10 free EMT practice questions: Transport Decision (Rapid vs. Focused)

Give oral antacids and reassess before deciding on transport: Antacids are a reasonable thought for epigastric pain and are harmless in most cases. They do nothing for pancreatic inflammation, and using the response to them as a transport filter delays a patient whose condition can progress to shock and organ failure.

Treat as gastritis; the pain followed a heavy drinking episode: Alcoholic gastritis follows the same trigger and produces epigastric pain, which makes it the closest competitor. Two features point past it: pain radiating straight through to the back, and relief on leaning forward. Both reflect a retroperitoneal organ, and gastritis does not produce them.

Encourage a small meal to settle the stomach before transport: Eating is exactly the wrong instruction. Food stimulates pancreatic enzyme secretion, which drives the inflammation the patient already has, and these patients are kept with nothing by mouth for that reason.

Attempt to manually remove the obstruction by performing a deep blind finger sweep of the throat: A blind finger sweep belongs to a scenario where you can see or feel an object lodged in the oropharynx, and even then it's discouraged. This obstruction sits in the esophagus at the mid-chest, well past where a finger sweep can reach, so the maneuver risks pushing the bolus further, triggering vomiting, or injuring the airway for no benefit.

Perform abdominal thrusts immediately, treating the obstruction as a life-threatening airway emergency: Abdominal thrusts are correct for true FBAO, an object blocking the trachea with poor air exchange or an inability to speak. This patient's clear voice and unlabored breathing show the airway is patent, so thrusts treat an airway emergency that isn't happening here and won't move an esophageal bolus anyway.

Encourage the patient to drink water forcefully to push the impacted food down into the stomach: Forcing fluids to wash the bolus down is a folk remedy, aimed at pushing the impaction into the stomach on the patient's own. Since the esophagus, not the airway, is obstructed, drinking against a blockage tends to trigger vomiting and aspiration rather than clearing anything, and it's not a taught field intervention.

Continue monitoring at the current altitude and reassess in a few hours before making a decision about descent: This fits isolated AMS, headache and nausea alone, where rest and reassessment at altitude is appropriate. The new ataxia in this question breaks that plan: once gait is affected, waiting hours to decide risks progression to coma before descent starts.

Treat the unsteadiness as dehydration with oral fluids and rest, remaining at the current campsite altitude: Dehydration is common at altitude and causes headache, nausea, and lightheadedness that can resemble unsteadiness. It breaks against the ataxia in this question: true inability to walk a straight line comes from rising intracranial pressure, not fluid loss. Oral fluids and rest at the same altitude leave the swelling untreated and let it worsen.

Have the patient rest in a tent and continue the planned itinerary the next day if he feels better: Mild symptoms sound like they just need rest before continuing the hike, the plan for ordinary fatigue. Ataxia and progressing AMS make further ascent or resuming the itinerary directly dangerous, since altitude gain worsens cerebral edema.

Perform a focused assessment on the lower extremities and transport non-emergently: Checking the lower extremities makes sense when you're hunting for a bleeding source behind orthostatic dizziness, and non-emergent transport fits a patient who's stable. A blood pressure of 88/56 with a heart rate of 118 rules out stable, so the transport mode has to be emergent, not calm and delayed.

Perform a complete secondary assessment at the scene before transport: A complete secondary assessment at the scene is the normal next step once the primary assessment is clear, and it feels thorough. Here the primary assessment already found shock, tachycardia at 118 and a pressure of 88/56, so the secondary assessment belongs in the moving ambulance, not holding up the scene.

Place the patient on high-flow oxygen and reassess vitals in 5 minutes before deciding on transport mode: High-flow oxygen is genuine shock treatment, and reassessing vitals is routine, so this option looks careful. A pressure of 88/56 with a heart rate of 118 shows where this patient is heading; waiting five minutes on scene trades time you don't have for data you already have. Oxygen belongs en route, not as a reason to stay parked.

Non-urgent transport; stable vital signs indicate a minor event: Reasoning from stable vital signs to a non-urgent transport is correct when the primary assessment is also clean and the complaint is genuinely minor. The trap is treating stable numbers as evidence of a stable patient. Here the primary assessment already failed on mental status, and compensating vital signs in an unresponsive patient describe how much reserve is left, not how serious the problem is.

