10 free EMT practice questions: Focused History (SAMPLE / OPQRST)

Ongoing alcohol intoxication; the findings will clear with time: This has the timeline inverted, and it is the error that most often delays recognition. The patient has had no alcohol for three days, so intoxication has long since resolved. These findings are what the absence of alcohol produces in a dependent patient, and they escalate rather than clear on their own.

A primary psychiatric disorder with hallucinations: Hallucinations invite a psychiatric explanation and this patient certainly appears agitated and disorganized. The vital signs settle it: a pulse of 138, a pressure of 172/98, and a temperature of 101.8°F are autonomic findings a primary psychiatric disorder does not produce, and they are the part of this presentation that can be fatal.

Alcoholic hallucinosis, in which mentation and vital signs stay intact: Alcoholic hallucinosis is the genuine look-alike and the strongest distractor here, because it also produces vivid hallucinations in a withdrawing patient. The separator is exactly what this option names: in alcoholic hallucinosis the sensorium stays clear and the vital signs stay normal. This patient is disoriented with marked autonomic instability, which places it in the delirium tremens category.

Sudden onset difficulty breathing indicates the patient requires supplemental oxygen administration before completing the rest of the secondary assessment: Incorrect. While oxygen may indeed be indicated, the clinical significance of sudden onset is not simply that oxygen is needed immediately; many dyspneic patients require oxygen regardless of onset timing. The real significance is recognizing potential acute life threat.

Sudden onset difficulty breathing means the patient requires advanced airway management more urgently than a patient with gradual onset: Incorrect. Advanced airway management (intubation, RSI) is not within EMT scope; this answer confuses EMT assessment with paramedic-level interventions.

Sudden onset difficulty breathing indicates the condition cannot be asthma, which develops over a longer period: Incorrect. Asthma can present acutely and suddenly; onset timing alone does not rule out asthma. Sudden onset is significant for a broader range of acute serious conditions, not exclusion of any single diagnosis.

The hysterectomy performed 15 years ago: Incorrect. A hysterectomy from 15 years ago is remote surgical history with no relevance to acute chest pain presentation.

The hypothyroidism managed with daily medication: Incorrect. While hypothyroidism is a medical condition, it is not a direct risk factor for acute coronary events and has minimal relevance to chest pain evaluation compared to diabetes.

The appendectomy performed 10 years ago: Incorrect. An appendectomy from 10 years ago is distant surgical history and has no bearing on current chest pain etiology or urgency.

The name of the physician who prescribed each of the four medications: A student picks this because they think the medications element is an inventory of the prescribing record. The prescriber's name does not tell the EMT or the receiving facility what is currently circulating in the patient.

Whether the patient has ever reacted badly to any of the four medications: A student picks this because they merge the medications element with the allergies element. A previous reaction belongs under allergies; it is important, but it is not what completes the medications element.

How long the patient has been taking each of the four prescribed medications: A student picks this because they confuse how long a medication has been taken with how often it is taken. Duration of therapy is background; the element asks what the patient is taking and how it is being taken.

Record it under quality, and transport the patient sitting upright: A student picks this because the patient described a change in the breathing. Quality is what the symptom feels like in the patient's own description; a position that makes it worse is not a quality.

Record it under provocation and palliation, and place the patient supine: A student picks this because supine is the habitual position for an assessment. The patient has already demonstrated that lying flat worsens the breathing, and the history element the EMT just recorded is the reason not to do it.

Record it under onset, and transport the patient in a position of comfort: A student picks this because the breathing changed when the position changed and that felt like a timing finding. Onset is what the patient was doing when the problem began, which here was 2 days ago, not the response to lying back.

Obtain the whole history from the staff member, who knows the patient well: A student picks this because they assume a patient with a developmental disability cannot give a reliable account. This patient is alert, answering, and engaged, and bypassing the patient discards the only firsthand description of the symptom.

Limit the questions to those the patient can answer with yes or no: A student picks this because closed questions feel easier for the patient. Yes-or-no questions constrain the account and put the EMT's wording in place of the patient's; the patient is already answering in sentences.

Postpone the history until a guardian can be reached by telephone: A student picks this because they confuse gathering a history with obtaining consent from a legal representative. Waiting on a telephone call delays care while the patient who can describe the symptom is sitting in front of the EMT.

Interrupt as soon as the account moves off the abdominal discomfort: A student picks this because controlling the interview feels like efficiency. Interrupting is one of the named hazards of interviewing; it costs rapport and often cuts off the detail that explains the complaint.

Switch to questions the patient can answer with a single word: A student picks this because closed questions bring the account back under control fastest. They also replace the patient's own account with the EMT's assumptions, which is how relevant history gets missed.

Let the patient continue uninterrupted until the account is finished: A student picks this because they over-apply the rule against interrupting. Free rein is the technique for the opening minutes, not for the whole interview; without periodic summarizing the EMT never gets the complaint pinned down.

Have the adult child answer so the history is not delayed: A student picks this because an older patient answering slowly seems like an unreliable historian. This patient is alert, oriented, and answering appropriately; the slow responses are a sensory and pacing issue, not a mental status one.

Raise the volume of the questions and shorten them to yes-or-no answers: A student picks this because volume is the reflex response to a patient who asks for repetition. Shouting does not correct a hearing deficit that the patient's own device corrects, and yes-or-no questions strip the account down to the EMT's assumptions.

Have the adult child repeat each question loudly to the patient: A student picks this because relaying through family feels like a workaround for the hearing problem. It inserts a second person between the EMT and the patient's own words when the device that removes the barrier is on the table.

“Is the discomfort crushing, like a weight on the chest?”: A student picks this because supplying a familiar descriptor seems to help a patient who is struggling to explain a symptom. It is a leading question: it hands the patient the classic answer and the EMT can no longer tell whether the description came from the patient.

“Is the discomfort retrosternal or epigastric?”: A student picks this because clinical vocabulary sounds precise and professional. Professional jargon is a named hazard of interviewing; a patient who does not know the words will guess or agree, and the answer is then worthless.

“Do you have any history of angina, and did it start with exertion?”: A student picks this because it gathers two useful pieces of history in one breath. Two questions at once produce one ambiguous answer, and the EMT cannot tell which half the patient responded to.

“What were you doing when the pain started?”: This is a real and important question that you should ask on this patient. It is the O for Onset, and it is what separates chest pain that started during exertion from chest pain that started at rest. That makes it the closest distractor here, because it and the key are both anchored to the beginning of the symptom. The clinching split is that Onset asks what was happening, while Time asks how long ago it happened.

“Does the pain radiate anywhere?”: Asking about radiation is the R, region and radiation, the question that catches chest pain traveling to the jaw, the left arm, or through to the back. It is squarely relevant to this patient, just filed under a different letter. Nothing about it addresses duration or the moment of onset, which is what the item asked for.

“What does the pain feel like?”: Asking what the pain feels like is the Q for Quality, and it is deliberately open-ended so the patient supplies the word, crushing, tearing, burning, pressure, rather than being led to one. Like the other two wrong choices, it belongs in this same history on this same patient. The item is testing which letter each question maps to, and a description of the sensation is quality, not time.