A
You arrive to find a 40-year-old male who was stabbed in the left chest. He is conscious but struggling to breathe, with decreased breath sounds on the left and JVD.
What do you do first?
A. Apply occlusive dressing
B. Begin BVM ventilations
C. Place the patient in a prone position
D. Begin CPR
A. Apply an occlusive dressing
A 23-year-old collapses during exercise, had tonic-clonic activity for 20 seconds, now confused.
Vitals: HR 120, BP 96/58, RR 24, SpO₂ 98%, Glucose: 112
Next best step?
A. Encourage fluid intake
B. Reassess in 10 min
C. Monitor airway, transport for eval
D. Administer oral glucose
C. Monitor airway and transport for eval
A 25-year-old hiker is pulled from a river after being lost overnight. He is cold to the touch, lethargic, and his pulse is slow and irregular.
What’s the priority in management?
A. Begin vigorous rewarming and massage extremities
B. Administer hot fluids orally and stimulate to awaken
C. Remove wet clothing, apply warm blankets, handle gently, transport
D. Defibrillate if rhythm is bradycardia
Answer: C – Hypothermic patients are at risk for arrhythmias; rewarm passively and handle carefully.
You arrive at a warehouse with two unconscious patients and a strong chemical odor. Bystanders are coughing.
What should you do first?
A. Enter and remove victims to safety
B. Put on gloves and assess patients in the building
C. Call for HazMat, establish safe zone, and prevent exposure
D. Apply oxygen to patients inside the building
Answer: C – Never enter a HazMat scene without appropriate PPE. Secure the scene, isolate, and deny entry.
A 68-year-old woman presents with slurred speech and right-sided weakness. Her daughter says she's diabetic and hasn’t eaten today. GCS is 13.
What’s your differential and immediate step?
A. Assume stroke and begin rapid transport to stroke center
B. Perform blood glucose check before deciding next steps
C. Administer oral glucose and recheck vitals
D. Load and go, checking glucose en route
Answer: B – Stroke and hypoglycemia can present similarly. A glucose check is quick and essential.
A 21-year-old female passed out during a lecture. Witnesses report jerky movements. She's now awake but confused. Skin is warm and dry, glucose is 110.
What's your next step?
A. Treat for seizure, transport for evaluation
B. Administer oral glucose
C. Place in recovery position and advise refusal
D. Reassure and monitor
A. Treat for seizure, transport for evaluation
A 72-year-old male with known COPD complains of increasing SOB. He’s sitting upright and using accessory muscles.
Vitals: HR 110, BP 140/84, RR 28 labored, SpO₂ 86% on 2L O₂
Best next action?
A. High-flow O2 via NRB
B. CPAP if tolerated
C. BVM
D. Administer aspirin
B - CPAP If tolerated
A 19-year-old is found unresponsive at a party. Pupils are pinpoint, respirations are 6/min, skin is cyanotic.
What should you do first?
A. Begin CPR and call for ALS
B. Administer naloxone, support ventilations with BVM
C. Provide high-flow O2 and wait for improvement
D. Suction airway and apply AED
Answer: B – Classic opioid overdose; airway and breathing must be managed first, and naloxone is appropriate.
You arrive to find a 58-year-old male pulseless and apneic. CPR has been in progress for 3 minutes. AED advises “No Shock.”
What’s your next move?
A. Continue CPR, reassess every 2 minutes, transport when ready
B. Wait for shockable rhythm to appear
C. Immediately begin transport
D. Check for pulse manually
Answer: A – Continue high-quality CPR. AED only shocks shockable rhythms. Reassess every 2 minutes.
An intoxicated patient has a head injury and is vomiting with ALOC. What should you do first?
A. Call for law enforcement
B. Assume it’s alcohol and let them sleep it off
C. Suction airway and treat as head trauma
D. Give oral glucose
C. Suction airway and treat as head trauma
A 3-year-old male is in tripod position with inspiratory stridor and drooling. He is febrile and anxious.
What do you suspect and how do you manage it?
A. Asthma – Nebulizer treatment
B. Epiglottitis – Calm, blow-by O2, rapid transport
C. Croup – Humidified oxygen
D. Anaphylaxis – Administer epinephrine
b. Epiglottis - Calm, Blow by O2, rapid transport
A 33-year-old, 35-weeks pregnant woman is actively seizing.
Vitals: HR 120, BP 186/112, RR postictal, SpO₂ 91%, Temp: 99.0°F
Best course of action?
A. Lay supine, restrain limbs
B. Left lateral recumbent, suction, O2, rapid transport
C. Administer oral glucose
D. Delay transport until seizure stops
B- Left lateral recumbent, suction, O2, rapid transport
You respond to a school bus crash with multiple injured children. As the first arriving EMT, you find 10+ patients and one driver unconscious.
What is your primary role upon arrival?
A. Begin triaging immediately and radio for backup
B. Assume Incident Command, size up the scene, and request additional resources
C. Begin treating the unconscious driver and assign triage roles to bystanders
D. Call medical control for instructions before acting
Answer: B – In MCI, the first EMT becomes IC until relieved. Scene safety, size-up, and resource request come before treatment.
A 60-year-old male has facial droop, slurred speech, and cannot raise his right arm. Symptoms began 20 minutes ago. BP is 198/110.
What’s your transport decision?
