22 Medical & Obstetrics/Gynecology Practice Questions & Answers

1. 1. You arrive to find a 60-year-old man unresponsive with no signs of trauma. After completing your primary assessment and correcting any immediate life threats, what is the BEST next step?

   • A.Perform a rapid full-body exam, then gather the history from bystanders or family✓ Answer
   • B.Obtain a detailed SAMPLE history from the patient before any physical exam
   • C.Focus only on the chief-complaint area and take the history from the patient
   • D.Transport immediately without any further physical exam

   For an unresponsive medical patient the EMT performs a rapid full-body exam and then obtains the history from bystanders or family, because the patient cannot give a reliable history; a responsive medical patient instead receives a history-focused exam first.

   Source: National EMS Education Standards — Medical patient assessment (unresponsive medical patient)Report a problem with this question

2. 2. During the primary assessment of an unresponsive medical patient you hear snoring respirations. What should you do FIRST?

   • A.Open the airway with a head-tilt/chin-lift or jaw-thrust and reposition✓ Answer
   • B.Begin chest compressions
   • C.Obtain a blood glucose reading
   • D.Apply a nonrebreather mask at 15 L/min

   Snoring respirations indicate partial airway obstruction by the tongue; opening and repositioning the airway is always the first correction, because oxygen and other interventions are ineffective through an obstructed airway.

   Source: National EMS Education Standards — Airway management (primary assessment, airway first)Report a problem with this question

3. 3. A 72-year-old woman has sudden facial droop and slurred speech, and the Cincinnati Prehospital Stroke Scale is positive. Besides rapid transport to a stroke center, which action is MOST important?

   • A.Administer aspirin for the stroke
   • B.Lay her flat with the legs elevated
   • C.Give oral glucose to raise her blood sugar
   • D.Check her blood glucose level✓ Answer

   Hypoglycemia is the classic stroke mimic, so blood glucose must always be checked; oral glucose is given only if hypoglycemia is confirmed and the patient can protect the airway, and aspirin is not indicated for an undifferentiated stroke.

   Source: AHA/ASA prehospital stroke care; Cincinnati Prehospital Stroke Scale protocol (mandatory glucose check)Report a problem with this question

4. 4. You witness a patient having a generalized tonic-clonic seizure. What is the MOST appropriate action?

   • A.Protect the patient from injury and place nothing in the mouth✓ Answer
   • B.Restrain the patient supine and transport rapidly
   • C.Insert a bite block between the teeth
   • D.Hold the limbs still to stop the convulsions

   During a seizure you protect the patient from injury and never restrain them or place anything in the mouth, which risks injury and aspiration; afterward you position for airway and suction and manage the postictal phase.

   Source: National EMS Education Standards — Neurologic emergencies (seizure management)Report a problem with this question

5. 5. A 45-year-old is found with an altered mental status and no obvious cause. Until proven otherwise, EMTs should assume the cause includes which two immediately reversible conditions?

   • A.Anxiety and intoxication
   • B.Hypoglycemia and hypoxia✓ Answer
   • C.Dehydration and fever
   • D.Stroke and seizure

   Altered mental status is assumed to involve hypoglycemia and/or hypoxia until ruled out because both are rapidly reversible and immediately life-threatening, so glucose and oxygenation are assessed early.

   Source: National EMS Education Standards — Altered mental status (AEIOU-TIPS differential)Report a problem with this question

6. 6. A known diabetic is unresponsive and cannot follow commands or swallow. Family hands you an oral glucose tube. What should you do?

   • A.Place the oral glucose between the cheek and gum
   • B.Give a full tube of oral glucose immediately
   • C.Withhold oral glucose because the patient cannot protect the airway✓ Answer
   • D.Mix the glucose with water and have them drink it

   Oral glucose is contraindicated in a patient who is unresponsive or unable to swallow because of the aspiration risk; it may be given only to a patient who is awake and able to protect the airway.

