EMT (NREMT)
EMT exam questions with answers
Pick a domain and read every question in it, with the right answer and the reasoning. Open an answer only after you have chosen yours.
1.What is the first step of the primary assessment once the scene is safe?
- A. Take a full set of vital signs
- B. Obtain a SAMPLE history
- C. Perform a head-to-toe exam
- D. Form a general impression of the patient (answer)
The primary assessment begins with a general impression: age, sex, level of distress and whether the patient looks sick. It is followed by checking responsiveness, airway, breathing and circulation. Vital signs and history come later, after life threats are managed.
Outline point: NREMT EMT exam outline: Primary Assessment (general impression)
2.A patient does not respond to your voice but moans and pulls away when you pinch the trapezius muscle. How is the patient described using AVPU?
- A. Alert
- B. Responds to verbal stimuli
- C. Unresponsive
- D. Responds to painful stimuli (answer)
In AVPU, P means the patient responds only to a painful stimulus. V would mean a response to voice, and U means no response at all. Any level below alert is a reason to watch the airway closely.
Outline point: NREMT EMT exam outline: Primary Assessment (responsiveness, AVPU)
3.A patient keeps her eyes closed but opens them and answers when you speak loudly. How do you describe her on the AVPU scale?
- A. Alert
- B. Responds to verbal stimuli (answer)
- C. Responds to painful stimuli
- D. Unresponsive
A patient who reacts only when spoken to is at the V level. An alert patient has the eyes open and interacts without prompting. Recording the AVPU level allows later changes to be noticed.
Outline point: NREMT EMT exam outline: Primary Assessment (responsiveness, AVPU)
4.An unresponsive patient fell from a ladder. Which technique should you use to open the airway?
- A. Head-tilt, chin-lift maneuver
- B. Neck extension with a pillow
- C. Jaw-thrust maneuver (answer)
- D. Rolling the patient face down
The jaw-thrust opens the airway while keeping the head and neck in line, which is preferred when spinal injury is suspected. If the jaw-thrust does not open the airway, opening the airway takes priority and the head-tilt, chin-lift is used.
Outline point: NREMT EMT exam outline: Primary Assessment (airway management, trauma)
5.An adult is found unresponsive in bed with no sign of trauma. Which method should you use to open the airway?
- A. Head-tilt, chin-lift (answer)
- B. Abdominal thrusts
- C. Back blows
- D. Chest thrusts
Without suspected trauma, the head-tilt, chin-lift is the simplest and most effective way to lift the tongue away from the back of the throat. Abdominal thrusts, chest thrusts and back blows are used for foreign body obstruction, not routine airway opening.
Outline point: NREMT EMT exam outline: Primary Assessment (airway management, medical patient)
6.How is an oropharyngeal airway sized?
- A. From the tip of the nose to the chin
- B. From the corner of the mouth to the earlobe (answer)
- C. From the chin to the sternal notch
- D. From the lips to the eyebrow
The correct oropharyngeal airway reaches from the corner of the mouth to the earlobe or the angle of the jaw. An airway that is too long can push the epiglottis over the opening of the airway, and one that is too short can push the tongue back.
Outline point: NREMT EMT exam outline: Primary Assessment (airway adjuncts, OPA sizing)
7.You insert an oral airway into an unresponsive patient, and the patient begins to gag. What should you do?
- A. Push it in further to get past the gag
- B. Tape it in place and keep ventilating
- C. Replace it with a larger oral airway
- D. Remove the airway and have suction ready (answer)
A gag reflex means the patient can partly protect the airway, and an oral airway can trigger vomiting and aspiration. It is removed, suction is kept ready, and a nasopharyngeal airway may be considered instead.
Outline point: NREMT EMT exam outline: Primary Assessment (airway adjuncts, OPA contraindication)
8.How is a nasopharyngeal airway sized?
- A. From the corner of the mouth to the chin
- B. From the tip of the nose to the earlobe (answer)
- C. From the nose to the sternal notch
- D. From the earlobe to the collarbone
The nasopharyngeal airway length matches the distance from the tip of the nose to the earlobe, and its diameter should fit the nostril. It is lubricated with a water-soluble lubricant before insertion.
Outline point: NREMT EMT exam outline: Primary Assessment (airway adjuncts, NPA sizing)
9.Which finding is a reason not to insert a nasopharyngeal airway?
- A. An intact gag reflex in a drowsy patient
- B. Snoring respirations in an overdose patient
- C. Clear fluid draining from the nose after head trauma (answer)
- D. Clenched teeth during a seizure
Clear fluid from the nose after head trauma may be cerebrospinal fluid from a skull fracture, and the airway could pass into the skull. Nasopharyngeal airways are tolerated by patients with a gag reflex and are useful when the teeth are clenched.
Outline point: NREMT EMT exam outline: Primary Assessment (airway adjuncts, NPA contraindication)
10.When inserting a nasopharyngeal airway into the right nostril, which way should the bevel face?
- A. Toward the outer nostril wall
- B. Toward the upper lip
- C. Toward the forehead
- D. Toward the nasal septum (answer)
The bevel faces the septum, the wall between the nostrils, so the tip slides along it without catching tissue. Using a lubricated airway and gentle insertion straight back along the floor of the nose reduces bleeding.
