EMT practice test

EMT Primary Assessment Practice Test

Airway, breathing, circulation and the life threats that weigh most. Here are 10 EMT primary assessment questions, each with the answer and the reason.

Updated 2026-11-14 by the Tigertest team. Weighted to the NREMT EMT examination specifications (April 2025). Protocols vary; follow local medical direction. Not affiliated with the NREMT.

1. 1.

   A 55-year-old driver struck the steering wheel. A section of his left chest moves inward when he inhales and outward when he exhales. This finding indicates:

   • A.

     A single rib fracture

   • B.

     Cardiac tamponade

   • C.

     An open pneumothorax

   • D.

     Flail chest

   Answer: D.

   Paradoxical movement of a chest wall segment means two or more adjacent ribs are broken in two or more places; support ventilation with a BVM if breathing is inadequate. A single rib fracture causes pain but not paradoxical motion.

2. 2.

   A 24-year-old has a gunshot wound to the right chest that bubbles and makes a sucking sound with each breath. Your immediate priority is:

   • A.

     Pack the wound tightly with gauze

   • B.

     Seal it with an occlusive dressing

   • C.

     Cover it with a bulky dry dressing

   • D.

     Roll him onto his uninjured side to breathe

   Answer: B.

   An open chest wound lets air enter the pleural space, so seal it immediately with an occlusive dressing and watch for tension pneumothorax, burping the dressing if needed. A dry gauze dressing lets air pass through.

3. 3.

   When obtaining a baseline respiratory rate on an adult whose breathing is regular, the recommended method is to count:

   • A.

     For 5 seconds and multiply by 12

   • B.

     For 10 seconds and multiply by 6

   • C.

     For 30 seconds and multiply by 2

   • D.

     After telling the patient you are counting

   Answer: C.

   Count regular respirations for 30 seconds and double it, or a full minute if irregular, without telling the patient since awareness changes breathing. Very short counts multiply small errors into large ones.

4. 4.

   Your protocol permits EMT 12-lead acquisition. A 61-year-old with chest pain has a tracing interpreted as acute STEMI. You should:

   • A.

     Wait for ALS to confirm before leaving

   • B.

     Repeat the tracing twice on scene first

   • C.

     Give nitroglycerin from ambulance stock

   • D.

     Transmit it and call a STEMI alert

   Answer: D.

   Early transmission and a STEMI alert let the hospital activate the cath lab before arrival, shortening time to reperfusion. EMTs only assist with the patient's own prescribed nitroglycerin, and delaying transport for repeat tracings wastes heart muscle.

5. 5.

   A 28-year-old with GCS 7 after a motorcycle crash is trapped in a rural ravine, 70 minutes by ground from the trauma center. You should:

   • A.

     Wait until extrication ends to request help

   • B.

     Drive him to the nearest clinic

   • C.

     Request air medical transport early

   • D.

     Request one more BLS ground unit

   Answer: C.

   A critical trauma patient far from a trauma center benefits from air medical, and requesting it early lets the aircraft arrive during extrication. Waiting adds avoidable delay, and a clinic cannot provide trauma care.

6. 6.

   A 4-year-old girl with a painful, deformed forearm clings to her mother and cries as you approach. To assess her, you should:

   • A.

     Separate her from her mother to reduce distraction

   • B.

     Promise her that nothing you do will hurt

   • C.

     Examine her while she sits on her mother's lap

   • D.

     Start at her head and move quickly down

   Answer: C.

   Keeping a young child with the caregiver lowers fear and improves cooperation, and toddlers tolerate a toe-to-head approach better. Promising no pain is dishonest and destroys trust when it does hurt.

7. 7.

   A 34-year-old woman lies very still on her side with her knees drawn to her chest and refuses to move. This position most suggests:

   • A.

     Respiratory distress from a lung infection such as pneumonia

   • B.

     Low blood sugar with confusion

   • C.

     The recovery phase after a seizure

   • D.

     Abdominal pain, possibly peritoneal irritation

   Answer: D.

   Patients with peritoneal irritation lie still with knees drawn up because movement worsens the pain. A patient in respiratory distress usually sits upright or tripods rather than curling on the side.

8. 8.

   After a fall, a 40-year-old man opens his eyes only to pain, makes incomprehensible sounds, and withdraws from pain. His Glasgow Coma Scale score is:

   • A.

     7

   • B.

     10

   • C.

     9

   • D.

     8

   Answer: D.

   Eye opening to pain is 2, incomprehensible sounds is 2, and withdrawal from pain is 4, so 2 + 2 + 4 = 8. A score of 7 would require abnormal flexion, which scores 3 for motor.

9. 9.

   A feverish 3-year-old girl sits upright, drooling, with high-pitched inspiratory stridor. She is anxious but alert. You should:

   • A.

     Lay her supine and insert an oral airway to hold it open

   • B.

     Keep her calm with her parent and transport

   • C.

     Look at her throat with a tongue depressor

   • D.

     Give 5 back slaps and 5 chest thrusts

   Answer: B.

   Drooling, fever and stridor suggest epiglottitis, and upsetting her or probing the throat can cause complete obstruction. Keep her in a position of comfort with her parent, give oxygen as tolerated, and transport.

10. 10.

    A 30-year-old assaulted with a bat has bruising behind both ears and clear fluid draining from his nose. He has snoring respirations. Which is contraindicated?

    • A.

      A jaw-thrust maneuver

    • B.

      Suctioning blood from the mouth

    • C.

      A nasopharyngeal airway

    • D.

      Supplemental oxygen

    Answer: C.

    Battle's sign and fluid from the nose point to a basilar skull fracture, so an NPA could enter the cranial vault. Jaw thrust, oral suction and oxygen are all appropriate.