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Free NREMT practice questionsFree AEMT practice questions · Clinical Judgment

10 free AEMT practice questions: Pediatric and Geriatric Clinical Judgment

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.

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Question 1 of 10

An AEMT is called to a private home for a 90-year-old patient with a history of dementia after a neighbor reported that the patient seems more confused than usual. The patient is awake and gives the wrong month. The skin is warm and dry, the lungs are clear, and there is no weakness on one side. The blood glucose level is 104 mg/dL. The vital signs are BP 132/78, P 88, R 18, and SpO₂ 96% on room air. Which action will do the most to clarify the impression?

Show the answer and rationale

Correct answer · Ask family or staff what the patient is like on a normal day

The neighbor says the patient is more confused than usual. More confused than usual is a new change on top of the dementia. Dementia gets worse slowly, over months. A new change on top of dementia points to delirium. Delirium is a sudden confused state caused by something like an infection, low oxygen, a medication, or a metabolic problem. Ask family or staff who see the patient every day what the patient is like on a normal day. The answer tells you whether this is a reversible medical emergency or the patient's usual dementia.

Why the others are wrong

Record the confusion as expected in a patient of this age with dementia: Dementia does cause long-term confusion, and some confusion is normal for this patient. The neighbor says the patient is more confused than usual, which is a change from normal. Calling the change expected can hide an infection, low oxygen, or a metabolic cause that can be reversed.

Repeat the mental status questions in ten minutes and compare the answers: Repeating the mental status questions shows you whether the patient changes over the next ten minutes. Both sets of answers come from today. Neither one tells you how this patient answers on a normal day.

Ask the patient to name the year and the current president: Asking the year and the president is a standard way to test orientation. This patient already gave the wrong month, so you know the patient is disoriented. Another orientation question cannot tell you whether the confusion is new or how the patient always is.

Question 2 of 10

An AEMT is assessing a 4-month-old infant with a fever and a runny nose. The infant is alert, tracks a caregiver across the room, feeds during the assessment, and has pink skin with capillary refill under 2 seconds. A newer provider on the crew says the heart rate is dangerously high. The vital signs are BP 84/54, P 162, R 42, and SpO₂ 98% on room air. How should the AEMT interpret the heart rate?

Show the answer and rationale

Correct answer · It falls inside the awake range for an infant of this age

A heart rate of 162 is normal for an awake 4-month-old. An awake infant runs about 100 to 180, so 162 is inside the range. Adult ranges used on a child cause mistakes in both directions. Adult ranges make a normal toddler look tachycardic, and they make a heart rate of 70 in a six-month-old look fine. A rate of 70 at six months is profound bradycardia. Check the heart rate against the range for the age before you decide what it means. The rest of the exam fits a well compensated infant. The infant is alert, feeding, and pink, with capillary refill under 2 seconds.

Why the others are wrong

It is dangerously high and calls for a fluid bolus: A fluid bolus treats poor perfusion. This infant has no signs of poor perfusion. Pink skin, capillary refill under 2 seconds, alertness, and feeding all show the circulation is working.

It is high enough that the fever must be treated before transport: Fever does raise the heart rate. This infant's heart rate is still inside the normal range, so there is nothing about the heart rate to treat. Comfort measures for the fever are fine.

It cannot be judged until a brachial pulse is felt in both arms: A brachial pulse is the right place to feel an infant's pulse, and checking its quality is worth doing. Feeling the brachial pulse confirms the reading. A rate of 162 at 4 months still means the same thing after you feel the pulse.

Question 3 of 10

An AEMT is called for an 89-year-old patient who has felt weak and short of breath since waking and vomited once. The patient denies any chest pain or pressure. The skin is pale and damp, the lungs are clear, and there is no weakness on one side. The blood glucose level is 122 mg/dL. The vital signs are BP 138/84, P 96, R 22, and SpO₂ 94% on room air. What should the AEMT suspect first?