Outline point: NREMT EMT exam outline: Primary Assessment (airway adjuncts, NPA insertion)
11.What is the maximum time to suction an adult's airway in a single attempt?
- A. 30 seconds
- B. 45 seconds
- C. 15 seconds (answer)
- D. 60 seconds
Suction removes oxygen along with secretions, so adult attempts are limited to about 15 seconds, with shorter times for children and infants. The patient is oxygenated or ventilated between attempts.
Outline point: NREMT EMT exam outline: Primary Assessment (suction, adult)
12.How long should a single suction attempt last for an infant?
- A. About 15 seconds
- B. About 5 seconds (answer)
- C. About 20 seconds
- D. About 30 seconds
Infants have small oxygen reserves and become hypoxic quickly, and suctioning can slow the heart rate. EMT teaching limits infant suction attempts to about 5 seconds, compared with about 10 seconds for children and 15 seconds for adults.
Outline point: NREMT EMT exam outline: Primary Assessment (suction, infant)
13.When suctioning the mouth with a rigid tip, how far should it be inserted?
- A. Down into the trachea
- B. Only as far as you can see (answer)
- C. Until the patient gags
- D. Past the vocal cords
The rigid tip goes only where the EMT can see it, usually not beyond the base of the tongue, to avoid injuring tissue or triggering vomiting and a slow heart rate. Suction is applied while the tip is withdrawn.
Outline point: NREMT EMT exam outline: Primary Assessment (suction, technique)
14.An unresponsive patient has gurgling sounds with each breath. What should you do first?
- A. Insert an oral airway
- B. Apply a nasal cannula
- C. Check the blood glucose
- D. Suction the airway (answer)
Gurgling means fluid is in the upper airway, and it must be cleared before ventilation or adjuncts are used. Inserting an airway or ventilating first can push secretions deeper and cause aspiration.
Outline point: NREMT EMT exam outline: Primary Assessment (airway sounds, gurgling)
15.An unresponsive patient's breathing sounds like snoring. What is the most likely cause?
- A. Fluid in the lower airways
- B. The tongue partly blocking the airway (answer)
- C. Spasm of the small airways
- D. A collapsed lung on one side
Snoring respirations come from the tongue and soft tissue falling back into the upper airway. Repositioning the head and jaw or inserting an airway adjunct usually corrects it. Fluid causes gurgling, and small-airway spasm causes wheezing.
Outline point: NREMT EMT exam outline: Primary Assessment (airway sounds, snoring)
16.A child makes a harsh, high-pitched sound when breathing in. What does this sound indicate?
- A. Fluid in the small air sacs
- B. Normal breathing for a child
- C. Narrowing of the upper airway (answer)
- D. Spasm of the lower airways
Stridor is a harsh, high-pitched sound, usually on inhalation, caused by partial obstruction or swelling of the upper airway, as with croup or a foreign body. Wheezing points to narrowing of the lower airways. A child with stridor is kept calm in a position of comfort.
Outline point: NREMT EMT exam outline: Primary Assessment (airway sounds, stridor in a child)
17.At what flow rate should a nonrebreather mask be set for an adult?
- A. 10 to 15 liters per minute (answer)
- B. 1 to 2 liters per minute
- C. 4 to 6 liters per minute
- D. 20 to 25 liters per minute
A nonrebreather needs 10 to 15 L/min so the reservoir bag stays inflated during inhalation and delivers a high concentration of oxygen. With too little flow the bag collapses and the patient may not get enough air.
Outline point: NREMT EMT exam outline: Primary Assessment (oxygen devices, nonrebreather)
18.What is the usual flow range for a nasal cannula?
- A. 1 to 6 liters per minute (answer)
- B. 10 to 15 liters per minute
- C. 8 to 12 liters per minute
- D. 15 to 25 liters per minute
A nasal cannula delivers low-concentration oxygen at 1 to 6 L/min. Higher flows dry and irritate the nose without adding much oxygen. It suits patients with mild hypoxia or those who cannot tolerate a mask.
Outline point: NREMT EMT exam outline: Primary Assessment (oxygen devices, nasal cannula)
19.According to current AHA guidance, what is appropriate for a patient with chest pain who is alert, breathing normally and has an oxygen saturation of 98 percent on room air?
- A. Apply a nonrebreather at 15 L/min
- B. Begin ventilations with a BVM
- C. Withhold supplemental oxygen and monitor (answer)
- D. Apply a nasal cannula at 6 L/min
Current AHA guidance does not recommend routine oxygen for suspected acute coronary syndrome when the saturation is normal and there is no respiratory distress. Oxygen is given when the saturation is low or the patient shows hypoxia or breathing difficulty.
Outline point: NREMT EMT exam outline: Primary Assessment (oxygen administration, indications)
20.An adult has a pulse but is not breathing adequately. How often should you ventilate with a bag-valve mask?
- A. One breath every 6 seconds (answer)
- B. One breath every 2 seconds
- C. One breath every 12 seconds
- D. One breath every 15 seconds
For an adult with a pulse who needs ventilation, about one breath every 6 seconds, or 10 breaths per minute, is given. Each breath lasts about 1 second and just makes the chest rise. Faster rates cause stomach inflation and reduce blood return to the heart.
