PARAMEDIC NATIONAL REGISTRY EXAM 2026 ACCURATE REAL
EXAM QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES EACH | CURRENTLY TESTING AND FREQUENTLY
TESTED QUESTIONS | GUARANTEED PASS |
LATEST UPDATE
SECTION A: AIRWAY, RESPIRATION & VENTILATION – 50 QUESTIONS
1. A patient is found unresponsive with gurgling respirations. What is the first
action?
A) Insert an oropharyngeal airway.
B) Suction the oropharynx.
C) Ventilate with a bag-valve mask.
D) Perform a jaw-thrust maneuver.
Correct Answer: B
Rationale: Gurgling indicates fluid in the airway; suctioning must precede any
airway adjunct or ventilation to clear the obstruction. An OPA (A) should not be
inserted until the airway is clear of fluid. BVM ventilation (C) would push fluid into
the lungs. Jaw-thrust (D) is for suspected spinal injury but does not address the
fluid. Suctioning is the immediate priority to establish a patent airway
[reference:0].
2. The normal ETCO₂ (end-tidal carbon dioxide) range in a healthy adult is:
A) 25-30 mmHg
B) 35-45 mmHg
C) 45-55 mmHg
D) 55-65 mmHg
Correct Answer: B
Rationale: Normal ETCO₂ is 35-45 mmHg. Values below 35 mmHg indicate
hyperventilation or decreased perfusion. Values above 45 mmHg indicate
hypoventilation or increased metabolic activity. ETCO₂ monitoring is essential for
confirming endotracheal tube placement and monitoring CPR quality
[reference:1].
1
,3. A 45-year-old patient is found unconscious with sonorous respirations. What is
the most appropriate initial airway maneuver?
A) Oropharyngeal airway insertion
B) Nasopharyngeal airway insertion
C) Head-tilt/chin-lift maneuver
D) Jaw-thrust maneuver
Correct Answer: C
Rationale: Sonorous respirations indicate partial upper airway obstruction from
the tongue. The head-tilt/chin-lift maneuver is the initial intervention to open the
airway. An OPA (A) or NPA (B) can be inserted after the airway is opened. Jaw-
thrust (D) is for suspected spinal injury. Opening the airway is the first priority
[reference:2].
4. A patient with a history of type 1 diabetes is found unconscious with a blood
glucose of 28 mg/dL. An IV is established. Which of the following is the most
appropriate initial pharmacologic intervention?
A) Administer 50 mL of 50% dextrose IV push
B) Administer 1 mg glucagon intramuscularly
C) Administer 100 mL of 10% dextrose IV infusion
D) Administer 2 mg naloxone IV
Correct Answer: A
Rationale: In a patient with severe hypoglycemia and an IV line, 50% dextrose (25
grams) is the standard of care for rapid reversal. Glucagon (B) is an alternative
when IV access is unavailable. 10% dextrose infusion (C) is used for maintenance,
not acute reversal. Naloxone (D) is for opioid overdose, not hypoglycemia
[reference:3].
5. A paramedic is assessing a patient with severe asthma exacerbation. Which of
the following findings indicates impending respiratory failure?
A) Wheezing
B) Silent chest
C) Use of accessory muscles
2
,D) Respiratory rate of 28
Correct Answer: B
Rationale: A silent chest indicates minimal air movement and is a sign of
impending respiratory failure. Wheezing (A) indicates airflow and is expected in
asthma. Accessory muscle use (C) indicates distress but not impending failure.
Respiratory rate of 28 (D) is elevated but not immediately life-threatening. A
silent chest requires immediate intervention.
6. Which of the following is the correct compression-to-ventilation ratio for a 2-
rescuer infant CPR?
A) 15:2
B) 30:2
C) 5:1
D) 10:2
Correct Answer: A
Rationale: For 2-rescuer infant CPR, the compression-to-ventilation ratio is 15:2.
