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Free NREMT practice questionsFree EMT practice questions · Primary Assessment

10 free EMT practice questions: Airway Assessment

These are real questions from the same bank the app draws from. Each one is written to the NREMT EMT content specifications and kept inside the EMT 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 24-year-old patient is trapped in a mangled vehicle after a high-speed crash. A jagged piece of metal has partially amputated the lower leg, and bright red blood is spurting from the wound in pulses. The patient is moaning with snoring respirations. A bystander is pressing a towel against the wound without effect. What should the EMT do first?

Show the answer and rationale

Correct answer · Apply a tourniquet proximal to the wound

This patient has life-threatening arterial bleeding, and the bleeding gets treated first. The leg is partially amputated, and bright red blood is spurting from the wound in pulses. Bright red blood that spurts in pulses is arterial bleeding. The towel is not stopping the bleeding. A patient bleeding like this can lose their whole circulating blood volume in minutes. You usually go airway, breathing, then circulation. Trauma with life-threatening external bleeding changes that order. Major bleeding comes first, then airway, breathing, and circulation. The airway is a real problem too. Snoring in a moaning patient is a partial obstruction from the tongue. The patient is still moving enough air to make noise, so the airway will not kill as fast as the bleeding. A tourniquet proximal to the wound stops the bleeding in seconds. Then go straight to the airway.

Why the others are wrong

Perform a jaw-thrust to open the airway: A jaw-thrust is right for this patient, and it is your very next step. In trauma, the jaw-thrust is the airway maneuver of choice. A jaw-thrust lifts the tongue off the back of the throat without moving the cervical spine. Snoring respirations are what call for a jaw-thrust. The only problem is the order. If you open the airway first, the patient keeps losing arterial blood onto the pavement. Both are needed, and the bleeding goes first because the bleeding kills faster.

Insert an oropharyngeal airway: An oropharyngeal airway holds the tongue forward in a patient with no gag reflex. This patient is moaning. A moaning patient is responsive enough to likely still have a gag reflex. An OPA in this patient can cause vomiting and aspiration before you have even tried a jaw-thrust. Within the airway step, the OPA comes after the jaw-thrust. The airway step itself comes after the bleeding.

Apply high-concentration oxygen by NRB: High-concentration oxygen belongs on this call once the immediate threats are controlled. Oxygen is carried by hemoglobin, and the hemoglobin is spurting onto the ground right now. More oxygen in the blood that is left does nothing about the blood being lost. A mask also does not open an obstructed airway. Oxygen is support you add afterward, and oxygen will not change what happens in the next sixty seconds.

Question 2 of 10

A 50-year-old patient was struck by a car and thrown several feet. There is no external bleeding, but the abdomen appears distended and the skin is pale, cool, and diaphoretic. The patient responds only to painful stimuli, and the EMT hears snoring with each breath. What should the EMT do first?

Show the answer and rationale

Correct answer · Perform a jaw-thrust to open the airway

This patient has an airway blocked by the tongue. The patient responds only to painful stimuli, and you hear snoring with each breath. A patient this unresponsive has lost the muscle tone that holds the tongue off the back of the throat. Snoring is the sound of the tongue partly blocking the airway. Massive external bleeding would come first, but this patient has no external bleeding. That puts the airway first. Oxygen, ventilations, and care for the internal bleeding do no good until air can reach the lungs. This patient was struck by a car and thrown, so you have to open the airway without moving the neck. The jaw thrust lifts the jaw, and the tongue with it, while the head stays neutral.

Why the others are wrong

Position the patient supine with the legs elevated to treat shock: Raising the legs is aimed at shock, and this patient is in shock. The distended abdomen and the pale, cool, diaphoretic skin tell you there is bleeding inside. Raising the legs does not replace lost blood, and it helps very little at best. The airway still comes first. A blocked airway starves the brain in minutes, and this bleeding needs an operating room that no position can replace.

Apply a pelvic binder to control suspected internal bleeding: A pelvic binder is for a suspected unstable pelvic fracture. You suspect one when the pelvis is unstable or has crepitus on gentle palpation. You also suspect one when the mechanism fits and the shock has no other explanation. Closing the pelvic ring presses on the bleeding and slows it. This question describes a distended abdomen, not an unstable pelvis. Even if the pelvis were bleeding, circulation comes after you open the airway.

Obtain a full set of vital signs before intervening: Vital signs are part of your assessment, but they come after the primary assessment. In the primary assessment, you fix each problem as you find it. Snoring in a patient who responds only to pain means you open the airway right then. Vital signs taken while the tongue blocks the airway change nothing and cost this patient time.

Question 3 of 10

The EMT is caring for an adult patient. Following the NREMT primary assessment sequence, the EMT has completed the scene size-up and formed a general impression. Which action does the EMT perform next?

Show the answer and rationale

Correct answer · Assess level of consciousness using AVPU

The next step is checking the level of consciousness with AVPU. AVPU stands for Alert, Verbal, Painful, and Unresponsive. In the primary assessment, level of consciousness comes right after the general impression. The level of consciousness tells you how well the patient can protect their own airway. Depending on the AVPU level, you may need to open the airway by hand or place an adjunct. Sometimes the airway is fine, and you can move on to breathing. That's why you check AVPU before you go to the airway.

