NEW YORK STATE PARAMEDIC CERTIFICATION EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Airway, Respiration, and Ventilation
Cardiology and Resuscitation
Trauma Care
Medical Emergencies
EMS Operations
Clinical Judgment and Decision-Making
Legal, Ethical, and Professional Standards
Pharmacology
Introduction
The purpose of this assessment is to evaluate the knowledge and
clinical judgment required of a New York State certified
paramedic. It assesses skills in patient assessment, airway
management, cardiac care, trauma stabilization, and medication
administration. The structure consists of multiple-choice and
scenario-based questions designed to mirror the complexity of
prehospital practice. Emphasis is placed on the application of New
York State protocols, safety principles, and ethical standards to
real-world decision-making in emergency medical services.
SECTION ONE: QUESTIONS 1–100
1. A paramedic is preparing to administer a medication via the
intravenous route. Which of the following is the primary
advantage of IV administration over intramuscular
administration in the prehospital setting?
,A. Slower onset of action
B. More predictable and rapid onset of action
C. Reduced risk of infection
D. No need for aseptic technique
🟢 Correct answer
B. More predictable and rapid onset of action
🔴 RATIONALE: Intravenous administration delivers medication
directly into the bloodstream, resulting in the most rapid and
predictable onset of action compared with other routes. This is
critical in emergency situations where immediate therapeutic
effect is required.
2. According to New York State BEMS Policy Statement 9810,
what is the definitive requirement for a paramedic to operate
under "Online Medical Control"?
A. A signed standing order from the Medical Director
B. Direct voice communication with a physician
C. A radio in the ambulance
D. Completion of an ALS assessment
🟢 Correct answer
B. Direct voice communication with a physician
🔴 RATIONALE: Policy 9810 defines Online Medical Control as
"direct communication (radio/phone) between an ALS provider
and a physician." Offline control involves standing orders without
direct physician contact.
3. A 56-year-old male presents with crushing chest pain
radiating to his left arm. Which of the following is the most
appropriate initial treatment?
,A. Nitroglycerin sublingual only
B. Aspirin and oxygen
C. Administer oxygen, aspirin, and prepare for rapid transport
D. Morphine sulfate only
🟢 Correct answer
C. Administer oxygen, aspirin, and prepare for rapid transport
🔴 RATIONALE: Early oxygen, aspirin, and rapid transport are key
interventions for suspected acute myocardial infarction. Aspirin
inhibits platelet aggregation, reducing further clot formation.
4. Which of the following is a contraindication for the
administration of nitroglycerin?
A. Chest pain due to myocardial infarction
B. Systolic blood pressure < 90 mmHg
C. Pulmonary edema
D. History of angina
🟢 Correct answer
B. Systolic blood pressure < 90 mmHg
🔴 RATIONALE: Nitroglycerin is a potent vasodilator that can
cause severe hypotension. It is contraindicated in patients with a
systolic blood pressure below 90 mmHg.
5. What is the most accurate method to confirm endotracheal
tube placement?
A. Visual confirmation of tube passing through vocal cords
B. Bilateral chest rise
C. Capnography
D. Auscultation of breath sounds
, 🟢 Correct answer
C. Capnography
🔴 RATIONALE: Capnography provides continuous, real-time
confirmation of carbon dioxide in exhaled air, making it the gold
standard for confirming endotracheal tube placement.
6. A patient refuses care. He is alert, oriented, and understands
the risks. He speaks only Spanish. You do not speak Spanish. His
10-year-old daughter offers to translate. What is the MOST
appropriate action?
A. Accept the daughter as translator and obtain refusal
B. Refuse to take the refusal; transport against his will
C. Make a reasonable effort to find a qualified medical interpreter
before accepting refusal
D. Have him sign the refusal form without translation
🟢 Correct answer
C. Make a reasonable effort to find a qualified medical interpreter
before accepting refusal
🔴 RATIONALE: New York State law requires "reasonable efforts"
to obtain a qualified interpreter for informed consent or refusal. A
10-year-old child is not considered a qualified medical interpreter
for high-stakes decisions.
