Medic Basics

Sample questions

Free NREMT EMT practice questions

15 free NREMT EMT practice questions from the Medic Basics bank of 909, each with the answer and a rationale for every choice. Try them here, then practice the rest free in your browser. No account, no ads.

The EMT Certification Examination is adaptive: 70 to 120 items (10 of them unscored) in up to 2 hours, and it stops early once it is sure of the result. Since April 2025 its five domains follow a call: scene size-up and safety, primary assessment, secondary assessment, patient treatment and transport, and operations, with pediatric care throughout. This mock draws items to those domains and stops by the same kind of confidence rule. Item difficulty here is estimated by the writers rather than calibrated from candidates, so treat the result as practice, not a prediction.

From the live Medic Basics bank. How questions are written and reviewed · EMT Exam Guide

Practice all 909 NREMT EMT questions free in your browserMock exams, rationales for every choice and a study plan. No account or download needed.

Question 1 · Scene Size-Up and Safety

During a spring flood, a woman calls 911 because her 16-year-old son went into their basement to restart the sump pump and has not come back up. The EMT finds him lying face down in about 6 inches of water at the foot of the stairs, not moving, with an orange extension cord running into the water beside him. The breaker panel is on the far wall of the flooded basement. His mother starts down the stairs toward him. What should the EMT do FIRST?

  1. Pull him onto the stairs by his belt with a dry wooden broom handle
  2. Keep everyone out of the water until fire or the utility cuts the power
  3. Wade to the panel in rubber boots and switch off the main breaker
  4. Step in to turn him face up, because drowning is the immediate threat
Show the answer and rationale

Answer: B

  • A. Pushing a victim off a source with a dry object is a familiar bystander technique, but here the water itself may carry current, and the rescuer would have to reach into it.
  • B. Correct. The water around him may be energized through the cord, and the panel can only be reached by wading. The electrical source must be disabled before anyone reaches him, so everyone stays on the stairs while the power is cut from outside.
  • C. Shutting off the power is the right goal, but reaching this panel means crossing water that may be energized, and ordinary rubber boots are not rated electrical protection.
  • D. The airway is the next priority once he can be reached, which makes this tempting, but stepping into energized water would make the EMT a second patient.

The NASEMSO electrical injury guideline begins with scene security: the electrical source must be disabled before assessment, and power is shut off before contact. OSHA's electrical safety quick card warns never to operate electrical equipment while standing in water. Fire crews and the utility can cut power at the meter or service line without entering the basement. Once the power is confirmed off, the EMT turns him face up, opens the airway, checks breathing and pulse, and starts CPR with an AED if needed, because NASEMSO notes that electrical injury patients who appear dead may do well with prompt resuscitation. Spinal care is considered, since he may have fallen on the stairs.

Sources: NASEMSO Model EMS Guidelines v3.0 (2022); OSHA Quick Card: Electrical Safety

Question 2 · Scene Size-Up and Safety

At a school van crash, an EMT using JumpSTART reaches a 5-year-old boy who is not walking and is not breathing. After the EMT positions his airway, he still does not breathe, but a pulse can be felt. What should the EMT do NEXT?

  1. Give five rescue breaths, then recheck his breathing
  2. Give two rescue breaths, as the SALT sequence directs
  3. Tag him black and move on to the next patient
  4. Stay and ventilate him until an ambulance can take him
Show the answer and rationale

Answer: A

  • A. Correct. JumpSTART gives this brief trial of ventilation to a child who stays apneic but still has a pulse.
  • B. SALT does use two breaths for children, but this EMT is working from JumpSTART, which uses a different number.
  • C. Moving on quickly is tempting in a crash with many patients, but it skips the breaths that JumpSTART gives a child with a pulse.
  • D. Sustained ventilation helps one child, but triage must keep moving so that the other patients are reached.

JumpSTART applies to patients who appear younger than 8, while START is meant for those who appear older. Merck notes that infants and young children are prone to a slow heart rate caused by low oxygen, which means ventilation is a sensible brief trial while a pulse remains. The EMT gives the breaths, reassesses and tags according to the response, then moves on. Local protocols choose the triage tool, and NASEMSO accepts SALT or START/JumpSTART.

