EMT Scene Size-Up and Safety Practice Test

25 practice questions

Choose an answer, then check it under Show answer.

1. Question 1 of 25Medium

   An EMT is assessing an unrestrained driver whose vehicle was struck broadside directly on the driver-side door. Which internal organ is at greatest risk for blunt trauma secondary to direct door intrusion?

   1. AA. Appendix
   2. BB. Liver
   3. CC. Gallbladder
   4. DD. Spleen
   Show answer to question 1

   Answer: D. Spleen

   In a driver-side lateral impact (T-bone crash), direct intrusion into the passenger compartment impacts the driver's left anatomical side. The spleen is located in the left upper quadrant of the abdomen and is highly susceptible to rupture from left-sided blunt forces. The liver is located in the right upper quadrant and is more commonly injured in passenger-side lateral collisions.

2. Question 2 of 25Easy

   When working at a crash scene on a roadway, which personal protective measure is most important for EMTs?

   1. AA. A dark uniform jacket for a professional appearance
   2. BB. Standing in the traffic lane to direct cars
   3. CC. Keeping your back to traffic while you work
   4. DD. A high-visibility reflective safety vest
   Show answer to question 2

   Answer: D. A high-visibility reflective safety vest

   Responders working on or near roadways risk being struck by vehicles. High-visibility reflective apparel makes them easier for drivers to see, especially at night.

   Why the other options are wrong

   • ADark clothing makes responders harder for drivers to see.
   • BDirecting traffic from a live lane is dangerous and is usually a police or fire role.
   • CTurning your back to traffic keeps you from seeing approaching hazards.

3. Question 3 of 25Easy

   You arrive at an outdoor park where an older adult was found lying in the grass during freezing rain. The patient is shivering violently and wearing saturated clothing. What is the most appropriate first step in managing this patient?

   1. AA. Vigorously rub the patient's extremities to restore circulation
   2. BB. Move the patient into the heated ambulance compartment
   3. CC. Perform a detailed secondary examination on the ground
   4. DD. Administer warm oral fluids while obtaining a baseline blood pressure
   Show answer to question 3

   Answer: B. Move the patient into the heated ambulance compartment

   Moving the hypothermic patient into a warm, dry environment such as the heated ambulance is essential to halt ongoing heat loss and initiate safe treatment. Performing prolonged assessments in freezing precipitation worsens hypothermia and delays necessary care. Vigorously rubbing cold extremities can damage fragile tissues and precipitate cardiac arrhythmias.

4. Question 4 of 25Medium

   An alert 68-year-old female reports severe dizziness and weakness. She is located on the second floor of a home with a narrow, curved staircase and has no history of trauma. Which device provides the safest means of moving her down the stairs?

   1. AA. Long spine board
   2. BB. Scoop stretcher
   3. CC. Wheeled ambulance stretcher
   4. DD. Stair chair
   Show answer to question 4

   Answer: D. Stair chair

   A stair chair is specifically designed to safely transport conscious, seated patients down narrow, steep, or winding stairways. A wheeled ambulance stretcher cannot safely negotiate steps and poses an extreme tip hazard. A scoop stretcher or long spine board does not keep the patient in a seated position and is difficult to maneuver around sharp corners.

5. Question 5 of 25Medium

   While responding to a motor vehicle crash on an icy highway during freezing rain, you see several vehicles in a ditch around a blind curve. How should you position your ambulance to protect the scene?

   1. AA. Position the ambulance past the scene and downhill to optimize vehicle traction.
   2. BB. Park upstream before the curve with an extended buffer to warn approaching traffic.
   3. CC. Pull fully onto the unpaved shoulder directly opposite the crashed vehicles.
   4. DD. Park directly alongside the damaged vehicles to minimize walking distance on ice.
   Show answer to question 5

   Answer: B. Park upstream before the curve with an extended buffer to warn approaching traffic.

   On icy roadways, stopping distances are dramatically increased; placing the ambulance upstream before the curve creates a barrier and gives oncoming drivers adequate warning and stopping distance. Parking alongside or directly next to the damaged vehicles leaves the crew vulnerable to secondary collisions from vehicles that lose control on the curve.