For 1-rescuer infant CPR, it is 30:2 (B). 5:1 (C) is for neonatal resuscitation. 10:2
(D) is not a standard ratio. High-quality CPR with appropriate ratios is critical for
survival.
7. A patient has a tracheostomy and is experiencing respiratory distress. What is
the first action?
A) Suction the tracheostomy.
B) Administer oxygen via mask.
C) Notify the provider.
D) Reposition the patient.
Correct Answer: A
Rationale: The first action for a patient with a tracheostomy in respiratory distress
is to suction to clear secretions and maintain airway patency. Administering
oxygen (B) is important but suctioning is the priority. Notifying the provider (C) is
3
, done after initial intervention. Repositioning (D) may help but suctioning is the
priority.
8. Which of the following is a contraindication for oropharyngeal airway (OPA)
insertion?
A) Unresponsive patient
B) Intact gag reflex
C) Absent cough reflex
D) Snoring respirations
Correct Answer: B
Rationale: An OPA should not be inserted in a patient with an intact gag reflex (B)
because it can cause vomiting and aspiration. An OPA is appropriate for
unresponsive patients (A) and those with absent cough reflex (C) or snoring
respirations (D). The gag reflex must be assessed before OPA insertion.
9. A patient with COPD is experiencing an acute exacerbation. Which of the
following oxygen delivery methods is most appropriate?
A) Nasal cannula at 2 L/min
B) Non-rebreather mask at 15 L/min
C) Simple face mask at 6 L/min
D) Venturi mask at 28%
Correct Answer: D
Rationale: A Venturi mask at 28% provides controlled oxygen therapy for COPD
patients, who may be sensitive to high oxygen concentrations. Nasal cannula (A)
is low-flow and less precise. Non-rebreather (B) delivers high concentrations and
may suppress the hypoxic drive. Simple face mask (C) is less controlled. Venturi
masks allow precise FiO₂ delivery.
10. Which of the following findings indicates inadequate ventilation during BVM
use?
A) Chest rise and fall
B) ETCO₂ of 40 mmHg
C) Gastric distension
4
EXAM QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES EACH | CURRENTLY TESTING AND FREQUENTLY
TESTED QUESTIONS | GUARANTEED PASS |
LATEST UPDATE
SECTION A: AIRWAY, RESPIRATION & VENTILATION – 50 QUESTIONS
1. A patient is found unresponsive with gurgling respirations. What is the first
action?
A) Insert an oropharyngeal airway.
B) Suction the oropharynx.
C) Ventilate with a bag-valve mask.
D) Perform a jaw-thrust maneuver.
Correct Answer: B
Rationale: Gurgling indicates fluid in the airway; suctioning must precede any
airway adjunct or ventilation to clear the obstruction. An OPA (A) should not be
inserted until the airway is clear of fluid. BVM ventilation (C) would push fluid into
the lungs. Jaw-thrust (D) is for suspected spinal injury but does not address the
fluid. Suctioning is the immediate priority to establish a patent airway
[reference:0].
2. The normal ETCO₂ (end-tidal carbon dioxide) range in a healthy adult is:
A) 25-30 mmHg
B) 35-45 mmHg
C) 45-55 mmHg
D) 55-65 mmHg
Correct Answer: B
Rationale: Normal ETCO₂ is 35-45 mmHg. Values below 35 mmHg indicate
hyperventilation or decreased perfusion. Values above 45 mmHg indicate
hypoventilation or increased metabolic activity. ETCO₂ monitoring is essential for
confirming endotracheal tube placement and monitoring CPR quality
[reference:1].
1
,3. A 45-year-old patient is found unconscious with sonorous respirations. What is
the most appropriate initial airway maneuver?
A) Oropharyngeal airway insertion
B) Nasopharyngeal airway insertion
C) Head-tilt/chin-lift maneuver
D) Jaw-thrust maneuver
Correct Answer: C
Rationale: Sonorous respirations indicate partial upper airway obstruction from
the tongue. The head-tilt/chin-lift maneuver is the initial intervention to open the
airway. An OPA (A) or NPA (B) can be inserted after the airway is opened. Jaw-
thrust (D) is for suspected spinal injury. Opening the airway is the first priority
[reference:2].