   Source: National EMS Education Standards — oral glucose administration (contraindication: cannot protect airway)Report a problem with this question

7. 7. Which set of findings BEST fits hypoglycemia rather than hyperglycemia (DKA)?

   • A.Rapid onset with cool, pale, diaphoretic skin and altered mentation✓ Answer
   • B.Warm, dry skin with fruity breath and deep, rapid (Kussmaul) respirations
   • C.Acetone breath odor with signs of dehydration
   • D.Gradual onset over days with excessive urination and thirst

   Hypoglycemia has a rapid onset with cool, pale, diaphoretic skin and altered mental status, whereas hyperglycemia/DKA develops gradually with warm, dry skin, Kussmaul respirations, fruity breath, and polyuria/polydipsia.

   Source: National EMS Education Standards — Endocrine emergencies (hypo- vs hyperglycemia presentation)Report a problem with this question

8. 8. An adult in anaphylaxis has stridor and hypotension, and you are assisting with an epinephrine auto-injector. What is the correct adult dose and injection site?

   • A.0.3 mg IM into the lateral (mid-outer) thigh✓ Answer
   • B.0.5 mg subcutaneously into the abdomen
   • C.0.15 mg IM into the deltoid
   • D.1 mg IM into the buttock

   The adult epinephrine auto-injector dose is 0.3 mg intramuscularly into the lateral thigh (pediatric dose is 0.15 mg); epinephrine reverses anaphylaxis by causing vasoconstriction and bronchodilation.

   Source: National EMS Education Standards — anaphylaxis / epinephrine auto-injector (adult 0.3 mg IM lateral thigh)Report a problem with this question

9. 9. Which patient is the BEST candidate for an epinephrine auto-injector?

   • A.Sneezing and watery eyes during allergy season
   • B.Localized redness at a bee-sting site with no other symptoms
   • C.Hives and itching on one arm with normal breathing and blood pressure
   • D.Facial and airway swelling, wheezing, and a falling blood pressure after eating shellfish✓ Answer

   Epinephrine is indicated for anaphylaxis — a multi-system reaction with airway swelling/wheezing and hypotension — and not for a mild, localized allergic reaction without airway or circulatory compromise.

   Source: National EMS Education Standards — allergic reaction vs anaphylaxis (epinephrine indication)Report a problem with this question

10. 10. An unresponsive patient has a respiratory rate of 4/min and pinpoint pupils, and naloxone is available. What is your FIRST priority?

    • A.Apply a cardiac monitor
    • B.Perform a rapid full-body exam
    • C.Administer naloxone before anything else
    • D.Begin assisting ventilations with a bag-valve mask✓ Answer

    The immediate life threat in opioid overdose is respiratory depression, so ventilations are supported with a BVM first; naloxone is then given per protocol, with awareness of possible re-sedation or combativeness.

    Source: National EMS Education Standards — Toxicology (opioid overdose: ventilate first, then naloxone)Report a problem with this question

11. 11. Several people in a home with a faulty furnace have headache and nausea. Regarding pulse oximetry in suspected carbon monoxide (CO) poisoning, which statement is TRUE?

    • A.Pulse oximetry can read falsely normal, so give high-flow oxygen and remove them from the source✓ Answer
    • B.Oxygen should be withheld until the SpO2 drops below 90%
    • C.The pulse ox reading is reliable and rules out hypoxia
    • D.Carbon monoxide has no effect on oxygen delivery

    A standard pulse oximeter cannot distinguish carboxyhemoglobin from oxyhemoglobin and may read falsely normal, so suspected CO patients receive high-flow oxygen and immediate removal from the source regardless of the SpO2 number.

    Source: National EMS Education Standards — Toxicology (carbon monoxide; pulse oximetry limitation)Report a problem with this question

12. 12. A patient in respiratory distress now has a rate of 6/min, shallow tidal volume, and a declining mental status. What is the MOST appropriate action?

