Skip to content
Free NREMT practice questionsFree AEMT practice questions · Trauma

10 free AEMT practice questions: Advanced Trauma Interventions

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

An AEMT has held firm direct pressure on a deep forearm laceration for five minutes without lifting it. Blood is now soaking through the gauze. What should the AEMT do?

Show the answer and rationale

Correct answer · Add gauze on top of the soaked dressing and press harder

Blood is soaking through, but you have held firm direct pressure for five minutes without lifting it. Under that gauze, a clot of platelets and fibrin is starting to form at the laceration. The clot is still fragile. If you disturb the dressing, the bleeding starts over from zero. Leave the soaked gauze where it is, add more gauze on top, and press harder. Pressing harder puts more pressure on the bleeding point without breaking the clot. If blood still comes through the added gauze and firmer pressure, the next step is a tourniquet on the arm.

Why the others are wrong

Remove the soaked gauze and replace it with a dry dressing: Taking off a soaked dressing and putting on a dry one is how you change the dressing on most wounds. Here the five minutes of pressure has already started a clot at the laceration. Pulling the soaked gauze off tears the clot away, and the bleeding starts over from the beginning.

Lift the dressing to find the exact bleeding point, then reapply: Finding the exact bleeding point would let you aim your pressure. Lifting the dressing to look breaks the same clot the five minutes of pressure built. You do not need to see the vessel to press harder on it.

Elevate the arm above the heart while holding pressure: Elevating the arm above the heart was taught for years as a routine bleeding control step. Elevation is not part of the current bleeding control steps. Spend that time on more gauze, firmer pressure, or a tourniquet.

Question 2 of 10

An AEMT applied a tourniquet about three inches above a mangled lower leg wound. The bright bleeding has slowed considerably but has not stopped, and a pulse is still palpable at the ankle. What should the AEMT do?

Show the answer and rationale

Correct answer · Tighten it until the bleeding and the distal pulse both stop

This tourniquet is not tight enough. The bleeding has slowed but has not stopped, and you can still feel a pulse at the ankle. A tourniquet is tight enough only when the bleeding stops and the distal pulse is gone. You need both. The pulse at the ankle tells you blood is still getting into the leg through the arteries. A tourniquet that is too loose squeezes the veins shut while the arteries keep pumping blood in. The blood has no way back out of the leg, so the wound keeps bleeding and can bleed worse. Tighten the tourniquet until the bleeding stops and the ankle pulse is gone. A tourniquet goes two to three inches above the wound, on skin when you can, and never over a joint. Write the time on the tourniquet, on tape, or on the skin.

Why the others are wrong

Loosen it slightly and add direct pressure over the wound: Loosening the tourniquet and adding direct pressure sounds gentler when the patient is in pain. A loose tourniquet only partly blocks the blood flow, and that is what makes bleeding worse. Treat the pain with pain medication, which is within your scope, and leave the tourniquet tight.

Leave it exactly as applied and cover it so that it is not disturbed: Leaving the tourniquet as it is would be right if the bleeding had stopped. Slowed is not stopped, and the ankle pulse is still there. Covering a tourniquet is a mistake too, because the hospital team needs to see the device and the time written on the tourniquet.

Move it closer to the wound and retighten it there: Moving a tourniquet makes sense when the tourniquet is in the wrong spot. The right spot is two to three inches above the wound, and this tourniquet is about three inches above the wound. Moving the tourniquet wastes time while the leg keeps bleeding. The real problem is that the tourniquet is not tight enough.

Question 3 of 10

An AEMT finds a penetrating wound to the anterior chest that bubbles with each breath. The unit does not carry a commercial vented chest seal. Which dressing is the appropriate alternative?

Show the answer and rationale

Correct answer · An occlusive dressing taped on three sides

This patient has an open pneumothorax. The wound bubbles with each breath, so air is moving through the hole in the chest wall. When the patient breathes in, air gets pulled in through the wound instead of through the trachea. That air needs a way back out when the patient breathes out. Air that cannot get out builds up and turns into a tension pneumothorax. An occlusive dressing taped on three sides works like a one-way valve. When the patient breathes out, the untaped edge lifts and lets the trapped air escape. When the patient breathes in, the untaped edge gets pulled flat and seals the hole. A commercial vented chest seal does the same thing with a built-in valve. The three-sided dressing keeps this patient from developing a tension pneumothorax while you transport.

