10 free AEMT practice questions: Resuscitation and IV/IO Access

Remove the needle and place a new one in the other leg: Starting over is the instinct when something does not work, and a misplaced needle is a real possibility. A needle standing upright without support is the sign that it is seated in bone. Pulling a good line and spending another minute on the other leg gives up the access you already have.

Raise the fluid bag higher to increase the gravity head: Height does drive flow in a gravity line, so this is the right reflex for an intravenous drip. An intraosseous line does not flow by gravity at useful rates no matter how high the bag goes, which is why a pressure bag or syringe pushes are standard. Raising the bag tests nothing about the real problem.

Rotate the needle a quarter turn to open the marrow space: Repositioning hardware sounds like a reasonable next move, and turning things often frees them. Rotating a seated needle risks widening the tract around it, which is how fluid ends up leaking into the surrounding tissue. The marrow opens with pressure from a flush, not with movement of the needle.

Distal veins are larger, so they accept a bigger catheter: Catheter size does follow vein size, and matching the two is real practice. The relationship runs the other way, since proximal veins are the larger ones, which is why a patient needing volume fast gets a proximal site. Distal veins are chosen for sequence, not for size.

Distal sites are less painful, so the patient tolerates the stick better: Hand sticks feel different from antecubital sticks, so a comfort explanation sounds plausible. Distal sticks are often the more uncomfortable ones, because the skin there is thinner and better supplied with nerves. Comfort is not what sets the order.

Distal sites reach the central circulation faster than proximal ones: Every peripheral vein does drain to the same place, so speed of delivery is a reasonable thing to wonder about. Circulation time from the hand is slightly longer, not shorter, and the difference does not drive site selection at this level. Flow rate and preserving future sites are what matter.

Hold further fluid, since two boluses is the pediatric maximum: Two boluses is where many people remember the sequence ending, and stopping feels cautious in a small patient. The third bolus is part of the taught sequence rather than an overreach, and what limits it is uncontrolled hemorrhage rather than a count. This child is still poorly perfused with clear lungs, which is the situation the third bolus exists for.

Give 800 mL this time, since the smaller boluses have not held: Escalating when smaller doses have not held is a reasonable pattern in other settings, and this child clearly needs more volume. Doubling the increment gives up the reassessment that sits between boluses, which is the part that catches overload before it becomes a problem. The increment stays the same; what changes is whether you give another one.

Hold fluid and give oxygen alone, since the losses are not from bleeding: Oxygen belongs in the care of any child this sick, and it costs nothing. Oxygen does not replace circulating volume, and a child with a four second capillary refill after two boluses is still short of fluid. The absence of bleeding is a reason to keep giving crystalloid rather than a reason to stop.

A heart rate of 116/min with cool, clammy skin: Tachycardia with cool, clammy skin is a genuine shock finding and it appears in almost every category, which is what makes it feel important. That is exactly why it does not sort anything here. A clamped-down, fast circulation is just as consistent with an empty tank, and an empty tank is the patient who needs the fluid.

A systolic pressure of 82 mmHg in a patient this age: A systolic of 82 mmHg is the number that makes this patient look like the patient needs volume, so reading it as an argument against fluid feels backwards. Hypotension tells you perfusion has failed; it does not tell you why. In a failing pump the low pressure comes from output the heart cannot generate, and volume does not fix that.

A saturation of 90 percent with a respiratory rate of 26: A saturation of 90 percent with fast breathing is a real problem and it does deserve treatment. It is a consequence of the fluid already sitting in the patient's lungs rather than an independent reason to withhold more. The finding that tells you where that fluid came from is the one to reason from.

Give a repeat dose until the patient is awake and answering questions: Full wakefulness feels like the obvious sign the drug worked, and a patient who answers questions is easier to assess. Waking the patient completely precipitates withdrawal and agitation while adding nothing to the ventilation you already restored. The rate of 14 with improved color is the result you were after.

Give the rest of the dose so the effect lasts longer than the opioid: Worrying about naloxone wearing off before the opioid does is exactly the right worry, and it is a real risk. More drug now does not extend the duration; it deepens the reversal and brings on withdrawal sooner. The answer to that risk is continued monitoring with repeat dosing per protocol if the breathing slows again.