A. Treat on scene until BP lowers
B. Administer aspirin and transport non-emergent
C. Notify stroke center and transport rapidly
D. Wait to confirm with blood glucose and ECG
Answer: C – Suspected stroke within time window: rapid transport to stroke center is priority. No aspirin given for suspected stroke.
A 4-year-old is found sitting upright, drooling, and struggling to breathe with stridor. Parents say symptoms started rapidly after a fever this morning.
What condition do you suspect, and what is the best initial management?
A. Asthma; administer albuterol via nebulizer
B. Croup; provide humidified oxygen and transport
C. Epiglottitis; avoid airway manipulation, provide blow-by O2, transport rapidly
D. Foreign body aspiration; perform abdominal thrusts
Answer: C – Sudden onset with fever, drooling, stridor, and tripod position suggests epiglottitis. Do not agitate or try to visualize the airway.
An 82-year-old is found pulseless and apneic. Family presents a valid DNR form.
What should you do?
A. Begin CPR until online medical control confirms DNR
B. Confirm DNR validity, provide comfort care
C. Begin BVM and transport
D. Ask family to decide
B. Confirm DNR Validity, provide comfort care
A 60-year-old male with SOB and audible wheezing has pink, frothy sputum.
Vitals: HR 124, BP 152/100, RR 34, SpO₂ 84%, Skin: pale, clammy
Most likely cause and treatment?
A. CHF – BVM
B. Asthma – Albuterol
C. CHF – CPAP
D. PE – Transport supine
C. CHF - CPAP
A 32-year-old pregnant woman, 36 weeks gestation, complains of painless vaginal bleeding. She denies trauma and fetal movement has decreased.
What is the most likely cause and best management?
A. Placenta previa; transport on left side, monitor vitals
B. Abruptio placenta; apply pelvic binder and transport supine
C. Labor in progress; prepare for delivery on scene
D. Ectopic pregnancy; transport in Trendelenburg
Answer: A – Painless bleeding in late pregnancy is likely placenta previa. Never perform vaginal exam.
A 72-year-old male passed out at church. He is awake now, but pale and bradycardic at 38 bpm. No chest pain.
What’s your best immediate action?
A. Administer oxygen, transport with lights and sirens
B. Monitor, reassure, and advise patient to call PCP
C. Give glucose and reassess
D. Encourage oral fluids and transport later
Answer: A – Symptomatic bradycardia = priority transport. ALS may pace, but BLS must recognize severity.
A 50-year-old male was burned when a chemical exploded in his garage. He has partial and full-thickness burns on his chest, arms, and face. He is coughing and has soot around his nose and mouth.
What are your main concerns, and how should this patient be managed?
A. Begin cooling the burns with water and wrap in dry dressings
B. Administer high-flow oxygen, protect the airway, and prepare for early transport
C. Decontaminate with sterile saline and transport to burn unit
D. Apply wet dressings and assess for other injuries
Answer: B – This is a critical burn with likely airway involvement. Early airway protection and rapid transport are essential.
A 26-year-old fell 15 feet onto concrete. He is alert but cannot move or feel his legs. Skin is warm, pink, and dry.
Vitals: HR 54, BP 78/40, RR 20, SpO₂ 97%
What type of shock is this and initial care?
A. Cardiogenic – BVM and Trendelenburg
B. Hypovolemic – High-flow O2 and fluid bolus
C. Neurogenic – Secure airway, spinal motion restriction, maintain perfusion
D. Septic – Remove clothing and rapid transport
C. Neurogenic - Secure airway, spinal motion restriction, maintain perfusion
A 31-year-old female at 36 weeks gestation presents with sudden abdominal pain and dark red vaginal bleeding.
Vitals: HR 128, BP 90/58, RR 28, SpO₂ 94%
What do you suspect?
A. Ectopic pregnancy
B. Normal labor
C. Placental abruption – life-threatening
D. UTI
C. Placental abruption - life threatening
You assess a 45-year-old female after a mass shooting. She is not breathing. You reposition the airway; she starts breathing at 8/min.
What triage category does she fall into using START?
A. Minor (green)
B. Delayed (yellow)
C. Immediate (red)
D. Deceased (black)
Answer: C – Once breathing returns after airway repositioning, she is red/immediate.
A 19-year-old male collapses while playing basketball. Witnesses say he shook briefly, then was unresponsive for 1 minute. He is now awake but confused.
What is the likely cause, and how should you proceed?
A. Cardiac event; apply AED and transport
B. Heat stroke; cool and monitor
C. Seizure; reassure, check glucose, and transport for eval
D. Drug overdose; administer naloxone
Answer: C – Postictal confusion after brief seizure-like activity suggests seizure. Glucose check is essential.
You arrive on scene of a high-speed T-bone collision. A 35-year-old male is found unresponsive in the driver's seat. He has obvious head trauma, snoring respirations, a deformed femur, and a weak radial pulse. His GCS is 6.
What is your immediate priority, and how do you proceed with treatment and transport?
A. Apply cervical collar and splint femur before transport
B. Perform jaw-thrust, apply OPA, begin BVM, rapid extrication, and transport
C. Administer oxygen via NRB and reassess GCS in 5 minutes
D. Wait for ALS to arrive before moving the patient
Answer: B - ABCs take priority. The airway must be opened immediately, and BVM with OPA is indicated. Rapid extrication is warranted due to altered mental status.