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Free NREMT practice questionsFree EMT practice questions · Patient Treatment and Transport

10 free EMT practice questions: Neurological & EENT Emergencies

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.

Work through all 10, then move on to the next topic. When you want the full picture, the free EMT diagnostic covers every topic in one sitting. No account needed for any of it.

Question 1 of 10

A 6-year-old is brought to the EMT by their mother, who states that the child placed a small plastic bead into their left ear canal approximately 2 hours ago. The EMT can visualize part of the bead in the outer ear canal. The child is uncomfortable but alert and not in acute distress. Their hearing in the right ear is normal. There is no visible trauma or sign of infection in the affected ear. What is the EMT's most appropriate action?

Show the answer and rationale

Correct answer · Refer the child to the emergency department for evaluation and removal by an appropriate healthcare provider

Foreign objects in the ear canal, especially non-organic items like beads, require professional removal under controlled conditions to avoid impaction, ear canal trauma, or tympanic membrane rupture. Removal of objects from the ear canal is outside the EMT scope of practice; transport to the ED for evaluation and removal by an ENT specialist or emergency physician is appropriate.

Why the others are wrong

Use a cerumen curette or small curved instrument to carefully remove the bead from the ear canal: Incorrect. Attempting removal with any instrument risks pushing the object deeper, perforating the tympanum, or causing canal trauma. Instrument removal is not within EMT scope and is contraindicated.

Gently flush the ear canal with warm water to dislodge and remove the bead: Incorrect. Irrigation may lodge the object more firmly into the canal or cause secondary complications such as canal swelling or tympanic membrane rupture. Irrigation is not an appropriate EMT intervention for ear foreign bodies.

Observe and reassure the parent that the bead will likely work itself out within 1-2 weeks: Incorrect. The bead is unlikely to pass spontaneously and may become impacted over time, leading to complications such as infection or hearing loss. Professional removal is indicated; delaying care risks worsening the patient's condition.

Question 2 of 10

A 45-year-old patient struck the left temple in a motor-vehicle accident. During the EMT's assessment, clear fluid is noted draining slowly from the left ear canal. The patient is alert and oriented but reports dizziness. Vital signs are BP 138/82 mmHg, P 88/min, R 16/min, and the airway is patent. The clear fluid is suspected to be cerebrospinal fluid from a basilar skull fracture. How should the EMT manage this drainage?

Show the answer and rationale

Correct answer · Position on the affected (left) side, place a loose sterile dressing over the ear without packing it, and transport

When cerebrospinal fluid or other fluid is draining from the ear following head trauma, the drainage must NEVER be occluded or sealed. Blocking or packing the drainage pathway can increase intracranial pressure and worsen neurological deterioration. Position the patient on the affected side to allow gravity-assisted drainage, apply a loose absorbent dressing without packing the canal, and transport.

Why the others are wrong

Gently pack sterile gauze into the ear canal to seal off the drainage pathway and prevent further loss of cerebrospinal fluid: Packing sterile gauze into the ear canal seals off the drainage pathway, which can increase intracranial pressure and worsen neurological deterioration: CSF drainage is never occluded or packed.

Apply direct manual pressure over the external ear, as for any external bleeding, until the drainage slows and stops: Treating the drainage like external bleeding and holding direct pressure over the ear has the same problem as packing. It traps the fluid and raises intracranial pressure instead of letting it drain freely.

Irrigate the ear canal gently with normal saline to flush away debris and reduce the risk of infection during transport: Irrigating the ear canal with normal saline introduces infection risk into an open pathway to the intracranial space and isn't part of managing this finding.

Question 3 of 10

An EMT responds to a patient who has just completed a generalized tonic-clonic seizure and is now post-ictal. The patient is confused and drowsy but breathing spontaneously at 18 breaths per minute with clear air exchange. The airway is clear of secretions. What is the appropriate immediate management?

