Critical care paramedic Exam PRACTICE
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP
GRADED A+*INSTANT DOWNLOAD PDF
1. A critically ill patient has severe respiratory distress, altered
mental status, and a respiratory rate of 8/min. Which intervention is
the priority?
A. Apply a nonrebreather mask
B. Obtain a 12-lead ECG
C. Assist ventilation with a bag-valve mask
D. Administer a bronchodilator
The patient has inadequate ventilation. Immediate assisted
ventilation takes priority over diagnostic testing or medication.
2. Which finding is most concerning for impending respiratory
failure?
A. Respiratory rate of 22/min
B. Mild anxiety
C. Increasing fatigue with decreasing respiratory effort
D. Oxygen saturation of 95%
An initially high respiratory rate followed by decreasing effort and
fatigue suggests respiratory muscle exhaustion and impending
ventilatory failure.
3. A patient with severe asthma suddenly develops minimal
wheezing despite worsening dyspnea. What does this finding
suggest?
A. Improvement
,B. Resolution of bronchospasm
C. Severe airflow obstruction with poor air movement
D. Anxiety
The “silent chest” can indicate critically reduced airflow and
impending respiratory failure.
4. Which oxygen-delivery device can provide a high inspired oxygen
concentration in a spontaneously breathing patient?
A. Nasal cannula
B. Venturi mask
C. Simple face mask
D. Nonrebreather mask
With an adequate seal and sufficient flow, a nonrebreather mask can
provide a high concentration of inspired oxygen.
5. Which finding is most consistent with hypercapnia?
A. Bradycardia and hypothermia
B. Altered mental status and headache
C. Isolated hypertension
D. Severe peripheral edema
Elevated carbon dioxide can cause cerebral vasodilation, headache,
confusion, somnolence, and eventually coma.
6. A patient with COPD is lethargic and hypoventilating. What is the
most important initial concern?
A. Hypoglycemia
B. Hyperkalemia
C. Ventilatory failure
D. Hypertension
Lethargy with hypoventilation suggests inadequate alveolar
ventilation and possible carbon dioxide retention.
7. What is the primary purpose of positive-pressure ventilation?
A. Reduce heart rate
,B. Improve alveolar ventilation and oxygenation
C. Increase urine output
D. Lower blood glucose
Positive-pressure ventilation supports ventilation and oxygenation
when spontaneous breathing is inadequate.
8. Which capnography finding is most consistent with
bronchospasm?
A. Flat line
B. Normal rectangular waveform
C. Sloping “shark-fin” waveform
D. Abrupt loss of waveform only
Airflow obstruction produces a prolonged, sloping expiratory
upstroke commonly described as a shark-fin pattern.
9. A sudden loss of an ETCO₂ waveform in an intubated patient
should first prompt assessment for:
A. Hyperglycemia
B. Disconnection or airway displacement
C. Hypertension
D. Renal failure
Sudden disappearance of capnography may indicate circuit
disconnection, tube displacement, or complete obstruction.
10. Which airway adjunct is generally appropriate for an unconscious
patient without a gag reflex?
A. Nasopharyngeal airway
B. Oropharyngeal airway
C. Supraglottic airway only
D. Nasal cannula
An OPA helps prevent the tongue from obstructing the airway but is
inappropriate in a patient with an intact gag reflex.
, 11. Which airway adjunct is often better tolerated in a patient with
an intact gag reflex?
A. OPA
B. NPA
C. Bite block
D. Oral endotracheal tube
An NPA can be used in many patients who cannot tolerate an OPA
because of an intact gag reflex.
12. A patient develops stridor after extubation. What does stridor
most strongly suggest?
A. Lower airway obstruction
B. Pulmonary edema
C. Upper airway obstruction
D. Metabolic acidosis
Stridor is a high-pitched sound associated with upper-airway
narrowing.
13. What is the most appropriate immediate intervention for
complete airway obstruction in a conscious adult who cannot speak
or cough effectively?
A. Encourage oral fluids
B. Perform appropriate choking-relief maneuvers
C. Apply CPAP
D. Obtain a chest x-ray
Complete foreign-body airway obstruction requires immediate
choking-relief intervention.
