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Free NREMT practice questionsFree AEMT practice questions · Airway, Respiration & Ventilation

10 free AEMT practice questions: Advanced Airway Management and Adjuncts

These are real questions from the same bank the app draws from. Each one is written to the NREMT AEMT content specifications and kept inside the AEMT scope of practice. Pick an answer and you get the full rationale, including why the other three options are wrong.

Work through all 10, then move on to the next topic. When you want the full picture, the free AEMT diagnostic covers every topic in one sitting. No account needed for any of it.

Question 1 of 10

A 30-year-old patient is unresponsive after being struck in the head, has snoring respirations, and gags when the oropharynx is touched. The AEMT is about to place a nasopharyngeal airway and reassesses the head and face first. Which finding makes the nasal route the wrong choice?

Show the answer and rationale

Correct answer · Bruising behind one ear

Bruising behind the ear is a sign of a basilar skull fracture, a break in the base of the skull. Bruising around both eyes and clear drainage from the nose or ears are signs of the same fracture. The roof of the nasal cavity is a thin sheet of bone with small holes in it. That same bone is part of the floor of the skull. A nasal airway pushed through the nose can pass through a fracture in that bone. Most systems treat a suspected basilar skull fracture as a hard contraindication for a nasal airway. This patient also gags, so an oral airway is out too. That leaves you with manual positioning, suction, and ventilation.

Why the others are wrong

A hematoma over the left forehead: A forehead hematoma tells you where the head was hit. Any sign of head trauma should make you look harder at everything else. A hematoma over the forehead does not tell you the base of the skull is broken, and it does not change which airway you use.

Bleeding from a scalp laceration: The scalp bleeds heavily even from small wounds, so a scalp laceration can look dramatic. A scalp laceration is a soft tissue injury. On its own, a laceration says nothing about the bone under it or about the nose.

A left pupil larger than the right: Unequal pupils are a serious finding, and they should make you move faster. A larger left pupil points to rising pressure inside the skull, not to a fracture at the base of the skull. Unequal pupils do not change which airway adjunct you use.

Question 2 of 10

A 3-month-old patient choked during a feed and now has milky secretions in the mouth and nose with noisy breathing. The crew's suction unit is set at its usual working pressure. How does the AEMT clear this infant's airway?

Show the answer and rationale

Correct answer · Use a bulb syringe, clearing the mouth first

This infant has milk in the airway after choking on a feed. There are milky secretions in the mouth and nose, and the breathing is noisy. An infant gets a bulb syringe instead of the suction unit and a catheter. Clear the mouth before the nose. Suctioning the nose makes an infant take a breath. If milk is still sitting in the mouth, that breath pulls the milk straight down into the airway. Once the mouth is clear, clear both nares too. Babies under about six months breathe mostly through the nose, so open nares matter a lot for this patient. Keep each pass to 5 seconds for an infant. An adult gets 15 seconds.

Why the others are wrong

Use a bulb syringe, clearing both nares first: The bulb syringe is the right tool, and an infant's nares do need to be cleared. The order is what is wrong. Going to the nose first makes the baby breathe in, and that breath pulls the milk still in the mouth down into the airway.

Use a soft catheter in the nares with the unit's pressure turned down: Turning the pressure down sounds like the gentle choice for a small patient. Suction force does not change with age. A unit turned down that far will not clear the milk, and an infant gets a bulb syringe instead of a catheter anyway.

Use a rigid catheter in the mouth for no more than 10 seconds: A rigid catheter is what you use for an adult with a mouth full of fluid. An infant's mouth is too small for one. The 10 second limit is for a child, and an infant's limit is 5 seconds.

Question 3 of 10

A paramedic on a shared call placed an endotracheal tube in a 49-year-old patient, and the AEMT is managing the airway during transport. Secretions are visible in the tube and the capnogram has become erratic. The AEMT preoxygenates and measures the catheter against the tube. How is the catheter used?

Show the answer and rationale

Correct answer · Inserted with no suction, then withdrawn with suction while rotating

Put the catheter in with no suction, then suction while you withdraw and rotate the catheter. Secretions are visible in the tube, and the capnogram has become erratic. Suctioning through an endotracheal tube follows the same rule you use in the mouth, with one addition. The vacuum stays off on the way down. Suction while you advance pulls oxygen out of the lungs and pulls the tip against the tracheal wall. The vacuum goes on as you withdraw. Roll the catheter between your fingers so the side holes sweep all the way around instead of grabbing one spot. The depth comes from the length of the tube, so the tip goes only a little past the end of the tube. Preoxygenate first, and ventilate with high-concentration oxygen right after. Watch the heart rate. Stimulating the trachea can drop the heart rate through a vagal response, especially in a child.