Outline point: NREMT EMT exam outline: Primary Assessment (ventilation, adult with a pulse)
21.An infant has a pulse but is breathing inadequately. At what rate should you give rescue breaths?
- A. One breath every 6 to 8 seconds
- B. One breath every 10 seconds
- C. One breath every 2 to 3 seconds (answer)
- D. One breath every 15 seconds
Current AHA guidance for infants and children with a pulse who need rescue breathing is one breath every 2 to 3 seconds, or 20 to 30 breaths per minute. Children use oxygen faster and need a higher ventilation rate than adults.
Outline point: NREMT EMT exam outline: Primary Assessment (ventilation, infant with a pulse)
22.During adult CPR, an advanced airway is in place. How should ventilations be given?
- A. Two breaths after every 30 compressions
- B. One breath every 2 seconds without pausing
- C. One breath every 6 seconds with continuous compressions (answer)
- D. Two breaths after every 15 compressions
With an advanced airway, compressions continue without pauses and a breath is given about every 6 seconds. The 30 to 2 ratio applies to adults without an advanced airway. Overventilation reduces blood flow back to the heart.
Outline point: NREMT EMT exam outline: Primary Assessment (CPR, advanced airway)
23.Two rescuers are performing CPR on a 6-year-old. What compression to ventilation ratio should they use?
- A. 30 compressions to 2 breaths
- B. 15 compressions to 2 breaths (answer)
- C. 5 compressions to 1 breath
- D. 3 compressions to 1 breath
For children and infants with two rescuers, the ratio is 15 to 2. A single rescuer uses 30 to 2 for all ages beyond the newborn period. The 3 to 1 ratio is used for newborns just after birth.
Outline point: NREMT EMT exam outline: Primary Assessment (CPR, pediatric ratio)
24.What compression rate is recommended during CPR?
- A. 100 to 120 per minute (answer)
- B. 60 to 80 per minute
- C. 80 to 100 per minute
- D. 120 to 150 per minute
High-quality CPR uses a rate of 100 to 120 compressions per minute. Slower rates produce less blood flow, and faster rates reduce depth and leave too little time for the heart to refill between compressions.
Outline point: NREMT EMT exam outline: Primary Assessment (CPR, compression rate)
25.How deep should chest compressions be for an adult?
- A. At least 2 inches but not more than 2.4 inches (answer)
- B. About 1 inch, to avoid any rib fractures
- C. About 1.5 inches, the same as for an infant
- D. At least 3 inches, for adequate blood flow
Adult compressions should be at least 2 inches (5 cm) deep but not more than 2.4 inches (6 cm), with full chest recoil after each one. Shallow compressions do not move enough blood, and excessive depth increases injury.
Outline point: NREMT EMT exam outline: Primary Assessment (CPR, adult compression depth)
26.How deep should chest compressions be for an infant?
- A. About 1.5 inches, one third of chest depth (answer)
- B. About 0.5 inch, one tenth of chest depth
- C. About 2.5 inches, half of chest depth
- D. About 3 inches, the same as an adult
Infant compressions are about one third of the front-to-back depth of the chest, which is about 1.5 inches (4 cm). For children it is about 2 inches. Compressions that are too shallow give little blood flow.
Outline point: NREMT EMT exam outline: Primary Assessment (CPR, infant compression depth)
27.Two rescuers are performing CPR on an infant. Which compression technique is recommended?
- A. Heels of both hands on the lower sternum
- B. One closed fist on the upper sternum
- C. Two fingers placed over the xiphoid
- D. Two thumbs with the hands encircling the chest (answer)
The two thumb-encircling hands technique produces better depth and blood flow and is recommended when two rescuers are present. Compressions are on the lower half of the sternum, just below the nipple line, and never over the xiphoid process.
Outline point: NREMT EMT exam outline: Primary Assessment (CPR, infant technique)
28.You arrive at an adult in cardiac arrest with an AED while your partner performs CPR. What should you do first with the AED?
- A. Check a pulse for 30 seconds
- B. Give two breaths before using it
- C. Turn it on and attach the pads (answer)
- D. Wait for paramedics to arrive
Early defibrillation improves survival in shockable rhythms, so the AED is turned on and the pads applied as soon as it arrives, while CPR continues until the device analyzes. Long pulse checks delay both compressions and shocks.
Outline point: NREMT EMT exam outline: Primary Assessment (AED, early use)
29.The AED announces that it is analyzing the heart rhythm. What should the rescuers do?
- A. Continue compressions during the analysis
- B. Give two breaths while it is analyzing
- C. Check for a pulse at the wrist
- D. Pause compressions and not touch the patient (answer)
Movement from compressions or touching the patient can interfere with rhythm analysis. Everyone clears the patient, and CPR resumes right after a shock is delivered or a no-shock message is given.
Outline point: NREMT EMT exam outline: Primary Assessment (AED, analysis)
30.You are using an AED on a 4-year-old in cardiac arrest, but pediatric pads are not available. What should you do?
- A. Skip the AED and continue CPR alone
- B. Use adult pads, making sure they do not touch (answer)
- C. Cut the adult pads to a smaller size
- D. Use one adult pad on the chest only
For children under 8, pediatric pads or a dose attenuator are preferred. When they are not available, adult pads are used, placed front and back if needed so they do not touch. A shock through adult pads is better than no defibrillation.
