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10 free AEMT practice questions: Treatment Prioritization Under Uncertainty

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

A 46-year-old patient has had vomiting and diarrhea for three days and reports feeling weak and thirsty. The skin is pale, cool, and clammy, and capillary refill is three seconds. The patient is anxious and answers questions appropriately. The vital signs are BP 118/92, P 126, R 22, and SpO₂ 97% on room air. A set taken by a first responder twenty minutes earlier was BP 120/70 and P 98. What should the AEMT do next?

Show the answer and rationale

Correct answer · Establish vascular access and begin a measured fluid bolus

This patient is in compensated hypovolemic shock from three days of vomiting and diarrhea. Shock means the body is not getting enough blood flow. Blood pressure is the last number to drop in shock, because the body fights to hold it up. This patient is holding a systolic of 118 by tightening the blood vessels. That's why the diastolic climbed from 70 to 92 and the pulse pressure got narrow. The pulse went from 98 to 126. The skin is pale, cool, and clammy, and capillary refill is three seconds. All of those findings are the body compensating for low volume. Start vascular access and give a measured bolus of isotonic crystalloid. Reassess between each increment. If you wait for the pressure to fall, you are waiting for this patient to run out of compensation.

Why the others are wrong

Recheck the blood pressure in ten minutes: A normal blood pressure makes a patient look stable. Blood pressure is the number that stays normal the longest in shock. This patient's pulse pressure has already narrowed while nobody was treating.

Withhold fluid until the systolic pressure falls below 90: A systolic below 90 is the number for hypotension in an adult. A pressure that low marks decompensated shock, after the body can no longer compensate. Holding fluid until then means waiting for this patient to reach the late stage before you do anything.

Transport without vascular access and reassess on arrival: Transporting without vascular access is load and go thinking. This patient is not trapped and is not bleeding into a body cavity. Three days of fluid loss is treated with measured fluid through a line you place. Start that fluid en route, not at the hospital door.

Question 2 of 10

An AEMT has just finished giving a 500 mL increment of isotonic crystalloid to a 62-year-old patient with poor perfusion from two days of vomiting. The protocol allows further increments toward a weight-based total. What should the AEMT do next?

Show the answer and rationale

Correct answer · Reassess the patient before giving more fluid

This patient has poor perfusion from two days of vomiting and just received a 500 mL increment. Every fluid increment is an intervention, and every intervention gets a reassessment before the next step. Check mental status, airway, breathing, pulse quality, skin, lung sounds, blood pressure, and the IV line itself. Those findings tell you whether to give more fluid, slow down, or stop. The volume on the bag cannot tell you any of that.

Why the others are wrong

Give the next increment without stopping the flow: Running the increments back to back is the fastest way to reach the weight-based total. Fluid that starts backing up into the lungs shows up in the lung sounds. If you start the next increment without listening to the lungs, you miss the fluid backing up.

Record the volume given and continue transport: Writing down the volume is real work, and it does need to get done. The chart shows what you gave. Documentation does not tell you how this patient responded to the fluid.

Slow the line to a keep-vein-open rate: Slowing to a keep-vein-open rate is right once the patient has improved and the improvement is holding. You only learn that from a reassessment. Nothing has been rechecked yet, so there is no response to slow down for.

Question 3 of 10

A 58-year-old patient in hypovolemic shock from prolonged vomiting has received 1,000 mL of isotonic crystalloid, and the weight-based total has not been reached. The radial pulse is stronger and the patient is more alert. Lung sounds were clear at the start of the call and now have crackles at both bases. The vital signs are BP 104/70, P 108, R 24, and SpO₂ 93% on room air. What should the AEMT do next?

Show the answer and rationale

Correct answer · Stop the infusion and reassess the patient

This patient is going into fluid overload. The lungs were clear at the start of the call, and now there are crackles at both bases. Crackles come from fluid sitting in the alveoli. The IV fluid you have been giving is backing up into the lungs. The stronger radial pulse and better mental status are real improvements. They do not cancel out the new crackles. The weight-based total is a starting point, not an amount you owe the patient. Stop the infusion and reassess. The next set of findings decides whether any more fluid goes in.