Why the others are wrong

Inserted with suction applied so secretions are caught on the way down: Catching secretions on the way down sounds like it saves time. Suction on the way in pulls oxygen out of the lungs the whole trip down. The tip can also grab tracheal tissue, so you cause injury and hypoxia for nothing.

Advanced to the carina, then withdrawn with the suction cycled on and off: Going all the way to the carina sounds more thorough. Touching the carina sets off the strongest vagal response and the worst coughing. That's why you measure the catheter against the tube, so the tip sits just past the end.

Inserted and withdrawn with continuous suction for a full 15 seconds: The 15 second limit is real, and the limit is the most time you get, not a target. Continuous suction also means the vacuum is on during insertion. Suction on the way in pulls oxygen out and grabs tissue no matter how long the attempt runs.

Question 4 of 10

An AEMT is inserting a supraglottic airway in an apneic 57-year-old patient. The device stops advancing about halfway in, and the depth marking is well short of the teeth. What does the AEMT do?

Show the answer and rationale

Correct answer · Withdraw it slightly and add a jaw thrust before readvancing

The tip of the supraglottic airway has most likely caught on the tongue or the epiglottis. The device stopped about halfway in, and the depth marking is well short of the teeth. Resistance partway in almost always means a blocked path, not a device that is too big. Back the device out a little to unhook the tip. A jaw thrust lifts the tongue and the epiglottis out of the way. The device usually slides the rest of the way on the next try. Never force a supraglottic airway, because the tissue in front of the tip is what tears. Keep the head neutral or slightly sniffing and the device midline. If the device still will not seat, go back to two-person BVM ventilation.

Why the others are wrong

Hold steady pressure until the device passes through the resistance: Pushing through resistance seems right when the patient is not breathing and you need an airway in. Force causes bleeding and swelling in the tissue you need. Pushing harder does not free a tip that has caught on the tongue or the epiglottis.

Remove it and insert the next smaller size instead: A smaller size is right when the device truly does not fit. Resistance at the halfway point is a path problem, not a size problem. Swapping devices uses up an insertion attempt you did not need to spend.

Rotate it 90 degrees and advance along the lateral pharynx: Rotating during insertion is a real technique for an oral airway. A supraglottic airway goes in along the midline. The device follows the curve of the tongue and the hard palate into the hypopharynx. Advancing along the side of the pharynx takes the tip off that path.

Question 5 of 10

A 45-year-old patient is unresponsive after falling from a ladder and does not gag when the mouth is suctioned. Respirations are 12 and snoring. There is bruising behind the left ear and clear fluid draining from the right nostril. A partner hands the AEMT a lubricated nasopharyngeal airway. What should the AEMT do?

Show the answer and rationale

Correct answer · Insert an oropharyngeal airway instead

This patient may have a basilar skull fracture, which is a fracture at the base of the skull. The patient has bruising behind the left ear and clear fluid draining from the right nostril. Bruising behind the ear, bruising around both eyes, and clear fluid from the nose or ears all point to a basilar skull fracture. With that fracture, the floor of the nasal cavity may be broken. A nasal airway pushed along that floor can follow the fracture instead of the airway. Most systems use a different plan when these signs are present. An oral airway works here because the patient did not gag when you suctioned. No gag reflex is the one thing an oral airway needs. Keep the head neutral while you work, because this patient fell from a ladder.

Why the others are wrong

Insert the nasopharyngeal airway in the opposite nostril: Switching nostrils is the fix for a deviated septum or a nosebleed, where the problem is on one side. The fluid is only coming from the right nostril, so the left side looks clean. The fracture is at the base of the skull, and both sides of the nose share that floor. Switching sides does not move the nasal airway away from the fracture.

Suction the drainage away and then insert the nasopharyngeal airway: Suctioning fluid before you place a device is a good habit. This clear fluid is a sign of the skull fracture and is not blocking anything. Suctioning the fluid away does not change where the nasal airway would travel.

Hold a manual jaw thrust for the rest of the transport: A jaw thrust is the right way to open the airway of a patient who fell from a ladder. A jaw thrust opens the airway without tilting the neck back. Holding a jaw thrust alone for the whole transport leaves the tongue without support. Holding the jaw also keeps one provider at the head who is needed elsewhere. Use the jaw thrust and place the oral airway this patient can take.