Outline point: NREMT EMT exam outline: Primary Assessment (AED, pediatric use)
31.How long should a rescuer take to check for a pulse in an unresponsive adult who is not breathing normally?
- A. No more than 10 seconds (answer)
- B. At least 20 seconds
- C. About 30 seconds
- D. A full 60 seconds
Pulse checks are limited to 10 seconds so compressions are not delayed. If a definite pulse is not felt within that time in an unresponsive patient who is not breathing normally, CPR is started.
Outline point: NREMT EMT exam outline: Primary Assessment (circulation, pulse check)
32.Where should you check the pulse of an unresponsive infant?
- A. The carotid artery in the neck
- B. The radial artery at the wrist
- C. The brachial artery in the upper arm (answer)
- D. The pedal pulse on top of the foot
An infant's short, chubby neck makes the carotid pulse hard to find, so the brachial artery on the inside of the upper arm is used. For children, the carotid or femoral pulse is checked.
Outline point: NREMT EMT exam outline: Primary Assessment (circulation, infant pulse)
33.An unresponsive adult is taking occasional gasping breaths and has no pulse. What should you do?
- A. Apply a nonrebreather mask
- B. Place the patient on the side
- C. Begin chest compressions (answer)
- D. Wait to see if breathing improves
Occasional gasps, called agonal breathing, are not effective breathing and are common early in cardiac arrest. A pulseless, unresponsive patient with only gasping needs CPR right away. Oxygen by mask does not help a patient who is not moving air.
Outline point: NREMT EMT exam outline: Primary Assessment (breathing assessment, agonal breathing)
34.A patient who took an unknown amount of pills is breathing 6 times per minute with shallow chest rise. What is the priority?
- A. Apply a nasal cannula at 4 L/min
- B. Obtain a full list of medications
- C. Assist ventilations with a bag-valve mask (answer)
- D. Place the patient on the side and observe
A rate of 6 with shallow breaths does not move enough air, so ventilation is assisted with a BVM and oxygen. A cannula or mask needs adequate breathing to work. The history is gathered after the airway and breathing are managed.
Outline point: NREMT EMT exam outline: Primary Assessment (breathing assessment, inadequate breathing)
35.A patient has steady dark red bleeding from a cut on the forearm. What should you do first?
- A. Apply a tourniquet above the elbow
- B. Apply firm direct pressure to the wound (answer)
- C. Raise the arm and wait before pressure
- D. Place a cold pack on the forearm
Most external bleeding stops with firm direct pressure. A tourniquet is used for life-threatening limb bleeding that direct pressure does not control, or when pressure cannot be applied. Elevation alone is not a reliable way to control bleeding.
Outline point: NREMT EMT exam outline: Primary Assessment (bleeding control, direct pressure)
36.Direct pressure fails to control severe bleeding from a lower leg wound. Where should the tourniquet be applied?
- A. Directly over the wound itself
- B. Just below the wound, toward the foot
- C. Over the knee joint for a firmer hold
- D. 2 to 3 inches above the wound, not over a joint (answer)
A tourniquet is placed 2 to 3 inches above the wound, avoiding joints, and tightened until the bleeding stops and the distal pulse is gone. If the wound location is unclear, it is placed high on the limb.
Outline point: NREMT EMT exam outline: Primary Assessment (bleeding control, tourniquet placement)
37.After applying a tourniquet that stopped the bleeding, what should the EMT do?
- A. Loosen it every 10 minutes
- B. Note the time and leave it in place (answer)
- C. Hide it under clothing for warmth
- D. Remove it once the bleeding slows
Once applied, a tourniquet is left in place and loosened only by hospital staff. The time of application is written down and reported, and the tourniquet stays visible. Loosening it can restart heavy bleeding.
Outline point: NREMT EMT exam outline: Primary Assessment (bleeding control, tourniquet care)
38.A patient has severe bleeding from a deep wound in the groin where a tourniquet cannot be applied. What should you do?
- A. Pack the wound and hold firm direct pressure (answer)
- B. Apply a tourniquet around the waist
- C. Cover it lightly and transport quickly
- D. Raise the leg and apply an ice pack
Junctional wounds, such as in the groin or armpit, cannot be controlled with a limb tourniquet. Packing the wound tightly with gauze, hemostatic if available, and holding firm pressure is the accepted approach. A light covering does not stop arterial bleeding.
Outline point: NREMT EMT exam outline: Primary Assessment (bleeding control, junctional wounds)
39.Which description fits arterial bleeding?
- A. Dark red blood flowing steadily
- B. Slow oozing from small vessels
- C. Clear fluid weeping from the skin
- D. Bright red blood spurting with the pulse (answer)
Arterial blood is rich in oxygen, so it is bright red, and it spurts in time with the heartbeat because it is under high pressure. Venous bleeding is darker and flows steadily, while capillary bleeding oozes slowly.
Outline point: NREMT EMT exam outline: Primary Assessment (bleeding, types)
40.Which finding is an early sign of shock in an adult?
- A. Low blood pressure
- B. Fixed, dilated pupils
- C. Absent radial pulses
- D. Anxiety and a rapid pulse (answer)
Early in shock, the body compensates by raising the heart rate and narrowing blood vessels, and reduced brain perfusion causes restlessness or anxiety. Falling blood pressure and loss of peripheral pulses are late signs that compensation is failing.