Stop dosing and support a refusal if the patient stays this stable on scene: The patient looks stable and patients in this situation often want to stay, so the conversation feels reasonable. Naloxone frequently wears off before the opioid does, which means the patient who looks fine on scene can stop breathing after you leave. That is what makes a refusal here high-risk rather than routine.

In the right proximal tibia again, since the old tract has already closed over: Tempting because a day feels like a long time and the puncture is small enough that you expect it to seal. Wrong because manufacturer guidance commonly holds that bone off limits for roughly twenty four to forty eight hours, and yesterday afternoon sits well inside that window.

In the right distal tibia, below the previous site in the same bone: Tempting because the distal tibia is a real alternative site and you have put visible distance between the two punctures. Wrong because the contraindication names the bone, and the distal tibia is the same bone, so the old tract is still open upstream of your new needle.

Back to peripheral attempts, since a previous line rules out both legs: Tempting because it takes the conservative path and avoids using a bone you were warned about. Wrong because only one bone is compromised, the other leg is available, and a child in septic shock needs volume rather than more attempts at veins that have already failed.

Remove the needle and place a second one in the opposite tibia: Tempting because no flow and no marrow together look like a failed placement, and starting over feels decisive. Wrong because you have not yet done the step that makes flow possible, so you would be pulling a needle that may be sitting exactly where it belongs.

Confirm placement by aspirating again with a larger syringe: Tempting because aspirating marrow is a genuine confirmation and a bigger syringe seems like it would pull harder. Wrong because the absence of marrow does not prove failure, and more suction pulls marrow contents against the catheter rather than opening the space.

Raise the pressure bag higher and wait sixty seconds for flow to start: Tempting because intraosseous lines really do need pressure, and you have correctly recognized that gravity alone will not move this fluid. Wrong because pressure against an unflushed marrow space still meets a closed network, so the wait buys nothing and costs a minute in an arrest.

Remove the catheter and place a new line in the other arm: Tempting because a new line in a fresh site is the answer to several intravenous problems and it feels like decisive action. Wrong because the catheter is working exactly as intended, and replacing it gives you a new way to deliver the fluid that is already harming the patient.

Clamp the tubing and place the patient left side down with the head lowered: Tempting because that position is a real and correct maneuver, and sudden dyspnea with chest discomfort on a running line does raise air embolism. Wrong because an air embolism follows a loose connection or an unprimed line rather than a steady infusion, and putting a patient in pulmonary edema head down floods the upper lungs.

Continue the fluid at a slower rate and reassess the patient's lungs in ten minutes: Tempting because slowing rather than stopping feels cautious, and it keeps a route open for a patient who came in dehydrated. Wrong on three counts that have nothing to do with the rate: it leaves the patient flat instead of upright, it gives no oxygen to a patient who is short of breath, and it spends ten more minutes before the next look at someone who is getting worse now.

Continue at the current rate and titrate oxygen to a saturation of 94 to 99 percent instead: Tempting because the oxygen target is real and titrating it is genuinely part of post arrest care. Wrong because it leaves the rate at double what it should be, and the ventilation rate is the problem the capnography number is pointing at.

Slow to one breath every 10 seconds until the end tidal carbon dioxide hits 45 mmHg: Tempting because it correctly recognizes that the rate is too fast and moves in the right direction. Wrong because one breath every 10 seconds is 6 a minute, which undershoots the target, and chasing a value of 45 aims above the 35 to 40 mmHg band.

Increase the tidal volume so that each breath moves more air at the same rate: Tempting because moving more air per breath sounds like a way to ventilate better rather than faster. Wrong because larger volumes at an already excessive rate raise pressure in the chest even further, and each breath should go in only until chest rise begins.

Pause compressions for each task so it can be completed cleanly: How cleanly a task goes is not the outcome being optimized. Vascular access and rhythm checks are performed around continuing compressions precisely because the compressions are what is keeping the brain perfused.

Delay vascular access until return of spontaneous circulation: Vascular access is one of the things the AEMT level adds to a resuscitation, and delaying it until circulation returns removes the route for protocol-authorized medication and fluids. The fix is to obtain it without stopping compressions, not to skip it.

Lengthen the rhythm check so the tracing can be studied carefully: A longer look at the tracing does not change the decision, which is only whether the rhythm is shockable. Extending the check trades certainty the crew already has for perfusion the patient cannot spare.