Show the answer and rationale

Correct answer · Acute coronary syndrome, which can arrive without chest pain at this age

Suspect acute coronary syndrome. Older patients feel pain less, so the classic crushing chest pressure is often missing. What shows up instead is weakness, shortness of breath, nausea, or just feeling off. This 89-year-old woke up weak and short of breath, vomited once, and has pale, damp skin. No chest pain does not rule out a heart problem. Pale, damp skin with new shortness of breath at this age is a perfusion problem until something proves otherwise. The heart is the organ that kills fastest, so think of the heart first. Work this call as a possible cardiac event. Get the monitor and a 12-lead on early, and let the hospital rule out the heart.

Why the others are wrong

A viral illness, since weakness and vomiting together point to infection: Weakness and vomiting can come from a viral illness. Nothing in this question points to infection. There is no fever, no cough, and no source listed. Pale, damp skin fits poor perfusion better than a virus.

A stroke, since new weakness in an older adult points there first: New weakness on one side of the body points to a stroke. This patient's weakness is all over, and the exam shows no weakness on one side. A stroke also does not explain the damp skin and the new shortness of breath.

Dehydration from the vomiting, which explains the pale and damp skin: Dehydration can follow vomiting. One episode of vomiting is not enough fluid loss to dehydrate a patient. Dehydration also leaves the skin dry, not pale and damp.

Question 4 of 10

An AEMT is called for an 11-month-old infant who has been vomiting for a day, has not eaten since morning, and is now limp and difficult to rouse. There is no history of diabetes in the family. The skin is pale and cool. The vital signs are BP 82/50, P 158, R 36, and SpO₂ 97% on room air. Which assessment should the AEMT perform next?

Show the answer and rationale

Correct answer · Check a blood glucose level, even with no history of diabetes

This infant is likely hypoglycemic, which means the blood sugar is low. The infant has been vomiting for a day, has not eaten since morning, and is now limp and difficult to rouse. Poor intake plus an altered mental status points to low blood sugar. An 11-month-old only stores a small amount of sugar, called glycogen. A day of vomiting with nothing to eat uses that stored sugar up fast. The blood sugar drops even with no family history of diabetes. A glucose below 60 in an infant with symptoms is the field level for treating with dextrose. The meter gives you that number before you work through any other cause.

Why the others are wrong

Check a temperature, since a fever would explain the lethargy: A fever can make an infant lethargic, and a temperature belongs in a workup for infection. This infant is limp and difficult to rouse. A thermometer does not explain or treat that mental status. Low blood sugar is a reversible cause, and you check for low blood sugar first.

Check the pupils, since lethargy in an infant points to a head injury: Checking the pupils fits a head injury, where unequal or fixed pupils point to rising pressure inside the skull. Nothing in this call gives you a mechanism of injury. The history is a day of vomiting and skipped feeds.

Recheck the saturation on a different site before anything else: Rechecking the saturation on another site makes sense when a reading looks off from cold skin or poor perfusion. This reading is a normal 97% on room air. Confirming a normal number does nothing to find out why the infant is limp.

Question 5 of 10

An AEMT is assessing a 91-year-old patient at a senior apartment after a fall in which no injury was found. The patient looks directly at the AEMT, does not answer questions, and nods at random moments in the conversation. A hearing aid sits on the nightstand with the battery door open. The vital signs are BP 142/80, P 78, R 16, and SpO₂ 97% on room air. What should the AEMT do next?

Show the answer and rationale

Correct answer · Restore the hearing aid and face the patient in good light

This patient most likely cannot hear you. The hearing aid is sitting on the nightstand with the battery door open. The patient looks right at you, nods at random times, and does not answer questions. A patient who cannot hear your question is not an altered patient. Charting the patient as altered because the two of you could not communicate is a documentation error, not an assessment finding. A wrong mental status in the chart follows the patient through the hospital and affects every decision made after. Put the hearing aid back in. Face the patient so the light is on your mouth. Write the question down if that works better. Do all of this before you document any mental status finding. A mental status finding only counts if the patient could actually hear the question.

Why the others are wrong

Document the patient as altered and begin transport: Documenting a patient as altered is right when the patient truly is confused. This patient makes eye contact and responds socially. A truly altered patient does not act like that. Nothing here shows the patient is altered yet.

Perform a stroke screen, since not answering suggests aphasia: A stroke screen is quick and does no harm, and not answering can come from aphasia. The hearing aid with the open battery door is a simpler explanation. You can test the hearing aid in seconds.

