Page 1 of 75
NYS EMT PSI PRACTICE EXAM 2026- QUESTIONS LATEST 2026
– 2027 VERSION SOLVED QUESTIONS & ANSWERS
NYS EMT PSI Practice Exam: Multiple Choice Questions
AIRWAY, RESPIRATION & VENTILATION (Questions 1-25)
1. When managing a patient who is apneic but has a palpable carotid pulse, what is
the most appropriate initial action to ensure adequate oxygenation and ventilation?
A) Immediately perform chest compressions at a rate of 100-120 per minute
B) Administer high-flow oxygen via a non-rebreather mask at 15 liters per minute
C) Provide positive pressure ventilation using a bag-valve-mask device with
supplemental oxygen
D) Insert a nasopharyngeal airway and apply a continuous positive airway pressure
device
Correct Answer: C - A patient who is apneic with a pulse requires ventilatory support,
not chest compressions. The BVM device with supplemental oxygen provides positive
pressure ventilation to maintain oxygenation while the heart continues to perfuse
tissues.
2. What is the most reliable method to confirm proper placement of a supraglottic
airway device in an apneic patient during continuous cardiopulmonary
resuscitation?
A) Visualizing the vocal cords using a laryngoscope blade before device insertion
B) Observing for adequate bilateral chest rise and auscultating breath sounds
C) Measuring end-tidal carbon dioxide waveform capnography for consistent readings
D) Checking for gastric insufflation sounds in the epigastric region
Correct Answer: C - End-tidal CO2 waveform capnography provides continuous,
objective confirmation of proper airway placement. While chest rise and breath sounds
are important, capnography is considered the gold standard for confirming airway
device position.
, Page 2 of 75
3. Why is it essential to avoid hyperventilation when providing bag-valve-mask
ventilation to a patient with suspected traumatic brain injury during emergency
care?
A) Excessive ventilation causes gastric distension which can lead to vomiting and
aspiration
B) Hyperventilation induces hypocapnia which causes cerebral vasoconstriction and
reduces cerebral blood flow
C) Hyperventilation increases intrathoracic pressure compromising venous return to the
heart
D) Excessive ventilation depletes the patient's energy reserves leading to metabolic
acidosis
Correct Answer: B - Hyperventilation causes hypocapnia, leading to cerebral
vasoconstriction and decreased cerebral blood flow, which can worsen outcomes in
traumatic brain injury patients. Ventilation should target normocapnia.
4. Which physical finding during your respiratory assessment would be most
concerning for a patient experiencing severe hypoxia requiring immediate high-
flow oxygen administration?
A) Respiratory rate of 18 breaths per minute with shallow depth
B) Pulse oximetry reading of 94% on room air at rest
C) Cyanosis observed in the oral mucosa and nail beds of the extremities
D) Patient reports mild shortness of breath after climbing one flight of stairs
Correct Answer: C - Cyanosis of the oral mucosa and nail beds is a late sign of severe
hypoxia indicating significant oxygen desaturation. This requires immediate high-flow
oxygen and possibly ventilatory support.
5. When opening the airway of a patient with a suspected cervical spine injury,
which manual maneuver should be used to minimize spinal movement while
establishing a patent airway?
A) Head tilt-chin lift maneuver using both hands on the forehead and chin
B) Jaw-thrust maneuver without head extension or neck movement
C) Triple airway maneuver with head tilt, chin lift, and mouth opening
D) Modified jaw-thrust with slight head extension to improve visualization
Correct Answer: B - The jaw-thrust maneuver is the preferred technique for opening the
airway in patients with suspected cervical spine injury as it does not require head
extension. Proper technique involves lifting the angles of the mandible.
, Page 3 of 75
6. What is the primary indication for using an oropharyngeal airway in a patient who
is receiving positive pressure ventilation during emergency care?
A) The patient is conscious but unable to maintain their own airway due to fatigue
B) The patient has a gag reflex and requires airway support during transport
C) The patient is unresponsive and has no gag reflex, requiring airway maintenance
D) The patient has sustained facial trauma and requires nasal airway placement
Correct Answer: C - An oropharyngeal airway is indicated for unresponsive patients
without a gag reflex. It prevents the tongue from obstructing the airway. Insertion in a
patient with an intact gag reflex can induce vomiting and aspiration.
7. What is the significance of assessing for tracheal deviation in a patient who has
sustained blunt chest trauma during a motor vehicle collision?
A) Tracheal deviation helps determine the need for supplemental oxygen therapy
B) Tracheal deviation indicates possible tension pneumothorax requiring immediate
needle decompression
C) Tracheal deviation confirms the presence of a simple rib fracture requiring pain
management
D) Tracheal deviation suggests the patient may require fluid resuscitation for
hypovolemic shock
Correct Answer: B - Tracheal deviation away from the injured side is a late sign of
tension pneumothorax. This life-threatening condition requires immediate needle
decompression followed by chest tube placement.
8. Which type of oxygen delivery device is most appropriate for a patient who is
breathing spontaneously but requires precise, high-concentration oxygen for a
suspected carbon monoxide poisoning emergency?
