20 free NREMT AEMT practice questions

Correct answer: C · Give cycles of 5 back blows followed by 5 chest thrusts until it is expelled

The 2025 AHA adult BLS guideline recommends repeated cycles of 5 back blows followed by 5 chest thrusts for a severe obstruction in the late stages of pregnancy, and the same pattern whenever the rescuer cannot encircle the person's abdomen; both apply here. Back blows followed by abdominal thrusts is the sequence for other adults with a severe obstruction, so it does not fit late pregnancy. A blind finger sweep is something the guideline says should not be done for adults with an obstruction. High-flow oxygen and rapid transport cannot move air past a complete blockage, so the obstruction has to be relieved on scene; if she becomes unresponsive, the guideline moves to CPR.

Look for this next time: For severe choking in late pregnancy, or when you cannot encircle the abdomen, alternate 5 back blows with 5 chest thrusts.

Correct answer: A · Continuous compressions, with 1 breath every 6 seconds through the airway

Once an advanced airway is in place, the 2025 AHA adult ALS guideline says it may be reasonable to deliver 1 breath every 6 seconds, or 10 breaths per minute, while chest compressions continue without pauses. Cycles of 30 compressions and 2 breaths are the guideline's pattern before an advanced airway is placed, so keeping those pauses gives up the uninterrupted compressions the airway allows. One breath every 2 to 3 seconds is the pediatric rate for a child who has a pulse but inadequate breathing, far faster than the adult rate with an advanced airway. Giving breaths only at rhythm checks leaves long stretches of CPR with no ventilation at all.

Look for this next time: With an advanced airway in place during adult CPR, give 1 breath every 6 seconds without pausing compressions.

Correct answer: D · A peripheral IV first, moving to IO if the IV fails or is not feasible

The 2025 AHA adult ALS guideline recommends that professionals first attempt IV access for drug administration in adult cardiac arrest and calls IO access reasonable when initial IV attempts are unsuccessful or not feasible. With usable arm veins, a peripheral IV comes first. Starting with an IO line reverses that order. Waiting for a paramedic delays access the protocol already lets the AEMT establish, and the National EMS Scope of Practice Model places IV and IO initiation within the AEMT level. The same model lists no medication route through a supraglottic airway, and it places the endotracheal route at the paramedic level only.

Look for this next time: In adult cardiac arrest, try IV access first and move to IO when IV attempts fail or are not feasible.

Correct answer: B · Withhold it, because he took sildenafil within the past 24 hours

The 2025 ACC/AHA acute coronary syndromes guideline says to avoid nitrates within 24 hours of sildenafil or vardenafil, within 48 hours of tadalafil, and within 12 hours of avanafil. A dose taken 10 hours ago falls inside the sildenafil window, so nitroglycerin is withheld whatever his pressure. A systolic pressure of at least 90 mm Hg is one condition the guideline sets for nitroglycerin, but meeting it does not cancel the drug-interaction warning. Giving it now and rechecking the pressure afterward accepts the interaction the guideline says to avoid. ST-segment elevation on a transmitted 12-lead changes the destination and the hospital's plan, but it does not remove the sildenafil restriction.

Look for this next time: Withhold nitroglycerin within 24 hours of sildenafil or vardenafil, within 48 hours of tadalafil, and within 12 hours of avanafil.

Correct answer: B · Attach the pediatric pads and attenuator while compressions continue

For infants and children in cardiac arrest, the 2025 AHA pediatric BLS guideline says an AED should be attached as soon as possible, using a pediatric attenuator and pediatric pads if available, and it recommends the attenuator for children younger than 8 years. CPR continues until the device is ready to shock. An AED without an attenuator is the fallback the guideline allows only when neither a manual defibrillator nor an attenuator-equipped AED is available, and here the attenuator is in the kit. Waiting for a paramedic's manual defibrillator delays a shock the AED can deliver now; manual defibrillation is a paramedic skill in the National EMS Scope of Practice Model. Leaving the AED aside gives up defibrillation, which the guideline calls the only effective therapy for shockable rhythms.