Sources: NASEMSO Model EMS Guidelines v3.0 (2022); CHEMM: START Adult Triage; Merck Manual, Professional Version; Vassallo et al., Major Incident Triage Tools in Children (2022); CHEMM: JumpSTART Triage; CHEMM: SALT Triage

Question 3 · Scene Size-Up and Safety

An EMT crew is caring for two workers at a casualty collection point set up upwind of a chlorine leak at a water treatment plant. Twenty minutes into the call, the wind shifts, the flag at the gate now points toward the crew, and the EMT notices a faint, sharp odor. Both patients are stable on oxygen. What should the crew do FIRST?

  1. Move the patients and ambulance upwind and uphill, and notify command
  2. Shelter both patients inside the closed ambulance and keep treating
  3. Stay in place, since the odor is faint and both patients are stable
  4. Put on N95 respirators and continue care at the current location
Show the answer and rationale

Answer: A

  • A. Correct. The position that was upwind no longer is. The crew relocates out of the vapor path and tells command so the whole operation can adjust its zones.
  • B. Sheltering in place is a protective action for the public in some releases, but the ambulance's ventilation can draw outside air in, and staying downwind of an active leak is avoidable here.
  • C. The ERG warns against judging a vapor by its smell. A faint odor means the plume has reached the crew, and stable patients can deteriorate with further exposure.
  • D. An N95 filters particles, not gases such as chlorine. Staying in the vapor path with the wrong protection makes the crew the next patients.

The Emergency Response Guidebook's safety precautions tell responders to approach from upwind, uphill or upstream, stay clear of vapors, fumes and spills, consider weather and terrain, and reassess the situation continually. Wind direction can change during an incident, so the safe zone moves with it. A change that puts the crew in the plume is a new hazard that is managed before any other task: move people and vehicles out of the path, then report to command so isolation zones, staging and the casualty collection point can be reset for every unit. An N95 offers no protection against chlorine gas.

Sources: Emergency Response Guidebook (2024)

Question 4 · Primary Assessment

A 52-year-old mechanic had his lower leg pinned under a fallen engine block for about 2 hours until co-workers lifted it off just before EMS arrived. He is alert, his calf is swollen and he says that it barely hurts. Data are: BP 128/78, HR 88, RR 16, SpO₂ 98%. He wants to go home. Why should the EMT urge transport?

  1. Hidden fractures are the main cause of death after this injury
  2. His normal pulse shows that he is compensating for blood loss
  3. Injured muscle can release potassium and toxins
  4. He needs a tetanus booster within 6 hours of any crush injury
Show the answer and rationale

Answer: C

  • A. A fracture may be present and needs assessment, but a lower-leg fracture is not what makes crush syndrome deadly.
  • B. Compensation is real in hemorrhage, but it produces a fast pulse, and nothing here suggests major blood loss.
  • C. Correct. Crushed muscle releases potassium that can cause lethal rhythms, and later toxins can cause acute kidney injury despite a benign first look.
  • D. Tetanus status matters for wounds, yet it is not time-critical in this way and is not the main danger of a crush.

NASEMSO warns that a crush patient may initially present with very few signs and symptoms, so suspicion rests on the mechanism. Sudden release can bring reperfusion problems, hyperkalemia and hypovolemia early, and acute kidney injury from muscle toxins later. The EMT explains these risks, checks distal pulses and sensation, watches for compartment syndrome with pain and tense swelling, requests ALS because monitoring and fluids are beyond EMT scope and documents any refusal carefully.

Sources: NASEMSO Model EMS Guidelines v3.0 (2022)

Question 5 · Primary Assessment

At night, a 35-year-old pedestrian struck by a car lies supine on a wet road in a heavy winter coat. He answers questions, his breathing is unlabored, and no blood is visible on the front of his clothing. His radial pulse is fast and weak and his skin is pale and cool. What should the EMT do NEXT?