Outline point: NREMT EMT exam outline: Primary Assessment (shock, early signs)
41.Why is blood pressure an unreliable early sign of shock in children?
- A. Children have higher pressure than adults
- B. Children maintain pressure until shock is advanced (answer)
- C. Blood pressure cannot be measured in children
- D. Children rarely lose enough blood to drop it
Children compensate well by increasing heart rate and narrowing vessels, so blood pressure stays near normal until a large share of blood volume is lost. A fast heart rate, delayed capillary refill and mottled skin are earlier signs. Low blood pressure in a child is an ominous late finding.
Outline point: NREMT EMT exam outline: Primary Assessment (shock, pediatric considerations)
42.A trauma patient has cool, pale skin and a rapid, weak pulse. Which action is appropriate?
- A. Give sips of water to replace lost fluid
- B. Keep the patient warm and transport promptly (answer)
- C. Have the patient walk to the ambulance
- D. Stay on scene until the pulse slows down
Shock care at the EMT level includes controlling bleeding, giving oxygen as needed, keeping the patient supine and warm, and rapid transport. Nothing is given by mouth because surgery may be needed, and walking increases oxygen demand.
Outline point: NREMT EMT exam outline: Primary Assessment (shock, treatment)
43.In a 3-year-old, capillary refill takes 4 seconds. What does this suggest?
- A. Poor perfusion, a possible sign of shock (answer)
- B. Normal circulation for a toddler
- C. Fever without any circulation problem
- D. Good hydration and normal perfusion
In infants and young children, capillary refill longer than about 2 seconds suggests poor perfusion. Combined with a fast heart rate or cool skin, it points to shock. Cold surroundings can also slow refill, so it is interpreted together with other findings.
Outline point: NREMT EMT exam outline: Primary Assessment (circulation, capillary refill in a child)
44.Which patient is a high priority for rapid transport?
- A. An alert patient with a minor ankle injury
- B. An unresponsive patient with no gag reflex (answer)
- C. A patient with a small cut on one hand
- D. An alert patient with a mild headache
Unresponsiveness and loss of the gag reflex mean the patient cannot protect the airway and may be getting worse. Such patients need immediate airway management and prompt transport. The other patients are stable and lower priority.
Outline point: NREMT EMT exam outline: Primary Assessment (priority and transport decisions)
45.A trauma patient is unresponsive and shows signs of shock. What is the goal for on-scene time?
- A. Stay at least 30 minutes to stabilize
- B. Finish a detailed exam before leaving
- C. Wait until all splints are applied
- D. Keep it short, ideally 10 minutes or less (answer)
Critical trauma patients often need surgery that cannot be done in the field. The aim is to treat immediate life threats and keep scene time to about 10 minutes or less. Detailed exams and splinting of minor injuries are done during transport if time allows.
Outline point: NREMT EMT exam outline: Primary Assessment (priority and transport decisions, trauma)
46.A patient has a stab wound to the chest with air bubbling from it. What should you do?
- A. Pack the wound with dry gauze
- B. Leave it open so air can escape
- C. Cover it with a moist dressing
- D. Cover it with an occlusive dressing (answer)
An open chest wound lets air enter the chest, so it is sealed quickly with an occlusive dressing or vented chest seal. The patient is watched for signs of tension pneumothorax, and the dressing is lifted briefly to release pressure if breathing worsens.
Outline point: NREMT EMT exam outline: Primary Assessment (breathing, open chest wound)
47.How can you keep an unresponsive infant's airway in a neutral position on a flat surface?
- A. Place a thick pillow under the head
- B. Tilt the head back as far as possible
- C. Place a thin pad under the shoulders (answer)
- D. Turn the head fully to one side
An infant's large back of the head pushes the chin toward the chest when lying flat, which can block the airway. A thin pad under the shoulders brings the airway to a neutral position. Overextending the neck can also block the soft infant airway.
Outline point: NREMT EMT exam outline: Primary Assessment (airway management, infant positioning)
48.A responsive infant is choking and cannot cry or cough. What should you do?
- A. Give abdominal thrusts until it clears
- B. Give 5 back slaps and 5 chest thrusts (answer)
- C. Sweep the mouth blindly with a finger
- D. Hold the infant upside down by the feet
For a responsive infant with a severe obstruction, repeated cycles of 5 back slaps and 5 chest thrusts are used. Abdominal thrusts can injure an infant's liver, and blind finger sweeps may push the object deeper.
Outline point: NREMT EMT exam outline: Primary Assessment (airway obstruction, infant)
49.An adult who was choking becomes unresponsive. What should you do?
- A. Keep giving abdominal thrusts while standing
- B. Do blind finger sweeps before anything else
- C. Start CPR and look in the mouth before breaths (answer)
- D. Give back blows with the patient on the floor
When a choking adult becomes unresponsive, the rescuer lowers the patient and starts CPR, since compressions may dislodge the object. Each time the airway is opened for breaths, the rescuer looks in the mouth and removes a visible object. Blind sweeps are avoided.
Outline point: NREMT EMT exam outline: Primary Assessment (airway obstruction, adult becomes unresponsive)
50.A woman who is 8 months pregnant is choking and cannot speak. Which maneuver should you use?