7. You are called to a nursing home. The patient has a valid
MOLST form. It states: "DNR – No CPR, No Intubation, No
Mechanical Ventilation." The patient is in respiratory arrest with
a pulse. You are providing BVM ventilations. The nurse demands
you stop. You should:
A. Stop ventilations immediately
B. Continue ventilations; intubate the patient
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Airway, Respiration, and Ventilation
Cardiology and Resuscitation
Trauma Care
Medical Emergencies
EMS Operations
Clinical Judgment and Decision-Making
Legal, Ethical, and Professional Standards
Pharmacology
Introduction
The purpose of this assessment is to evaluate the knowledge and
clinical judgment required of a New York State certified
paramedic. It assesses skills in patient assessment, airway
management, cardiac care, trauma stabilization, and medication
administration. The structure consists of multiple-choice and
scenario-based questions designed to mirror the complexity of
prehospital practice. Emphasis is placed on the application of New
York State protocols, safety principles, and ethical standards to
real-world decision-making in emergency medical services.
SECTION ONE: QUESTIONS 1–100
1. A paramedic is preparing to administer a medication via the
intravenous route. Which of the following is the primary
advantage of IV administration over intramuscular
administration in the prehospital setting?
,A. Slower onset of action
B. More predictable and rapid onset of action
C. Reduced risk of infection
D. No need for aseptic technique
🟢 Correct answer
B. More predictable and rapid onset of action
🔴 RATIONALE: Intravenous administration delivers medication
directly into the bloodstream, resulting in the most rapid and
predictable onset of action compared with other routes. This is
critical in emergency situations where immediate therapeutic
effect is required.
2. According to New York State BEMS Policy Statement 9810,
what is the definitive requirement for a paramedic to operate
under "Online Medical Control"?
A. A signed standing order from the Medical Director
B. Direct voice communication with a physician
C. A radio in the ambulance
D. Completion of an ALS assessment
🟢 Correct answer
B. Direct voice communication with a physician
🔴 RATIONALE: Policy 9810 defines Online Medical Control as
"direct communication (radio/phone) between an ALS provider
and a physician." Offline control involves standing orders without
direct physician contact.
3. A 56-year-old male presents with crushing chest pain
radiating to his left arm. Which of the following is the most
appropriate initial treatment?
,A. Nitroglycerin sublingual only
B. Aspirin and oxygen
C. Administer oxygen, aspirin, and prepare for rapid transport
D. Morphine sulfate only
🟢 Correct answer
C. Administer oxygen, aspirin, and prepare for rapid transport
🔴 RATIONALE: Early oxygen, aspirin, and rapid transport are key
interventions for suspected acute myocardial infarction. Aspirin
inhibits platelet aggregation, reducing further clot formation.
4. Which of the following is a contraindication for the
administration of nitroglycerin?
A. Chest pain due to myocardial infarction
B. Systolic blood pressure < 90 mmHg
C. Pulmonary edema
D. History of angina
🟢 Correct answer
B. Systolic blood pressure < 90 mmHg
🔴 RATIONALE: Nitroglycerin is a potent vasodilator that can
cause severe hypotension. It is contraindicated in patients with a
systolic blood pressure below 90 mmHg.
5. What is the most accurate method to confirm endotracheal
tube placement?
A. Visual confirmation of tube passing through vocal cords
B. Bilateral chest rise
C. Capnography
D. Auscultation of breath sounds
, 🟢 Correct answer
C. Capnography
🔴 RATIONALE: Capnography provides continuous, real-time
confirmation of carbon dioxide in exhaled air, making it the gold
standard for confirming endotracheal tube placement.
6. A patient refuses care. He is alert, oriented, and understands
the risks. He speaks only Spanish. You do not speak Spanish. His
10-year-old daughter offers to translate. What is the MOST
appropriate action?
A. Accept the daughter as translator and obtain refusal
B. Refuse to take the refusal; transport against his will
C. Make a reasonable effort to find a qualified medical interpreter
before accepting refusal
D. Have him sign the refusal form without translation
🟢 Correct answer
C. Make a reasonable effort to find a qualified medical interpreter
before accepting refusal
🔴 RATIONALE: New York State law requires "reasonable efforts"
to obtain a qualified interpreter for informed consent or refusal. A
10-year-old child is not considered a qualified medical interpreter
for high-stakes decisions.
7. You are called to a nursing home. The patient has a valid
MOLST form. It states: "DNR – No CPR, No Intubation, No
Mechanical Ventilation." The patient is in respiratory arrest with
a pulse. You are providing BVM ventilations. The nurse demands
you stop. You should:
A. Stop ventilations immediately
B. Continue ventilations; intubate the patient