6. Question 6 of 25Hard

   An EMT arrives at an apartment building for a "welfare check" on an occupant with no other information available from dispatch. When approaching the apartment door to initiate contact, which action best minimizes responder risk?

   1. AA. Stand directly in front of the door while knocking to establish rapid visual contact
   2. BB. Turn the doorknob and push the door open quickly to observe the room
   3. CC. Stand to the doorknob side of the door frame while knocking and listening
   4. DD. Position both crew members centered directly in front of the adjacent hallway windows
   Show answer to question 6

   Answer: C. Stand to the doorknob side of the door frame while knocking and listening

   Standing to the side of the door frame (the doorknob side) keeps the EMT out of the "fatal funnel," which is the path of potential gunfire or physical assault through the doorway. Standing directly in front of the door or pushing it open unannounced exposes the crew to severe danger if the occupant is armed or hostile.

7. Question 7 of 25Hard

   Rescuers are using step chocks to stabilize a passenger sedan resting on all four wheels to eliminate suspension bounce before patient access. Where should the step chocks be inserted?

   1. AA. Under the front and rear bumpers centered with the license plates.
   2. BB. Under the rocker panels on both sides just behind front wheels and ahead of rear wheels.
   3. CC. Directly under the oil pan and rear differential along the vehicle centerline.
   4. DD. Beneath the vehicle floorboards directly under each occupant seat.
   Show answer to question 7

   Answer: B. Under the rocker panels on both sides just behind front wheels and ahead of rear wheels.

   Step chocks must be placed under the structural rocker panels or frame rails directly behind the front wheels and in front of the rear wheels to isolate suspension movement and create a stable platform. Bumpers, floorboards, and central drivetrain components are either non-structural or too narrow to provide effective lateral stability.

8. Question 8 of 25Medium

   You are the first arriving unit at an interstate highway collision involving two passenger cars blocking the left travel lane. How should you position the ambulance to provide the safest working environment for your crew?

   1. AA. Park 100 feet downstream from the collision with the front wheels aligned straight.
   2. BB. Park directly behind the crashed vehicles parallel to the lane with wheels turned toward traffic.
   3. CC. Park in front of the damaged vehicles in the median with high-beam headlights on.
   4. DD. Park 50 feet upstream at an angle across the lane with the front wheels turned away from the crash.
   Show answer to question 8

   Answer: D. Park 50 feet upstream at an angle across the lane with the front wheels turned away from the crash.

   Positioning an emergency vehicle upstream (between approaching traffic and the crash) at an angle creates a physical barrier known as a fend-off position, shielding the work zone. Turning the front wheels away from the incident ensures that if the ambulance is struck from behind, it will roll away from rather than into the responders and patients. Parking downstream fails to provide a barrier against oncoming motorists.

9. Question 9 of 25Easy

   An EMT is assessing an agitated patient in an emergency department triage area. Which set of behaviors indicates the highest immediate risk of impending physical violence?

   1. AA. Flat emotional affect, monotone voice, and avoidance of eye contact
   2. BB. Tearfulness, trembling hands, and repeated requests for reassurance
   3. CC. Clenched fists, continuous pacing, and aggressive scanning of the room
   4. DD. Slurred speech, heavy leaning against the wall, and nodding off
   Show answer to question 9

   Answer: C. Clenched fists, continuous pacing, and aggressive scanning of the room

   Clenched fists, pacing, tense posture, and hypervigilant scanning of the room are classic indicators of escalating agitation and impending physical assault. Providers should recognize these signs early, maintain distance, and request assistance before violence erupts. Drowsiness, flat affect, and tearfulness may reflect intoxication, depression, or distress, but they do not signal immediate physical hostility.

10. Question 10 of 25Easy

    Which reference helps EMS responders identify a hazardous material from its placard number and determine initial isolation and protective actions?

    1. AA. The patient care report
    2. BB. The local street map
    3. CC. The ambulance's vehicle maintenance log
    4. DD. The Emergency Response Guidebook
    Show answer to question 10

    Answer: D. The Emergency Response Guidebook

    The Emergency Response Guidebook, published by the U.S. Department of Transportation, links placard and identification numbers to guide pages that list hazards, initial isolation distances and protective actions.