    • A.Assist ventilations with a bag-valve mask and supplemental oxygen✓ Answer
    • B.Coach the patient to breathe more slowly
    • C.Apply a nasal cannula at 4 L/min
    • D.Assist the patient with a metered-dose inhaler

    Inadequate breathing — signaled by a low rate, poor tidal volume, and falling mental status — requires positive-pressure ventilation with a BVM; a cannula or inhaler cannot correct inadequate ventilation.

    Source: National EMS Education Standards — Respiratory (adequate vs inadequate breathing; BVM)Report a problem with this question

13. 13. Which patient with pulmonary edema is the BEST candidate for CPAP where it is authorized?

    • A.An unresponsive patient with agonal respirations
    • B.An awake patient following commands with an adequate blood pressure and crackles✓ Answer
    • C.A patient with a systolic blood pressure of 70 mmHg
    • D.A patient who is vomiting and cannot protect the airway

    CPAP is used for CHF/pulmonary edema in patients who are awake, follow commands, and have an adequate blood pressure; it is contraindicated in patients who are unresponsive, hypotensive, or unable to protect their airway.

    Source: National EMS Education Standards — CPAP indications/contraindicationsReport a problem with this question

14. 14. A 58-year-old with crushing chest pressure and diaphoresis has no aspirin allergy or other contraindication. What aspirin dose is appropriate?

    • A.1000 mg swallowed with water
    • B.650 mg chewable
    • C.81 mg enteric-coated, swallowed whole
    • D.162–324 mg chewable✓ Answer

    For suspected cardiac chest pain, 162–324 mg of chewable aspirin is given (absent allergy or contraindication) for its antiplatelet effect, and chewing speeds absorption.

    Source: AHA ACS guidelines; National EMS Education Standards — aspirin for suspected ACS (162–324 mg chewable)Report a problem with this question

15. 15. Before assisting a chest-pain patient with his prescribed nitroglycerin, which finding is a reason to WITHHOLD it?

    • A.His systolic blood pressure is 150 mmHg
    • B.He has already taken two of his own nitroglycerin tablets today
    • C.He rates his pain 8 out of 10
    • D.He took an erectile-dysfunction drug (sildenafil) 12 hours ago✓ Answer

    Nitroglycerin is contraindicated within 24–48 hours of an erectile-dysfunction drug (e.g., sildenafil, tadalafil) because the combination can cause severe, refractory hypotension; you also withhold it for low systolic BP and recheck BP after each dose.

    Source: National EMS Education Standards — nitroglycerin assist (ED-drug interaction and hypotension contraindications)Report a problem with this question

16. 16. An older patient reports sudden tearing abdominal and back pain, and you feel a pulsating mass in the abdomen. What is the BEST management?

    • A.Delay transport to obtain a full set of repeat vitals
    • B.Give oral fluids to treat for shock
    • C.Handle gently, treat for shock, give nothing by mouth, and transport rapidly✓ Answer
    • D.Palpate the mass firmly to assess its size

    Tearing pain with a pulsatile abdominal mass suggests an abdominal aortic aneurysm, so the EMT handles the patient gently, keeps them NPO, treats for shock, and transports rapidly, because deep palpation could precipitate rupture.

    Source: National EMS Education Standards — Abdominal emergencies (suspected AAA)Report a problem with this question

17. 17. A combative patient must be restrained per protocol. Which practice is correct to prevent positional asphyxia?

    • A.Restrain the patient face-down (prone) and hobble the limbs
    • B.Place a mask over the mouth and leave the patient unattended
    • C.Never restrain the patient prone, and monitor airway and breathing continuously✓ Answer
    • D.Assume the behavior is purely psychiatric and skip a medical assessment

    Patients must never be restrained prone or hobbled because of the positional-asphyxia and sudden-death risk (excited delirium); restrained patients need continuous airway and breathing monitoring, and organic causes must be ruled out.

