10 free EMT practice questions: Pediatric, Geriatric & Special Populations

This is not shock because the blood pressure is within the normal range for age: This is the most common pediatric error in EMS, and it comes from adult-shaped thinking where hypotension is a fairly reliable alarm bell. In a child, blood pressure is the last parameter to fall, and by the time it does, arrest is close behind. The key reads that same normal blood pressure as the definition of compensated shock rather than as an all-clear.

This is decompensated shock because the heart rate is markedly elevated: Decompensated shock is real, and this child can get there, but the label is defined by compensation failing, which shows up as hypotension, obtundation, and often a falling or inappropriately slow heart rate. A high heart rate is compensation succeeding, not failing, and this child is fussy but consolable rather than unresponsive. The key names the stage the findings actually match, while this one skips ahead on the wrong criterion.

This is dehydration without shock, and only oral rehydration is indicated: This would be the right read on the same illness caught earlier: dry lips, fewer wet diapers, but warm pink extremities, brisk capillary refill, and a heart rate near baseline. Cool, mottled skin with a 3-second refill means perfusion has already fallen off, and that is the line between dehydration and shock. The key crosses that line, and what follows is shock management and transport rather than a cup of oral rehydration solution.

Continue ventilations alone and reassess in 2 minutes: Continuing ventilations alone and reassessing is exactly right during the first two minutes, when hypoxic bradycardia usually corrects itself once oxygen reaches the lungs. That is what the EMT already did, and the reassessment is the whole point of the question: it was performed, and the answer came back 48 with poor perfusion. Repeating an intervention that has already failed for two minutes only delays the circulation this child no longer has, while the key adds the step the reassessment criteria call for.

Deliver abdominal thrusts for a possible obstruction: Abdominal thrusts belong to a witnessed foreign body obstruction in a responsive patient, and even then an unresponsive patient gets compressions and an airway look rather than thrusts. Nothing here suggests obstruction, since the airway was opened and the ventilations are described as effective, which by definition means air is going in. Drowning fills the lungs with water; it does not plug the airway with an object, so the key treats the failing circulation rather than a blockage that is not there.

Apply the automated external defibrillator first: The AED is the right first move for a witnessed sudden collapse in an older child or an adult, where a shockable rhythm is likely from the start. Pediatric drowning arrest is hypoxic, and hypoxic arrests are overwhelmingly non-shockable, so oxygenation and compressions are the treatment that works. This child also still has a pulse at 48, so there is no arrest rhythm to analyze yet, and the key starts moving blood instead of pausing to look for a rhythm that is very unlikely to be present.

Continue delivering abdominal thrusts with the child positioned supine: Abdominal thrusts are the correct technique, right up until the patient loses consciousness, which is what just happened in this question. In an unresponsive patient thrusts are less effective, harder to deliver well, and provide no circulation to a child whose heart is about to stop from hypoxia. The key switches to the technique that both works on the obstruction and supports perfusion.

Deliver alternating back blows and chest thrusts as used for an infant: Back blows alternating with chest thrusts is the right sequence for a responsive infant under one year, where abdominal thrusts risk injury to the liver and spleen. This patient is five years old, and more decisively, is now unresponsive, at which point the age-specific responsive technique stops being the question. The key uses the unresponsive pathway, which converges on compressions regardless of age.

Perform a blind finger sweep of the mouth before starting compressions: Blind finger sweeps are prohibited at every level and every age. Sweeping a finger through a mouth you cannot see into pushes the object deeper and wedges it more firmly in an airway that is already small. The key permits a look and a removal only when the object is actually visible, which is the safe version of the same instinct.

The Glasgow Coma Scale: It's the standard tool for grading level of consciousness. The Glasgow Coma Scale scores Eye opening, Verbal response, and Motor response, and the motor score requires applying a stimulus to see the response. That hands-on step contradicts the no-touch method described, and GCS answers a different question than a general impression.

The SAMPLE history: This fits when the question hints at gathering history. SAMPLE stands for Signs and symptoms, Allergies, Medications, Pertinent past history, Last oral intake, and Events leading to the incident, a verbal interview, not the sight-and-sound impression asked about here.

The rapid trauma assessment: This belongs to a trauma patient needing a hands-on exam. The rapid trauma assessment is a physical, head-to-toe check for injuries, which requires touching the child, the opposite of the hands-off tool the question describes.

Acute stroke causing the confusion and drowsiness: Acute stroke shows up as a focal deficit, facial droop, arm drift, or slurred speech under the Face, Arm, Speech, Time mnemonic, and this patient has none of that, only global drowsiness tied to a witnessed double dose and a respiratory rate of 8.

Diabetic emergency producing the altered mental status: Diabetic emergency, especially hypoglycemia, causes altered mental status but comes with tachycardia and diaphoresis, not a respiratory rate of 8/min and an empty pill bottle pointing straight to the medication as the cause of the AMS instead of the glucose.