    Why the other options are wrong

    • AThe patient care report documents care, not hazard information.
    • BA street map does not identify chemicals.
    • CThe maintenance log records vehicle upkeep.

11. Question 11 of 25Easy

    While treating a toddler experiencing severe respiratory distress, the child's parent is crying hysterically and repeatedly grabbing the EMT's hands, preventing oxygen administration. Which action by the EMT is most appropriate?

    1. AA. Inform the parent that interfering with medical care constitutes criminal endangerment.
    2. BB. Assign the parent a specific supportive role, such as holding the child's hand.
    3. CC. Direct law enforcement to remove the parent from the room immediately.
    4. DD. Withhold oxygen therapy until the parent calms down and steps outside.
    Show answer to question 11

    Answer: B. Assign the parent a specific supportive role, such as holding the child's hand.

    Assigning a distraught family member a constructive task channels their anxiety, reduces interference, and provides emotional comfort to a pediatric patient. Forcibly ejecting the parent can escalate the situation and increase the child's distress, while withholding necessary oxygen therapy delays life-saving care.

12. Question 12 of 25Hard

    An EMT crew arrives at an excavation site where a construction worker is trapped waist-deep in an unreinforced trench following a dirt wall collapse. What resource must be requested before attempting to reach the patient?

    1. AA. A technical rescue team trained in trench rescue
    2. BB. Advanced life support to manage crush injury syndrome
    3. CC. Law enforcement for site security
    4. DD. The municipal building code enforcement officer
    Show answer to question 12

    Answer: A. A technical rescue team trained in trench rescue

    Trench rescues carry an extremely high risk of secondary collapse and require specially trained technical rescue personnel with trench shoring equipment before any provider can safely enter. Although advanced life support will be valuable for crush syndrome management, patient access cannot be achieved safely without technical rescue teams securing the trench walls.

13. Question 13 of 25Easy

    A 33-year-old woman's car was struck from behind while she was stopped at a light. Her headrest was set too low. Which injury is most likely from this mechanism?

    1. AA. Hip dislocation from striking the dashboard
    2. BB. Neck injury from the head snapping backward
    3. CC. Chest injury from the steering wheel
    4. DD. Burns from airbag deployment
    Show answer to question 13

    Answer: B. Neck injury from the head snapping backward

    In a rear-end collision, the body is pushed forward while the head lags behind. With a low headrest, the neck bends backward over it, causing neck sprains or more serious cervical injuries.

    Why the other options are wrong

    • AHip dislocations are typical of frontal crashes in which the knees strike the dashboard.
    • CSteering wheel impact is typical of frontal crashes.
    • DFront airbags usually do not deploy in rear impacts, and burns are not the main concern.

14. Question 14 of 25Medium

    You are dispatched to a residence for a patient complaining of severe shortness of breath. As you step onto the front porch, you detect a strong odor of rotten eggs and hear a loud hissing sound near the gas meter. What is your immediate priority?

    1. AA. Open exterior windows to ventilate the gas accumulation around the structure
    2. BB. Enter the home quickly to rescue the occupant before an explosion occurs
    3. CC. Retreat to a safe location upwind and request the gas company and fire department
    4. DD. Turn off the main electrical breaker located on the exterior wall
    Show answer to question 14

    Answer: C. Retreat to a safe location upwind and request the gas company and fire department

    A strong rotten egg odor and hissing indicate a major natural gas leak with a severe risk of explosion. EMTs must retreat immediately upwind and uphill to a safe distance and request specialized resources; attempting rescue or operating electrical switches creates ignition sources that can trigger a blast.

15. Question 15 of 25Medium

    At a hazardous materials incident, in which zone do EMTs usually treat patients after decontamination?

    1. AA. Cold zone
    2. BB. Warm zone
    3. CC. Hot zone
    4. DD. Exclusion zone
    Show answer to question 15

    Answer: A. Cold zone

    The hot zone contains the contamination, and decontamination takes place in the warm zone. EMTs usually provide care in the cold zone, after patients have been decontaminated.

    Why the other options are wrong

    • BThe warm zone is where decontamination takes place, not routine EMS care.
    • CThe hot zone is entered only by specially trained, protected hazmat teams.
    • DExclusion zone is another name for the hot zone.