Why the others are wrong

Obtain a full set of baseline vital signs: A full set of baseline vital signs comes later, in the secondary assessment or reassessment. You do not take full vitals until the airway, breathing, and circulation are handled.

Open the airway with a head-tilt/chin-lift: A head-tilt/chin-lift is the right move for a patient who is not fully alert, once you know the level of consciousness. AVPU has not been checked yet here. The AVPU level is what tells you whether this patient needs you to open the airway.

Palpate a radial pulse to assess circulation: Palpating a radial pulse checks circulation, and circulation comes after airway and breathing. Airway and breathing come after the AVPU check. Feeling for a pulse now skips two steps.

Question 4 of 10

A caregiver at a residence is giving abdominal thrusts to a 7-month-old infant who suddenly stopped making sounds while eating. When the EMT arrives, the infant is awake with a silent cough and no audible cry. What is the most appropriate action for the EMT to take?

Show the answer and rationale

Correct answer · Alternate 5 back blows with 5 chest thrusts

This infant has a severe foreign body airway obstruction. The infant is awake, the cough is silent, and there is no cry. An awake infant with a severe obstruction gets 5 back blows alternated with 5 chest thrusts. Deliver the back blows with the heel of one hand. Keep repeating the cycles until the object comes out or the infant becomes unresponsive. Abdominal thrusts are never used on an infant because they can injure the liver and other organs in the belly. That's why you take over from the caregiver and switch to back blows and chest thrusts. Chest compressions and CPR start only if the infant becomes unresponsive.

Why the others are wrong

Resume the abdominal thrusts the caregiver started: Picking up the abdominal thrusts the caregiver started continues a technique that is never used on infants. At this age, abdominal thrusts can injure the liver and other belly organs.

Begin chest compressions on a firm surface: Chest compressions on a firm surface are for an infant who has become unresponsive. This infant is still awake. An awake infant gets back blows and chest thrusts first.

Begin positive pressure ventilations with a BVM: BVM ventilations push air into the lungs, and that air cannot get past an airway that is still blocked. This infant is awake and needs back blows and chest thrusts to clear the object.

Question 5 of 10

An EMT is opening the airway of an unresponsive patient who has no suspected spinal trauma using the head tilt-chin lift maneuver. Where should the EMT place the fingertips of the hand that lifts the jaw?

Show the answer and rationale

Correct answer · Under the bony part of the chin

In a head tilt-chin lift, your fingertips go under the bony part of the chin. Lifting on bone moves the lower jaw forward without pressing into the floor of the mouth. Lifting the jaw while tilting the head back pulls the tongue and the epiglottis off the back of the throat, and air can get through. This patient has no suspected spinal trauma, so tilting the head is safe.

Why the others are wrong

On the soft tissue under the chin: Pressing on the soft tissue under the chin happens when you try to lift too fast. The pressure pushes the tongue and the floor of the mouth up into the airway. The airway gets more blocked instead of opening.

Behind the angles of the lower jaw: Fingers behind the angles of the lower jaw are used for the jaw-thrust. The jaw-thrust is for suspected spinal trauma, because it opens the airway without moving the neck. This patient has no suspected spinal trauma, so you use the head tilt-chin lift.

On the patient's forehead: The forehead is where your other hand goes. The heel of that hand on the forehead tilts the head back, and the fingertips of the lifting hand stay under the chin.

Question 6 of 10

An EMT is opening the airway of an unresponsive patient found after a fall down a flight of stairs. Which technique should the EMT use to open the airway?

Show the answer and rationale

Correct answer · Jaw-thrust maneuver

This patient may have a spinal injury. A fall down a flight of stairs can injure the cervical spine. The patient is unresponsive, so you cannot ask about neck pain to rule a neck injury out. The jaw-thrust lifts the jaw forward. Lifting the jaw pulls the tongue off the back of the throat and opens the airway. The neck does not bend forward or back while you lift the jaw. Open the airway with a jaw-thrust while you or a partner hold manual in-line stabilization of the head and neck.

Why the others are wrong

Head tilt-chin lift maneuver: Head tilt-chin lift is the right maneuver for a medical patient with no suspected trauma. Tilting the head back extends the cervical spine. A fall down the stairs is a trauma mechanism, and extending the neck could make a spinal injury worse.

Recovery position with no airway maneuver: The recovery position protects a breathing patient's airway from vomit or secretions after the airway is already open. This unresponsive patient needs the airway opened first. Rolling the patient onto the side does nothing to move the tongue off the back of the throat.

Blind finger sweep of the mouth: A finger sweep is only for a foreign object you can see and hook out. Done blind, a finger sweep can push the object deeper into the airway.

Question 7 of 10

A patient fell off a roof. During the primary assessment, EMS finds that the patient is not breathing. What is the proper way to open this patient's airway?