Why the others are wrong

A dry sterile dressing secured with a pressure bandage: A dry sterile dressing under a pressure bandage is what you use to control bleeding on most open wounds. Gauze lets air through. Air keeps moving in and out of this wound with every breath, and the lung stays partly collapsed. The bubbling tells you this wound is an air problem, not just a bleeding problem.

An occlusive dressing taped on all four sides: Taping all four sides gives you the tightest seal you can make without a commercial valve. A full seal also gives trapped air no way out when the patient breathes out. Pressure builds up in the chest with every breath. The trapped air pushes on the heart and cuts off the blood coming back to the heart. You end up with a tension pneumothorax under your own dressing.

A petroleum gauze pad laid over the wound and left uncovered: Petroleum gauze is a real occlusive layer for chest wounds. Left uncovered, petroleum gauze will not stay sealed against the chest wall while the patient breathes and moves. Air keeps getting in through the wound with every bubble. The petroleum gauze needs a backing taped over the gauze to work as a seal.

Question 4 of 10

A 7-year-old patient fell off a scooter and will not use the right arm. The wrist looks normal with no swelling and no deformity, and the child has point tenderness just above the joint. What should the AEMT do?

Show the answer and rationale

Correct answer · Splint the arm and treat the injury as a fracture

Splint this arm and handle the injury as a growth plate fracture. The child has point tenderness just above the wrist and will not use the arm, even though the wrist looks normal. Children have growth plates, and adults do not. A growth plate is cartilage, and cartilage is weaker than the bone around it. A force that would sprain an adult's ligament breaks a child's bone through the growth plate instead. Often there is nothing to see from the outside. A child with point tenderness near a joint is treated as having a fracture, even when the arm looks normal. A missed growth plate fracture can leave the child with an arm that grows crooked. Splinting an arm that turns out to be a sprain only costs a few minutes. Check circulation, sensation, and movement below the injury before the splint goes on. Check them again after the splint is secured, and document both sets.

Why the others are wrong

Apply a cold pack and reassess before deciding to splint: A cold pack and a recheck are reasonable for a soft tissue injury, and this wrist looks normal. Growth plate fractures often do not swell, so waiting for swelling tells you nothing. A child who will not use the arm is already showing you something is broken.

Have the child move the wrist to judge whether it is broken: Having the patient move the joint is a common way providers try to tell a sprain from a fracture. Moving a broken growth plate can shift the fracture out of place. In a child, range of motion does not reliably tell a sprain from a fracture.

Use a sling alone, since there is no deformity to immobilize: A sling holds the arm up and is comfortable. A sling alone does not immobilize the joint above and the bone below. The injured wrist keeps moving inside the sling every time the child shifts.

Question 5 of 10

A 33-year-old patient's hand was severed in a machine. Bleeding at the stump is controlled and the amputated hand has been recovered, wrapped in lightly moistened sterile gauze, and sealed in a bag. How should the bag be handled during transport?

Show the answer and rationale

Correct answer · Kept cool beside ice, without the part touching the ice

Keep the bagged hand cool beside ice, without letting the hand touch the ice. Cooling slows down the tissue's metabolism, and that buys the surgical team more time to reattach the hand. Ice touching the hand freezes the tissue. Freezing destroys the cells the reattachment depends on. That's why the barrier between the hand and the ice matters as much as the cooling. Lightly moistened gauze keeps the tissue from drying out. Soaked gauze would make the tissue soft and waterlogged. The sealed bag keeps melted ice water off the hand. An amputated part always travels with the patient. Bring the part even when reattachment looks unlikely, because that decision belongs to the surgeon, not to you in the field.

Why the others are wrong

Packed directly in ice so the part stays as cold as possible: Ice is how you keep most perishable things cold, so packing the hand in ice sounds right. Ice in direct contact with the hand freezes the tissue and kills it. A frozen hand is ruined for reattachment.

Kept at room temperature in the warm patient compartment: Room temperature avoids any chance of freezing the hand. Warm tissue keeps using oxygen, and the hand is no longer getting any. Warm storage quickly uses up the time the surgeon has to reattach the hand.

Submerged in cold sterile saline for the whole transport: Moisture is part of caring for an amputated part, and cold saline adds cooling too. Submerging the hand soaks the tissue and waterlogs it. The hand needs gauze that is lightly damp, not a hand sitting in fluid.

Question 6 of 10

A 26-year-old patient was standing about 15 feet from an explosion in a warehouse. The patient walked out on their own, has no visible injuries, and says they feel fine. The respiratory rate, pulse, and oxygen saturation are all normal and the lungs are clear. What is the appropriate disposition?