16. Question 16 of 25Medium

    You and your partner arrive to find a 70-year-old man in cardiac arrest with no bystander CPR. During your scene size-up, which request is most appropriate?

    1. AA. Request law enforcement to secure the home
    2. BB. Request a supervisor to help with documentation
    3. CC. Request ALS and additional personnel
    4. DD. Request a second ambulance for the family
    Show answer to question 16

    Answer: C. Request ALS and additional personnel

    High-quality CPR with defibrillation, ventilation, and regular compressor changes needs more hands than a two-person crew. Request ALS and additional personnel early, as part of the scene size-up.

    Why the other options are wrong

    • ALaw enforcement is requested when there is a safety threat, which is not described here.
    • BHelp with documentation does not improve the patient's chance of survival.
    • DThe family does not need a separate ambulance; the patient needs more rescuers.

17. Question 17 of 25Hard

    During a chemical spill at a factory, a worker in wet, chemical-smelling clothing walks up to your ambulance in the cold zone asking for help. What should you do?

    1. AA. Load him into the ambulance and transport
    2. BB. Remove his clothing yourself without protection
    3. CC. Keep him out and direct him to decontamination
    4. DD. Have him wait inside the ambulance for the hazmat team
    Show answer to question 17

    Answer: C. Keep him out and direct him to decontamination

    A contaminated patient can expose the crew and take the ambulance out of service. Keep him out of the vehicle and direct him to decontamination, using protective equipment if contact is necessary.

    Why the other options are wrong

    • ALoading him contaminates the ambulance and the crew.
    • BHandling contaminated clothing without protective gear exposes you to the chemical.
    • DPlacing him in the ambulance contaminates the vehicle even if you stay outside.

18. Question 18 of 25Hard

    An EMT unit is dispatched to a two-vehicle crash in a remote region where the nearest mutual-aid ambulance is 45 minutes away. The crew finds three patients: one with severe head trauma, one with an open femur fracture, and one with bilateral wrist pain. Why does this scenario qualify as a multiple-casualty incident?

    1. AA. The incident includes injuries classified as both medical and traumatic.
    2. BB. The presence of head trauma mandates an automatic regional disaster response.
    3. CC. Any collision with more than two injured individuals automatically triggers an MCI protocol.
    4. DD. Resource capability is dictated by geographic isolation and extended response times.
    Show answer to question 18

    Answer: D. Resource capability is dictated by geographic isolation and extended response times.

    An MCI is defined by the balance between available resources and patient needs; because mutual aid is 45 minutes away, a single ambulance cannot adequately treat and transport two severely injured individuals simultaneously, making it an MCI despite the modest patient count. An MCI is not governed by a rigid patient count or specific injury types, but rather by the operational capacity of the local system.

19. Question 19 of 25Easy

    On the NFPA 704 standard hazard identification system diamond, which color represents health hazards?

    1. AA. Yellow
    2. BB. Blue
    3. CC. Red
    4. DD. White
    Show answer to question 19

    Answer: B. Blue

    In the NFPA 704 system, the blue diamond indicates health hazards on a scale from 0 to 4. Red represents flammability, yellow denotes instability or reactivity, and white is reserved for special hazards such as oxidizers or water-reactive chemicals.

20. Question 20 of 25Medium

    During primary START triage at an explosion, what is the appropriate management for an adult patient who remains apneic after the airway is manually opened?

    1. AA. Initiate continuous chest compressions for two minutes
    2. BB. Deliver five rapid rescue breaths before reevaluating
    3. CC. Tag the patient as expectant and move to the next person
    4. DD. Insert a supraglottic airway device and begin ventilations
    Show answer to question 20

    Answer: C. Tag the patient as expectant and move to the next person

    In adult START triage, opening the airway is the sole intervention for apnea; if the patient does not begin spontaneous breathing, they are tagged black (expectant/deceased) so responders can focus scarce resources on salvageable victims. Performing rescue breathing or CPR depletes critical personnel and violates the core triage objective of doing the greatest good for the greatest number.

21. Question 21 of 25Hard

    You are the first EMS unit to arrive at a highway incident involving three heavily damaged sedans. You observe occupants trapped inside two of the vehicles and two walking wounded individuals waving for help. What is the correct initial action?