- A. Abdominal thrusts
- B. Chest thrusts (answer)
- C. Back slaps alone
- D. Blind finger sweeps
Chest thrusts are used in late pregnancy, and in patients so large the rescuer cannot reach around the abdomen. Abdominal thrusts could harm the uterus and fetus. Back slaps alone are not the standard adult technique.
Outline point: NREMT EMT exam outline: Primary Assessment (airway obstruction, pregnancy)
51.A woman in her third trimester becomes dizzy and pale while lying flat on her back. What should you do?
- A. Raise her legs and keep her flat
- B. Turn her onto her left side (answer)
- C. Have her stand and walk around
- D. Place her head lower than her feet
In late pregnancy, the uterus can press on the inferior vena cava when the woman lies on her back, reducing blood return to the heart and lowering blood pressure. Turning her to the left side moves the uterus off the vessel.
Outline point: NREMT EMT exam outline: Primary Assessment (OB, supine hypotension)
52.A patient who is 34 weeks pregnant is secured to a long board after a crash. How should the board be positioned during transport?
- A. Flat with the feet raised
- B. Head down at 30 degrees
- C. Upright at 90 degrees
- D. Tilted toward her left side (answer)
Tilting the board to the left keeps the heavy uterus from pressing on the inferior vena cava, which could cause low blood pressure in the mother and reduced blood flow to the fetus. Raising the feet or lowering the head does not relieve this compression.
Outline point: NREMT EMT exam outline: Primary Assessment (OB, trauma positioning)
53.A woman at 32 weeks of pregnancy has heavy, painless, bright red vaginal bleeding and a rapid pulse. What is the priority?
- A. Look inside the vagina for the source
- B. Treat for shock and transport promptly (answer)
- C. Pack the vagina to stop the bleeding
- D. Have her walk to help the uterus settle
Heavy bleeding in late pregnancy can come from the placenta and lead to shock in the mother and harm to the fetus. The EMT places a pad over the vaginal opening, treats for shock and transports rapidly. Nothing is placed inside the vagina.
Outline point: NREMT EMT exam outline: Primary Assessment (OB, bleeding in late pregnancy)
54.An adult is unresponsive, not breathing and has no pulse. In what order should care begin?
- A. Airway, then breathing, then compressions
- B. Breathing, then compressions, then airway
- C. Airway, then compressions, then breathing
- D. Compressions, then airway, then breathing (answer)
For adult cardiac arrest, the sequence is compressions, airway, breathing, because moving oxygenated blood quickly matters most and starting compressions avoids delays. For patients with a pulse, the airway and breathing are assessed and managed first.
Outline point: NREMT EMT exam outline: Primary Assessment (cardiac arrest sequence)
55.Which is an early sign of hypoxia?
- A. Blue lips and nail beds
- B. A slowing heart rate
- C. No response to pain
- D. Restlessness and anxiety (answer)
The brain is sensitive to low oxygen, so restlessness, anxiety and confusion appear early, along with a fast heart rate. Cyanosis, a slowing heart rate and unresponsiveness are late signs that call for immediate airway and ventilation support.
Outline point: NREMT EMT exam outline: Primary Assessment (breathing assessment, hypoxia)
56.A 2-year-old with difficulty breathing shows skin pulling in between the ribs with each breath. What does this indicate?
- A. Normal breathing for a toddler
- B. A rib fracture from a fall
- C. Low blood sugar in the child
- D. Increased work of breathing (answer)
Retractions between the ribs, above the collarbones or below the sternum show the child is working hard to breathe. Other signs include nasal flaring, grunting and head bobbing. These children need oxygen, a position of comfort and close monitoring for fatigue.
Outline point: NREMT EMT exam outline: Primary Assessment (breathing assessment, pediatric work of breathing)
57.A patient with COPD is sitting upright, leaning forward with the hands on the knees. What does this position suggest?
- A. Abdominal pain only
- B. Low blood sugar
- C. Respiratory distress (answer)
- D. A normal resting posture
This tripod position helps the patient use accessory muscles to move air, and it is a sign of significant respiratory distress. The patient is allowed to stay in this position of comfort and is not forced to lie flat.
Outline point: NREMT EMT exam outline: Primary Assessment (breathing assessment, posture)
58.A patient with a suspected opioid overdose is unresponsive, has a pulse and is breathing 4 times per minute. What is the first priority?
- A. Open the airway and ventilate with a BVM (answer)
- B. Give naloxone before any other care
- C. Obtain a blood glucose reading
- D. Search the area for drug items
Inadequate breathing is the immediate threat, so the airway is opened and ventilations are given with a BVM and oxygen. Naloxone is given as soon as practical, but it takes time to work and ventilation is not delayed for it.
Outline point: NREMT EMT exam outline: Primary Assessment (airway and ventilation, opioid overdose)
59.A patient who breathes through a neck stoma needs ventilations. How should you deliver them?
- A. Ventilate through the mouth and nose
- B. Cover the stoma with a dry dressing first
- C. Seal a small mask over the stoma and ventilate (answer)
- D. Insert an oral airway into the stoma
A patient who has had the larynx removed breathes through the stoma, so ventilations go through it, often with an infant or child mask for a good seal. Covering the stoma blocks the airway. If air escapes from the mouth or nose, they may need to be sealed.