Show the answer and rationale

Correct answer · Place the patient in the recovery position and monitor airway, breathing, and circulation

A post-ictal patient has residual altered mental status and loss of protective airway reflexes, creating aspiration risk. The recovery position (left-lateral recumbent) maintains airway patency, allows drainage of secretions, and protects against aspiration: the priority in post-ictal care. Continuous monitoring of ABCs is essential. The respiratory rate is adequate, so supplemental oxygen is not immediately indicated unless hypoxia is detected.

Why the others are wrong

Restrain the patient's limbs to prevent recurrence of seizure activity: Restraining a post-ictal patient causes injury and is contraindicated; the seizure is already concluded. Gentle positioning and reassurance are appropriate; physical restraint is not.

Immediately obtain IV access and prepare to administer seizure-prevention medication: IV access and anti-seizure medications are Paramedic or Advanced EMT scope, not Basic EMT. Basic EMT management focuses on airway protection and positioning.

Keep the patient upright and alert by engaging them in conversation during transport: Attempting to keep an altered patient upright and stimulated increases aspiration risk and contradicts the protective recovery position. The patient's post-ictal state requires passive airway protection, not forced interaction.

Question 4 of 10

A 55-year-old patient is found seated in a chair at home by family members. Bystanders report the patient stood up from dinner, then suddenly collapsed into the chair. When the EMT arrives 2 minutes later, the patient is alert, oriented, and able to recall the entire event. Vital signs are BP 124/78 mmHg, P 88/min (regular), R 16/min, and SpO₂ 98% on room air. The patient denies chest pain, difficulty breathing, or weakness and has no focal neurological deficits. The patient reports feeling lightheaded for a moment and then 'waking up' in the chair. Which of the following is the most appropriate assessment of this episode?

Show the answer and rationale

Correct answer · The patient had a brief syncopal episode with rapid recovery; transport for evaluation

Sudden collapse from standing with immediate loss of consciousness, rapid spontaneous recovery, full orientation and recall, and normal vitals with no focal deficit is classic syncope. Any syncope still warrants transport to rule out cardiac or other serious causes. Stroke, cardiac arrest, and seizure are each clearly excluded by the exam findings.

Why the others are wrong

The patient is experiencing a stroke requiring immediate neurological assessment: Calling this a stroke requiring immediate neurological assessment doesn't fit. This patient has full recall of the event, no focal deficits, and rapid complete recovery, none of which is typical of a stroke.

The patient is having a seizure and must be protected from further injury and given oxygen: Calling this a seizure requiring protection and oxygen doesn't fit either. There's no description of convulsive activity, and the patient has immediate full recall of the event, which isn't typical of a postictal seizure presentation.

The patient is in cardiac arrest and requires CPR immediately: Calling this cardiac arrest requiring immediate CPR is inconsistent with an alert, oriented patient with normal vital signs who is talking and answering questions.

Question 5 of 10

A 72-year-old patient is found unresponsive by family members. Vital signs are BP 168/94 mmHg, P 54/min, and respirations irregular and slow at 12/min. The patient's pupils are equal and reactive, but the patient does not move spontaneously and does not respond to verbal stimuli. When the EMT applies a painful stimulus, the patient extends both arms and legs rigidly. What do these findings indicate?

Show the answer and rationale

Correct answer · Decerebrate posturing indicates severe brainstem dysfunction and rising ICP

The triad of hypertension, bradycardia, and irregular respirations (Cushing's triad) plus decerebrate (extensor) posturing to pain indicates severe brainstem dysfunction from markedly increased intracranial pressure. The patient has a pulse and some respiratory drive, ruling out cardiac arrest; sustained rigid extension to pain is posturing, not the rhythmic activity of a seizure; and the depth of unresponsiveness plus brainstem signs rules out a 'light' coma.

Why the others are wrong

The patient is in a light level of coma and will likely recover consciousness soon: Calling this a light level of coma with likely quick recovery misreads decerebrate posturing and Cushing's triad, both of which indicate severe, worsening brainstem dysfunction, not a mild or resolving state.