Ask a neighbor to give the history in the patient's place: A neighbor can fill in gaps in the history. The patient may be able to answer just fine once the hearing aid is in. Going around a patient who can speak for themselves loses your best source.

Question 6 of 10

An AEMT is called for a 7-month-old infant who has been sick for three days and is now hard to wake. The chest rises shallowly and the infant does not cry when moved. The vital signs are BP 80/48, P 96, R 16, and SpO₂ 94% on room air. What should the AEMT do next?

Show the answer and rationale

Correct answer · Begin assisted ventilation with a BVM and oxygen

This infant is in respiratory failure. The respiratory rate is 16, and the chest rises shallowly. A 7-month-old normally breathes about 30 to 60 times a minute. A rate of 16 is far too slow for an infant. Slow, shallow breaths mean very little air is moving in and out. Carbon dioxide is building up in the blood. The saturation of 94% has not dropped yet because oxygen saturation is one of the last vital signs to fall. The infant is also hard to wake and does not cry when moved. Begin ventilating with a bag-valve mask and oxygen now. Do not wait for the saturation to confirm what the rate already shows you.

Why the others are wrong

Apply an NRB and watch the saturation: A nonrebreather mask fits a child who is breathing well enough but not oxygenating well. The saturation of 94% looks like the number to fix. This infant's rate is 16 with shallow chest rise, so the infant is barely moving air. A mask only adds oxygen to breaths that are not happening. Fix the breathing first.

Hold treatment for now, since the saturation is acceptable: A saturation of 94% can look good enough to wait. The rate of 16, the shallow chest rise, and an infant who does not cry when moved all show the breathing is failing. The saturation has not caught up yet.

Give blow by oxygen and recheck the rate in five minutes: Blow-by oxygen with a recheck fits a child who is breathing a little fast and still moving enough air. This infant is breathing 16 times a minute with shallow chest rise. Those breaths are not moving enough air, and the infant needs bagging now, not a five-minute wait.

Question 7 of 10

An AEMT is assessing a 12-year-old who has had four days of fever and diarrhea. The child answers questions but is slow to respond, the hands are cool and mottled, and capillary refill is 3 seconds. The vital signs are BP 106/72, P 142, R 26, and SpO₂ 97% on room air. What do these findings together represent?

Show the answer and rationale

Correct answer · Compensated shock, in which perfusion is already inadequate

This child is in compensated shock. The blood pressure is a normal 106/72. The hands are cool and mottled, capillary refill is 3 seconds, the pulse is 142, and the child is slow to respond. In compensated shock, the body releases adrenaline. Adrenaline speeds up the heart and tightens the blood vessels in the arms and legs. Blood gets pulled away from the skin to protect the organs in the core. The tightened vessels hold the blood pressure up even though the tissues are already not getting enough blood flow. The normal blood pressure is the body compensating, not a sign the child is fine. Give fluids and transport fast, before the body can no longer keep up and the pressure drops into decompensated shock.

Why the others are wrong

Fever alone, since a high temperature raises the heart rate: A high temperature does push the heart rate up on its own. Fever does not explain cool, mottled hands or a 3 second capillary refill. Those are blood flow findings, not temperature findings.

Decompensated shock, since the skin signs are already abnormal: Decompensated shock is when abnormal skin signs come with a falling blood pressure. This child's pressure is 106/72, which is still normal for a 12-year-old. The body is still compensating.

Normal findings for a child recovering from a viral illness: A child who is truly getting over a viral illness perks up, eats and drinks, and looks better as fluids catch up. This child is slow to respond with cool, mottled hands and a pulse of 142. Those are signs that blood flow is getting worse, and the shock still needs treatment now.

Question 8 of 10

An AEMT is ventilating a 9-month-old infant whose breathing has become too slow and shallow to be effective. A brachial pulse of 118 is present and the airway is clear. How much force should each squeeze of the bag deliver?

