Michigan Paramedic Specialist Exam
Practice Questions And Correct Answers
(Verified Answers) Plus Rationale 2026
Q&A| Instant Download Pdf
1. Which of the following ECG findings is most indicative of a
third-degree atrioventricular (AV) block?
A. Prolonged PR interval with occasional dropped beats
B. Progressive PR lengthening followed by a dropped QRS
C. AV dissociation with independent atrial and ventricular rhythms
D. Narrow QRS complexes with irregular rhythm
Third-degree AV block is diagnosed by the presence of complete AV
dissociation, indicating that atria and ventricles are depolarizing
independently.
2. A paramedic arrives at an adult patient in respiratory distress with
stridor and severe swelling of the face and neck after a bee sting.
Initial treatment should include:
A. Inhaled bronchodilator
B. Subcutaneous epinephrine
C. Intramuscular epinephrine and airway support
D. Intravenous corticosteroids only
Anaphylaxis with airway compromise requires prompt intramuscular
epinephrine and airway management to prevent complete
obstruction.
3. During rapid sequence intubation (RSI), which medication is typically
used for sedation prior to paralysis?
A. Succinylcholine
B. Rocuronium
C. Etomidate
, D. Ketamine
Etomidate is commonly chosen for sedation in RSI due to its rapid
onset and minimal hemodynamic effects.
4. A 58-year-old male presents with crushing chest pain and diaphoresis.
Which cardiac marker rises earliest following myocardial injury?
A. Myoglobin
B. Troponin I
C. CK-MB
D. Lactate dehydrogenase (LDH)
Troponin I rises within hours of myocardial injury and remains
elevated longer, making it useful for early and late diagnosis.
5. A trauma patient with hypotension and distended neck veins likely
has:
A. Cardiac tamponade
B. Tension pneumothorax
C. Massive hemothorax
D. Either cardiac tamponade or tension pneumothorax
Both cardiac tamponade and tension pneumothorax can present
with hypotension and JVD, requiring clinical correlation and
immediate intervention.
6. The primary action of naloxone is to:
A. Increase respiratory drive
B. Block opioid receptors
C. Reduce pain perception
D. Reverse opioid effects
Naloxone competitively antagonizes opioid receptors, rapidly
reversing opioid-induced respiratory depression.
7. A patient with suspected ischemic stroke arrives within the
therapeutic window for tPA. Which is a contraindication to fibrinolytic
therapy?
A. Onset of symptoms 1 hour prior
B. Blood pressure 170/90 mm Hg
C. Elevated blood glucose
D. INR > 1.7
, An elevated INR indicates coagulopathy and increases bleeding risk,
making fibrinolytics contraindicated.
8. In pediatric respiratory distress, grunting is a sign of:
A. Upper airway obstruction
B. Lower airway pathology and respiratory fatigue
C. Normal breathing effort
D. Cyanosis only
Grunting in children is a compensatory mechanism for increased
work of breathing and indicates significant respiratory distress.
9. A paramedic recognizes a wide-complex tachycardia with pulse. The
appropriate initial treatment is:
A. Vagal maneuvers
B. Adenosine
C. Synchronized cardioversion
D. Defibrillation
Symptomatic wide-complex tachycardias typically require
synchronized cardioversion to restore perfusing rhythm.
10. A burn involving the entire epidermis and dermis with blistering
and pain describes:
A. First-degree burn
B. Second-degree (partial thickness) burn
C. Third-degree burn
D. Fourth-degree burn
Second-degree burns affect both epidermis and dermis, cause
blistering and significant pain.
11. The dose of epinephrine for an adult in anaphylactic shock is:
A. 0.01 mg/kg IV
B. 0.1 mg IM
C. 0.3–0.5 mg IM
D. 1.0 mg IV
Standard treatment for anaphylaxis is 0.3–0.5 mg IM epinephrine to
rapidly counteract systemic allergic response.