Question 6 of 10

A 5-year-old patient is unresponsive with no gag reflex after being pulled from a backyard pool. The AEMT has sized an oropharyngeal airway from the corner of the mouth to the angle of the jaw. How should the device be inserted?

Show the answer and rationale

Correct answer · Sideways, rotating it 90 degrees once the tip reaches the back of the mouth

In a child, the oral airway goes in sideways and turns 90 degrees once the tip reaches the back of the mouth. The sizing is already done, from the corner of the mouth to the angle of the jaw. Going in sideways keeps the tip off the soft palate. Waiting to turn until the tip is at the back drops the curve in behind the tongue. A child's mouth has very little room, and turning late keeps you from shoving the tongue back into the throat. A child's soft palate tears easily and bleeds into the airway. That's why the adult 180-degree flip is not used in a child. Keep the head neutral while you insert the airway. A child's trachea is soft and kinks closed when the neck is pushed back.

Why the others are wrong

With the tip toward the roof of the mouth, rotating it 180 degrees: Inserting with the tip toward the roof of the mouth and flipping 180 degrees is the adult technique, and it is right for an adult. In a 5-year-old, the flip scrapes hard plastic across a soft palate that tears. The small mouth also leaves no room to spin the device without pushing the tongue back into the throat. A tongue pushed into the throat is the blockage the oral airway is supposed to fix.

With the tip toward the roof of the mouth, advanced to the flange without rotating: Advancing with the tip toward the roof of the mouth and never turning leaves the curve pointed the wrong way. The tip stays pressed on the soft palate, the surface in the mouth most likely to bleed. The device never gets behind the tongue, so nothing is held open.

Straight back with the head extended as far as it will go: Tilting the head back opens the airway in an adult. In a child, the soft trachea kinks closed when the head is pushed back, so the head stays neutral. Option C also does not answer how the device goes in.

Question 7 of 10

A 48-year-old patient choked while eating and could not speak or cough. Abdominal thrusts were performed without relieving the obstruction, and the patient is now unresponsive on the floor. Two ventilation attempts produce no chest rise even after the airway is repositioned. What is the most appropriate action?

Show the answer and rationale

Correct answer · Begin chest compressions, looking in the mouth before each breath

This patient has a complete airway obstruction and is now unresponsive. Two breaths gave no chest rise, even after the airway was repositioned, so the object is still in the airway. Once the patient is unresponsive, chest compressions take the place of abdominal thrusts. Compressions push air pressure up against the object. Compressions also move blood in a patient who is at high risk of cardiac arrest. Do compressions, then open the airway and look in the mouth before each breath. Take the object out only if you can see it. Then try to ventilate. Keep repeating that cycle until the object comes out or you hand off care. Compressions come before any airway adjunct.

Why the others are wrong

Perform a blind finger sweep to remove the object: A finger sweep is for an object you can actually see in the mouth of an unresponsive patient. Nothing in this question says the object is visible. The failed breaths only tell you something is blocking the airway. A blind sweep can push the object deeper. That's why you look in the mouth before each breath instead of guessing.

Insert a supraglottic airway in an attempt to bypass the obstruction: A supraglottic airway is for an unresponsive patient who is not breathing and whose airway below the glottis is open, like in cardiac arrest. The device sits above the vocal cords and moves air through the glottic opening. A supraglottic airway cannot get past an object blocking that opening. Placing one also delays the compressions this patient needs now.

Remove the object with Magill forceps under direct laryngoscopy: Pulling an object out with Magill forceps under direct laryngoscopy is a paramedic skill for an object you can see. Direct laryngoscopy is outside AEMT scope. Start compressions now. Compressions push on the object and move blood while you arrange for a paramedic.

Question 8 of 10

An AEMT is ventilating a 61-year-old patient in cardiac arrest. Two-person BVM ventilation with an oropharyngeal airway has been attempted, the head has been repositioned, and a large volume of air still escapes around the mask with each breath. The chest does not rise, and waveform capnography shows no waveform. Compressions are in progress. What is the most appropriate action regarding the airway?

Show the answer and rationale

Correct answer · Insert a supraglottic airway and confirm placement

BVM ventilation has failed, and a supraglottic airway is the next step. Every fix for the mask has already been tried. There are two rescuers, an oropharyngeal airway is in, and the head has been repositioned. Air still leaks around the mask, the chest does not rise, and capnography shows no waveform. No air is getting into this patient at all. A supraglottic airway seals below the level of the face, so you no longer need a mask seal. Confirm placement with chest rise, breath sounds, no sounds over the epigastrium, and a steady rectangular waveform. Of those checks, only the waveform keeps confirming placement after the first one. A supraglottic airway is the most advanced airway in the AEMT scope. An endotracheal tube is not in the AEMT scope.

