?
A. Administer 324 mg of Aspirin (chewable)
B. Administer 0.4 mg of Nitroglycerin sublingually
C. Establish IV access
D. Administer high-flow oxygen via non-rebreather mask
CORRECT ANSWER: A. Administer 324 mg of Aspirin (chewable)
Rationale: While Nitroglycerin is important for pain relief and vasodilation, Aspirin is
the single most important immediate intervention for Acute Coronary Syndrome (ACS)
because it reduces mortality by inhibiting platelet aggregation and preventing further
clot formation. It should be given as soon as possible, provided there are no
contraindications.
Question 10: A patient sustains a blunt injury to the right chest wall. You note
paradoxical movement of a segment of the ribs during inspiration and
expiration. This condition is known as:
A. Pneumothorax
B. Hemothorax
C. Flail chest
D. Cardiac tamponade
CORRECT ANSWER: C. Flail chest
Rationale: A flail chest occurs when two or more adjacent ribs are fractured in two or
more places, creating a free-floating segment of the chest wall. This segment moves in a
paradoxical manner: it is pulled inward during inspiration (negative intrathoracic
pressure) and outward during expiration (positive pressure).
Question 11: The administration of intravenous crystalloids to a patient in
hypovolemic shock is primarily intended to:
A. Increase the oxygen-carrying capacity of the blood
B. Restore intravascular volume and improve preload
C. Increase the colloidal osmotic pressure
D. Buffer metabolic acidosis
CORRECT ANSWER: B. Restore intravascular volume and improve preload
Rationale: Crystalloids (like Normal Saline or Lactated Ringer’s) are used in
hypovolemic shock to rapidly expand the intravascular volume. This increases venous
return (preload) to the heart, which, according to the Frank-Starling law, increases stroke
volume and cardiac output.
Intermediate/85 National Certification Review
Updated 2026 | 500+ Practice Questions & Verified
Answers | Advanced EMS Exam Prep Study Guide,
Prehospital Emergency Care Test Bank, Trauma
Management, Airway & Ventilation, Cardiology,
Medical Emergencies, IV Therapy, Pharmacology,
Pediatric & Geriatric Care, Detailed Rationales
Question 1: A 45-year-old male presents with confusion, diaphoresis, and
tachycardia. His blood glucose is 42 mg/dL. After establishing IV access,
which of the following is the MOST appropriate initial pharmacologic
intervention if the patient is unable to protect his airway?
A. Oral glucose paste administered buccally
B. 1 mg of Glucagon administered intramuscularly
C. 25 grams of 50% Dextrose administered intravenously
D. 1 amp of D50W administered via endotracheal tube
CORRECT ANSWER: C. 25 grams of 50% Dextrose administered intravenously
Rationale: For a patient with severe hypoglycemia who is unable to protect their airway
(altered mental status), IV access should be utilized to administer D50W. Glucagon is a
second-line agent when IV access cannot be established and is less predictable in its
effect.
Question 2: In the context of the EMT-I/85 scope of practice, which of the
following dysrhythmias would be the MOST appropriate indication for the
administration of Atropine?
A. Symptomatic sinus bradycardia with a rate of 42 and hypotension
B. Asystole confirmed in two leads
C. Third-degree heart block with a wide-complex escape rhythm
D. Pulseless electrical activity (PEA) with a rate of 30
CORRECT ANSWER: A. Symptomatic sinus bradycardia with a rate of 42 and
hypotension
Rationale: Atropine is indicated for symptomatic bradycardias, particularly sinus
bradycardia. It increases the heart rate by blocking the parasympathetic nervous system.
It is not effective for asystole, high-degree blocks with wide complexes (which often
require pacing), or PEA where the primary issue is mechanical.
Question 3: During the assessment of a trauma patient with a suspected pelvic
fracture, you note a significant drop in blood pressure and an increase in heart
rate. Which of the following classifications of shock is MOST consistent with
these findings?
,A. Neurogenic shock
B. Cardiogenic shock
C. Hypovolemic shock
D. Obstructive shock
CORRECT ANSWER: C. Hypovolemic shock
Rationale: Pelvic fractures can cause significant internal blood loss into the
retroperitoneal space, leading to hypovolemic shock. The classic signs of hypovolemic
shock include hypotension, tachycardia, pale/cool skin, and delayed capillary refill.
Question 4: A 60-year-old male with a history of COPD presents with severe
respiratory distress and a diminished level of consciousness. His SpO2 is 78%
on room air. You are unable to obtain an ETCO2 reading due to the small tidal
volume. After assisting ventilations with a BVM, the patient’s gastric
distention increases, compromising the ability to ventilate. What is the MOST
appropriate next step?
A. Continue BVM ventilations and apply cricoid pressure
B. Insert an oropharyngeal airway and continue ventilating
C. Perform a needle decompression of the stomach
D. Insert a nasogastric tube to decompress the stomach
CORRECT ANSWER: D. Insert a nasogastric tube to decompress the stomach
Rationale: Gastric distention from BVM ventilations can elevate the diaphragm and
restrict lung expansion. While cricoid pressure can help prevent this initially, the best
remedy for an already distended stomach in a patient with an advanced airway or who is
obtunded is the insertion of an NG tube to relieve the pressure.
