EMS Operations Practice Questions for Paramedics

3,525 free paramedic practice questions on EMS systems, workforce safety, public health, medical-legal and ethical issues, communications, and documentation, plus transport operations, incident management and mass-casualty incidents, vehicle extrication and special rescue, hazardous materials, terrorism response, disaster response, and crime scene awareness. Every question has the answer and a short explanation.

25 sample questions

1. The H in CHART stands for:

   1. A. Hand-off to receiving staff
   2. B. Head-to-toe exam findings
   3. C. History, present and past
   4. D. Heart rhythm and 12-lead
   Show answer

   Answer: C. History, present and past

   History covers the present illness and past history, including SAMPLE and OPQRST.

2. A 3-year-old with a fever needs transport. You do not have a pediatric restraint, but the child's mother has the child's car seat. The best option is to:

   1. A. Have the mother hold the child on her lap
   2. B. Secure the car seat to the cot per its design
   3. C. Lay the child flat on the cot with one strap
   4. D. Put the child in the front seat with an adult belt
   Show answer

   Answer: B. Secure the car seat to the cot per its design

   When no pediatric cot restraint is available, an intact, appropriate car seat can often be secured to the cot following ambulance and seat guidance. A child on a lap or loosely strapped on the cot is unprotected in a crash.

3. When testifying about a victim's injuries in front of a jury, you should:

   1. A. Use exact medical terms to sound expert
   2. B. Offer your view on who is guilty
   3. C. Use plain language a juror can follow
   4. D. Face the attorney who called you as you answer
   Show answer

   Answer: C. Use plain language a juror can follow

   Clear, plain language helps jurors understand your observations; explain any medical term you must use. Jargon used to sound expert loses the jury. Opinions on guilt are not your role and damage your credibility. Jurors are the audience, so answers are directed toward them, not to the attorney who called you.

4. In a trench 1.2 m (4 ft) deep or deeper, OSHA requires a ladder or other way out within a lateral travel distance of:

   1. A. 1.5 m (5 ft)
   2. B. 15 m (50 ft)
   3. C. 7.6 m (25 ft)
   4. D. 30 m (100 ft)
   Show answer

   Answer: C. 7.6 m (25 ft)

   Workers in a trench 4 ft or deeper must be no more than 25 ft from a ladder, ramp, or other exit. A ladder too far away can trap workers when a wall starts to fail.

5. After a dirty bomb made with cesium-137, a frightened bystander asks you for potassium iodide. You should explain that potassium iodide:

   1. A. Will not help, as cesium is not radioiodine
   2. B. Should be taken by people near the blast
   3. C. Will flush the cesium out of his body
   4. D. Shields his bone marrow from the gamma rays
   Show answer

   Answer: A. Will not help, as cesium is not radioiodine

   Potassium iodide protects the thyroid against radioactive iodine by filling it with stable iodine. A cesium-137 dirty bomb releases no radioiodine, so KI offers no benefit and still carries side effects, which is also why it should not be handed out to people near the blast. It does not remove cesium from the body; a different drug is used for internal cesium. It gives no shielding from gamma radiation to the bone marrow or any other organ.

6. One finding highlighted by the White Paper was that:

   1. A. Most ambulances carried modern lifesaving equipment
   2. B. Ambulance attendant training was already nationally standardized
   3. C. Hospital emergency rooms were overstaffed and underused
   4. D. Vietnam casualties survived better than US crash victims
   Show answer

   Answer: D. Vietnam casualties survived better than US crash victims

   It noted that a soldier wounded in Vietnam had a better chance of survival than someone injured on an American highway. That comparison drove political support.

7. A paramedic receiving an incomplete report from an outgoing crew should:

   1. A. Ask specific questions until it is complete
   2. B. Accept it and fill in gaps with your own exam
   3. C. Document the gap and proceed with transport
   4. D. Refuse to accept the patient until it is fixed
   Show answer

   Answer: A. Ask specific questions until it is complete

   The questions you ask now are the ones you won't be guessing about later.