    1. AA. Declare a mass-casualty incident, establish command, and call for additional resources
    2. BB. Place the walking wounded inside your ambulance and begin detailed physical exams
    3. CC. Begin extricating the entrapped patients to determine who requires immediate transport
    4. DD. Disconnect the negative battery cables of the vehicles to prevent an engine fire
    Show answer to question 21

    Answer: A. Declare a mass-casualty incident, establish command, and call for additional resources

    When arriving first at an incident where the number of patients and severity of entrapment clearly overwhelm initial unit capacity, the EMT must establish Incident Command, declare a mass-casualty incident, and request appropriate transport and rescue assets. Becoming task-focused on individual treatment or extrication before establishing command and calling for help delays the overall system response for all victims.

22. Question 22 of 25Medium

    While an EMT crew is treating an assault victim in a residence that was previously secured by law enforcement, an armed individual re-enters through a back door shouting threats. Police officers are occupied in an adjacent room. What is the EMTs' primary action?

    1. AA. Attempt to physically disarm the individual using restraint techniques.
    2. BB. Immediately retreat from the residence to a safe location.
    3. CC. Verbally confront the individual to negotiate a surrender.
    4. DD. Shield the patient with your body until officers intervene.
    Show answer to question 22

    Answer: B. Immediately retreat from the residence to a safe location.

    If a secured scene becomes unsafe, personal safety is the top priority and EMTs must immediately retreat from danger to a safe staging area and notify police. Attempting to shield the patient or physically disarm an armed subject places EMS personnel at high risk of fatal injury.

23. Question 23 of 25Hard

    You are treating a 34-year-old woman with facial bruises in her apartment when her partner arrives, shouting and threatening your crew. Police are not on scene. What should you do?

    1. AA. Retreat to safety, with the patient if possible, and call police
    2. BB. Stay and argue with the partner to defend your patient
    3. CC. Ask the patient to calm her partner down
    4. DD. Restrain the partner yourself with straps from the stretcher
    Show answer to question 23

    Answer: A. Retreat to safety, with the patient if possible, and call police

    When a scene becomes unsafe, the crew's safety comes first. Retreat to a safe location, taking the patient if it can be done safely, and request law enforcement before returning.

    Why the other options are wrong

    • BArguing can escalate the threat and endanger the crew and the patient.
    • CAsking the patient to manage the aggressor may put her at further risk.
    • DPhysically restraining an aggressor is a law enforcement role and is dangerous for EMTs.

24. Question 24 of 25Medium

    A 22-year-old unrestrained passenger was thrown from a vehicle that rolled over. She is now conscious and says she feels fine. How should this mechanism influence your care?

    1. AA. Ejection is a high-risk mechanism, so suspect serious injury.
    2. BB. Since she feels fine, her injuries are likely minor.
    3. CC. Ejection matters only if the vehicle hit another car.
    4. DD. She needs care only if she has visible bleeding.
    Show answer to question 24

    Answer: A. Ejection is a high-risk mechanism, so suspect serious injury.

    Partial or complete ejection is a high-risk mechanism in the field triage guidelines. Suspect serious hidden injuries, perform a thorough assessment, and consider transport to a trauma center even if she feels well.

    Why the other options are wrong

    • BAdrenaline and distraction can mask pain, so feeling fine does not rule out serious injury.
    • CEjection is dangerous whether or not another vehicle was involved.
    • DSerious internal injuries can occur without any visible bleeding.

25. Question 25 of 25Medium

    A 10-year-old boy is struggling in a pond about 15 feet from the bank. You are not trained in water rescue. What should you do first?

    1. AA. Reach with a pole or throw a flotation device
    2. BB. Swim out to the child immediately
    3. CC. Row out in a boat before trying anything else
    4. DD. Wait for the child to reach the bank
    Show answer to question 25

    Answer: A. Reach with a pole or throw a flotation device

    Water rescue follows the sequence reach, throw, row, then go. Untrained rescuers should first reach with an object or throw a flotation device rather than enter the water.

    Why the other options are wrong

    • BSwimming out is the last resort and is reserved for trained rescuers.
    • CRowing comes after reaching and throwing have failed.
    • DA struggling child may soon go under, so waiting is not appropriate.

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