12. Signs of increased intracranial pressure (ICP) include:
A. Hypotension
B. Bradypnea
Practice Questions And Correct Answers
(Verified Answers) Plus Rationale 2026
Q&A| Instant Download Pdf
1. Which of the following ECG findings is most indicative of a
third-degree atrioventricular (AV) block?
A. Prolonged PR interval with occasional dropped beats
B. Progressive PR lengthening followed by a dropped QRS
C. AV dissociation with independent atrial and ventricular rhythms
D. Narrow QRS complexes with irregular rhythm
Third-degree AV block is diagnosed by the presence of complete AV
dissociation, indicating that atria and ventricles are depolarizing
independently.
2. A paramedic arrives at an adult patient in respiratory distress with
stridor and severe swelling of the face and neck after a bee sting.
Initial treatment should include:
A. Inhaled bronchodilator
B. Subcutaneous epinephrine
C. Intramuscular epinephrine and airway support
D. Intravenous corticosteroids only
Anaphylaxis with airway compromise requires prompt intramuscular
epinephrine and airway management to prevent complete
obstruction.
3. During rapid sequence intubation (RSI), which medication is typically
used for sedation prior to paralysis?
A. Succinylcholine
B. Rocuronium
C. Etomidate
, D. Ketamine
Etomidate is commonly chosen for sedation in RSI due to its rapid
onset and minimal hemodynamic effects.
4. A 58-year-old male presents with crushing chest pain and diaphoresis.
Which cardiac marker rises earliest following myocardial injury?
A. Myoglobin
B. Troponin I
C. CK-MB
D. Lactate dehydrogenase (LDH)
Troponin I rises within hours of myocardial injury and remains
elevated longer, making it useful for early and late diagnosis.
5. A trauma patient with hypotension and distended neck veins likely
has:
A. Cardiac tamponade
B. Tension pneumothorax
C. Massive hemothorax
D. Either cardiac tamponade or tension pneumothorax
Both cardiac tamponade and tension pneumothorax can present
with hypotension and JVD, requiring clinical correlation and
immediate intervention.
6. The primary action of naloxone is to:
A. Increase respiratory drive
B. Block opioid receptors
C. Reduce pain perception
D. Reverse opioid effects
Naloxone competitively antagonizes opioid receptors, rapidly
reversing opioid-induced respiratory depression.
7. A patient with suspected ischemic stroke arrives within the
therapeutic window for tPA. Which is a contraindication to fibrinolytic
therapy?
A. Onset of symptoms 1 hour prior
B. Blood pressure 170/90 mm Hg
C. Elevated blood glucose
D. INR > 1.7
, An elevated INR indicates coagulopathy and increases bleeding risk,
making fibrinolytics contraindicated.
8. In pediatric respiratory distress, grunting is a sign of:
A. Upper airway obstruction
B. Lower airway pathology and respiratory fatigue
C. Normal breathing effort
D. Cyanosis only
Grunting in children is a compensatory mechanism for increased
work of breathing and indicates significant respiratory distress.
9. A paramedic recognizes a wide-complex tachycardia with pulse. The
appropriate initial treatment is:
A. Vagal maneuvers
B. Adenosine
C. Synchronized cardioversion
D. Defibrillation
Symptomatic wide-complex tachycardias typically require
synchronized cardioversion to restore perfusing rhythm.
10. A burn involving the entire epidermis and dermis with blistering
and pain describes:
A. First-degree burn
B. Second-degree (partial thickness) burn
C. Third-degree burn
D. Fourth-degree burn
Second-degree burns affect both epidermis and dermis, cause
blistering and significant pain.
11. The dose of epinephrine for an adult in anaphylactic shock is:
A. 0.01 mg/kg IV
B. 0.1 mg IM
C. 0.3–0.5 mg IM
D. 1.0 mg IV
Standard treatment for anaphylaxis is 0.3–0.5 mg IM epinephrine to
rapidly counteract systemic allergic response.
12. Signs of increased intracranial pressure (ICP) include:
A. Hypotension
B. Bradypnea
