Bystanders found a 71-year-old unresponsive and did not start CPR. The arrest was not witnessed. The patient has been in asystole throughout, received no shocks, and has not had ROSC after full ALS care on scene. What is the most appropriate next step?

Contact medical direction to discuss termination of resuscitation

Give high-dose epinephrine 5 mg IV and continue for 20 more minutes

Transport with mechanical CPR to the closest PCI-capable center

Deliver a precautionary shock at maximum energy in case of fine VF

A 3-year-old who is not vaccinated has fever, cough, runny nose, red watery eyes, and a blotchy rash that began on the face and spread downward. Which respiratory protection should the crew wear?

A surgical mask with eye shield

A surgical mask on the crew only

Police have secured the scene where a man was stabbed in the chest. He is in cardiac arrest and resuscitation is indicated. Which action best preserves evidence while providing care?

Cut clothing around rather than through the stab holes and keep removed items for police

Move furniture freely and report the changes only if an officer asks about them later

Delay care until detectives have photographed the scene and the patient as he was found

Wash the wounds with saline and discard the clothing to reduce the risk of infection

A dialysis patient's arteriovenous fistula in the left forearm is bleeding steadily from a needle site after treatment. The patient is alert with stable vital signs. What should the paramedic do first?

Apply firm, direct pressure over the site with a gauze dressing

Inflate a BP cuff on the fistula arm to 150 mmHg to stop the flow

Apply a tourniquet above the fistula, then document the time

Start an IV in the fistula arm to give fluids as close as possible

A 17-year-old who is legally married and lives on her own has a minor wrist injury after a fall. She is alert and oriented and declines transport. Which statement is most accurate?

She is likely an emancipated minor and may refuse like an adult if she has capacity

She must be transported under implied consent, since every minor needs evaluation

She cannot refuse, so the crew must reach a parent before she is allowed to leave

She may refuse only after a police officer arrives on scene and approves the refusal

Paramedic Exam

Free Paramedic Practice Questions

10 sample questions for the Paramedic Exam, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.

Sections covered on the exam: Airway, Respiration and Ventilation, Cardiology and 12-Lead ECG Interpretation, Resuscitation and Post-Arrest Care, Neurologic, Endocrine, Immunologic and Hematologic Emergencies, Abdominal, Renal, Infectious Disease and Sepsis Emergencies, Toxicology, Behavioral and Environmental Emergencies, Obstetrics, Gynecology and Neonatal Care, EMS Operations, Legal Issues and Safety, Patient Assessment and the Clinical Judgment Model.