Look for this next time: For a child younger than 8 in cardiac arrest, attach the AED as soon as possible with pediatric pads and an attenuator if available.

Correct answer: D · Pack hemostatic gauze into the wound and hold firm, continuous pressure

The 2024 AHA and American Red Cross first aid guidelines make direct manual pressure the first step and say a hemostatic dressing can improve its effectiveness. They also note that a tourniquet helps extremity bleeding only when it can be applied proximal to the wound, which this groin wound does not allow. Packing hemostatic gauze and holding continuous pressure combines both, and the 2021 field triage guideline lists active bleeding that needs wound packing with continuous pressure as a red criterion, so he also needs the highest-level trauma center available. A tourniquet below the wound sits on the wrong side of the bleeding. The first aid guidelines call the value of pressure points uncertain, and moving pressure off the wound gives up control. A loose dressing with the leg raised applies no real pressure.

Look for this next time: When a tourniquet cannot go above the wound, pack a hemostatic dressing and hold firm, continuous pressure.

Correct answer: A · Pregnancy over 20 weeks is an EMS-judgment risk factor; if concerned, use a trauma center

In the 2021 guideline, pregnancy over 20 weeks appears under EMS judgment as a risk factor to consider, with the instruction that if the crew is concerned, the patient goes to a trauma center. It is not a red criterion: her mental status, vital signs, and injury patterns meet none of those, so the highest-level center is not required on that basis. Saying no criterion applies leaves out the pregnancy risk factor the guideline asks EMS to weigh. The yellow high-risk crash criteria include ejection, significant intrusion, the need for extrication, and a death in the passenger compartment, and this low-speed crash has none of them.

Look for this next time: Pregnancy over 20 weeks is a field-triage risk factor for EMS judgment: if concerned, take the patient to a trauma center.

Correct answer: C · IV dextrose per protocol, then a recheck of glucose and mental status

The 2024 AHA and American Red Cross first aid guidelines say oral glucose should not be given to a person who is not awake or not able to swallow, because it can lead to choking and aspiration, and they note that IV dextrose can be lifesaving when a person with hypoglycemia cannot swallow. The National EMS Scope of Practice Model includes dextrose among the IV medications an AEMT may give under medical direction, and his protocol allows it, so IV dextrose with a recheck of glucose and mental status fits. Glucose gel against the cheek and juice by mouth both put sugar in the mouth of a patient who cannot swallow safely, whatever his position. An IV fluid bolus does not correct low blood glucose, and nothing in the stem points to low blood pressure.

Look for this next time: Give nothing by mouth to a hypoglycemic patient who cannot swallow safely; where protocol allows, the AEMT gives IV dextrose.

Correct answer: A · Start CPR with bag-mask breaths, oxygen, and compressions before the AED

The 2025 AHA special circumstances guideline says that adults and children in cardiac arrest after drowning should receive CPR with breaths and chest compressions once out of the water, and that CPR with breaths should start before an AED or defibrillator is applied, because the arrest is usually hypoxic. It also says trained rescuers should give supplemental oxygen if available and that bag-mask ventilation is reasonable. Letting the AED analyze before any CPR reverses that order. Compression-only CPR is for rescuers unwilling, untrained, or unable to give breaths, which does not describe an AEMT crew with a bag-mask. Turning her to drain water first delays the breaths and compressions the guideline puts first.

Look for this next time: In cardiac arrest after drowning, start CPR with breaths, adding oxygen if available, before applying the AED.

Correct answer: D · Dry her, place her skin-to-skin with her mother, and keep her warm

The 2025 AHA neonatal guidelines say routine oral, nasal, oropharyngeal, or endotracheal suctioning of newborns is not recommended, whether the fluid is clear or meconium-stained, and that babies who are breathing well or crying are cared for skin-to-skin with their mothers. Drying her, placing her skin-to-skin, and keeping her warm follows that. Deep suctioning because of the meconium is the routine suctioning the guideline advises against. For a newborn who does not need resuscitation, the guideline favors deferring cord clamping for at least 60 seconds, so clamping at once to suction has it backward. Positive-pressure ventilation is for newborns who are apneic, gasping, or below 100 beats per minute despite the initial steps, and this baby is crying.

