Primary Assessment

Sample questions.

8 free primary assessment 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 reported unresponsive male at a bus stop. On arrival bystanders state he collapsed suddenly. He is unresponsive. You perform the AVPU assessment and receive no response. He is not breathing and has no palpable carotid pulse. A bystander shouts that the patient has a DNR. What do you do?

   • A.Begin CPR immediately
   • B.Call medical control before doing anything
   • C.Always begin CPR regardless of any DNR documentation
   • D.Request verification of the DNR documentCorrect

   Why:Correct. A valid prehospital DNR or POLST form that applies to the patient's current situation should be followed. However if the document is unavailable unclear or does not apply to the current situation resuscitation should be initiated. The EMT-B must see a valid document — verbal statements from bystanders alone are not sufficient.

2. Question 2

   At a college dorm, a 20-year-old female is alert with no life threats after your primary assessment. What comes next?

   • A.Ignore vitals
   • B.End the assessment
   • C.Immediate discharge
   • D.Focused secondary assessmentCorrect

   Why:Correct. Once primary threats are ruled out, move to history, focused exam, and ongoing reassessment.

3. Question 3

   At a assisted-living room, a 70-year-old male is awake but has a weak radial pulse after major trauma. What does this suggest?

   • A.No concern
   • B.Normal circulation
   • C.Minor anxiety
   • D.Poor perfusionCorrect

   Why:Correct. A weak radial pulse after trauma suggests possible shock and should raise transport priority.

4. Question 4

   You arrive on scene of a single-car MVC. The driver is unconscious in the vehicle. The car is stable on a flat surface and there are no hazards present. You have donned BSI. As you approach the vehicle and open the door to reach the patient, what is the FIRST assessment you perform?

   • A.Check responsivenessCorrect
   • B.Check for a carotid pulse
   • C.Apply oxygen immediately
   • D.Open the airway with jaw thrust

   Why:Correct. The first step after scene safety and BSI is establishing unresponsiveness. A patient who appears unconscious may be asleep, heavily sedated, or in a postictal state and may respond to stimulation. Tapping shoulders and shouting while looking for response is the correct first step before any intervention.

5. Question 5

   You respond to a 5-year-old male who was struck by a bicycle. He is lying on the ground, not moving. From across the room you observe: he does not respond to your voice, his chest is barely moving, his color is mottled purple-grey, and he has audible gurgling. Before you reach him, what is your immediate working diagnosis and priority?

   • A.He likely has a broken arm from the impact — assess the injury
   • B.He is likely in pain
   • C.Critical airway and circulation failureCorrect
   • D.He probably has a concussion — GCS assessment should come first

   Why:Correct. The Pediatric Assessment Triangle (PAT) is designed for assessment from across the room before touching the patient. All three components abnormal (appearance, work of breathing, circulation to skin) = critically ill child with immediate life threats. Approach rapidly, suction the gurgling airway, perform jaw thrust, begin BVM if breathing is inadequate. This child is in cardiopulmonary failure.

6. Question 6

   You respond to a 66-year-old male with altered mental status for 1 hour. Blood glucose is 22 mg/dL. GCS is 10. He is drooling and coughs when attempting to swallow. Can you administer oral glucose?

   • A.GCS 10 is sufficient for oral glucose administration
   • B.GCS 10 always contraindicates oral glucose in all patients
   • C.BGL 22 requires immediate oral glucose regardless of GCS
   • D.GCS 10 combined with drooling and coughingCorrect

   Why:Correct. Oral glucose requires a patient who can safely swallow and protect their airway. GCS 10 combined with active drooling and coughing on swallowing indicates impaired swallow function — aspiration risk is significant. Buccal gel application without swallowing is acceptable per protocol. ALS for IV dextrose.

7. Question 7

   You respond to a 44-year-old male who collapsed at a gym. He is pulseless and apneic. A gym trainer has been doing CPR for approximately 3 minutes. As you take over compressions your partner attaches the AED. Before the AED analyzes, the trainer says he thinks he felt a pulse and asks if you should stop compressions to check. What is the best response?

   • A.Continue compressions until the AED is ready to analyzeCorrect
   • B.Stop compressions and check for a pulse
   • C.Continue compressions while your partner feels for a pulse
   • D.Stop and let the AED analyze for a shockable rhythm as scheduled

   Why:Correct. Bystander pulse impression during CPR: do not interrupt compressions for an unverified bystander observation. The AED will analyze imminently and provide objective rhythm information. Any interruption degrades coronary perfusion pressure. If the bystander felt movement, it was likely the compressions themselves or muscle activity — not a pulse. Continue CPR until the AED is ready to analyze.

8. Question 8

   At a church basement, a 64-year-old male has a patent airway but respirations are 6/min. What is the priority intervention?

   • A.Give aspirin
   • B.Nasal cannula only
   • C.Ask OPQRST
   • D.Assist ventilationsCorrect

   Why:Correct. Inadequate respiratory rate requires assisted ventilations with oxygen.