Outline point: NREMT EMT exam outline: Primary Assessment (ventilation, stoma)
60.While you ventilate a patient with a BVM, the abdomen grows larger. What is the likely cause?
- A. Breaths given too fast or with too much force (answer)
- B. A mask sized slightly too small for the face
- C. Oxygen flow to the bag set a little too low
- D. Blood collecting in the patient's lungs
Air pushed in too quickly or with too much volume enters the esophagus and inflates the stomach, which can cause vomiting and limit lung expansion. Each breath is given over about 1 second, with just enough volume to see the chest rise, at the proper rate.
Outline point: NREMT EMT exam outline: Primary Assessment (ventilation, gastric distention)
61.How much volume should each BVM ventilation deliver to an adult?
- A. The full bag squeezed as hard as possible
- B. A small puff that causes no chest rise
- C. Enough to make the chest visibly rise (answer)
- D. Twice the patient's usual breath size
The goal is visible chest rise with each breath, delivered over about 1 second. Squeezing hard or overfilling the lungs leads to stomach inflation and higher pressure in the chest, which lowers blood return to the heart.
Outline point: NREMT EMT exam outline: Primary Assessment (ventilation, tidal volume)
62.In which situation may a pulse oximeter show a falsely normal reading?
- A. A patient with a normal pulse
- B. A well-warmed finger
- C. Carbon monoxide poisoning (answer)
- D. A patient breathing room air
Standard pulse oximeters cannot tell oxygen from carbon monoxide bound to hemoglobin, so the reading may look normal while tissues are starved of oxygen. Cold fingers, poor perfusion and some nail polish can also cause inaccurate readings.
Outline point: NREMT EMT exam outline: Primary Assessment (oxygenation, pulse oximetry limits)
63.An unresponsive adult with no suspected trauma is breathing adequately and has a pulse. How should the patient be positioned?
- A. Flat on the back with the head still
- B. In the recovery position on the side (answer)
- C. Face down with the head turned
- D. Sitting upright with the head forward
The recovery position keeps the airway open and lets fluids drain from the mouth, lowering the risk of aspiration. An unresponsive patient lying on the back can lose the airway to the tongue or vomit. Breathing is monitored continuously.
Outline point: NREMT EMT exam outline: Primary Assessment (airway protection, recovery position)
64.A patient is having a generalized seizure. What should you do during the seizure?
- A. Place a bite block between the teeth
- B. Protect the patient from injury (answer)
- C. Hold the arms and legs to stop jerking
- D. Pour water in the mouth to wake them
During a seizure, the EMT moves objects away, cushions the head and does not restrain movement or put anything in the mouth. After the seizure, the airway is opened and suctioned as needed and oxygen is given. A long or repeated seizure needs urgent care.
Outline point: NREMT EMT exam outline: Primary Assessment (airway, active seizure)
65.A newborn is not breathing after being dried, warmed and stimulated. What should you do?
- A. Start chest compressions right away
- B. Keep stimulating for two more minutes
- C. Hold the newborn upside down
- D. Begin ventilations with a BVM (answer)
Most newborns who need help respond to effective ventilation. If a newborn is apneic or gasping, or has a heart rate below 100 per minute after the initial steps, ventilation with a BVM begins at 40 to 60 breaths per minute.
Outline point: NREMT EMT exam outline: Primary Assessment (newborn resuscitation, ventilation)
66.A newborn's heart rate stays below 60 per minute despite 30 seconds of effective ventilation. What should be added?
- A. Chest compressions at a 3 to 1 ratio (answer)
- B. Oral glucose placed in the cheek
- C. Chest compressions at a 30 to 2 ratio
- D. Back slaps given between breaths
In newborn resuscitation, a heart rate below 60 per minute despite effective ventilation calls for chest compressions coordinated with breaths at 3 compressions to 1 breath. The 30 to 2 ratio is for single-rescuer CPR in older patients.
Outline point: NREMT EMT exam outline: Primary Assessment (newborn resuscitation, compressions)
67.You have two patients: one with a broken arm who is screaming in pain, and one who is quiet with snoring respirations. Whom do you treat first?
- A. The screaming patient with the broken arm
- B. Both equally, switching every minute
- C. The quiet patient with snoring respirations (answer)
- D. Whoever was injured first at the scene
Snoring respirations in a quiet patient suggest decreased responsiveness and a partly blocked airway, an immediate life threat. A patient who can scream has an open airway and is breathing. Airway problems are managed before painful but stable injuries.
Outline point: NREMT EMT exam outline: Primary Assessment (priority decisions, multiple patients)
68.A patient stung by a bee has hives, wheezing and a weak, rapid pulse. What do these findings suggest?
- A. A local reaction needing ice
- B. Anxiety needing reassurance
- C. Mild asthma needing rest only
- D. Anaphylaxis needing epinephrine (answer)
Hives together with breathing difficulty and signs of shock indicate anaphylaxis, a life-threatening allergic reaction. Epinephrine by auto-injector is the key treatment, followed by rapid transport. A local reaction involves only swelling at the sting site.
Outline point: NREMT EMT exam outline: Primary Assessment (circulation and breathing, anaphylaxis recognition)
69.A 4-year-old with asthma was struggling to breathe but now seems sleepy, with slower and weaker breaths. What does this suggest?