Look for this next time: A crying newborn needs no routine suctioning, even with meconium-stained fluid: dry, warm, and place skin-to-skin.

Correct answer: C · CPR with breaths and the AED, adding naloxone only if CPR is not interrupted

For a patient in cardiac arrest with suspected opioid overdose, the 2025 AHA special circumstances guideline says naloxone may be reasonable only if it does not interfere with high-quality compression-ventilation CPR, and it tells rescuers not to delay standard resuscitation while giving naloxone or waiting for a response. It adds that opioid antagonists are extremely unlikely to help a person in cardiac arrest who is not receiving CPR and do not reverse ventricular fibrillation. Giving naloxone and pausing to watch, or holding CPR for a second dose, puts the drug ahead of CPR. Naloxone with rescue breaths and no compressions fits respiratory arrest with a definite pulse, and this man has no pulse.

Look for this next time: In opioid-associated cardiac arrest, high-quality CPR and the AED come first; naloxone is added only if it does not interrupt CPR.

Correct answer: B · Give nothing by mouth while he is drowsy, and keep him on his side

The 2024 AHA and American Red Cross first aid guidelines say nothing should be put in the mouth, and no food, liquids, or oral medicines given, to a person who is having a seizure or has decreased responsiveness after one. They also say antipyretics such as acetaminophen do not stop a febrile seizure or prevent another one, that a person having a seizure should not be restrained, and that the person can be placed on their side in the recovery position. Giving the acetaminophen now offers no seizure protection and puts liquid in the mouth of a drowsy child. A bite block is an object in the mouth, which the guidelines rule out. Holding his limbs still is restraint, which the guidelines list as harmful.

Look for this next time: After a febrile seizure, give nothing by mouth while the child is drowsy; fever medicine does not prevent another seizure.

Correct answer: D · Her state license and the medical director's protocols for her agency

The National Registry's AEMT Candidate Handbook says certification does not grant the right to practice; a state-issued license does, and the National Registry does not establish scopes of practice or standards of care. The National EMS Scope of Practice Model limits AEMT medication routes to medical director approved medications, and it notes that its changes are not in effect until the state licensing authority and the medical director adopt them. So her state license and her agency's medical director protocols govern, even when they list fewer drugs. The national model does not apply on its own, and certification is not a license. Course skills sheets show training, not authorization to practice.

Look for this next time: An AEMT's practice is set by the state license and the medical director's protocols; National Registry certification does not grant the right to practice.

Correct answer: A · A mask on the patient and fit-tested N95 respirators for the crew

CDC's Transmission-Based Precautions guidance calls for Airborne Precautions for patients known or suspected to be infected with pathogens spread by the airborne route, and it names tuberculosis as an example. Those precautions include source control, by putting a mask on the patient, and a fit-tested, NIOSH-approved N95 or higher-level respirator for healthcare personnel. A surgical mask for the crew is not the respirator CDC specifies, and leaving the patient unmasked drops source control. Gloves and eye protection alone are standard precautions, and CDC adds Transmission-Based Precautions to them for suspected airborne infections. Waiting for a confirmed diagnosis ignores that the guidance covers suspected cases.

Look for this next time: For suspected tuberculosis, mask the patient and wear a fit-tested N95 or higher-level respirator.

Correct answer: B · Assign compressions, airway, and AED roles, and resuscitate where he lies

The 2025 AHA guidelines support continuing resuscitation at the scene of an out-of-hospital cardiac arrest in most cases rather than early transport, and the adult BLS chapter says resuscitation should generally happen where the patient is found as long as high-quality CPR can be given safely; the living room allows that. The guidelines also support delineating roles, with a team large enough to fill them. Assigning compressions, airway, and AED roles does both. Carrying him straight to the ambulance is the early transport the guidelines advise against in most cases. Letting people pick tasks as they go leaves roles undefined. Holding off on decisions until a paramedic arrives delays care this crew can lead now.