Heart failure explaining the low oxygen saturation: The SpO2 of 88% makes heart failure worth considering, since pulmonary edema drops oxygenation too, but heart failure drives hypoxia through tachypnea, crackles, and jugular venous distension, the opposite of this patient's respiratory rate of 8/min. That bradypnea comes from CNS depression suppressing the drive to breathe, so the low saturation traces to the overdose.

Document the patient's current mental status as the baseline and assume any confusion is new: Recording whatever mental status you find on scene as the baseline is reasonable when no history exists at all, but here the staff themselves flagged that she's not eating and seems "off," meaning they already have a reference point you haven't asked for. Locking in today's confusion as normal risks burying a genuine acute change inside a diagnosis of dementia.

Skip the mental status assessment entirely, as the patient cannot provide reliable information: It's true she can't give you reliable history herself, but the people who see her daily can, so skipping the assessment throws away information that's sitting right in front of you at the nursing home.

Transport the patient immediately without establishing baseline, as this will be determined at the hospital: Rapid transport is appropriate once you suspect an acute change, but leaving baseline undetermined skips a quick question you have time to ask on scene, information the hospital will want and that costs you nothing to gather before you go.

Perform five back blows followed by five abdominal thrusts: This comes from adult and child choking protocol, where abdominal thrusts, the Heimlich maneuver, are standard for a conscious victim over age 1. This infant is 7 months old: an infant's liver and spleen sit unprotected by the rib cage, so abdominal thrusts risk internal injury instead of relief.

Perform five abdominal thrusts followed by blind finger sweeps: This mixes two outdated ideas: abdominal thrusts, which carry the same organ injury risk in this 7-month-old as option A, plus blind finger sweeps, once taught but now discouraged because a sweep performed without seeing the object can push it deeper into the airway and worsen the obstruction rather than clear it.

Perform back blows only and proceed directly to CPR if the object is not expelled: Back blows alone are the correct first step but stop the sequence short of complete: infant relief calls for five back blows alternated with five chest thrusts, not blows only. Jumping straight to CPR after failed back blows skips the required chest thrust cycle, and CPR is reserved for once the infant becomes unresponsive, not as a substitute for it.

Hypotensive shock requiring immediate intravenous fluids and rapid transport: Hypotensive shock applies once systolic pressure actually drops below the expected range for age. This child's blood pressure of 90/58 is still normal, so the shock has not decompensated to that point yet.

Decompensated shock with altered mental status requiring airway intervention: Decompensated shock looks tempting since it shares the same tachycardia, tachypnea, and cool, pale skin seen here, and it correctly pairs altered mental status with airway management, but this child is alert and crying with a blood pressure of 90/58, both signs that compensation is still holding and shock has not progressed to that stage.

Normal vital signs for a 4-year-old in pain; no evidence of shock: Pain alone can raise a child's heart rate and respirations somewhat, but a pulse of 150, respirations of 32, and a 3-second capillary refill with cool, pale skin exceed normal variation and point to poor perfusion, not simple anxiety.

Elderly patients have stronger pain tolerance and rarely experience true chest pain during a heart attack: Elderly patients often report less pain with equal tissue damage. That change is altered pain perception from autonomic neuropathy, not higher tolerance, and this patient's diaphoresis and anxiety show the sympathetic response is intact. Naming it tolerance mislabels the mechanism.

Nausea and fatigue are normal for any 81-year-old and do not warrant concern: Nausea and fatigue alone are common complaints across geriatric patients and can be benign. Paired with this patient's diaphoresis, anxiety, and sudden onset this morning, they form a cluster that should raise suspicion for ACS, not get waved off as normal aging. Dismissing them treats the complaint as routine instead of investigating the cause.

The patient's medications, especially metoprolol and lisinopril, completely mask the symptoms: Beta blockers like metoprolol blunt reflex tachycardia and sympathetic surge, and a heart rate of only 88 makes that reasoning tempting, but metoprolol and lisinopril manage chronic rate and afterload; they don't erase pain signaling, and "completely mask" overstates their effect. The atypical presentation traces to age-related neuropathy, not the medication list.

Two of three normal sides mean the child is stable: The abnormal breathing side alone being the only one that needs to be abnormal doesn't apply as stated: actually any single side being abnormal, not specifically the breathing side, is enough to signal a problem.

Normal appearance means the child is stable: Normal appearance meaning the child is stable misreads the triangle. This child's appearance and circulation are both normal, but the abnormal work-of-breathing findings still identify a real problem on their own.

All three sides must be abnormal to signal a problem: Requiring all three sides to be abnormal before signaling a problem sets the bar too high: a single abnormal component, like nasal flaring and retractions here, is enough by itself, regardless of what the other two components show.