A) Simple face mask delivering 6-10 liters per minute of oxygen
B) Non-rebreather mask with a reservoir bag delivering 15 liters per minute
C) Nasal cannula delivering 2-4 liters per minute of oxygen
D) Venturi mask delivering a fixed oxygen concentration of 24-50%
Correct Answer: B - A non-rebreather mask delivers the highest concentration of
oxygen (up to 95%) at 15 L/min and is appropriate for carbon monoxide poisoning,
which requires high-flow oxygen to displace CO from hemoglobin.
, Page 4 of 75
9. What assessment finding would indicate that a patient's respiratory effort is
inadequate and requires immediate assisted ventilation with a bag-valve-mask
device during your primary survey?
A) Respiratory rate of 22 breaths per minute with audible wheezing on expiration
B) Patient reports chest tightness and uses accessory muscles to breathe
C) Respiratory rate of 8 breaths per minute with shallow depth and poor tidal volume
D) Pulse oximetry reading of 92% despite receiving 4 liters per minute via nasal cannula
Correct Answer: C - A rate of 8 breaths per minute with shallow depth indicates
inadequate ventilation requiring immediate BVM assistance. This bradypnea suggests
respiratory failure and imminent respiratory arrest.
10. When using a bag-valve-mask device for ventilation, what is the recommended
squeeze rate and volume to provide adequate ventilation while minimizing
complications?
A) 8-10 ventilations per minute with a volume sufficient to achieve visible chest rise
B) 12-14 ventilations per minute with a full squeeze of the bag each time
C) 16-20 ventilations per minute using half the bag capacity each squeeze
D) 10-12 ventilations per minute waiting for the bag to fully reinflate before each
squeeze
Correct Answer: A - 8-10 ventilations per minute (one ventilation every 6-8 seconds)
with enough volume to achieve visible chest rise is the recommended rate. This
minimizes the risk of hyperventilation and gastric insufflation.
11. What is the immediate priority when you encounter a patient who is conscious
but choking and cannot cough, speak, or breathe effectively during your scene
size-up?
A) Immediately transport the patient to the nearest emergency department for definitive
care
B) Administer back blows and abdominal thrusts until the obstruction is relieved
C) Perform a finger sweep to remove the foreign body from the patient's airway
D) Place the patient in a supine position and begin chest compressions immediately
Correct Answer: B - For a conscious patient with severe airway obstruction, immediate
back blows and abdominal thrusts (Heimlich maneuver) are indicated. The patient
cannot effectively clear the obstruction on their own.
NYS EMT PSI PRACTICE EXAM 2026- QUESTIONS LATEST 2026
– 2027 VERSION SOLVED QUESTIONS & ANSWERS
NYS EMT PSI Practice Exam: Multiple Choice Questions
AIRWAY, RESPIRATION & VENTILATION (Questions 1-25)
1. When managing a patient who is apneic but has a palpable carotid pulse, what is
the most appropriate initial action to ensure adequate oxygenation and ventilation?
A) Immediately perform chest compressions at a rate of 100-120 per minute
B) Administer high-flow oxygen via a non-rebreather mask at 15 liters per minute
C) Provide positive pressure ventilation using a bag-valve-mask device with
supplemental oxygen
D) Insert a nasopharyngeal airway and apply a continuous positive airway pressure
device
Correct Answer: C - A patient who is apneic with a pulse requires ventilatory support,
not chest compressions. The BVM device with supplemental oxygen provides positive
pressure ventilation to maintain oxygenation while the heart continues to perfuse
tissues.
2. What is the most reliable method to confirm proper placement of a supraglottic
airway device in an apneic patient during continuous cardiopulmonary
resuscitation?
A) Visualizing the vocal cords using a laryngoscope blade before device insertion
B) Observing for adequate bilateral chest rise and auscultating breath sounds
C) Measuring end-tidal carbon dioxide waveform capnography for consistent readings
D) Checking for gastric insufflation sounds in the epigastric region
Correct Answer: C - End-tidal CO2 waveform capnography provides continuous,
objective confirmation of proper airway placement. While chest rise and breath sounds
are important, capnography is considered the gold standard for confirming airway
device position.
, Page 2 of 75
3. Why is it essential to avoid hyperventilation when providing bag-valve-mask
ventilation to a patient with suspected traumatic brain injury during emergency
care?
A) Excessive ventilation causes gastric distension which can lead to vomiting and
aspiration
B) Hyperventilation induces hypocapnia which causes cerebral vasoconstriction and
reduces cerebral blood flow
C) Hyperventilation increases intrathoracic pressure compromising venous return to the
heart
D) Excessive ventilation depletes the patient's energy reserves leading to metabolic
acidosis
Correct Answer: B - Hyperventilation causes hypocapnia, leading to cerebral
vasoconstriction and decreased cerebral blood flow, which can worsen outcomes in
traumatic brain injury patients. Ventilation should target normocapnia.
4. Which physical finding during your respiratory assessment would be most
concerning for a patient experiencing severe hypoxia requiring immediate high-
flow oxygen administration?
