Paramedic NRP Exam Prep practice questions and answers 2026. Tap an option to test yourself — you'll see the correct answer and a plain-English explanation for every question. Free, no login.
Q11What is the primary reason for attaching EKG leads to specific body locations?
✓ Correct answer: C. To obtain a clear and accurate reading of the heart’s electrical activity
Answer: To obtain a clear and accurate reading of the heart’s electrical activity EKG leads are attached to specific body locations to ensure an accurate and clear reading of the heart's electrical activity. Placement at these standardized locations helps in achieving consistent results, which are crucial for proper diagnosis and treatment.
Q12During an adult cardiac resuscitation effort, what does an end-tidal $$CO_{2}$$ (ETCO2) of less than 10 mmHg suggest?
✓ Correct answer: A. Chest compressions are inadequate
Answer: Chest compressions are inadequate During a cardiac resuscitation effort, an ETCO2 reading of less than 10 mmHg suggests that the quality of chest compressions is not sufficient. In effective cardiopulmonary resuscitation (CPR), the target ETCO2 is between 35-40 mmHg. Low ETCO2 readings during resuscitation indicate poor circulation and inadequate perfusion, meaning that oxygen is not being delivered efficiently to the tissues. This does not relate to the effectiveness of defibrillation, the patient's body temperature, or oxygen saturation levels.
Q13A paramedic records a 12-lead EKG with a negative QRS in Lead II and a positive QRS in Lead III. What does this suggest?
✓ Correct answer: C. Left axis deviation
Answer: Left axis deviation. Assess leads II and III on the 12-lead EKG to determine axis deviation. A negative QRS in Lead II and a positive QRS in Lead III indicate left axis deviation. If there is a positive QRS in both leads, this indicates normal axis deviation. Negative QRS in both leads suggests extreme axis deviation.
Q14You are called to assist a 65-year-old patient with a history of congestive heart failure who is complaining of severe shortness of breath. On arrival, the patient is found to be in acute respiratory distress with frothy sputum production. His $$SpO_{2}$$ is 82 percent on room air. Respirations are 30 per minute and labored. His heart rate is 120 beats per minute with a blood pressure of 150 systolic. Which of the following interventions would be inappropriate at this point?
✓ Correct answer: B. Nitroglycerin therapy
Answer: Nitroglycerin therapy Nitroglycerin therapy should not be administered to a patient who is exhibiting symptoms of acute pulmonary edema with a high heart rate and blood pressure, as it may not provide immediate relief and could potentially worsen the patient's condition. This patient's condition suggests a different primary intervention such as CPAP or diuretics. High-flow oxygen therapy would be indicated to improve oxygenation. Intravenous access is crucial for administering medications or fluids. A twelve-lead electrocardiogram analysis helps in identifying any underlying cardiac issues.
Q15Which of the following hormones is responsible for naturally increasing both the heart rate (positive chronotropic effect) and the strength of the heart's contraction (positive inotropic effect)?
✓ Correct answer: D. Epinephrine
Answer: Epinephrine Epinephrine, also known as adrenaline, is released by the adrenal medulla and stimulates an increase in the heart rate (positive chronotropic effect) and the force of muscle contraction (positive inotropic effect). Insulin is a hormone that regulates blood glucose levels, and it has no direct effect on heart rate or contraction strength. Glucagon also regulates glucose levels but does not affect the heart in the same way as epinephrine. Thyroxine, produced by the thyroid gland, primarily affects metabolism and has a slower, more general effect on cardiovascular function.
Q16During an ambulance ride, how would a paramedic determine the atrial rate on an EKG strip?
✓ Correct answer: C. The number of P waves
Answer: The number of P waves To determine the atrial rate, the number of P waves is counted on the EKG strip. This is because each P wave represents one atrial contraction or depolarization.
Q17You are called to assist a 28-year-old pregnant patient who is experiencing severe nausea and vomiting in her third trimester. Her vital signs are BP 130/78, HR 115, R 18, $$SpO_{2}$$ 97%. She has been unable to keep any food or fluids down for the past 24 hours. What immediate intervention is required to manage her condition?
✓ Correct answer: C. The patient's $$SpO_{2}$$ is 97%, so oxygen therapy is not indicated; focus on preventing dehydration and consider transport for further evaluation.
The patient's $$SpO_{2}$$ is 97%, which indicates she is well-oxygenated and does not require supplemental oxygen at this time. The primary concern should be managing her nausea and preventing dehydration due to her inability to keep food or fluids down for the past 24 hours. Immediate intervention should include assessing her fluid status and considering transport to a medical facility for further management, including potential IV hydration and antiemetics.
Q18You are assessing a pregnant woman who is at 28 weeks of gestation. What is the expected normal range for her blood pressure during this stage of pregnancy?
✓ Correct answer: B. 110/70 to 120/80 mmHg
Answer: 110/70 to 120/80 mmHg During pregnancy, it is important to monitor the expectant mother's blood pressure to ensure both her health and the baby's health. The expected normal range for blood pressure during the second trimester of pregnancy is typically between 110/70 mmHg and 120/80 mmHg. Lower ranges, such as 90/60 to 100/70 mmHg, might be considered hypotensive, while higher ranges, such as 130/80 to 140/90 mmHg, could indicate hypertensive disorders like preeclampsia.
Q19During the transport of an intubated adult patient, you notice that the end-tidal $$CO_{2}$$ levels are suddenly rising and breath sounds are becoming diminished. Suctioning attempts reveal thick secretions that are hard to remove. What should be your next course of action to ensure effective ventilation?
✓ Correct answer: D. Instill 3 to 5 mL of sterile saline directly down the ET tube to loosen thick secretions
Answer: Instill 3 to 5 mL of sterile saline directly down the ET tube to loosen thick secretions To effectively manage thick secretions that impede ventilation, instilling 3 to 5 mL of sterile saline can help loosen the secretions, making them easier to suction out. Before performing tracheobronchial suctioning through the ET tube, oxygenate the patient with 100% $$O_{2}$$ for at least five minutes. Repeat the oxygenation process with 100% $$O_{2}$$ between suction attempts. Administering albuterol is not effective for loosening thick secretions and managing airway patency in this context. Increasing the rate and depth of ventilation may lead to lung tissue damage, including pneumothorax. Switching to a high-frequency ventilator is not appropriate in pre-hospital settings and could cause further complications due to increased intrapleural pressure.
Q20Which of the following conditions is characterized by an autoimmune attack on the neuromuscular junction, leading to fluctuating muscle weakness and fatigue?
✓ Correct answer: C. Myasthenia Gravis
Answer: Myasthenia Gravis Myasthenia Gravis is an autoimmune disorder that targets the acetylcholine receptors at the neuromuscular junction, leading to fluctuating muscle weakness and fatigue. This condition can cause severe weakness, including respiratory muscle involvement, which might require medical intervention. Multiple Sclerosis is a disease where immune-mediated processes attack the myelin sheath of nerve fibers in the brain and spinal cord, leading to progressive neurological deterioration but does not specifically target the neuromuscular junction. Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord, causing loss of muscle control but is not primarily an autoimmune disease. Muscular Dystrophy is a group of genetic diseases characterized by progressive weakness and loss of muscle mass, but it is not related to autoimmune attacks on the neuromuscular junction.
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