8. Posting photos or details of a call on social media is:

   1. A. A serious breach of confidentiality
   2. B. Encouraged when shared for education
   3. C. Permitted if posted after the call closes
   4. D. Allowed if the patient's name is not used
   Show answer

   Answer: A. A serious breach of confidentiality

   It can end a career and trigger penalties. Location and timing alone can identify a patient.

9. A hazmat specialist differs from a technician mainly by having:

   1. A. Authority to take command of the whole incident
   2. B. Training limited to recognition and notification
   3. C. Approval to give antidotes inside the hot zone
   4. D. Deep knowledge of certain agents or containers
   Show answer

   Answer: D. Deep knowledge of certain agents or containers

   Specialists have advanced, often product- or container-specific knowledge and support technicians and command, sometimes as liaison with other agencies. Command authority comes from the incident command structure, not from the specialist training level.

10. Which is the better documentation of a wound?

    1. A. Laceration present on the upper extremity
    2. B. 4 cm linear laceration, lateral left forearm
    3. C. Injury to the arm, bandaged on scene
    4. D. Big cut on the arm that was bleeding a lot
    Show answer

    Answer: B. 4 cm linear laceration, lateral left forearm

    Record size, type, location, and status, such as bleeding controlled.

11. A dying patient's anger directed at the paramedic should be understood as:

    1. A. A personal attack on the crew
    2. B. A reason to withdraw care
    3. C. Part of the grief process
    4. D. A sign of mental illness
    Show answer

    Answer: C. Part of the grief process

    Staying calm and present is the professional response. It is not really aimed at you.

12. Which population benefits most from fall prevention programs?

    1. A. Workers in construction trades
    2. B. High school and college athletes
    3. C. Older adults with prior falls
    4. D. Toddlers and young children
    Show answer

    Answer: C. Older adults with prior falls

    Targeting raises effectiveness. Medication risks also raise priority.

13. Tuberculosis remains a public health concern because it:

    1. A. Occurs only in travelers returning from overseas
    2. B. Has no reliable screening or diagnostic test
    3. C. Is airborne and needs months of treatment
    4. D. Is easily cured with a few days of antibiotics
    Show answer

    Answer: C. Is airborne and needs months of treatment

    EMS providers are screened for exposure because of close patient contact. Drug-resistant strains are emerging.

14. A 290-kg (640-lb) patient needs transport. The best vehicle choice is:

    1. A. A bariatric unit with a wide cot and a winch
    2. B. A standard ambulance with two or three extra lifters on scene
    3. C. A medium-duty unit with a standard cot
    4. D. A wheelchair van with a lift gate
    Show answer

    Answer: A. A bariatric unit with a wide cot and a winch

    Bariatric units have reinforced, wider cots and a ramp or winch, which protect the patient's dignity and the crew's backs. Extra lifters with a standard cot exceed the cot's rated capacity, and a wheelchair van cannot carry a supine patient.

15. During an active shooter event, patients removed from the warm zone are often brought to a:

    1. A. Hospital helipad directly
    2. B. Casualty collection point
    3. C. Command post for review
    4. D. Media staging location
    Show answer

    Answer: B. Casualty collection point

    A casualty collection point is a secure location where RTFs bring patients for triage, further care, and handoff to transport. Taking patients to the command post or helipad bypasses triage.

16. Documentation of continuing education should include:

    1. A. Attendance signature and instructor name
    2. B. Title, date, hours, provider number, category
    3. C. A certificate only for in-person courses
    4. D. Total hours, recorded as a single yearly sum
    Show answer

    Answer: B. Title, date, hours, provider number, category

    Audits are common.

17. Which is the correct order of the phases of a call?

    1. A. Preparation, dispatch, en route, scene, care, transfer
    2. B. Preparation, en route, dispatch, care, scene, transfer
    3. C. Dispatch, en route, scene, care, preparation, transfer
    4. D. Dispatch, preparation, en route, scene, care, transfer
    Show answer

    Answer: A. Preparation, dispatch, en route, scene, care, transfer

    The phases are preparation, dispatch, en route, arrival and scene size-up, patient care, transfer of care, and post-run. Each phase has its own safety and care tasks.