- A. The asthma attack is ending normally
- B. The child is calm because care worked
- C. The child is tiring and may be near failure (answer)
- D. The child simply needs to take a nap
A child who goes from working hard to breathe to drowsy with slow, shallow breathing is likely exhausted and in respiratory failure. This calls for assisted ventilation with a BVM and immediate transport. Real improvement looks like easier breathing with good alertness.
Outline point: NREMT EMT exam outline: Primary Assessment (breathing assessment, pediatric respiratory failure)
70.Which three components make up the Pediatric Assessment Triangle?
- A. Airway, blood pressure, pupil response
- B. Appearance, work of breathing, circulation to skin (answer)
- C. Pulse, temperature, blood glucose level
- D. Speech, arm drift, facial symmetry
The Pediatric Assessment Triangle is a quick look from across the room at the child's appearance, work of breathing and circulation to the skin. It helps the EMT judge how sick a child is before touching the child. Speech, arm drift and facial symmetry belong to a stroke scale.
Outline point: NREMT EMT exam outline: Primary Assessment (pediatric assessment triangle)
71.A frightened 3-year-old with breathing difficulty will not tolerate a mask. How can you give oxygen?
- A. Hold the mask or tubing near the child's face (answer)
- B. Strap the mask on firmly while the child cries
- C. Withhold oxygen until hospital arrival
- D. Give oxygen only by bag-valve mask
Blow-by oxygen, with the mask or tubing held near the face, often by a parent, delivers some oxygen without upsetting the child. Forcing a mask on increases crying and oxygen demand and can worsen airway swelling. A BVM is for inadequate breathing.
Outline point: NREMT EMT exam outline: Primary Assessment (oxygen devices, pediatric blow-by)
72.A child has stridor and drooling and sits leaning forward, refusing to lie down. What should you avoid?
- A. Looking in the throat with a tongue depressor (answer)
- B. Letting a parent hold the child
- C. Keeping the child in a position of comfort
- D. Giving blow-by oxygen near the face
These signs suggest a serious upper airway infection, and probing the throat can trigger spasm and complete obstruction. The EMT keeps the child calm in a position of comfort, gives oxygen as tolerated and transports promptly.
Outline point: NREMT EMT exam outline: Primary Assessment (airway, pediatric upper airway infection)
NREMT EMT · Primary assessment
72
questions in this domain, 178 for the NREMT EMT in all
Open a question for the four options, the answer, the reasoning and the outline point it trains. Written by Radif Partners; not questions from the real exam.
This page lists our EMT questions domain by domain, each with its four options, the right answer, an explanation and the part of the NREMT exam it trains. It holds 178 questions written by Radif Partners for the five domains of the NREMT EMT cognitive exam in force since April 7, 2025: scene size-up and safety, primary assessment, secondary assessment, patient treatment and transport, and operations. The real exam draws its questions from a secret bank and adapts their difficulty to each candidate, between 70 and 120 questions; no public list can contain them, and any site that promises the real questions should be avoided. Reading a bank with answers is useful in two moments: after a practice set, to read the questions around the ones you missed, and in the last days before the exam, to review the rules you already know quickly. The quiz and the timed mock remain the better tools for learning, because choosing before seeing the answer is what builds recall.
Questions, formats and fees by Radif Partners · Editorial policy · Method and sources
What the bank contains
| Domain | Questions in our bank |
|---|---|
| Scene Size-Up and Safety | 28 |
| Primary Assessment | 72 |
| Secondary Assessment | 12 |
| Patient Treatment and Transport | 45 |
| Operations | 21 |
Each question states a situation, often a patient with a complaint, a mechanism and a few vital signs, and asks for the best action or the most likely problem. The explanation gives the rule behind the answer, and the label under the question names the domain. Pediatric and obstetric cases are spread through the domains, as on the real exam.
How to read it without fooling yourself
- Cover the answer. Read the stem and the four options and pick one before you open the answer.
- When you were wrong, write the rule you missed in one sentence. If you were right for the wrong reason, count it as wrong.
- After ten or fifteen questions, switch to the practice test for the same domain and see whether the rules hold under a new draw.
The rules that come back most often
Across the domains, a short list of priorities answers a large share of the questions. Scene safety and protective equipment come before contact. In the primary assessment, an open airway, adequate breathing and control of severe bleeding come before anything else, and a patient with a problem there is a priority for transport. Ventilation with a bag-valve mask is for inadequate breathing, while a nonrebreather mask needs adequate breathing to work. An unresponsive patient without a gag reflex can take an oral airway; a nasal airway is avoided with signs of a skull fracture or facial trauma. In treatment, every medication question checks indication, contraindication, dose route and scope: an EMT assists with a patient's own prescribed nitroglycerin or inhaler but does not give drugs outside the national scope. In operations, a competent adult may refuse care, and the refusal must be informed and documented.
When the bank and the exam differ
Our explanations follow the national EMT education level. Local protocols can differ on details such as spinal motion restriction criteria or oxygen targets, and the NREMT tests the national standard rather than local practice. When your course taught a local variant, learn both and answer the exam with the national one. The exam guide explains the format and the rules; the full mock puts the whole bank under time pressure.
These questions are ours, written from the NREMT domains, and are not questions from the real exam. Their clinical content is exam knowledge, not medical advice.