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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 decisive finding is the neighbor's report that the patient is more confused than usual, a change layered on chronic dementia. Dementia itself progresses over months, so a new deficit sitting on top of it signals an acute confusional state, delirium, driven by infection, hypoxia, medication effect, or metabolic derangement rather than the dementia itself. Confirming the baseline from someone who sees the patient daily is what decides whether you treat this as a reversible medical emergency needing workup or document unchanged dementia.

Why the others are wrong

Record the confusion as expected in a patient of this age with dementia: Dementia produces chronic baseline confusion in a 90-year-old, but the neighbor's report that the patient is more confused than usual names a change, not that baseline, so calling it expected hides a reversible infection, hypoxia, or metabolic cause.

Repeat the mental status questions in ten minutes and compare the answers: Repeating the mental status questions ten minutes apart only compares two snapshots taken minutes apart to each other; it never tells you whether today's wrong month answer differs from how this patient answers on an ordinary day.

Ask the patient to name the year and the current president: Naming the year and the president is the standard way to test orientation, and it feels thorough once confusion is the complaint. The patient already failed the month question, so another orientation item only rescores a deficit already confirmed; it still can't tell you whether that deficit is new tonight or the patient's ordinary baseline.

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

An awake infant runs roughly 100 to 180, so 162 sits inside the band rather than above it. Adult ranges dropped onto a child do damage in both directions: they call a normal toddler tachycardic, and they accept a heart rate of 70 in a six-month-old as adequate when that is profound bradycardia. Check the number against the age band before you decide what it means. Everything else here agrees with a well compensated infant, since the child is alert, feeding, pink, and refilling briskly.

Why the others are wrong

It is dangerously high and calls for a fluid bolus: A bolus treats poor perfusion, and this infant has none of it. Pink skin, brisk refill, alertness, and feeding are the findings that tell you the circulation is working.

It is high enough that the fever must be treated before transport: Fever raises the heart rate, but the rate here has not left the normal band, so there is nothing about it to treat. Comfort measures are fine, chasing a number is not.

It cannot be judged until a brachial pulse is felt in both arms: A brachial pulse is the right place to feel an infant, and it is worth confirming quality. That confirms the reading rather than changing what a rate of 162 means at 4 months.

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

Pain perception dulls with age, so the classic crushing chest pressure is often simply missing, and what arrives instead is weakness, shortness of breath, nausea, or a vague feeling of being off. The absence of the textbook finding is not reassurance, it is the disease wearing a different mask. Pale, damp skin with new dyspnea in a patient this age is a perfusion problem until something proves otherwise, and the heart is the organ that kills fastest. Work it as a possible cardiac event, get the monitor and a 12-lead on early, and let the hospital rule it out.

Why the others are wrong

A viral illness, since weakness and vomiting together point to infection: Nothing here points to infection. There is no fever, no cough, and no source, and the pale damp skin fits poor perfusion better than it fits a virus.

A stroke, since new weakness in an older adult points there first: Generalized weakness is not the same as one sided weakness. The exam here shows no focal deficit, and a stroke screen with nothing on it does not explain damp skin and new dyspnea.

Dehydration from the vomiting, which explains the pale and damp skin: One episode of vomiting does not empty a patient out. Dehydration also does not explain why the skin is pale and damp rather than simply dry.

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

The infant has been vomiting for a day and hasn't eaten since morning, then turns limp and hard to rouse: that combination of poor intake and altered mental status is the tell. An 11-month-old carries only a small glycogen reserve, so a day of vomiting with nothing eaten burns through it fast and drops serum glucose even with zero family history of diabetes. A glucose below 60 in a symptomatic infant is the field threshold for treating with dextrose, and the meter gives you that answer before you build a differential around anything else.

Why the others are wrong

Check a temperature, since a fever would explain the lethargy: A fever genuinely can make an infant lethargic, and checking temperature belongs in a full sepsis or infection workup. This infant is described as limp and difficult to rouse, a mental status finding no thermometer explains or treats. Getting a temperature here treats the wrong problem before you've ruled out a reversible cause of unresponsiveness.

Check the pupils, since lethargy in an infant points to a head injury: Pupil checks fit a head injury workup with unequal or fixed pupils pointing to rising intracranial pressure, but nothing here, a day of vomiting and skipped feeds, gives a mechanism of injury, so a trauma exam here answers a question this call never asked.

Recheck the saturation on a different site before anything else: Rechecking the pulse ox site makes sense when a reading looks unreliable from cold skin or poor perfusion, but this SpO2 already reads a normal 97% on room air, so confirming a number that already fits does nothing to find the cause of the limpness.

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

A patient who cannot hear your question is not an altered patient. Recording altered because the two of you could not communicate is a documentation error rather than an assessment finding, and it follows the patient through the hospital and colors every decision made downstream. Put the hearing aid back in, face the patient where the light is on your mouth, and write the question down if that works better. Do that before you record any mental status finding, because the finding is only worth anything if the patient could actually receive the question.

Why the others are wrong

Document the patient as altered and begin transport: That records a conclusion you have not earned. The patient is making eye contact and responding socially, which is not what a truly altered patient looks like.

Perform a stroke screen, since not answering suggests aphasia: A stroke screen is quick and harmless, and it is not what the scene is telling you. The open battery door beside the bed is a simpler explanation, and you can test it in seconds.

Ask a neighbor to give the history in the patient's place: A neighbor can fill gaps, and the patient in front of you may be perfectly able to answer once the hearing aid is in. Going around a patient who can speak for themselves loses the best source you have.