Show the answer and rationale

Correct answer · Jaw-thrust maneuver

The jaw-thrust is the right way to open this airway. The patient fell off a roof, so you have to assume a spinal injury. The jaw-thrust opens the airway without moving the head or neck. You push the lower jaw forward, and that lifts the tongue off the back of the throat. Someone holds manual in-line stabilization the whole time, so the cervical spine stays in line.

Why the others are wrong

Cross-finger technique: The cross-finger technique does not lift the tongue off the back of the throat. The tongue falling back is the most common thing that blocks the airway in an unresponsive patient. If the tongue stays where it is, the airway stays closed.

Head-tilt chin-lift maneuver: The head-tilt chin-lift is how you open the airway on a medical patient with no trauma. It tilts the head back, and that moves the neck. This patient fell off a roof, and you can't rule out a spine injury.

Tongue-jaw lift: The tongue-jaw lift is not a real airway maneuver, and EMS will never do it. The only two maneuvers you use to open an airway are the head-tilt chin-lift when there is no trauma and the jaw-thrust when there is.

Question 8 of 10

Which structure is the dividing point between the upper airway and the lower airway?

Show the answer and rationale

Correct answer · Laryngopharynx

The laryngopharynx is the dividing point between the upper airway and the lower airway. The pharynx is the back of the throat. From top to bottom, it runs from the nasopharynx to the oropharynx to the laryngopharynx. At the laryngopharynx, the throat splits into two tubes. One is the trachea, for air. The other is the esophagus, for food. Everything above that split is upper airway. The trachea and everything below it is lower airway.

Why the others are wrong

Nasopharynx: The nasopharynx is the top part of the pharynx, behind the nose. It sits well above the laryngopharynx, so all of it is upper airway.

Oropharynx: The oropharynx is the middle part of the pharynx, behind the mouth. An oropharyngeal airway sits there. The oropharynx is above the laryngopharynx, so it is upper airway.

Pharynx: The pharynx is the whole back of the throat: the nasopharynx, the oropharynx, and the laryngopharynx together. The airway divides at one part of it, the laryngopharynx.

Question 9 of 10

The EMT is considering a nasopharyngeal airway for an adult with a decreased level of consciousness. Which finding is a contraindication to inserting the nasopharyngeal airway?

Show the answer and rationale

Correct answer · Clear fluid draining from the nose after significant facial trauma

Clear fluid from the nose after significant facial trauma is a contraindication to a nasopharyngeal airway. The clear fluid may be cerebrospinal fluid from a basilar skull fracture. Cerebrospinal fluid can leak out through a fractured cribriform plate. If you push a nasal airway through the nose, the tube can pass through the fracture and into the skull. Skip the nasal airway. Use an oropharyngeal airway instead if the patient tolerates one.

Why the others are wrong

An intact gag reflex in a patient with a decreased level of consciousness: An intact gag reflex is the reason you would use a nasopharyngeal airway over an oropharyngeal one. A gag reflex rules out the oral airway. Nothing about the nasal airway is blocked by a gag reflex, so this finding supports the nasal airway.

Snoring respirations that are relieved by repositioning of the head: Snoring that goes away when you reposition the head means the tongue is blocking the airway. A tongue blocking the airway is exactly what a nasopharyngeal airway is placed to fix. Snoring supports inserting the nasal airway.

A blood pressure of 148/92 mmHg with a strong and regular pulse: A blood pressure of 148/92 with a strong, regular pulse tells you the patient's circulation is stable. Blood pressure and pulse have nothing to do with the anatomy of the nose or mouth. Circulation does not decide whether a nasal airway can be passed safely.

Question 10 of 10

An unresponsive adult has copious vomit in the mouth and gurgling respirations. The EMT has a rigid suction catheter ready. Which of the following best describes correct suctioning of this adult?

Show the answer and rationale

Correct answer · Suction for no more than 15 seconds per attempt, then reoxygenate

Suction for no more than 15 seconds at a time, then reoxygenate. The rigid catheter pulls oxygen out of the airway along with the vomit. Suctioning too long makes the patient hypoxic. The catheter in the back of the throat can also stimulate the vagus nerve and drop the heart rate. Suction for up to 15 seconds, then give high-flow oxygen or ventilate with a bag-valve mask. Then suction again. Keep repeating those cycles until the vomit is cleared. You do not have to clear the airway in one pass.

Why the others are wrong

Apply continuous suction until the airway is completely clear: A completely clear airway is the right goal. Continuous suction ignores the 15-second limit. The catheter keeps pulling oxygen out the whole time. Hypoxia sets in, and the patient can become bradycardic before you ever reoxygenate.

Suction for up to 30 seconds per attempt to save time: Suctioning for up to 30 seconds is double the 15-second limit for an adult. The extra time without oxygen makes this patient more hypoxic, and the patient is already gurgling on vomit.

Suction for a full 20 seconds, then immediately insert an oropharyngeal airway: Placing an oropharyngeal airway after suctioning is a reasonable step, since an unresponsive patient without a gag reflex often needs one. Suctioning for 20 seconds is already over the 15-second limit for an adult. Going straight to the airway also skips reoxygenation. The patient stays hypoxic until someone gives a breath.

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