Look for this next time: Leadership: assign clear resuscitation roles and, in most cases, resuscitate an adult in cardiac arrest where he is found.

Correct answer: C · Assist her breathing with the bag-mask at 1 breath every 2 to 3 seconds

For infants and children with a pulse but absent or inadequate breathing, the 2025 AHA pediatric BLS guideline says it is reasonable to give 1 breath every 2 to 3 seconds, or 20 to 30 breaths per minute. Six shallow breaths a minute with blue lips is inadequate breathing, and she has a pulse, so bag-mask ventilation at that rate is the action. One breath every 6 seconds is the adult rate for a patient with a pulse and is too slow for a child. The 15-to-2 ratio is for two rescuers giving CPR to a child in cardiac arrest, and she has a pulse of 140. A nonrebreather mask only enriches the breaths she takes herself, which are too few and too shallow.

Look for this next time: Take action: a child with a pulse but inadequate breathing gets 1 breath every 2 to 3 seconds.

Correct answer: A · Keep compressions and bag-mask breaths going, and defer the airway for now

The 2025 AHA adult ALS guideline says that if placing an advanced airway would interrupt chest compressions, it should be deferred until the patient fails to respond to initial CPR and defibrillation attempts or has return of spontaneous circulation. Bag-mask ventilation is working and only one shock has been given, so continuing CPR with bag-mask breaths and deferring the airway fits. Pausing compressions now is the interruption the guideline asks the crew to avoid. Stopping ventilation drops a technique that is working. Stretching a rhythm check until placement is done is still an interruption in compressions at a stage when the guideline says to defer the airway.

Look for this next time: Generate solutions: when an airway attempt would pause compressions, defer it until initial CPR and defibrillation fail or circulation returns.

Correct answer: C · The baby's heart rate is rising with the breaths

The 2025 AHA neonatal guidelines say the effectiveness of ventilation is judged by an increase in heart rate and, to a lesser extent, by chest movement, and they make effective ventilation, shown by a rising heart rate, the priority for newborns who need resuscitation. If the heart rate does not rise, the guidelines point to ventilation corrective steps. The color of the hands and feet is not the measure the guidelines use. A bag that reinflates quickly and a mask that stays sealed describe the equipment, not whether air is reaching the baby's lungs.

Look for this next time: Evaluation: during newborn ventilation, a rising heart rate is the main sign that the breaths are working.

Correct answer: D · A stroke is still possible, since the deficit outlasted the low glucose

The 2024 AHA and American Red Cross first aid guidelines describe hypoglycemia as a common stroke mimic and use a glucose measurement to help rule it out. Her glucose is now normal, yet the right-arm weakness and slurred speech remain, so low glucose can no longer be assumed to account for them and stroke stays the working hypothesis. Assuming the low glucose explains the weakness closes the question while the deficits are still present. Giving more dextrose treats a glucose reading that is already normal. Better alertness shows the dextrose worked; it is not evidence against a second problem.

Look for this next time: Define hypothesis: if focal deficits persist after glucose is corrected, keep stroke as the working hypothesis.

Correct answer: B · One nondiagnostic ECG does not exclude ACS, so acquire and send another

The 2025 ACC/AHA acute coronary syndromes guideline says an initial nondiagnostic 12-lead ECG does not rule out ACS, that ACS can be dynamic, and that the timing of repeat ECGs should follow the symptoms, especially recurrent chest pain, and any change in condition; it adds that a second or third ECG during EMS transport may identify more STEMI cases. Worsening pressure and new sweating are that change, so the crew acquires and transmits another tracing. Treating the first tracing as ruling out a heart attack, or stopping monitoring, contradicts the guideline. The National EMS Scope of Practice Model places 12-lead acquisition and transmission at the AEMT level and interpretation at the paramedic level.

Look for this next time: Analyze cues: one nondiagnostic 12-lead does not rule out ACS; worsening symptoms call for a repeat tracing.