Show the answer and rationale

Correct answer · Only enough force to make the chest rise slightly

Too much pressure is the danger when you bag an infant. A child's lung tissue can tear under too much bagging pressure. A torn lung causes a pneumothorax, and that pneumothorax is an injury you caused during the resuscitation. Watch for slight chest rise, and stop squeezing once you see the chest rise. The same rule holds with a mask, a supraglottic airway, or a tracheostomy tube. The lung is the fragile part, not the airway you are bagging through.

Why the others are wrong

Enough to empty the bag completely with each breath: An adult bag holds far more air than an infant's chest needs. Emptying the bag into a 9-month-old is exactly how the pressure injury happens.

Enough to carry the oxygen saturation above 98 percent: The saturation changes slowly and lags behind what you are doing right now. A saturation number cannot tell you how big this breath should be. Chest rise shows you right away whether this breath is enough.

As much as the bag allows, since volume drives oxygen delivery: More volume in a small chest means more pressure, and pressure is what tears the lung. Bagging harder does not deliver more oxygen. Too much air does harm, just like too little air does.

Question 9 of 10

An AEMT is called for a 96-year-old patient who lost balance while standing at the sink and sat down hard on the tile floor. The patient reports right hip pain and cannot bear weight. A neighbor says the fall looked minor and asks whether transport is really needed. The vital signs are BP 146/82, P 88, R 18, and SpO₂ 96% on room air. Why does a fall this minor still warrant a full assessment?

Show the answer and rationale

Correct answer · Because bone strength falls with age, so a small force can fracture

Bones get weaker with age, so a small force can cause a fracture in this patient. This 96-year-old sat down hard on a tile floor, has right hip pain, and cannot bear weight. A fall from standing height can break a hip or cause bleeding in the head in an older adult. The same fall would barely bruise a younger patient. A fall onto the floor in this patient gets the same respect a fall down the stairs would get in a 30-year-old. Handle the patient gently, splint what hurts, and transport.

Why the others are wrong

Because age over 65 by itself meets trauma alert criteria: Your system sets its own trauma alert criteria, and age alone does not trigger them. The reason to take this fall seriously is how weak older bones are.

Because pain reporting is unreliable and the patient may be hiding a worse injury: Older adults do sometimes report less pain than they have. This patient is reporting the pain clearly and cannot bear weight. The concern here is the injury the patient is telling you about, not a hidden one.

Because a shortened and externally rotated leg is what confirms a hip fracture: A shortened and externally rotated leg shows up with some hip fractures and not with others. A leg that looks normal does not tell you the bone is intact. Waiting for that deformity is how a hip fracture gets missed.

Question 10 of 10

An AEMT is preparing a fluid bolus for a 10-month-old infant with poor perfusion after two days of diarrhea. A caregiver does not know the infant's weight and there is no recent weight on any paperwork in the home. The vital signs are BP 78/46, P 176, R 44, and SpO₂ 98% on room air. How should the AEMT determine the volume to give?

Show the answer and rationale

Correct answer · Estimate the weight with a length based tape and dose from that

Estimate the infant's weight with a length based tape. Fluid for a child is dosed by weight, never by a set bag volume. You need a weight before the fluid runs. A caregiver's report of a recent weight comes first, and this caregiver does not know the weight. Next is a length based resuscitation tape, measured from head to heel. These tapes are most accurate in children under about 18 kg. The color zone the heel lands in also gives you equipment sizes and volumes. With no tape and no caregiver report, a child age one to ten is estimated at twice the age in years plus eight kilograms. Once you have the weight, the standard bolus is 20 mL per kilogram. Reassess the infant after the bolus and repeat it if there is no response.

Why the others are wrong

Give 250 mL, the smallest volume the bag divides into evenly: Splitting the bag evenly doses by the packaging, not by the patient. Pediatric fluid is never dosed by a set volume. A volume of 250 mL has nothing to do with this infant's weight. That volume could be more than this infant should get.

Give half of an adult bolus, since the infant is under one year: Half an adult bolus is still an adult number. Cutting the adult number in half has nothing to do with this infant's weight, and the weight is what the dose is based on.

Give 500 mL and reassess, since infants tolerate volume well: Infants handle the right volume of fluid well. A bolus of 500 mL is far more than the right volume for an infant this size. Too much fluid in a small patient is its own emergency.

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