The patient is in cardiac arrest and requires immediate CPR: This patient has a pulse and some respiratory drive, which rules out cardiac arrest: the findings instead point toward severe intracranial pressure elevation.

The patient is having a tonic-clonic seizure and requires airway protection: Extension of both arms and legs to painful stimulus is sustained posturing, not the rhythmic jerking movements that define a tonic-clonic seizure.

Question 6 of 10

A 44-year-old patient with a history of migraines reports acute onset of right-sided weakness and visual disturbance 15 minutes ago. The patient reports experiencing a similar visual disturbance (shimmering lights at the edge of vision, lasting 20 minutes) about 20 minutes before the weakness began, which is typical for the patient's migraine aura. On examination, the EMT finds the right arm is weak (4/5 strength), but speech is normal and the patient is alert and oriented. The patient has had this exact pattern with migraines at least five times in the past 2 years, always with complete recovery. Vital signs are stable. Which of the following is the most appropriate EMT action?

Show the answer and rationale

Correct answer · Recognize this may be the patient's migraine with aura, but transport urgently because acute stroke must be ruled out

Migraine with aura can produce transient focal deficits that mimic stroke, but an EMT cannot definitively exclude acute stroke in the field regardless of a similar prior history. The safe, correct action is urgent transport for evaluation, not withholding transport (A), offering a treatment that does not reverse neurological deficits (C), or applying spinal motion restriction where there is no trauma indication (D).

Why the others are wrong

Recognize this as her typical migraine with aura, given prior episodes with full recovery; reassure her and let her rest at home: Reassuring the patient and letting her rest at home relies entirely on a prior pattern that an EMT can't confirm is repeating this time: an EMT cannot definitively rule out acute stroke in the field regardless of a similar past history.

This presentation is definitely a stroke; immobilize for spinal precautions and transport for emergency imaging: Immobilizing for spinal precautions and transporting for emergency imaging applies spinal motion restriction where there's no trauma indication. Nothing here describes an injury mechanism that would call for it.

Diagnose this as a migraine aura and administer oxygen to reverse the neurological deficits: Administering oxygen to reverse the neurological deficits offers a treatment that doesn't actually reverse anything: oxygen doesn't treat a migraine aura or a stroke, and it isn't a substitute for urgent transport and evaluation.

Question 7 of 10

A 41-year-old patient has an altered mental status. Bystanders report the patient was confused and stumbling before collapsing. The vital signs are BP 88/56 mmHg, P 104/min, R 12/min and shallow, and SpO₂ 88% on room air. The patient is unresponsive to verbal stimulus but grimaces to pain. The history indicates type 2 diabetes treated with metformin. The blood glucose level is 52 mg/dL. What is the most appropriate immediate action?

Show the answer and rationale

Correct answer · Withhold glucose, insert an oropharyngeal airway, apply oxygen, and transport rapidly

Oral glucose is authorized for suspected hypoglycemia in a conscious patient who can swallow and protect the airway. This patient is unresponsive to verbal stimulus, breathing shallowly, and hypoxic at 88%, making aspiration a critical risk. Airway protection, oxygenation, and rapid transport to a facility that can give intravenous dextrose are the appropriate EMT actions.

Why the others are wrong

Administer 15 g of oral glucose gel and monitor for response: Incorrect. Oral glucose is appropriate for conscious patients who can swallow and protect their airway. This patient responds only to pain and cannot protect the airway; aspiration of glucose gel is a major risk.

Attempt to have the patient swallow glucose tablets with water and recheck glucose in 5 minutes: Incorrect. Attempting to give glucose tablets to an unresponsive patient risks aspiration. Oral glucose is contraindicated when the patient cannot swallow safely.

Administer 25 mL of 50% dextrose intravenously and establish an intravenous line: Incorrect. Intravenous dextrose is paramedic-level or hospital-administered only; EMTs do not establish intravenous lines.