    Source: National EMS Education Standards — Behavioral emergencies (restraint; positional asphyxia)Report a problem with this question

18. 18. A woman in labor has contractions 90 seconds apart, a strong urge to push, and crowning is visible. What is the BEST decision?

    • A.Place her supine and elevate the legs to slow labor
    • B.Have her cross her legs to delay delivery
    • C.Prepare to deliver the baby on scene✓ Answer
    • D.Load and transport rapidly, discouraging her from pushing

    Crowning, contractions less than about 2 minutes apart, and an urge to push signal imminent delivery, so the EMT prepares to deliver on scene rather than transport, and attempts to delay delivery are unsafe.

    Source: National EMS Education Standards — Obstetrics (signs of imminent delivery)Report a problem with this question

19. 19. A newborn's heart rate remains 50/min despite 30 seconds of effective bag-valve-mask ventilation. What is the next step?

    • A.Continue ventilations only and reassess in 5 minutes
    • B.Begin chest compressions coordinated with ventilations at a 3:1 ratio✓ Answer
    • C.Score the APGAR before doing anything else
    • D.Provide blow-by oxygen and stimulate the feet

    If a newborn's heart rate stays below 60/min despite adequate ventilation, chest compressions are started using a 3:1 compression-to-ventilation ratio; resuscitation is never delayed to assign an APGAR score.

    Source: Neonatal Resuscitation guidelines; National EMS Education Standards — newborn care (HR<60 → compressions, 3:1 ratio)Report a problem with this question

20. 20. During delivery you see the umbilical cord protruding from the vagina ahead of the baby. What is the correct action?

    • A.Clamp and cut the cord immediately
    • B.Insert a gloved hand to lift the presenting part off the cord, position the mother hips-elevated/knee-chest, keep the cord moist, and transport rapidly✓ Answer
    • C.Gently push the cord back into the vagina
    • D.Have the mother sit upright and bear down to speed delivery

    For a prolapsed cord you insert a gloved hand to push the presenting part off the cord (relieving compression), place the mother knee-chest or hips-elevated, keep the cord moist, give oxygen, and transport rapidly; the cord is never pushed back in.

    Source: National EMS Education Standards — Obstetric complications (prolapsed umbilical cord)Report a problem with this question

21. 21. After delivery the mother has continued heavy vaginal bleeding. Which intervention is MOST appropriate?

    • A.Have the mother sit upright and withhold oxygen
    • B.Delay transport until the bleeding stops on its own
    • C.Massage the uterine fundus, allow the newborn to nurse, and treat for shock✓ Answer
    • D.Pack the vagina with sterile gauze to control the bleeding

    For postpartum hemorrhage, firm fundal (uterine) massage helps the uterus contract and slow bleeding, breastfeeding stimulates uterine contraction, and the patient is treated for shock; the vagina is never packed.

    Source: National EMS Education Standards — Postpartum hemorrhage managementReport a problem with this question

22. 22. A woman has heavy vaginal bleeding that is not related to childbirth. What is the correct EMT care?

    • A.Insert a tampon to absorb the blood
    • B.Perform an internal exam to locate the bleeding source
    • C.Place external sanitary pads, treat for shock, and transport; do not pack or insert anything✓ Answer
    • D.Pack the vagina with gauze to tamponade the bleeding

    For gynecologic (non-obstetric) vaginal bleeding, EMTs use external sanitary pads, treat for shock, and transport; nothing is ever packed or inserted into the vagina, and internal exams are outside the EMT scope.

    Source: National EMS Education Standards — Gynecologic emergencies (vaginal bleeding; do not pack)Report a problem with this question

Practice questions modeled on the National EMS Education Standards and NREMT cognitive-exam content areas. Not medical advice and not affiliated with or endorsed by the National Registry of Emergency Medical Technicians (NREMT) or NHTSA. Always follow your instructor, medical director, and local protocols. Study the official materials at nremt.org. Official NREMT →