Show the answer and rationale

Correct answer · Transport for evaluation and observation even though the patient now feels well

Transport this patient for evaluation and observation, because blast lung can show up hours later. This patient was about 15 feet from an explosion. Primary blast injury comes from the pressure wave itself. The wave damages organs that hold air, like the lungs, the middle ear, and the bowel, while the skin can look untouched. Blast lung is the most common primary blast injury that kills people who survive the explosion. Blast lung causes trouble breathing, hypoxia, chest pain, and coughing up blood. Those signs can take hours to appear. A patient who looks fine after a significant blast still needs transport and observation. The signs you would be waiting for have not had time to show up yet. Normal vital signs on scene do not tell you how the lungs will be doing hours from now. At a blast scene, also watch for a second device set to go off when responders arrive.

Why the others are wrong

Release the patient on scene after documenting a normal set of vital signs: Releasing a patient makes sense when every finding you can measure is normal and the patient walked out feeling fine. Here the explosion itself is the reason to transport. Blast lung shows up hours later in patients whose first vital signs looked exactly like these.

Transport only if the patient develops difficulty breathing on scene: Waiting for symptoms before you transport is how you handle most complaints, and it respects what the patient tells you. If you wait for trouble breathing, the patient may be at home when blast lung finally shows up hours later.

Observe the patient on scene for about 20 minutes, then release if unchanged: Watching the patient for a while sounds like a middle ground between transporting and releasing. Twenty minutes is nowhere near the time blast lung takes to develop. A patient who is unchanged after 20 minutes has not been cleared of anything.

Question 7 of 10

A 4-year-old patient in decompensated shock after a fall needs vascular access, and two peripheral attempts have failed. The AEMT is landmarking the left proximal tibia when a partner points out an obvious deformity of that same tibia just above the ankle. What should the AEMT do?

Show the answer and rationale

Correct answer · Insert the device in the opposite tibia

Use the opposite tibia. This tibia has an obvious deformity just above the ankle, and a fracture anywhere in the bone rules that bone out for intraosseous access. Fluid pushed into a broken bone leaks out through the fracture and does not reach the circulation. Go to a different site, and the other leg is usually the simplest one. The contraindications are the same at every site. One is a fracture in that bone. Another is an IO attempt in that same bone within the past twenty-four to forty-eight hours. Others are a prosthetic joint or orthopedic hardware at the site, and infection or a burn over the insertion point. Landmarks you cannot find and known bone disease like osteogenesis imperfecta are on the list too. Any one of those sends you to a different site. None of them is a reason to try carefully at the damaged bone. Intraosseous access is in your scope for adults and children. The usual trigger is two failed peripheral attempts or ninety seconds of trying.

Why the others are wrong

Insert the device in the same tibia below the deformity: Going below the break sounds like it keeps the needle away from the injury, and you keep the landmark you already found. The fracture is still between the needle and the heart. Fluid that goes in below the break has to cross the break, and the fluid leaks out into the leg along the way.

Make a third and a fourth peripheral attempt instead: A peripheral IV is the line you place most often, and another try can seem safer than an IO in a small child. Two failed attempts in a child in decompensated shock is already the point to stop. A third and fourth attempt use up minutes this child does not have.

Proceed at the planned site, since the marrow cavity is intact: The marrow at the top of the tibia really may be intact when the break is down near the ankle. The contraindication covers the whole bone, not one part of the bone, because a broken bone leaks. An IO placed here sends fluid into the leg instead of into the circulation.

Question 8 of 10

An AEMT has seated an intraosseous device in the proximal tibia of an adult trauma patient. Which step is mandatory before fluid will infuse at a useful rate?

Show the answer and rationale

Correct answer · A flush of 5 to 10 mL of saline

The IO line needs a saline flush before fluid will run at a useful rate. Marrow is not an open tube. Marrow is a network of small channels called sinusoids, and the flush opens those channels so fluid can move through them. Use 5 to 10 mL in an adult and 2 to 5 mL in a child. Skip the flush and the line will barely drip, no matter how well the device is seated. The flush hurts a lot in a patient who is awake. Even after a good flush, IO lines flow poorly by gravity. You usually need a pressure bag or syringe pushes to give fluid fast enough for a resuscitation. Feel the calf during and after the infusion. Fluid leaking into the tissue around the bone is the most common serious complication.

Why the others are wrong

Aspiration of marrow to confirm placement: Pulling back marrow is one way to confirm placement, and marrow often comes back. No marrow on aspiration does not mean the IO failed. A device that stands upright on its own and flushes without the tissue swelling is in the right place.