Why the others are wrong

Finish the weight-based volume, then reassess: Finishing the weight-based volume is right for a patient who is tolerating the fluid. The weight-based number is how much a typical patient can take. This patient's crackles tell you the limit came early.

Raise the flow rate to shorten the infusion: Raising the flow rate would get the bolus in faster. Fluid overload gets worse the faster the fluid goes in. Speeding up the line makes the crackles worse.

Change to Lactated Ringer's and keep infusing: Lactated Ringer's and normal saline both add volume. Switching from one to the other still puts more fluid into lungs that are already wet.

Question 4 of 10

A 71-year-old patient with a history of chronic obstructive pulmonary disease is poorly perfused from a gastrointestinal bleed. The patient is anxious, with pale, cool skin. The vital signs are BP 92/64, P 118, R 26, and SpO₂ 84% on room air. A crew member suggests keeping oxygen off so the patient's drive to breathe is not suppressed. What should the AEMT do?

Show the answer and rationale

Correct answer · Apply oxygen and titrate the saturation to 88% to 92%

This patient is hypoxic, with a saturation of 84% on room air, and is poorly perfused from a gastrointestinal bleed. A hypoxic patient gets oxygen. Chronic obstructive pulmonary disease, or COPD, changes how much oxygen you give, not whether you give it. The crew member's idea, that oxygen shuts off the drive to breathe in a COPD patient, is not a real mechanism. Do not act on it. Titrate a COPD patient to their own baseline saturation. When you do not know the baseline, use 88% to 92%, and use the lowest device that gets the patient there. Hypoxia on top of poor perfusion starves cells that are already short on oxygen. Apply oxygen now and titrate to the target.

Why the others are wrong

Keep oxygen off and watch the respiratory effort: Keeping oxygen off is what the crew member suggested. The idea behind it is not a real mechanism. No lung history makes it right to withhold oxygen from a saturation of 84%. Watching the respiratory effort does nothing for the hypoxia, and the patient stays hypoxic while you watch.

Apply oxygen and target a saturation above 98%: A saturation target of roughly 94% to 99% is right for most patients. A COPD patient lives at a lower baseline. Pushing this patient's saturation near 100% overshoots what the patient needs.

Apply oxygen only if the patient becomes confused: Waiting for confusion means waiting until the hypoxia has already reached the brain. You titrate oxygen to a measured saturation, not to a change in mental status.

Question 5 of 10

A 52-year-old patient has poor perfusion from a pelvic injury after a fall from a roof. An intravenous line is running with room-temperature fluid, the clothing was cut away for the assessment, and the patient is shivering in a cool ambulance compartment. The vital signs are BP 94/68, P 116, and R 22. What should the AEMT do next?

Show the answer and rationale

Correct answer · Cover the patient and warm the compartment

This patient is in shock from a pelvic injury and is getting cold. The patient is shivering, the clothing is cut away, the compartment is cool, and room temperature fluid is running into the IV. Keeping a shock patient warm is treatment, not comfort care. Cold blood does not clot well. Hypothermia, acidosis, and coagulopathy, which is poor clotting, each make the other two worse. Those three together are called the lethal triad. A pelvic injury can bleed into the retroperitoneum, and this patient needs the blood to clot. Cover the patient, warm the compartment, and warm the fluid you are giving.

Why the others are wrong

Raise the fluid rate to warm the patient: More fluid can look like more care for a shock patient. Room temperature fluid is well below body temperature. Running the fluid faster cools the patient faster.

Keep the patient uncovered to watch the skin color: Skin color, temperature, and moisture are real things to reassess. You can lift a blanket to look at the skin. Leaving the patient uncovered so you can keep looking gives up a treatment for a glance.

Delay warming until the pressure improves: Delaying warming treats warmth as something to do after the pressure is fixed. Clotting is part of how the bleeding gets controlled. Warming the patient is part of fixing the pressure, not a step that comes after it.