  1. Sweep under the coat and behind his body for hidden bleeding
  2. Begin the head-to-toe exam at the scalp and work down
  3. Apply a pelvic binder, since the pelvis is the likeliest source
  4. Obtain a blood pressure to confirm whether he is in shock
Show the answer and rationale

Answer: A

  • A. Correct. A fast, weak pulse with pale, cool skin and no visible blood means bleeding may be hidden under bulky clothing or beneath the patient; a body sweep that includes the back finds it so it can be controlled.
  • B. The head-to-toe secondary exam comes after the primary survey and must not delay finding and controlling a life-threatening bleed.
  • C. A binder is placed for a suspected pelvic fracture, which has not been found; external bleeding must be looked for first.
  • D. A blood pressure is useful, but it can stay normal until a large volume is lost; the perfusion signs already justify searching for bleeding.

Massive hemorrhage is the first priority in the trauma primary survey, and it starts with a visual check and a rapid body sweep. Heavy coats, dark clothing, rain and darkness can hide a large blood loss, and blood often pools under a supine patient, so the EMT runs gloved hands under the clothing and behind the back, buttocks and legs, checks the gloves, and rolls the patient to examine the back. A fast, weak radial pulse with pale, cool skin already indicates compensated shock, in which hypotension may not appear until blood loss is severe. If no external source is found, internal bleeding becomes likely and scene time should stay under 10 minutes.

Sources: NASEMSO Model EMS Guidelines v3.0 (2022)

Question 6 · Primary Assessment

A 66-year-old man on hemodialysis is bleeding bright red blood from a needle site on his left forearm fistula. Ten minutes of firm direct pressure on the needle site by the EMT has not stopped it, and blood soaks through each dressing. He is pale and sweaty. Data are: HR 124, BP 92/58, SpO₂ 96%. What should the EMT do NEXT?

  1. Stack more bulky dressings and wrap them tightly around the forearm
  2. Apply a tourniquet on the upper arm, above the fistula
  3. Keep up direct pressure, since a tourniquet will destroy the fistula
  4. Press on the brachial artery pressure point instead of the needle site
Show the answer and rationale

Answer: B

  • A. Bulky dressings soak up blood without stopping it and can hide ongoing bleeding. A circumferential wrap is also an uncontrolled tourniquet that may not stop arterialized flow.
  • B. Correct. Direct pressure has failed and he shows signs of shock, so this is life-threatening extremity bleeding. A commercial tourniquet above the fistula stops it; the time is marked and the receiving hospital told it is a dialysis access.
  • C. Tempting because protecting a dialysis access is a real priority and 5 to 10 minutes of direct pressure on the needle site is the right first step, but it has now failed for 10 minutes and he is in shock. A tourniquet can clot the fistula, but losing the access is survivable; exsanguination is not.
  • D. Tempting as a way to spare the fistula, but pressure points are unreliable for controlling hemorrhage and are at most a bridge while a tourniquet is applied.

Bleeding from an arteriovenous fistula is high-flow and can be fatal. The first step is firm direct pressure on the bleeding site for 5 to 10 minutes (emDocs, WikEM), not so hard that the fistula clots, and a bulky dressing alone lets bleeding continue. When that fails, WikEM lists an upper-extremity tourniquet, and emDocs reserves a tourniquet for bleeding that would otherwise be fatal, accepting that the fistula may clot. Pallor, sweating, a heart rate of 124 and a soft pressure show that this bleeding is now life-threatening. NASEMSO's hemorrhage guideline then applies: a commercial tourniquet 2 to 3 inches above the wound, tightened until the bleeding stops; pressure points may not be effective. The EMT marks the time, tells the hospital the limb has a fistula, and transports.

Sources: emDocs: Managing Fistula Complications (2016); WikEM: Hemorrhage of AV Fistula; NASEMSO Model EMS Guidelines v3.0 (2022)

Question 7 · Primary Assessment

An unresponsive patient is breathing 4 times per minute with occasional gasps. Which statement about these respirations is correct?

  1. Suctioning will restore a normal breathing pattern
  2. The patient should be placed in the recovery position and monitored
  3. Treat as absent breathing: check a pulse, then ventilate or start CPR
  4. Gasping respirations move enough air and require only a non-rebreather mask
Show the answer and rationale

Answer: C

  • A. Suction clears fluid; it does not fix a failing respiratory drive.
  • B. The recovery position is for adequate spontaneous breathing, which this is not.
  • C. Correct. Gasping, irregular breaths in an unresponsive patient are agonal respirations, a sign of severe hypoxia or cardiac arrest. The EMT checks for a pulse for no more than 10 seconds, starts CPR if none is found, and ventilates with a bag-valve mask if a pulse is present.
  • D. Agonal gasps do not provide effective ventilation.