Why the others are wrong

Continue the current BVM technique: Keeping the same BVM technique is right when the mask is working. No waveform proves the mask is not working. Repeating a technique that moves no air leaves this patient without ventilation the whole time.

Intubate the trachea to secure the airway: Endotracheal intubation is above AEMT scope, no matter how hard the airway is. A supraglottic airway is how an AEMT solves this same problem.

Insert a nasopharyngeal airway and continue: A nasopharyngeal airway keeps the tongue and soft tissue from blocking the airway. The oropharyngeal airway already in place is doing that job. A nasopharyngeal airway does nothing for a mask that will not seal, so the leak and the absent chest rise continue.

Question 9 of 10

An AEMT responds for a 68-year-old patient whose larynx was surgically removed two years ago and who is now unresponsive and apneic with a carotid pulse. There is a single midline opening at the base of the neck with no tube in it, and the opening is clear of secretions. A partner has begun BVM ventilation over the mouth and nose, and there is no chest rise and no waveform on capnography. What is the most appropriate action?

Show the answer and rationale

Correct answer · Seal an infant mask over the neck opening and ventilate through it

This patient had a laryngectomy, which means the larynx was surgically removed. The trachea now ends at a permanent opening at the base of the neck called a stoma. The mouth and nose no longer connect to the lungs. That's why bagging over the mouth and nose gives you no chest rise and no waveform on capnography. Every breath has to go in through the stoma. There is no tube in this stoma to attach the bag to. Put an infant or child mask on the bag-valve device and seal the mask right over the opening. Ventilate and watch for chest rise and a waveform on capnography. You do not need a head tilt-chin lift or a jaw thrust to ventilate through a stoma.

Why the others are wrong

Seal the neck opening and keep ventilating the mouth and nose: Covering the neck opening and bagging the mouth and nose is the backup for a tracheostomy patient, whose upper airway still connects to the lungs. Covering the opening keeps those breaths from leaking out of the neck. This patient's larynx was removed. The mouth and nose no longer reach the lungs, and sealing the stoma closes off the only path air has.

Suction the neck opening before attempting to ventilate through it: Suctioning comes first when thick secretions are blocking a stoma. The question says this opening is clear of secretions. There is nothing to suction out. Suctioning only delays the first breath that can actually reach the lungs.

Perform a jaw-thrust maneuver and keep ventilating the mouth and nose: A jaw thrust fixes poor chest rise when the tongue is blocking the airway. After a laryngectomy, the mouth and nose do not connect to the lungs at all. No maneuver on the upper airway will move air into this patient's lungs.

Question 10 of 10

An AEMT inserts a nasopharyngeal airway in a 52-year-old patient who is unresponsive with an intact gag reflex and snoring respirations. The airway was lubricated and met no resistance during insertion, and the flange rests against the nostril. Ventilations by BVM continue at the same rate and volume as before insertion, and chest rise is unchanged. Within a minute the pulse falls from 92 to 48 and the upper abdomen begins to distend with each delivered breath. What is most likely causing these findings?

Show the answer and rationale

Correct answer · The airway is too long for the patient

The nasal airway is too long. Right after the nasal airway went in, the pulse dropped from 92 to 48. The upper abdomen also started to swell with each breath. The ventilations did not change at all. A nasal airway that is too long can reach far enough to stimulate the vagus nerve, and the vagus nerve slows the heart. A tip that goes too far can also slip into the esophagus. Air from each breath then goes into the stomach. Pull the nasal airway out and measure again from the tip of the nose to the earlobe. Put the right length back in, then recheck the pulse and the chest rise.

Why the others are wrong

The airway was placed in the smaller nostril: The nasal airway does go in the larger nostril. This airway met no resistance going in, and the flange sits against the nostril. The wrong nostril does not explain a slow heart rate or air in the stomach. A nasal airway that is too long causes both.

The airway has become obstructed by mucus: Mucus, blood, or vomit can plug a nasal airway with a small diameter. A plugged airway lets less air through, and the chest rise gets worse. This patient's chest rise has not changed, so air is still getting to the lungs.

The bag is being squeezed with too much force: Squeezing the bag too hard is the usual reason air fills the stomach. The ventilations are the same rate and volume as before the nasal airway went in. The only thing that changed is the device sitting in the airway.

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