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

The respiratory rate of 16 is the finding that decides this: a 7-month-old's normal rate runs roughly 30 to 60, so 16 is profound bradypnea, not a reassuring number. Physiologically, a rate this low with shallow chest rise means minute ventilation has collapsed, carbon dioxide is climbing, and oxygen saturation has not caught up yet because it is the last vital sign to fail. Combined with an infant who will not cry when moved, this is respiratory failure in progress. Begin bag-mask ventilation with oxygen immediately rather than waiting for the SpO2 to confirm what the rate already tells you.

Why the others are wrong

Apply an NRB and watch the saturation: A non-rebreather fits because the SpO2 of 94% looks like the number to fix, and an NRB fits a child breathing adequately but oxygenating poorly. The rate of 16 and shallow chest rise say this infant is barely moving air, so a mask only layers oxygen onto breaths that aren't happening. Fix ventilation before oxygen concentration.

Hold treatment for now, since the saturation is acceptable: A 94% SpO2 can look acceptable enough to hold treatment, but the rate of 16, shallow chest rise, and an infant who won't cry when moved show ventilation failure the saturation hasn't caught up to yet.

Give blow by oxygen and recheck the rate in five minutes: Blow-by oxygen with a recheck fits a mildly tachypneic child still moving adequate air, but a rate of 16 with shallow chest rise here is inadequate ventilation needing 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

The deciding finding here is the normal blood pressure of 106/72 sitting next to cool mottled hands, a 3 second capillary refill, a pulse of 142, and slowed responses. In compensated shock, catecholamine release drives tachycardia and peripheral vasoconstriction, shunting blood from the skin to protect core organs, so the systolic pressure holds even though tissue perfusion has already failed. That normal number is not reassurance, it is the compensation working. For the AEMT this means treating now, fluids and rapid transport, before the mechanism exhausts and the pressure drops into decompensated shock.

Why the others are wrong

Fever alone, since a high temperature raises the heart rate: Fever alone is a real reach here, because a high temperature genuinely does push the heart rate up on its own. Fever does not explain the cool, mottled hands or the 3 second capillary refill in this child, those are perfusion findings, not thermal ones. This answer addresses the tachycardia while ignoring the skin findings that actually define the problem.

Decompensated shock, since the skin signs are already abnormal: Decompensated shock is the real diagnosis once abnormal skin signs are joined by a falling blood pressure, and the cool mottled skin here reaches for that stage. This child's pressure is 106/72, still normal for a 12-year-old, so compensation has not failed. Calling this decompensated skips a stage that has not happened yet.

Normal findings for a child recovering from a viral illness: A child truly recovering from four days of viral illness perks up, feeds, and looks progressively better as fluids catch up. This child is slow to respond with cool mottled hands and a rate of 142, signs of worsening perfusion, not improvement. Reading this as normal recovery misses a shock state that 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

Pressure, not volume, is the pediatric ventilation hazard. A child's lung tissue tears under excessive bagging pressure, and a pneumothorax created during a resuscitation is an injury you brought with you. The endpoint you titrate to is visible slight chest rise, and that holds whether you are bagging a mask, a supraglottic device, or a tracheostomy tube, because the fragile part is the lung rather than the airway you are ventilating through. Watch the chest instead of the bag, and let the rise tell you when to stop squeezing.

Why the others are wrong

Enough to empty the bag completely with each breath: An adult bag holds far more volume than an infant chest needs. Emptying it into a 9-month-old is the specific way providers cause the pressure injury this rule exists to prevent.

Enough to carry the oxygen saturation above 98 percent: Saturation lags behind what you are doing right now, so it cannot steer the size of the breath in your hand. Chest rise gives you feedback on this breath.

As much as the bag allows, since volume drives oxygen delivery: More volume in a small chest means more pressure, and pressure is the thing doing the damage. Oxygen delivery fails from too much just as readily as from too little.

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

Match the injury to the patient rather than to the height of the fall. Brittle bones mean you expect fractures from mechanisms that would barely bruise a younger patient, and a fall from standing height can break a hip or cause a head bleed in an older adult. That is why a fall onto a floor gets the same respect a fall down stairs would get in a 30-year-old. Handle gently, splint what hurts, and transport, because the number that predicts injury in this patient is the age rather than the distance.

Why the others are wrong

Because age over 65 by itself meets trauma alert criteria: Trauma alert criteria are set by your system and they are not triggered by age alone. The reason to take this seriously is the physiology of the bone, not a checkbox.

Because pain reporting is unreliable and the patient may be hiding a worse injury: Older adults do sometimes downplay pain, and this patient is reporting it clearly and cannot bear weight. The concern here is the injury itself, not a hidden one.

Because a shortened and externally rotated leg is what confirms a hip fracture: Shortening and rotation show up with some hip fractures and not with others, so their absence tells you nothing about whether the bone is broken. Waiting for the classic deformity is how a 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

In a child, fluid is dosed by weight and never by a fixed bag volume, which means the weight is a number you have to produce before the fluid runs. Every pediatric volume depends on a weight that is rarely known, so the order you reach for it goes: a caregiver's report of a recent weight first, then a length based resuscitation tape run head to heel, which is accurate up to roughly 18 kg and also hands you sizes and volumes off the same color zone. With no tape and no caregiver, ages one to ten estimate to twice the age in years plus eight kilograms. Once you have the weight, the standard bolus is 20 mL per kilogram, reassessed and repeated as indicated.

Why the others are wrong

Give 250 mL, the smallest volume the bag divides into evenly: Dividing the bag is dosing by packaging. A fixed volume is exactly what pediatric fluid is not dosed by, and 250 mL could be double what 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 cut in half. It has no relationship to this infant's actual mass, which is what the dose depends on.

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

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