Agonal respirations are misread by bystanders and even by rescuers as breathing, delaying CPR. Any unresponsive patient with absent or abnormal breathing is checked for a pulse for no more than 10 seconds; if none is definite, compressions start. If a pulse is present, rescue breathing at the age-appropriate rate begins.

Sources: AHA 2025 Part 7: Adult BLS; AHA BLS Provider Manual (2025)

Question 8 · Primary Assessment

A 9-month-old girl has had a runny nose and cough for 3 days. From across the room, the EMT applies the pediatric assessment triangle. Which observation indicates ABNORMAL work of breathing?

  1. Bluish mottling across both legs
  2. She does not follow her mother with her eyes
  3. A breathing rate of 40 while she sleeps
  4. A grunting sound at the end of each breath
Show the answer and rationale

Answer: D

  • A. Mottling is abnormal, but it belongs to the circulation-to-skin arm, which looks for pallor, mottling and cyanosis.
  • B. A poor gaze is abnormal, but it belongs to the appearance arm, judged with tone, interactiveness, consolability, look or gaze, and cry.
  • C. NASEMSO lists 30 to 60 breaths a minute as normal up to 1 year of age, so 40 during sleep is within range, and a counted rate is not one of the triangle's observations.
  • D. Correct. Grunting is an abnormal airway sound, one of the work-of-breathing signs along with stridor, wheezing, abnormal positioning, retractions and nasal flaring.

The work-of-breathing arm is judged by sight and sound from a distance: abnormal airway sounds such as stridor, grunting or wheezing; abnormal positioning such as tripoding or sniffing; and retractions or nasal flaring. Each arm points to a different problem, so placing a finding under the correct arm guides the general impression, such as respiratory distress when only work of breathing is abnormal. A counted respiratory rate comes later, in the hands-on assessment, and is compared with age norms; an infant normally breathes faster than an older child.

Sources: Pediatric Assessment Triangle, J Emerg Nurs (2013); NASEMSO Model EMS Guidelines v3.0 (2022); ENA ENPC Provider Manual, 6th ed.

Question 9 · Primary Assessment

After a bar fight, an EMT assesses two men. The first, 34, breathes 36 times a minute with very shallow breaths, his chest barely moving. The second, 28, breathes 12 times a minute with deep, full breaths. Both are awake and answer questions, and both read SpO₂ 94% on room air. Which statement about their breathing is MOST accurate?

  1. The slower breather is hypoventilating, since 12 is the lowest normal rate
  2. The faster breather moves less useful air and may soon need assisted breaths
  3. The faster breather moves more air, because a higher rate raises minute volume
  4. Both are breathing adequately, since their saturations are the same
Show the answer and rationale

Answer: B

  • A. A rate of 12 with deep, full breaths is within normal limits and moves plenty of air. Rate alone, without depth, does not define adequacy.
  • B. Correct. Much of each tiny breath only fills the airways, where no gas exchange happens, so rapid shallow breathing moves little air to the alveoli, and a rate of 36 cannot be kept up for long.
  • C. Tempting arithmetic, but minute volume counts the air that stays in the airways too. With very small breaths most of each breath is dead space, so effective ventilation falls.
  • D. SpO₂ measures oxygenation and often stays normal on room air while carbon dioxide builds up; it lags behind failing ventilation.

Each breath must first fill the dead space (the mouth, throat, trachea and bronchi) before any air reaches the alveoli. Merck puts physiologic dead space at about 30-40% of a normal tidal volume and notes that, for a given minute ventilation, more dead space means poorer removal of carbon dioxide. When breaths become very shallow, the dead space takes up most of each breath, so a high rate produces a lot of motion but little alveolar ventilation. Merck also notes that rates above about 28-30 a minute cannot be sustained for long and that falling tidal volume signals a breathing load the patient is losing to. The EMT watches the man at 36 closely, gives oxygen and is ready to assist ventilation with a bag-valve mask as his effort fails.