Question 8 of 10

A 67-year-old patient has sudden onset left facial droop, slurred speech, and right-sided weakness that started 45 minutes ago. The EMT recognizes a possible acute stroke. A family member says, "Please take us to General Hospital. That's where our family doctor is." The nearest hospital, Central Medical, is 10 minutes away and has a certified stroke center. General Hospital is 25 minutes away and does not have stroke capability. What is the appropriate transport decision?

Show the answer and rationale

Correct answer · Transport to Central Medical, the stroke center, for time-critical stroke care

Destination decisions are based on medical need and the closest appropriate facility, not on patient or family preference. Acute stroke requires a certified stroke center for rapid imaging, neurology evaluation, and potential thrombolytic therapy within 4.5 hours of onset or thrombectomy in selected cases. EMTs know regional stroke centers through dispatch protocols and transport accordingly.

Why the others are wrong

Honor the family's request and transport the patient to General Hospital: Incorrect. While preference is considered, it cannot override medical need. Transporting to a facility without stroke capability wastes the treatment window.

Transport to General Hospital; the extra 15 minutes will not change the outcome: Incorrect. The lost time would be far more than 15 minutes: General Hospital has no stroke capability, so the patient would need a second transfer to reach definitive care, and stroke treatment is time-critical.

Delay transport until medical direction confirms the appropriate destination facility: Incorrect. The information needed for the destination decision is already known: the closest hospital is a certified stroke center. Delaying on scene to consult wastes the treatment window.

Question 9 of 10

A patient splashes an alkaline cleaning solution into one eye. Which of the following is the most appropriate EMT technique for irrigating the affected eye?

Show the answer and rationale

Correct answer · Flush continuously from the inner corner toward the outer corner for 20 minutes

Alkaline and strong acid burns can penetrate deeply and require continuous irrigation for 20 minutes. Irrigation should always flow from the inner corner of the affected eye toward the outer corner to avoid washing the chemical into the unaffected eye.

Why the others are wrong

Flush for 2 to 3 minutes from the outer corner of the eye toward the inner corner: A few minutes of flushing is inadequate for an alkali burn, and directing the flow from the outer corner toward the inner corner washes the chemical toward the unaffected eye.

Cover both eyes with moist dressings and begin irrigation on arrival at the hospital: Covering the eyes and deferring irrigation is appropriate for a penetrating eye injury, not a chemical exposure; an alkali keeps burning deeper until it is diluted, so irrigation must begin immediately in the field.

Irrigate both eyes at the same time, directing the flow from the outer corners inward: Only the affected eye needs irrigation, and directing the flow from the outer corners inward risks carrying the chemical into the unaffected eye.

Question 10 of 10

A patient sustains a penetrating eye injury with a small object impaled in the globe. Which of the following is the most appropriate EMT management?

Show the answer and rationale

Correct answer · Stabilize the object in place and apply a rigid eye shield over both eyes

Stabilize the object in place and apply a rigid eye shield over both eyes. An impaled object in the eye should be stabilized, never removed. A rigid shield (not a soft or pressure patch) is used so nothing presses on the globe or the object; the shield should rest on the bony orbital rim. The uninjured eye is also shielded because the eyes move together (consensual movement), and movement of the uninjured eye can cause the injured eye to move and worsen the injury.

Why the others are wrong

Remove the object carefully and cover the injured eye with a pressure dressing: Removing an impaled object (however carefully) can cause further damage and uncontrolled bleeding, and a pressure dressing then presses directly on the injured globe; the object should be stabilized in place, not removed.

Irrigate the eye with saline and secure a gauze patch over the injured eye only: Irrigation is used for chemical burns, not penetrating injuries with an impaled object, and patching only the injured eye allows the uninjured eye's movement to disturb the injury.

Apply direct pressure over the object with a bulky dressing to control bleeding: Direct pressure over the impaled object, even through a bulky dressing, can drive the object deeper, extrude ocular contents, and cause further damage. This is exactly why a rigid, non-contact shield is used instead of any form of pressure.

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