National Registry Paramedic Certification Examination Free Sample Questions

A paramedic is preparing to intubate an adult female patient in respiratory failure. During direct laryngoscopy, only the epiglottis is visualized (Cormack-Lehane grade III). When advancing the endotracheal tube over a tracheal tube introducer (bougie), the paramedic aligns the feature labeled X in the figure with which anatomical landmark?

A 28-year-old male with severe traumatic brain injury following a motor vehicle collision is intubated. He displays a unilateral dilated and sluggish pupil with decerebrate posturing. Vital signs are blood pressure 178/94 mmHg, heart rate 56 bpm, and SpO2 98%. What is the appropriate ventilation strategy and target end-tidal carbon dioxide (EtCO2) level for this patient?

A 68-year-old male with acute cardiogenic pulmonary edema is receiving continuous positive airway pressure (CPAP) at 10 cmH2O. His work of breathing improves, but he suddenly pulls the mask off his face to speak to family. Why is preserving an uninterrupted mask seal critical during continuous positive airway pressure therapy?

A 62-year-old male reports crushing substernal chest pressure radiating to his jaw, accompanied by diaphoresis and nausea. His 12-lead ECG reveals 2 mm ST-segment elevation in leads II, III, and aVF with reciprocal depressions in leads I and aVL. Blood pressure is 118/76 mmHg and heart rate is 64 bpm. Which pharmacological assessment finding represents an absolute contraindication to sublingual nitroglycerin administration?

Following return of spontaneous circulation (ROSC) after prolonged cardiac arrest, a 58-year-old female remains comatose. Vital signs are blood pressure 82/46 mmHg (mean arterial pressure 58 mmHg), heart rate 92 bpm, SpO2 96% via endotracheal tube, and EtCO2 38 mmHg. What is the primary pathophysiological rationale for titrating vasopressors to maintain a mean arterial pressure (MAP) of at least 65 mmHg in the post-cardiac arrest phase?

Paramedics are treating a 54-year-old male in out-of-hospital ventricular fibrillation cardiac arrest. High-quality CPR is ongoing, two defibrillation shocks have been delivered, and 1 mg of epinephrine IV has been administered. The rhythm check shows persistent, coarse ventricular fibrillation. Which antiarrhythmic regimen is indicated next according to current resuscitation guidelines?