Injection of lidocaine to reduce the pain of infusion: Lidocaine treats the pain of the infusion in a patient who is awake. Lidocaine does nothing to open the marrow channels. The question asks what makes fluid run at a useful rate, and only the flush does that.

A check of the distal pulse in that limb: Checking the distal pulse is good practice after a splint or anything wrapped around an arm or leg. The distal pulse tells you about blood flow in the limb, not about whether fluid can get into the marrow. The limb check that matters after an IO is feeling the calf for swelling.

Question 9 of 10

A 15-year-old patient is struck in the center of the chest by a pitched ball during a game and immediately collapses, unresponsive and pulseless. Bystander CPR is in progress when the AEMT arrives with an automated external defibrillator. What is the most appropriate next action?

Show the answer and rationale

Correct answer · Apply the AED, analyze the rhythm, and defibrillate if advised, continuing CPR between analyses

This is commotio cordis. The 15-year-old was hit in the center of the chest by a pitched ball and collapsed right away, unresponsive and pulseless. The ball hit the chest at a vulnerable moment in the heartbeat. A blow at that moment can throw a healthy heart into ventricular fibrillation. Ventricular fibrillation is treated with high quality CPR and a shock from the AED. Both are fully within AEMT scope, so nothing here waits for a paramedic. Put the AED on right away, analyze, shock if advised, and keep doing CPR between analyses. A fast shock gives this patient the best chance to survive.

Why the others are wrong

Withhold defibrillation and transport immediately, because this mechanism requires a paramedic to defibrillate: The AED is a basic level skill, not a paramedic only skill. A blow to the chest does not change who can use the AED. Holding the shock and just transporting delays the one action most likely to get a pulse back.

Perform a pericardiocentesis to relieve suspected cardiac tamponade before defibrillating: Pericardiocentesis treats cardiac tamponade, and it is not a field skill at this level. A ball to the chest followed by sudden collapse with no pulse points to ventricular fibrillation from commotio cordis, not tamponade.

Delay CPR until IV access is obtained so epinephrine can be given first: An IV and epinephrine come after CPR and defibrillation are already going. Never hold compressions or shocks to start a line or give a medication.

Question 10 of 10

A 29-year-old patient has a deep laceration high in the left groin from a chainsaw. Bright red blood is pulsing from the wound despite a trauma dressing and firm direct pressure. The wound is too proximal for a tourniquet to be applied above it. The vital signs are BP 96/64, P 130, and R 24. What should the AEMT do next?

Show the answer and rationale

Correct answer · Pack the wound with hemostatic gauze and hold firm direct pressure

This patient has a junctional arterial bleed, and a junctional bleed gets packed. The wound is high in the groin. Bright red blood is pulsing through a trauma dressing and firm direct pressure. A junctional wound is at the groin, the armpit, or the neck, where there is no limb above the wound to put a tourniquet on. The question tells you a tourniquet will not fit above this wound. Packing takes the place of the tourniquet. Gauze pushed down into the wound puts pressure right on the bleeding vessel instead of on the skin above it. Hemostatic gauze also helps the blood clot right at the vessel. Hold firm pressure for several minutes, secure the packing, and transport to a trauma center. A junctional arterial bleed needs a surgeon to stop the bleeding for good.

Why the others are wrong

Apply additional dressings over the trauma dressing and transport: Adding dressings on top works for venous or capillary bleeding that has already slowed down. This blood is bright red and pulsing through the trauma dressing under firm pressure. Bleeding like that is arterial, and it is not slowing. Every new layer moves your pressure farther from the vessel. The dressings soak up blood while the bleeding keeps going underneath.

Elevate the extremity and apply pressure at a proximal pressure point: Elevation and pressure points were taught for years. Both were taken out of current bleeding control teaching because neither one reliably stops arterial bleeding. Both also use up time you need for packing. Elevation does nothing for a wound this high in the groin.

Apply a tourniquet as high on the thigh as it will fit: A tourniquet is the right next step for an arterial bleed on an arm or leg when there is room above the wound. The question tells you this wound is too high for a tourniquet to fit above it. A tourniquet at or below the wound cannot squeeze off the artery feeding the bleed. A tourniquet there can also raise the pressure in the veins and make the bleeding worse.

Find out which AEMT topics are costing you points

Ten questions on one topic tell you about that topic. The free diagnostic covers every AEMT topic and breaks your results down by topic, so you know what to drill next. No card, no signup to try it.

Take the free AEMT diagnostic

More free AEMT practice questions by topic