Focused assessment at the scene; transport only if vitals become abnormal: A focused assessment is a real and necessary step, but its place is after life threats are addressed and preferably en route rather than on scene. Making transport contingent on the vital signs going abnormal means waiting for compensation to fail, which is the last possible moment to act and the one where outcomes are worst.

Begin supplemental oxygen and reassess; transport urgently only if the patient regains consciousness: Supplemental oxygen is reasonable supportive care and is not the flaw in this option: the condition attached to it is. Waiting for the patient to regain consciousness before transporting urgently turns a rapid-transport patient into a long scene time, and most of the causes on the differential do not resolve on the bedroom floor.

Perform a complete secondary assessment and detailed neurological exam at the scene: A full secondary assessment with a detailed neurological exam belongs to a stable patient whose complaint isn't time-sensitive, and it feels thorough, which is exactly why it tempts, but the facial droop, slurred speech, and arm drift here already satisfy the FAST stroke screen on their own; a detailed exam adds no new information that changes the transport decision, it only spends minutes the patient doesn't have to give back.

Obtain baseline vital signs and repeat assessment every 5 minutes at the scene: Serial vitals every 5 minutes fit a patient you're trending on scene before committing to transport, not one with a known 30-minute onset whose window is already running.

Contact medical control for guidance before deciding whether rapid transport is necessary: Contacting medical control first fits an unclear protocol or an intervention needing prior authorization; the FAST-positive findings here already meet stroke alert criteria on their own, so the call only delays a transport decision you're already authorized to make.

A focused examination of the chest and lungs: A submersion emergency reads as purely a respiratory problem, so the exam should follow the lungs. The finding that decides the exam type is the patient's unresponsiveness, not the suspected organ system.

A focused examination guided by the bystanders' account: A bystander's account of the mechanism gets treated as proof that nothing else is injured, which is the most common way hidden injuries are missed. A patient who cannot answer questions cannot confirm or contradict that account, which is exactly why the whole body is examined.

A neurologic examination with repeated pupil checks: An unresponsive patient reads as a neurologic problem, which narrows the exam to mental status and pupils. That skips the trunk and extremities, where the hidden life threats this exam is designed to find would be located.

Complete a systematic full-body scan of every region: Any fall gets treated as a significant mechanism that mandates a head-to-toe scan. A fall of one step with a normal primary assessment and a single obvious injury is a nonsignificant mechanism, which calls for an examination focused on the affected part.

Move the patient to the stretcher and splint en route: Critically injured patients are packaged first and splinted en route, and that rule gets applied to every patient. That rule exists to protect scene time when life threats are present; with a normal primary assessment and an isolated bone injury, splinting first prevents pain and further injury during the move.

Begin high-concentration oxygen before moving the patient: Any painful deformed extremity sounds like it warrants oxygen. Oxygen is given for hypoxia or inadequate breathing, and this patient has unlabored breathing with an SpO₂ of 99% on room air.

Transport without urgency, since the injury is isolated: Urgency gets graded from the injury in front of you, and an isolated ankle injury with stable vital signs looks routine. The unstable angina makes the patient's overall condition potentially unstable, because the pain and stress of even a minor injury can provoke the cardiac event the history predicts.

Delay transport until a head-to-toe examination is complete: A complete examination feels like the thorough choice for a patient with a complicated history. For a patient whose condition may become unstable, the remainder of the assessment is performed en route rather than on scene.

Delay transport until an advanced life support unit responds: A cardiac history reads as an advanced life support problem. The patient has no chest discomfort at rest and stable vital signs, so there is nothing for an advanced provider to treat right now, and waiting only spends the time the prompt transport is meant to save.

Non-emergent transport; have the patient walk to the ambulance and position the patient comfortably: This fits a stable patient who can walk without raising oxygen demand, but the BP of 96/62 and SpO2 of 90% here show poor perfusion and hypoxia, so ambulation is contraindicated.

Non-emergent transport by stretcher, reassessing the vital signs every 15 minutes: The stretcher is correct, and vitals do need reassessing, which makes this look like the safe choice, but the 15-minute interval and the non-emergent label fit a stable patient, while the pulse of 118, BP 96/62, and SpO2 90% mark this patient as unstable: reassessment needs to run every 5 minutes and transport has to be emergent.

Delay transport on scene until a paramedic unit arrives to assume patient care: Waiting on scene for a paramedic intercept applies when a crew truly cannot manage a patient, but this patient can be treated and moved now; delaying transport only adds ischemic time to a shock picture already showing BP 96/62 and SpO2 90%.