18. A patient is pinned with both legs crushed under the dash, and you cannot find a vein in his arms. The best vascular access is:

    1. A. A tibial IO line in a pinned leg
    2. B. A distal femur IO line on one side
    3. C. Waiting until he is freed from the car
    4. D. A proximal humerus IO line
    Show answer

    Answer: D. A proximal humerus IO line

    The proximal humerus is reachable in a seated, trapped patient and gives fast access above the injury. A tibial or femoral IO in a crushed, pinned leg may lose fluid into damaged tissue and is hard to reach.

19. A chemical leak at a tank farm is expected to continue for many hours, and the vapor will reach a nearby neighborhood in about an hour. The best protective action for residents is usually to:

    1. A. Shelter in place until the leak is stopped
    2. B. Evacuate them before the vapor arrives
    3. C. Evacuate them once the vapor reaches the area
    4. D. Shelter them in a basement or low room
    Show answer

    Answer: B. Evacuate them before the vapor arrives

    Evacuation is preferred when there is time to move people before the plume arrives and the release will last long, because indoor air slowly fills with vapor during a long release. Sheltering in place suits short releases or when evacuation is unsafe. Waiting until the vapor reaches the neighborhood forces people to move through the plume. A basement or low room is a poor shelter because many toxic vapors are heavier than air and collect in low areas.

20. Vague terms such as "appears stable" are weak because they:

    1. A. Overstate how sick the patient is
    2. B. Are quotes, not provider findings
    3. C. Are considered slang by most agencies
    4. D. Do not describe what was observed
    Show answer

    Answer: D. Do not describe what was observed

    They do not describe what was observed or measured. Replace them with the actual findings. 'Appears stable' tends to understate rather than overstate, and it is the provider's own vague conclusion, not a quotation.

21. Which open-ended question invites the most information?

    1. A. Does your chest hurt?
    2. B. Is the pain sharp?
    3. C. Tell me what happened today.
    4. D. Did you take your medications?
    Show answer

    Answer: C. Tell me what happened today.

    It lets the patient tell their story.

22. A paramedic learns that a patient she cared for 2 days ago, without respiratory protection, has confirmed smallpox. She feels well. Regarding smallpox vaccine, she should be told that:

    1. A. It is too late to help once a day has passed
    2. B. Given now, it can still prevent or ease illness
    3. C. It should wait until she first develops a fever
    4. D. It must wait until a blood test confirms infection
    Show answer

    Answer: B. Given now, it can still prevent or ease illness

    Smallpox vaccine given within about 3 days of exposure may prevent disease or make it much milder, and given at 4 to 7 days it likely still offers some protection; this is the basis of ring vaccination of contacts. Two days after exposure she is well inside that window. The benefit does not end after 24 hours. Waiting for fever or a lab test would waste the window, because vaccine given after illness begins does little.

23. At a stadium, dozens of people collapse within minutes of a mist release. Which finding most suggests a nerve agent rather than cyanide?

    1. A. Seizures and a sudden collapse to the ground
    2. B. Rapid breathing and confusion
    3. C. Pinpoint pupils with heavy secretions
    4. D. Fast onset after inhaling a gas
    Show answer

    Answer: C. Pinpoint pupils with heavy secretions

    Miosis with copious secretions is the cholinergic signature of nerve agents. Seizures, sudden collapse, and rapid onset after inhalation occur with both nerve agents and cyanide, so they do not tell them apart.

24. An EMS agency wants more of its staff to report for duty when a disaster strikes. Besides family preparedness, the step most likely to help is:

    1. A. Training staff on their disaster roles
    2. B. Threatening discipline for no-shows
    3. C. Keeping disaster plans confidential
    4. D. Promising bonuses after the event
    Show answer

    Answer: A. Training staff on their disaster roles

    Responders are more willing to report when they know what they will be asked to do and feel trained and protected to do it. Threats of discipline do little to overcome fear or family duty, and secret plans leave staff unsure of their roles.

25. When communicating with a young child, it helps to:

    1. A. Separate them from the caregiver first
    2. B. Get low, use simple words, be honest
    3. C. Use correct medical terms so they learn
    4. D. Promise them that nothing will hurt
    Show answer

    Answer: B. Get low, use simple words, be honest

    Keep a caregiver close. Telling a child something will not hurt when it will destroys trust immediately.