1. C
Gurgling with incomplete sentences indicates airway compromise requiring immediate intervention.

2. B
Adults learn best through interactive, problem-based group scenarios that encourage engagement.

3. C
After ensuring safety, oxygen and cardiac monitoring are key to assessing perfusion and rhythm.

4. B
Simulation evaluates applied knowledge and decision-making, not just recall.

5. C
Vital signs are obtained before proceeding to detailed assessments.

6. B
Hands-on repetition supports long-term skill retention in adult learners.

7. B
Absent breath sounds and JVD are hallmark signs of tension pneumothorax.

8. B
Adult learners benefit from facilitation rather than authoritative instruction.

9. B
Fruity odor and tachypnea are classic DKA indicators.

10. B
Immediate, private feedback helps learners improve safely.

11. B
Initial fluid resuscitation and rapid transport are AMLS priorities in sepsis.

12. B
Scenario rubrics measure decision-making and analysis effectively.

13. A
AMLS follows the systematic approach: scene size-up, primary, secondary, ongoing assessment.

14. B
Spinal injury causes neurogenic (distributive) shock due to loss of vascular tone.

15. A
Self-directed case analysis enhances ownership of learning outcomes.

16. A
Unstable wide-QRS arrhythmias require synchronized cardioversion.

17. B
Compliance demands alignment with NAEMT and national standards.

18. B
Fluids help restore perfusion before transport.

19. A
Peer discussion and reflection encourage confidence and mastery.

20. B
Targeted feedback fosters individualized improvement.

21. C
Explanation: A pulmonary embolism blocks circulation through the pulmonary arteries, preventing blood return to the heart and causing obstructive shock. This limits preload despite normal cardiac function.

22. B
Explanation: Formative evaluation occurs throughout the learning process, allowing instructors to provide immediate feedback and coaching to enhance learner performance before final testing.

23. B
Formative feedback guides improvement during training.

24. B
JVD differentiates cardiogenic from hypovolemic shock.

25. A
Relevance and realism maximize learning engagement.

26. B
Explanation: Jugular venous distention (JVD) indicates elevated venous pressure and is characteristic of cardiogenic shock, where the heart fails to pump effectively. Hypovolemic shock, in contrast, shows flat neck veins from volume loss.

27. A
Effective communication enhances safety and teamwork.

28. B
Debriefing fosters reflective learning for improvement.

29. B
Clinical reasoning involves synthesizing data for diagnosis.

30. A
Interactive simulation keeps learners actively engaged.

31. C
Explanation: The debrief is a key element in AMLS education that promotes reflective learning, allowing participants to analyze decisions, reinforce best practices, and identify areas for improvement in a supportive environment.

32. A
Accurate, objective documentation ensures legal protection and quality care.

33. A
Role-play reinforces learning through experiential practice.

34. A
Fluids, oxygen, and early transport are sepsis priorities.

35. A
NAEMT and EMS standards govern AMLS updates and compliance.

36. A
Clinical judgment ensures patient-centered, not monitor-dependent, care.

37. A
Standardized rubrics ensure fair, objective evaluation.