Sources: Merck Manual Professional: Ventilatory Failure (2026); NASEMSO Model EMS Guidelines v3.0 (2022)

Question 10 · Secondary Assessment

How often should an EMT reassess an unstable patient during a 40-minute transport?

  1. Once, at the halfway point
  2. Only if the patient’s condition visibly changes
  3. At least every 5 minutes
  4. Every 15 minutes
Show the answer and rationale

Answer: C

  • A. A single reassessment misses deterioration.
  • B. Deterioration is often subtle and found only by scheduled reassessment.
  • C. Correct. Unstable patients are reassessed at least every 5 minutes, and after every intervention, repeating the primary assessment, vital signs and the response to treatment.
  • D. Fifteen minutes is the interval for stable patients.

Reassessment compares the patient to the baseline: mental status, airway, breathing, circulation, vital signs, chief complaint, and the effect of interventions. Trends matter more than single values. Findings are documented with times so the receiving team can see the trajectory.

Sources: Emergency Care & Transportation, 13th ed.; Brady Emergency Care, 15th ed.

Question 11 · Patient Treatment and Transport

A 9-month-old suddenly cannot cry or breathe after playing with small toys. Which maneuver is correct?

  1. 5 back blows, then 5 chest thrusts
  2. A blind finger sweep to hook out the toy
  3. Immediate bag-valve-mask ventilation
  4. Abdominal thrusts with the infant held upright against the rescuer’s chest
Show the answer and rationale

Answer: A

  • A. Correct. For a responsive infant with a severe obstruction, the rescuer supports the infant face down on the forearm with the head lower than the body, gives 5 back blows between the shoulder blades, turns the infant over, and gives 5 chest thrusts with two fingers on the lower sternum, repeating until the object clears.
  • B. A blind finger sweep can push the object deeper.
  • C. Ventilation is attempted only after the infant becomes unresponsive and CPR has begun.
  • D. Abdominal thrusts can injure an infant’s liver and are not used under 1 year.

Infant choking differs from child and adult choking: back blows and chest thrusts replace abdominal thrusts. If the infant becomes unresponsive, CPR begins with compressions, the mouth is checked before breaths, and the object is removed only if seen. Infants who choke and recover are still transported, because objects can lodge lower in the airway.

Sources: AHA/AAP 2025 Part 6: Pediatric BLS; AHA BLS Provider Manual (2025)

Question 12 · Patient Treatment and Transport

A newborn is delivered through thick meconium-stained fluid, is limp, and is not breathing. What is the correct sequence?

  1. Dry, warm, stimulate, then ventilate with a BVM
  2. Suction the trachea deeply before any stimulation
  3. Begin chest compressions while ALS clears the airway
  4. Withhold ventilation until the meconium is cleared by ALS
Show the answer and rationale

Answer: A

  • A. Correct. Current neonatal resuscitation guidance treats meconium-stained non-vigorous infants like any other: dry, warm and stimulate, suction the mouth and nose only for visible obstruction, and begin bag-valve-mask ventilation within the first minute if the infant is not breathing, with reassessment of heart rate.
  • B. Routine deep suctioning of non-vigorous infants is no longer recommended; it delays ventilation.
  • C. Compressions start only when the heart rate is below 60 after 30 seconds of effective ventilation.
  • D. Ventilation is the priority for an apneic newborn.

Meconium is the first stool, passed in utero when the fetus is stressed. Aspiration can cause pneumonia and respiratory failure. Field care focuses on ventilation and heart rate rather than airway clearing rituals. The infant is kept warm, and the receiving hospital is told about the meconium.

Sources: AHA/AAP 2025 Part 5: Neonatal Resuscitation; Emergency Care & Transportation, 13th ed.

Question 13 · Patient Treatment and Transport

A 28-year-old has palpitations with a regular pulse of 180, a blood pressure of 118/76, and mild lightheadedness. What should the EMT do?