14. Which assessment finding suggests a difficult airway?
A. Normal neck mobility
B. Large mouth opening
C. Limited mouth opening and reduced neck mobility
D. Normal dentition
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP
GRADED A+*INSTANT DOWNLOAD PDF
1. A critically ill patient has severe respiratory distress, altered
mental status, and a respiratory rate of 8/min. Which intervention is
the priority?
A. Apply a nonrebreather mask
B. Obtain a 12-lead ECG
C. Assist ventilation with a bag-valve mask
D. Administer a bronchodilator
The patient has inadequate ventilation. Immediate assisted
ventilation takes priority over diagnostic testing or medication.
2. Which finding is most concerning for impending respiratory
failure?
A. Respiratory rate of 22/min
B. Mild anxiety
C. Increasing fatigue with decreasing respiratory effort
D. Oxygen saturation of 95%
An initially high respiratory rate followed by decreasing effort and
fatigue suggests respiratory muscle exhaustion and impending
ventilatory failure.
3. A patient with severe asthma suddenly develops minimal
wheezing despite worsening dyspnea. What does this finding
suggest?
A. Improvement
,B. Resolution of bronchospasm
C. Severe airflow obstruction with poor air movement
D. Anxiety
The “silent chest” can indicate critically reduced airflow and
impending respiratory failure.
4. Which oxygen-delivery device can provide a high inspired oxygen
concentration in a spontaneously breathing patient?
A. Nasal cannula
B. Venturi mask
C. Simple face mask
D. Nonrebreather mask
With an adequate seal and sufficient flow, a nonrebreather mask can
provide a high concentration of inspired oxygen.
5. Which finding is most consistent with hypercapnia?
A. Bradycardia and hypothermia
B. Altered mental status and headache
C. Isolated hypertension
D. Severe peripheral edema
Elevated carbon dioxide can cause cerebral vasodilation, headache,
confusion, somnolence, and eventually coma.
6. A patient with COPD is lethargic and hypoventilating. What is the
most important initial concern?
A. Hypoglycemia
B. Hyperkalemia
C. Ventilatory failure
D. Hypertension
Lethargy with hypoventilation suggests inadequate alveolar
ventilation and possible carbon dioxide retention.
7. What is the primary purpose of positive-pressure ventilation?
A. Reduce heart rate
,B. Improve alveolar ventilation and oxygenation
C. Increase urine output
D. Lower blood glucose
Positive-pressure ventilation supports ventilation and oxygenation
when spontaneous breathing is inadequate.
8. Which capnography finding is most consistent with
bronchospasm?
A. Flat line
B. Normal rectangular waveform
C. Sloping “shark-fin” waveform
D. Abrupt loss of waveform only
Airflow obstruction produces a prolonged, sloping expiratory
upstroke commonly described as a shark-fin pattern.
9. A sudden loss of an ETCO₂ waveform in an intubated patient
should first prompt assessment for:
A. Hyperglycemia
B. Disconnection or airway displacement
C. Hypertension
D. Renal failure
Sudden disappearance of capnography may indicate circuit
disconnection, tube displacement, or complete obstruction.
10. Which airway adjunct is generally appropriate for an unconscious
patient without a gag reflex?
A. Nasopharyngeal airway
B. Oropharyngeal airway
C. Supraglottic airway only
D. Nasal cannula
An OPA helps prevent the tongue from obstructing the airway but is
inappropriate in a patient with an intact gag reflex.
, 11. Which airway adjunct is often better tolerated in a patient with
an intact gag reflex?
A. OPA
B. NPA
C. Bite block
D. Oral endotracheal tube
An NPA can be used in many patients who cannot tolerate an OPA
because of an intact gag reflex.
12. A patient develops stridor after extubation. What does stridor
most strongly suggest?
A. Lower airway obstruction
B. Pulmonary edema
C. Upper airway obstruction
D. Metabolic acidosis
Stridor is a high-pitched sound associated with upper-airway
narrowing.
13. What is the most appropriate immediate intervention for
complete airway obstruction in a conscious adult who cannot speak
or cough effectively?
A. Encourage oral fluids
B. Perform appropriate choking-relief maneuvers
C. Apply CPAP
D. Obtain a chest x-ray
Complete foreign-body airway obstruction requires immediate
choking-relief intervention.
14. Which assessment finding suggests a difficult airway?
A. Normal neck mobility
B. Large mouth opening
C. Limited mouth opening and reduced neck mobility
D. Normal dentition
