Airway Management

Sample questions.

8 free airway management questions with answers and explanations. MedRelay's full question bank covers every NREMT domain, plus live scenarios that grade the decision, not just the answer.

1. Question 1

   You respond to a 19-year-old male from a diving accident hitting the pool bottom head-first. He is pulseless and apneic. You must open the airway for CPR. What is the correct technique?

   • A.Head-tilt chin-lift — speed is critical for cardiac arrest
   • B.Apply a cervical collar before beginning any airway management
   • C.Do not open the airway until the spine is cleared
   • D.Jaw thrust with manual in-line spinal stabilizationCorrect

   Why:Correct. Jaw thrust with in-line cervical spine stabilization is correct when spinal injury is suspected. Head-tilt chin-lift extends the cervical spine and is contraindicated. Resuscitation does not wait for spinal clearance — airway management and CPR proceed with spinal precautions.

2. Question 2

   At a manufacturing floor, a 58-year-old male is unresponsive with wet snoring respirations and vomit at the lips. What should you do first?

   • A.Suction, then reassessCorrect
   • B.Insert OPA immediately
   • C.Begin OPQRST history
   • D.Give oral glucose

   Why:Correct. Visible fluid and vomit threaten airway patency. Suction first, then reassess breathing and ventilation.

3. Question 3

   You respond to a 58-year-old male with GCS 6 who needs airway management. When you test his gag reflex by touching the posterior pharynx, he gags briefly. You opt for an NPA. As you insert the NPA into the right nostril, you encounter resistance and cannot advance it. What is the correct next step?

   • A.Withdraw the NPA and attempt insertion into the left nostrilCorrect
   • B.Apply more force — resistance is expected
   • C.Rotate the NPA and push harder
   • D.Choose a smaller NPA and force it through

   Why:Correct. NPA insertion resistance: never force an NPA — significant resistance indicates anatomical obstruction. Try the other nostril. The NPA should advance with gentle steady pressure along the floor of the nasal passage. If resistance continues in both nostrils, reassess whether an OPA is appropriate given the current gag reflex status. Document the difficulty and the approach used.

4. Question 4

   When is continuous compression CPR with asynchronous ventilations at 10 per minute appropriate for EMT-Bs?

   • A.Only when an advanced airway device isCorrect
   • B.Always — it is superior to 30:2
   • C.Only when the arrest is witnessed
   • D.Only for patients over 65 years old

   Why:Correct. Continuous compressions with asynchronous ventilation is appropriate only when a supraglottic or advanced airway device protects the airway. Without an airway device, asynchronous BVM ventilation during compressions inflates the stomach, risking regurgitation and aspiration. Without an advanced airway, EMT-Bs use 30:2.

5. Question 5

   You respond to a 78-year-old male who was found on his kitchen floor. GCS is 6. He has no gag reflex. You are preparing to insert an OPA. You measure from the corner of his mouth to the earlobe — 90 mm. You have 80 mm, 90 mm, and 100 mm OPAs available. Which do you select and what is the correct insertion technique for an adult?

   • A.90 mm — matching the measurementCorrect
   • B.80 mm — always go one size
   • C.100 mm — always go one size larger
   • D.90 mm — insert with the curve

   Why:Correct. OPA sizing and adult insertion technique: match the measurement (corner of mouth to earlobe). Adult insertion technique: tip pointing toward the palate (curved end up), advance while rotating 180 degrees so the tip curves posteriorly into the pharynx. This rotation technique avoids pushing the tongue backward. Alternative: insert with tongue blade holding tongue forward and direct the OPA posteriorly without rotation.

6. Question 6

   A patient vomits during BVM ventilation. What should you do first?

   • A.Increase ventilation rate
   • B.Roll and suctionCorrect
   • C.Insert nasal airway
   • D.Continue without pause

   Why:Correct. Vomit must be cleared quickly. Roll if safe, suction, then resume airway support and reassess ventilation.

7. Question 7

   A semiconscious trauma patient needs an airway adjunct. Blood is seen behind both ears. What should you avoid?

   • A.OPA placement
   • B.BVM ventilation
   • C.NPA insertionCorrect
   • D.Jaw-thrust positioning

   Why:Correct. Signs of basilar skull fracture make NPA insertion contraindicated. Use positioning, suction, and ventilation as needed.

8. Question 8

   You respond to a 55-year-old male who is unconscious from alcohol intoxication. GCS is 7. He has a partial gag reflex. You are preparing to place an NPA. While inserting the NPA into his right nostril you feel it pass easily to the level of the flange. He coughs slightly but does not gag. SpO2 is 94%. You begin positioning him for transport. Your partner suggests placing him in the left lateral recumbent position. Why is this position preferred?

   • A.Left lateral recumbent (recovery position) for unconscious patientsCorrect
   • B.The lateral recumbent position improves SpO2 in all
   • C.The lateral position is preferred to prevent pressure sores
   • D.Lateral position improves NPA function

   Why:Correct. Left lateral recumbent (recovery position): positions the airway so that vomit and secretions drain by gravity away from the trachea. In supine position, vomit pools posteriorly in the pharynx and flows into the trachea. Lateral recumbent allows gravity drainage of the oral cavity and pharynx. Critical for any obtunded patient with possible vomiting risk. Maintain airway access while transporting.