4. A patient with a history of type 1 diabetes is found unconscious with a blood
glucose of 28 mg/dL. An IV is established. Which of the following is the most
appropriate initial pharmacologic intervention?
A) Administer 50 mL of 50% dextrose IV push
B) Administer 1 mg glucagon intramuscularly
C) Administer 100 mL of 10% dextrose IV infusion
D) Administer 2 mg naloxone IV
Correct Answer: A
Rationale: In a patient with severe hypoglycemia and an IV line, 50% dextrose (25
grams) is the standard of care for rapid reversal. Glucagon (B) is an alternative
when IV access is unavailable. 10% dextrose infusion (C) is used for maintenance,
not acute reversal. Naloxone (D) is for opioid overdose, not hypoglycemia
[reference:3].
5. A paramedic is assessing a patient with severe asthma exacerbation. Which of
the following findings indicates impending respiratory failure?
A) Wheezing
B) Silent chest
C) Use of accessory muscles
2
,D) Respiratory rate of 28
Correct Answer: B
Rationale: A silent chest indicates minimal air movement and is a sign of
impending respiratory failure. Wheezing (A) indicates airflow and is expected in
asthma. Accessory muscle use (C) indicates distress but not impending failure.
Respiratory rate of 28 (D) is elevated but not immediately life-threatening. A
silent chest requires immediate intervention.
6. Which of the following is the correct compression-to-ventilation ratio for a 2-
rescuer infant CPR?
A) 15:2
B) 30:2
C) 5:1
D) 10:2
Correct Answer: A
Rationale: For 2-rescuer infant CPR, the compression-to-ventilation ratio is 15:2.
For 1-rescuer infant CPR, it is 30:2 (B). 5:1 (C) is for neonatal resuscitation. 10:2
(D) is not a standard ratio. High-quality CPR with appropriate ratios is critical for
survival.
7. A patient has a tracheostomy and is experiencing respiratory distress. What is
the first action?
A) Suction the tracheostomy.
B) Administer oxygen via mask.
C) Notify the provider.
D) Reposition the patient.
Correct Answer: A
Rationale: The first action for a patient with a tracheostomy in respiratory distress
is to suction to clear secretions and maintain airway patency. Administering
oxygen (B) is important but suctioning is the priority. Notifying the provider (C) is
3
, done after initial intervention. Repositioning (D) may help but suctioning is the
priority.
8. Which of the following is a contraindication for oropharyngeal airway (OPA)
insertion?
A) Unresponsive patient
B) Intact gag reflex
C) Absent cough reflex
D) Snoring respirations
Correct Answer: B
Rationale: An OPA should not be inserted in a patient with an intact gag reflex (B)
because it can cause vomiting and aspiration. An OPA is appropriate for
unresponsive patients (A) and those with absent cough reflex (C) or snoring
respirations (D). The gag reflex must be assessed before OPA insertion.
9. A patient with COPD is experiencing an acute exacerbation. Which of the
following oxygen delivery methods is most appropriate?
A) Nasal cannula at 2 L/min
B) Non-rebreather mask at 15 L/min
C) Simple face mask at 6 L/min
D) Venturi mask at 28%
Correct Answer: D
Rationale: A Venturi mask at 28% provides controlled oxygen therapy for COPD
patients, who may be sensitive to high oxygen concentrations. Nasal cannula (A)
is low-flow and less precise. Non-rebreather (B) delivers high concentrations and
may suppress the hypoxic drive. Simple face mask (C) is less controlled. Venturi
masks allow precise FiO₂ delivery.
10. Which of the following findings indicates inadequate ventilation during BVM
use?
A) Chest rise and fall
B) ETCO₂ of 40 mmHg
C) Gastric distension
4