  1. Have her hold her breath and bear down repeatedly until the rate slows
  2. Keep her calm, request ALS, and transport with monitoring
  3. Apply the AED and deliver a shock to convert the rhythm
  4. Give her a cup of ice water to drink
Show the answer and rationale

Answer: B

  • A. Vagal maneuvers are performed by ALS with monitoring in most systems.
  • B. Correct. A stable narrow tachycardia is beyond EMT treatment. The EMT monitors for deterioration, keeps the patient calm and seated, requests ALS for vagal maneuvers or adenosine, and transports.
  • C. The AED shocks only pulseless patients in lethal rhythms.
  • D. Cold water is not a reliable treatment and delays care.

Supraventricular tachycardia produces a sudden regular rapid heartbeat in otherwise healthy people. Signs of instability that make it an emergency are hypotension, altered mental status, chest pain and heart failure, which require ALS cardioversion. The EMT gathers history of caffeine, stimulants, thyroid disease and prior episodes.

Sources: Emergency Care & Transportation, 13th ed.; AHA 2025 Part 9: Adult ALS

Question 14 · Operations

An EMT is called to a 5-year-old patient with a fever and an itchy rash of fluid-filled blisters in different stages, some already crusted, on the face and trunk. Which PPE should the EMT wear?

  1. Surgical mask, gown and gloves
  2. N95 respirator and gloves
  3. N95 respirator, gown and gloves
  4. Gown and gloves
Show the answer and rationale

Answer: C

  • A. A surgical mask is for droplet-spread diseases. Chickenpox also spreads by the airborne route and needs a respirator.
  • B. This covers the airborne route but not full contact precautions; a gown is added to protect the EMT’s clothing and skin from fluid from the blisters.
  • C. Correct. The findings suggest chickenpox (varicella), which needs airborne and contact precautions until all lesions are crusted. The EMT wears a fit-tested N95 with gown and gloves, and the child wears a surgical mask if tolerated.
  • D. Contact precautions alone leave the EMT unprotected from airborne spread.

Transmission-based precautions are chosen by how the suspected disease spreads. Airborne diseases (tuberculosis, measles, chickenpox) need an N95 or higher respirator, droplet diseases (influenza, pertussis, meningococcal disease) need a surgical mask, and contact diseases need gown and gloves. Chickenpox and disseminated shingles require both airborne and contact precautions until the lesions are dry and crusted, and the receiving facility is told before arrival so it can place the patient in an isolation room.

Sources: CDC Isolation Precautions Guideline (2007); Emergency Care & Transportation, 13th ed.

Question 15 · Operations

An ambulance running lights and siren to a cardiac arrest approaches a major intersection just as its signal turns green. Dispatch has also sent a fire engine from the cross street, which the crew can hear but not yet see. What should the ambulance driver do?

  1. Speed up to clear the intersection before the fire engine reaches it
  2. Continue at speed, since the green light gives the ambulance the right of way
  3. Slow, cover the brake and confirm each lane is clear before crossing
  4. Turn off the siren for a moment to hear which direction the engine is coming from
Show the answer and rationale

Answer: C

  • A. Racing another emergency vehicle to the intersection is how emergency vehicles collide with each other; it shortens the time both drivers have to react.
  • B. A green light controls ordinary traffic, but the fire engine on the cross street may legally proceed against its red, and drivers on that street may be yielding to the engine, not to the ambulance.
  • C. Correct. Even on a green light, the driver reduces speed, covers the brake, watches other drivers' reactions and crosses only when each lane is clear, expecting the second emergency vehicle.
  • D. Silencing the siren to listen removes the ambulance's own warning just as two emergency vehicles converge on the same intersection.

Intersections are the most dangerous point of an emergency response, and a green light does not make them safe: in one study, 37 percent of ambulance collisions occurred at intersections with a traffic control device. The fire engine may proceed against its red signal, and drivers who pulled over for one emergency vehicle may move back into traffic in front of another; official driver guidance tells them to wait until no other emergency vehicles are approaching, but many do not. Even on a green light, the ambulance driver slows, covers the brake, signals, tries to make eye contact with other drivers and clears each lane before crossing.

Sources: FireRescue1: Intersection Dangers for Emergency Vehicle Operators (2011); Government of Alberta: Reacting to Emergency Vehicles; Emergency Care & Transportation, 13th ed.

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