Question 5: You are on the scene of a motor vehicle collision. The driver
complains of neck pain and has a contusion on his forehead from striking the
windshield. He has a patent airway and is breathing 20 times per minute with
good tidal volume. Which of the following is the MOST appropriate initial
spinal motion restriction protocol for this patient?
A. Apply a rigid cervical collar only.
B. Apply a rigid cervical collar and secure to a long spine board.
C. Place the patient in a supine position on the stretcher with a cervical collar and head
blocks.
D. Allow the patient to self-extricate and sit upright on the stretcher.
CORRECT ANSWER: C. Place the patient in a supine position on the stretcher
with a cervical collar and head blocks.
Rationale: Current evidence-based guidelines suggest spinal motion restriction (SMR)
rather than immobilization. Unless the patient is critically unstable, it is preferred to
place the patient supine on the ambulance stretcher with a cervical collar and head
,blocks (or a vacuum splint) rather than a rigid long spine board, which is associated with
discomfort and respiratory compromise.
Question 6: Which of the following is the MOST reliable indicator of adequate
artificial ventilation in an adult patient?
A. The presence of bilateral breath sounds
B. The visible rise and fall of the chest
C. An ETCO2 reading of 35-45 mmHg
D. A SpO2 reading of 95%
CORRECT ANSWER: C. An ETCO2 reading of 35-45 mmHg
Rationale: While visible chest rise and bilateral breath sounds are essential, ETCO2
(end-tidal carbon dioxide) is the most reliable indicator of effective ventilation because it
directly measures the elimination of CO2 from the lungs, reflecting that gas exchange is
occurring. A normal ETCO2 range is 35-45 mmHg.
Question 7: A patient with a history of congestive heart failure is experiencing
acute pulmonary edema. You have applied CPAP and administered
Nitroglycerin. His blood pressure is 170/98. Which of the following is the
NEXT pharmacologic agent of choice for this patient as per standard
protocols?
A. Furosemide (Lasix)
B. Morphine
C. Dobutamine
D. Epinephrine
CORRECT ANSWER: A. Furosemide (Lasix)
Rationale: While CPAP and Nitroglycerin are front-line treatments for acute pulmonary
edema due to preload reduction, Furosemide is the next significant step to reduce fluid
volume by promoting diuresis, thereby reducing preload further. Morphine is considered
an adjunctive therapy for anxiety and preload reduction but is used less frequently now.
Question 8: You are transporting a patient who is in cardiac arrest. You are
performing CPR with an advanced airway in place. According to the 2020 AHA
guidelines, what compression-to-ventilation ratio should be used?
A. 30 compressions to 2 ventilations
B. 15 compressions to 2 ventilations
C. Continuous compressions at a rate of 100-120/min with 1 breath every 6 seconds
D. Continuous compressions at a rate of 80-100/min with 1 breath every 8 seconds
CORRECT ANSWER: C. Continuous compressions at a rate of 100-120/min
with 1 breath every 6 seconds
Rationale: Once an advanced airway (e.g., endotracheal tube or supraglottic airway) is
in place during CPR, the rescuers should provide continuous chest compressions at a
, rate of 100-120 per minute without pauses for ventilations, and deliver one breath every
6 seconds (10 breaths per minute).
Question 9: A 55-year-old female complains of chest pain that radiates to her
jaw. She is nauseated and pale. Her vital signs are BP 108/70, HR 110, RR 20.
What is the MOST important immediate action regarding her chest pain?
A. Administer 324 mg of Aspirin (chewable)
B. Administer 0.4 mg of Nitroglycerin sublingually
C. Establish IV access
D. Administer high-flow oxygen via non-rebreather mask
CORRECT ANSWER: A. Administer 324 mg of Aspirin (chewable)
Rationale: While Nitroglycerin is important for pain relief and vasodilation, Aspirin is
the single most important immediate intervention for Acute Coronary Syndrome (ACS)
because it reduces mortality by inhibiting platelet aggregation and preventing further
clot formation. It should be given as soon as possible, provided there are no
contraindications.
Question 10: A patient sustains a blunt injury to the right chest wall. You note
paradoxical movement of a segment of the ribs during inspiration and
expiration. This condition is known as:
A. Pneumothorax
B. Hemothorax
C. Flail chest
D. Cardiac tamponade
CORRECT ANSWER: C. Flail chest
Rationale: A flail chest occurs when two or more adjacent ribs are fractured in two or
more places, creating a free-floating segment of the chest wall. This segment moves in a
paradoxical manner: it is pulled inward during inspiration (negative intrathoracic
pressure) and outward during expiration (positive pressure).
Question 11: The administration of intravenous crystalloids to a patient in
hypovolemic shock is primarily intended to:
A. Increase the oxygen-carrying capacity of the blood
B. Restore intravascular volume and improve preload
C. Increase the colloidal osmotic pressure
D. Buffer metabolic acidosis
CORRECT ANSWER: B. Restore intravascular volume and improve preload
Rationale: Crystalloids (like Normal Saline or Lactated Ringer’s) are used in
hypovolemic shock to rapidly expand the intravascular volume. This increases venous
return (preload) to the heart, which, according to the Frank-Starling law, increases stroke
volume and cardiac output.