Question 6 of 10

A 38-year-old patient has poor perfusion after several hours of heavy work in the heat, with heavy sweating and no fluid intake. The skin is pale, cool, and clammy, the lungs are clear, and the patient is anxious but answers questions. The vital signs are BP 96/74, P 124, and R 24. How should the AEMT position this patient?

Show the answer and rationale

Correct answer · Supine on the cot

This patient is in hypovolemic shock from heavy sweating with no fluid intake. The skin is pale, cool, and clammy, the blood pressure is 96/74, and the pulse is 124. A patient in shock goes supine unless something rules supine out. The exception is a patient in cardiogenic shock or pulmonary edema who cannot tolerate lying flat. That patient sits up to breathe. This patient's lungs are clear. Lay the patient supine on the cot. Then put your attention on vascular access and measured fluid, because those are what improve perfusion.

Why the others are wrong

On the side in the recovery position: The recovery position is for an unresponsive patient with no trauma. Lying on the side lets secretions and vomit drain instead of being aspirated. This patient is anxious but answers questions. A patient in shock goes supine on the cot, not on the side.

Head lower than the feet: the old Trendelenburg position. Routine head down positioning has fallen out of favor for shock. This patient goes flat on the cot, with no tilt.

Sitting fully upright: right for a patient who cannot lie flat because fluid is backing up into the lungs. This patient's lungs are clear. There is nothing for sitting up to relieve.

Question 7 of 10

Why does the AEMT follow the Airway-Breathing-Circulation priority sequence as the default approach to patient assessment and treatment?

Show the answer and rationale

Correct answer · Because problems in an earlier letter typically cause death faster than problems in a later letter, on average

The ABC order is based on how fast each kind of problem kills. A blocked airway or breathing that is not adequate usually kills faster than poor circulation. That's why you take care of the airway first, then breathing, then circulation, as your default.

Why the others are wrong

Because airway problems occur more frequently than breathing or circulation problems in the field: The order is not built on how often each problem happens. Circulation problems, like uncontrolled bleeding, are common and serious too. How common a problem is and how fast a problem kills are different things.

Because protocols require completing each letter fully before moving to the next, regardless of findings: ABC is a priority order that tells you what to handle first. ABC is not a checklist where each letter has to be fully finished before you move on. What you find on the patient still changes what you do.

Because assessment naturally proceeds from the head downward, and the airway is encountered before the chest: A head to toe exam is a separate kind of assessment. Reaching the airway first on that exam is not why the airway comes first. The airway comes first because airway problems usually kill fastest.

Question 8 of 10

A trauma patient has a traumatic amputation of the lower leg with visibly spurting arterial bleeding, and is also making gurgling sounds suggestive of a partially obstructed airway. Using the current trauma priority framework (massive hemorrhage control first, then airway, respiration, circulation, and hypothermia or head-injury prevention), which intervention should the AEMT perform first?

Show the answer and rationale

Correct answer · Apply a tourniquet to control the massive arterial hemorrhage

This patient has massive hemorrhage from the traumatic amputation. The leg is spurting arterial blood. A major arterial bleed can kill in under three minutes, faster than the gurgling airway is likely to. The MARCH order is massive hemorrhage, airway, respiration, circulation, and hypothermia or head injury prevention. Massive bleeding comes before the airway in that order. Put a tourniquet on above the amputation site right away. As soon as the bleeding stops, go to the airway with a jaw thrust and suction.

Why the others are wrong

Perform a jaw-thrust and suction the airway before addressing the bleeding: A jaw thrust and suction is the right treatment for the gurgling airway. In the airway, breathing, circulation order, the airway would come first. The spurting arterial bleed changes that order. Under MARCH, massive bleeding comes before the airway, so A is the right treatment done in the wrong order.

Obtain IV access and begin fluid resuscitation before managing either problem: IV access and fluids are for circulation, the C in MARCH. Fluids only replace blood that has already been lost. Fluids do not stop the spurting bleed, and an IV line does nothing for the gurgling airway.

Complete a full secondary assessment before intervening on either problem: A full secondary assessment gathers information. This patient has a spurting bleed and a gurgling airway right in front of you. Both need treatment in the first moments of the call. Stopping for a secondary assessment leaves both of them untreated.