Question 1 · Airway, Respiration and Ventilation
A patient with suspected sepsis is placed on a nonrebreather mask at 12 L/min from an E cylinder that reads 2,000 psi. Using a safe residual of 200 psi and an E-cylinder constant of 0.28, about how long will the oxygen last?
- A.34 minutes
- B.24 minutes
- C.42 minutes
- D.47 minutes
Show answer and explanation
Answer: C. 42 minutes
Duration = (gauge psi - 200) x constant / flow = (2,000 - 200) x 0.28 / 12 = 1,800 x 0.28 / 12 = 504 / 12 = 42 minutes. Forgetting to subtract the 200 psi safe residual gives about 47 minutes, using the D-cylinder constant of 0.16 gives 24 minutes, and dividing by 15 L/min instead of 12 gives about 34 minutes.
Question 2 · Resuscitation and Post-Arrest Care
Bystanders found a 71-year-old unresponsive and did not start CPR. The arrest was not witnessed. The patient has been in asystole throughout, received no shocks, and has not had ROSC after full ALS care on scene. What is the most appropriate next step?
- A.Give high-dose epinephrine 5 mg IV and continue for 20 more minutes
- B.Transport with mechanical CPR to the closest PCI-capable center
- C.Deliver a precautionary shock at maximum energy in case of fine VF
- D.Contact medical direction to discuss termination of resuscitation
Show answer and explanation
Answer: D. Contact medical direction to discuss termination of resuscitation
The patient meets the ALS termination of resuscitation rule: unwitnessed arrest, no bystander CPR, no shock delivered and no ROSC after ALS care, so continuing on scene or transporting adds risk without benefit. Termination should be discussed with medical direction per protocol; asystole is not shocked, and high-dose epinephrine has no proven benefit.
Question 3 · Abdominal, Renal, Infectious Disease and Sepsis Emergencies
A 3-year-old who is not vaccinated has fever, cough, runny nose, red watery eyes, and a blotchy rash that began on the face and spread downward. Which respiratory protection should the crew wear?
- A.A fit-tested N95 respirator
- B.A surgical mask with eye shield
- C.A surgical mask on the crew only
- D.Gloves and gown with no mask
Show answer and explanation
Answer: A. A fit-tested N95 respirator
These findings suggest measles, which spreads by the airborne route and needs a fit-tested N95 (or higher) respirator, plus a surgical mask on the patient if tolerated. Surgical masks are droplet precautions suitable for influenza or meningococcus, and gown and gloves alone are contact precautions.
Question 4 · EMS Operations, Legal Issues and Safety
Police have secured the scene where a man was stabbed in the chest. He is in cardiac arrest and resuscitation is indicated. Which action best preserves evidence while providing care?
- A.Move furniture freely and report the changes only if an officer asks about them later
- B.Delay care until detectives have photographed the scene and the patient as he was found
- C.Wash the wounds with saline and discard the clothing to reduce the risk of infection
- D.Cut clothing around rather than through the stab holes and keep removed items for police
Show answer and explanation
Answer: D. Cut clothing around rather than through the stab holes and keep removed items for police
Patient care comes first, but paramedics can preserve evidence by cutting around holes, bagging clothing in paper for police, limiting scene disturbance, and documenting any changes they make. Delaying indicated care is never appropriate, and discarding clothing or rearranging the scene without telling police destroys evidence.
Question 5 · Patient Assessment and the Clinical Judgment Model
En Route: A 66-year-old woman stung by a wasp has hives, wheezing and BP 74/40 despite two IM epinephrine doses, 2 L of normal saline and an epinephrine infusion. Her medications include metoprolol and lisinopril. Which medication best addresses the likely reason her shock is refractory?
- A.Methylprednisolone 125 mg IV
- B.Calcium chloride 1 g slow IV
- C.Glucagon IV per protocol
- D.Atropine 1 mg IV push
Show answer and explanation
Answer: C. Glucagon IV per protocol
Beta blockade blunts the response to epinephrine; glucagon raises intracellular cAMP through a non-adrenergic pathway and is the recommended adjunct for anaphylaxis refractory to epinephrine in a patient taking a beta blocker. Steroids are second-line agents that do not reverse hypotension within minutes, and calcium and atropine do not treat the underlying mechanism.
Question 6 · Airway, Respiration and Ventilation
An adult with an opioid overdose is breathing 30 times per minute with a tidal volume of about 200 mL. Using an anatomic dead space of 150 mL per breath, what is the patient's approximate alveolar minute ventilation?
- A.6.0 L/min
- B.4.5 L/min
- C.1.5 L/min
- D.5.85 L/min
Show answer and explanation
Answer: C. 1.5 L/min
Alveolar ventilation = (tidal volume - dead space) x rate = (200 - 150) x 30 = 1,500 mL/min, or 1.5 L/min. Ignoring dead space gives 30 x 200 = 6.0 L/min, subtracting dead space only once gives 5.85 L/min, and 4.5 L/min is the dead-space ventilation (150 x 30). Rapid shallow breathing therefore ventilates very little alveolar space.
Question 7 · Resuscitation and Post-Arrest Care
A 4-year-old is in asystole and the length-based tape is unavailable. Using the formula (2 x age) + 8 for weight, what volume of epinephrine 0.1 mg/mL should the paramedic give IV/IO?
- A.0.8 mL
- B.16 mL
- C.0.16 mL
- D.1.6 mL
Show answer and explanation
Answer: D. 1.6 mL
Estimated weight = (2 x 4) + 8 = 16 kg; the dose is 0.01 mg/kg x 16 = 0.16 mg, and 0.16 mg / 0.1 mg/mL = 1.6 mL (the shortcut is 0.1 mL/kg). The 0.16 mL value mistakes the milligram dose for a volume, 0.8 mL uses 8 kg because the + 8 was left out, and 16 mL is ten times too much.
Question 8 · Abdominal, Renal, Infectious Disease and Sepsis Emergencies
A dialysis patient's arteriovenous fistula in the left forearm is bleeding steadily from a needle site after treatment. The patient is alert with stable vital signs. What should the paramedic do first?
- A.Inflate a BP cuff on the fistula arm to 150 mmHg to stop the flow
- B.Apply a tourniquet above the fistula, then document the time
- C.Start an IV in the fistula arm to give fluids as close as possible
- D.Apply firm, direct pressure over the site with a gauze dressing
Show answer and explanation
Answer: D. Apply firm, direct pressure over the site with a gauze dressing
Most fistula bleeding stops with firm, sustained direct pressure that does not occlude the access completely. A tourniquet is reserved for life-threatening hemorrhage not controlled by pressure. IVs and blood pressure cuffs should not be used on the fistula arm because they can damage or clot the access.
Question 9 · EMS Operations, Legal Issues and Safety
A 17-year-old who is legally married and lives on her own has a minor wrist injury after a fall. She is alert and oriented and declines transport. Which statement is most accurate?
- A.She must be transported under implied consent, since every minor needs evaluation
- B.She cannot refuse, so the crew must reach a parent before she is allowed to leave
- C.She is likely an emancipated minor and may refuse like an adult if she has capacity
- D.She may refuse only after a police officer arrives on scene and approves the refusal
Show answer and explanation
Answer: C. She is likely an emancipated minor and may refuse like an adult if she has capacity
Most states treat married minors, those in the military, and minors who are self-supporting and live independently as emancipated, able to consent to or refuse care like adults. The paramedic still assesses capacity, explains risks and documents the refusal. Implied consent applies to minors with a life or limb threat when no guardian is available, not to a capable emancipated minor.
Question 10 · Patient Assessment and the Clinical Judgment Model
En Route: Medical direction orders dopamine at 5 mcg/kg/min for an 80 kg patient in cardiogenic shock. The premixed bag contains 400 mg in 250 mL. What pump rate should the paramedic set?
- A.33 mL/h
- B.15 mL/h
- C.24 mL/h
- D.0.25 mL/h
Show answer and explanation
Answer: B. 15 mL/h
400 mg / 250 mL = 1.6 mg/mL = 1,600 mcg/mL. Rate = 5 mcg/kg/min x 80 kg x 60 min/h / 1,600 mcg/mL = 24,000 / 1,600 = 15 mL/h. Assuming 1,000 mcg/mL gives 24 mL/h, using the weight in pounds (176) gives 33 mL/h, and leaving out the 60 min/h conversion gives 0.25 mL/h.

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