A) Respiratory rate of 18 breaths per minute with shallow depth
B) Pulse oximetry reading of 94% on room air at rest
C) Cyanosis observed in the oral mucosa and nail beds of the extremities
D) Patient reports mild shortness of breath after climbing one flight of stairs
Correct Answer: C - Cyanosis of the oral mucosa and nail beds is a late sign of severe
hypoxia indicating significant oxygen desaturation. This requires immediate high-flow
oxygen and possibly ventilatory support.
5. When opening the airway of a patient with a suspected cervical spine injury,
which manual maneuver should be used to minimize spinal movement while
establishing a patent airway?
A) Head tilt-chin lift maneuver using both hands on the forehead and chin
B) Jaw-thrust maneuver without head extension or neck movement
C) Triple airway maneuver with head tilt, chin lift, and mouth opening
D) Modified jaw-thrust with slight head extension to improve visualization
Correct Answer: B - The jaw-thrust maneuver is the preferred technique for opening the
airway in patients with suspected cervical spine injury as it does not require head
extension. Proper technique involves lifting the angles of the mandible.
, Page 3 of 75
6. What is the primary indication for using an oropharyngeal airway in a patient who
is receiving positive pressure ventilation during emergency care?
A) The patient is conscious but unable to maintain their own airway due to fatigue
B) The patient has a gag reflex and requires airway support during transport
C) The patient is unresponsive and has no gag reflex, requiring airway maintenance
D) The patient has sustained facial trauma and requires nasal airway placement
Correct Answer: C - An oropharyngeal airway is indicated for unresponsive patients
without a gag reflex. It prevents the tongue from obstructing the airway. Insertion in a
patient with an intact gag reflex can induce vomiting and aspiration.
7. What is the significance of assessing for tracheal deviation in a patient who has
sustained blunt chest trauma during a motor vehicle collision?
A) Tracheal deviation helps determine the need for supplemental oxygen therapy
B) Tracheal deviation indicates possible tension pneumothorax requiring immediate
needle decompression
C) Tracheal deviation confirms the presence of a simple rib fracture requiring pain
management
D) Tracheal deviation suggests the patient may require fluid resuscitation for
hypovolemic shock
Correct Answer: B - Tracheal deviation away from the injured side is a late sign of
tension pneumothorax. This life-threatening condition requires immediate needle
decompression followed by chest tube placement.
8. Which type of oxygen delivery device is most appropriate for a patient who is
breathing spontaneously but requires precise, high-concentration oxygen for a
suspected carbon monoxide poisoning emergency?
A) Simple face mask delivering 6-10 liters per minute of oxygen
B) Non-rebreather mask with a reservoir bag delivering 15 liters per minute
C) Nasal cannula delivering 2-4 liters per minute of oxygen
D) Venturi mask delivering a fixed oxygen concentration of 24-50%
Correct Answer: B - A non-rebreather mask delivers the highest concentration of
oxygen (up to 95%) at 15 L/min and is appropriate for carbon monoxide poisoning,
which requires high-flow oxygen to displace CO from hemoglobin.
, Page 4 of 75
9. What assessment finding would indicate that a patient's respiratory effort is
inadequate and requires immediate assisted ventilation with a bag-valve-mask
device during your primary survey?
A) Respiratory rate of 22 breaths per minute with audible wheezing on expiration
B) Patient reports chest tightness and uses accessory muscles to breathe
C) Respiratory rate of 8 breaths per minute with shallow depth and poor tidal volume
D) Pulse oximetry reading of 92% despite receiving 4 liters per minute via nasal cannula
Correct Answer: C - A rate of 8 breaths per minute with shallow depth indicates
inadequate ventilation requiring immediate BVM assistance. This bradypnea suggests
respiratory failure and imminent respiratory arrest.
10. When using a bag-valve-mask device for ventilation, what is the recommended
squeeze rate and volume to provide adequate ventilation while minimizing
complications?
A) 8-10 ventilations per minute with a volume sufficient to achieve visible chest rise
B) 12-14 ventilations per minute with a full squeeze of the bag each time
C) 16-20 ventilations per minute using half the bag capacity each squeeze
D) 10-12 ventilations per minute waiting for the bag to fully reinflate before each
squeeze
Correct Answer: A - 8-10 ventilations per minute (one ventilation every 6-8 seconds)
with enough volume to achieve visible chest rise is the recommended rate. This
minimizes the risk of hyperventilation and gastric insufflation.
11. What is the immediate priority when you encounter a patient who is conscious
but choking and cannot cough, speak, or breathe effectively during your scene
size-up?
A) Immediately transport the patient to the nearest emergency department for definitive
care
B) Administer back blows and abdominal thrusts until the obstruction is relieved
C) Perform a finger sweep to remove the foreign body from the patient's airway
D) Place the patient in a supine position and begin chest compressions immediately
Correct Answer: B - For a conscious patient with severe airway obstruction, immediate
back blows and abdominal thrusts (Heimlich maneuver) are indicated. The patient
cannot effectively clear the obstruction on their own.