Question 9 of 10

An AEMT is on scene with a 29-year-old patient who has a stab wound to the left chest. The patient is anxious and pale, with a weak radial pulse. An occlusive dressing has been applied and the chest is rising equally. The vital signs are BP 84/58, P 128, and R 28, with an SpO₂ of 92% on room air. The trauma center is 9 minutes away. Which action is most appropriate?

Show the answer and rationale

Correct answer · Begin transport and attempt intravenous access en route

This patient is in hemorrhagic shock from a stab wound to the chest. The blood pressure is 84/58, the pulse is 128, and the radial pulse is weak. The pressure has already dropped, so this patient is decompensating. The only thing that stops this bleeding is a surgeon, and the trauma center is 9 minutes away. An IV is worth having. Plain IV fluid does not carry oxygen and does not close a bleeding blood vessel. The only skills worth staying on scene for are the ones you cannot do in a moving ambulance. Starting an IV is not one of them. Start transport now and work on the IV on the way. You get the line and the transport at the same time.

Why the others are wrong

Establish intraosseous access before moving the patient: Intraosseous (IO) access is the right call when a patient needs fluid or a drug right away and a peripheral line is not possible. A cardiac arrest is one example. Nothing given through an IO here changes the outcome. This patient is losing blood through a hole a surgeon has to close. You can place an IO or an IV in a moving ambulance if you need one.

Establish two large-bore intravenous lines before moving: Two large-bore IVs are the classic setup for a trauma patient who is going to get a lot of fluid. Starting both before you move doubles the time on scene. This patient's problem is blood loss, not a lack of saline. Large amounts of fluid in uncontrolled bleeding thin out the clotting factors and can break up a clot that is already forming.

Wait on scene for a paramedic unit to establish access: Waiting for a paramedic makes sense on a long rural transport, when the patient needs a skill only a paramedic can do. This trauma center is 9 minutes away. No paramedic skill can do what the operating room does.

Question 10 of 10

An AEMT is caring for a 63-year-old patient with a history of diabetes who is diaphoretic and responds only to painful stimuli. The blood glucose level is 34 mg/dL. Two attempts at peripheral intravenous access have been unsuccessful, and local protocol reserves intraosseous access for patients in cardiac arrest or profound shock. The vital signs are BP 138/84, P 104, and R 16, with an SpO₂ of 97% on room air. Which action is most appropriate?

Show the answer and rationale

Correct answer · Administer glucagon by the intramuscular route

This patient is hypoglycemic, with a blood glucose of 34 mg/dL. The patient responds only to painful stimuli. A patient that altered cannot protect their own airway, so nothing can go in by mouth. Two IV attempts have failed, so dextrose through a vein is not an option right now. Glucagon is the drug for this situation. Unlike dextrose, glucagon does not give the patient sugar directly. Glucagon signals the liver to break down its stored sugar, called glycogen, and release the glucose into the blood. That's why glucagon works when it is given into a muscle, and why glucagon works more slowly than dextrose. The name helps you remember the drug. Gluc means sugar and agon means to drive, so glucagon drives the stored sugar out. Low blood sugar is injuring the brain the whole time the level stays low. Treat now with the route you are allowed to use, instead of waiting for the route you would prefer.

Why the others are wrong

Place oral glucose between the cheek and gum: Oral glucose is for a patient who is awake enough to swallow and protect their own airway. This patient responds only to painful stimuli. Oral glucose here could be aspirated into the lungs, which adds a second emergency to the first.

Continue intravenous attempts and treat once access is obtained: More IV attempts are reasonable in a stable patient. In this patient, the brain is being injured every minute the glucose stays at 34 mg/dL. You already have a route you are allowed to use right now that does not need a vein.

Establish intraosseous access and administer dextrose: Intraosseous access is in the AEMT scope, but being in scope is not the same as being authorized. This system only allows IO access in cardiac arrest or profound shock. This patient is in neither, so an IO here breaks protocol with no clinical need for it. Intramuscular glucagon reaches the same goal and stays inside the rules.

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