How are the NORTH CAROLINA OFFICE OF EMS state credentialing examination items/questions developed? 

Questions for the NORTH CAROLINA OFFICE OF EMS exam are developed by EMS subject matter experts using several key references: Job Task Analysis (JTA), National EMS Education Standards, Current Accepted Standards of Care (AHA, NAEMT, ITLS) and EMS textbooks currently in circulation. Questions are not taken from county, state or national protocols.  

 

Applicants taking the state credentialing exam will encounter core knowledge, open-ended and/or scenario based multiple choice and multiple answer questions. These questions can require exam candidates to critically think through simple and complex clinical situations. When dealing with multiple choice questions, the applicant can expect to see one correct (Best choice) answer and three distractors. With multiple answer questions, the applicant can expect that more than one correct answer may be accepted or required.  

 

Below are some samples of examination items/questions you may encounter on the NORTH CAROLINA OFFICE OF EMS state credentialing examination. Examination items/questions may be in various forms to include and not limited to: 

 

  • Multiple choice  
  • Multiple answer questions.  

 

EMR, EMT, AEMT & Paramedic: Assessing Operations 

 

Multiple Choice: Core knowledge 
What is the first action you should take when arriving at the scene of an unconscious patient? 
 

  1. A) Assess the environment for safety 
  2. B) Check the patient’s pulse 
  3. C) Administer oxygen 
  4. D) Begin CPR

 

Correct answer: A) Assess the environment for safety 

 

 

EMT, AEMT & Paramedic: Can be used to assess ARV, Medical Emergencies or Special Patient Populations  

 

Multiple Answer: Core Knowledge 
Which of the following is the correct dosage of epinephrine for an adult patient in anaphylactic shock?” 
 

  1. A) 0.3 mg 
  2. B) 0.4 mg 
  3. C) 0.5 mg 
  4. D) 0.6 mg

 

Correct answer: There are 3 correct answers A, B or C would be correct. As long as one of the correct answers is chosen, the answer is marked correct. This is based on the standard SQ dosage of Epi 1:1000 0.3mg-0.5mg. Whereas epi auto injectors typically administer 0.3mg or 0.5mg IM, individuals may have to draw up the medication with a syringe (SC or IM) from a medication ampule or vial and considers the variations in dosage.     

 

 

AEMT/Paramedic: Can be used to assess ARV, Medical Emergencies or Special Patient Populations  

 

Multiple Choice: Scenario Based  
You are called to treat an 8-year-old male patient weighing 88 lbs who is experiencing an allergic reaction after eating peanuts. He presents with hives, mild wheezing, and anxiety but is alert and breathing adequately. Vital signs: HR 120, RR 32, BP 100/60, SpO₂ 95% on room air. As an advanced level EMS provider, what is the “Most” appropriate dose and route of epinephrine (1:1000)? 

 

  1. A) 0.3 mg SC
  2. B) 0.4 mg IM
  3. C) 0.5 mg IN
  4. D) 0.6 mg IV

 

Correct answer: B would be correct. This is based on pediatric dose of 0.01mg/kg of Epi 1:1000 0.3mg-0.5mg 

 

 

AEMT/Paramedic: Can be used to assess ARV, Cardiovascular Emergencies (Shock) or Traumatic Emergencies 

 
Multiple Answer: Core knowledge, Open ended and Scenario based  

You are called to a 21-year-old male that was working in a factory and suddenly became short of breath with chest pain. Once physically seeing your patient you find the patient is pale, diaphoretic and borderline tachypneic. Further assessment reveals BP of 88/48, Pulse of 118, Respirations are 28 with a 92% SPO2. Upon auscultation of the individual’s chest, you note normal cardiac tones (S1,S2), lungs sounds are present, with same slightly diminished in the right upper lobe. You suspect this patient is dealing with a spontaneous tension pneumothorax. To manage this patient, list in order all treatments that would be utilized: 1) Administer oxygen 2) Perform needle decompression 3) Provide positive pressure ventilation, if needed 4) Secure the airway 

 

  1. A) 1, 2, 3,4
  2. B) 4, 1, 3, 2
  3. C) 4, 2, 1 
  4. D) 4, 1, 2
  5. E) 1, 3, 4, 2
  6. F) 4, 3, 2, 1

 

Correct answer: All answers are correct. However, B is the correct progression. To get this question correct, you would list from start to finish what treatment modalities are applicable. 

 

Examination items/questions are developed to assess the individual’s understanding of core knowledge, critical thinking ability and clinical decision-making skills.