PARAMEDIC NATIONAL REGISTRY COMPREHENSIVE
EXAM 2026 QUESTIONS AND ANSWERS GRADED A+
✔✔Biot (ataxic) respirations - ✔✔Irregular pattern, rate, and depth of respirations with
intermittent periods of apnea; result from increased intracranial pressure.
✔✔Cheyne-Stokes respiration - ✔✔Increasing in rate and depth, decreasing in rate and
depth with period of apnea, results from a neurological condition
✔✔Hyperventilation - ✔✔Rapid and shallow
✔✔Kussmaul respirations - ✔✔Deep, rapid breathing; usually the result of an
accumulation of certain acids when insulin is not available in the body.
Fruity breath
✔✔Rales/Crackles - ✔✔Fluid in small airways/alveoli
✔✔Causes of Rales/Crackles - ✔✔CHF, pulmonary edema, drowning, pneumonia,
COPD
✔✔Rhonchi - ✔✔Mucus or fluid in larger airways/bronchi
✔✔Causes of rhonchi - ✔✔Bronchitis, COPD, penumonia
✔✔Wheezing - ✔✔Whistling sound due to bronchoconstriction or narrowing of the
terminal bronchioes due to edema
✔✔Causes of wheezing - ✔✔Asthma and allergic reactions
✔✔Right upper quadrant - ✔✔-Liver
-Gallbladder
-Stomach
✔✔Left upper quadrant - ✔✔-Spleen
-Liver
-Stomach
-Pancreas
✔✔Right Lower Quadrant (RLQ) - ✔✔-Appendix
-Right ovary & tube
-Bladder if distended
✔✔Left Lower Quadrant (LLQ) - ✔✔-Left ovary & tube
-Bladder if distended
,✔✔Somatic pain - ✔✔-irritation of peritoneal lining
-sharp, localized, throbbing, deep breath increases pain
✔✔Referred pain - ✔✔Discomfort perceived in other parts of body, such as cardiac pain
referred to jaw or arm
✔✔Cullen's sign - ✔✔Ecchymosis around umbilicus, bleeding in abdominal cavity
✔✔Grey Turner's sign - ✔✔-ecchymosis involving the flanks.
-Indication for bleeding from kidneys, hemorrhagic pancreatitis
✔✔Kehr's sign - ✔✔Refereed pain to shoulder
Ectopic or spleen injury, blood under diaphragm
✔✔Murphy's sign - ✔✔Right upper quadrant pain
✔✔Cause of Murphy's sign - ✔✔Cholecystitis
✔✔Homan's sign - ✔✔Pain in calf on dorsiflexing foot while leg is straight, results from
DVT
✔✔Clubbing of fingers - ✔✔flattening of the nail angle mean chronic hypoxemia found
in conditions such as COPD
✔✔How to calculate blood pressure - ✔✔cardiac output x systemic vascular resistance
✔✔Pulse pressure - ✔✔difference between systolic and diastolic pressure
✔✔Pulse pressure widen or narrows? - ✔✔pulse pressure narrows in shock
widens in increased ICP
✔✔Orthostatic vital signs / tilt test - ✔✔-supine, sitting and standing
-decrease of systolic B/P 20 mm Hg
-increase diastolic 10 mm Hg
-increase heart rate of 20 suggests hypovolemia
✔✔MAP (mean arterial pressure) - ✔✔normally between 70-110 mm Hg
, DBP + 1/3 pulse pressure
✔✔Osteoporosis - ✔✔atrophy of muscles, degenerative bone loss
✔✔How to do a head to two assessment on a infant? - ✔✔-exam toe to head
-outside to inside
✔✔Hydrocephalus - ✔✔a condition in which excess cerebrospinal fluid (CSF) builds up
within the ventricles (fluid-containing cavities) of the brain and may increase pressure
within the head.
✔✔ECG lead placements for V1 - ✔✔4th intercostal space to the right of the sternum
✔✔ECG placement for V2 - ✔✔4th intercostal space to the left of the sternum
✔✔ECG placement for V3 - ✔✔directly between V2 and V4
✔✔ECG placement for V4 - ✔✔5th intercostal space at midclaviclar line
✔✔ECG placement for V5 - ✔✔Level with V4 at left anterior axillary line
✔✔ECG placement for V6 - ✔✔level wth V5 at left midaxiallry line
(Under the midpoint of the armpit)
✔✔Normal blood glucose - ✔✔80-140 mg/dL
✔✔pulse oximeter limitations - ✔✔-Hypoperfusion
-Dehydration
-Cold
-Vasopressors
-Anemia
-CO
-Nail polish
-Methemogobinemia
-Cyanide poisoning
✔✔Methmeglocinemia - ✔✔is a blood disorder in which an abnormal amount of
methemoglobin is produced. Hemoglobin is the protein in red blood cells (RBCs) that
carries and distributes oxygen to the body.
✔✔Co binds with hemoglobin to form? - ✔✔carboxyhemoglobin
✔✔CO exposure causes? - ✔✔-CNS depression
-Headache
EXAM 2026 QUESTIONS AND ANSWERS GRADED A+
✔✔Biot (ataxic) respirations - ✔✔Irregular pattern, rate, and depth of respirations with
intermittent periods of apnea; result from increased intracranial pressure.
✔✔Cheyne-Stokes respiration - ✔✔Increasing in rate and depth, decreasing in rate and
depth with period of apnea, results from a neurological condition
✔✔Hyperventilation - ✔✔Rapid and shallow
✔✔Kussmaul respirations - ✔✔Deep, rapid breathing; usually the result of an
accumulation of certain acids when insulin is not available in the body.
Fruity breath
✔✔Rales/Crackles - ✔✔Fluid in small airways/alveoli
✔✔Causes of Rales/Crackles - ✔✔CHF, pulmonary edema, drowning, pneumonia,
COPD
✔✔Rhonchi - ✔✔Mucus or fluid in larger airways/bronchi
✔✔Causes of rhonchi - ✔✔Bronchitis, COPD, penumonia
✔✔Wheezing - ✔✔Whistling sound due to bronchoconstriction or narrowing of the
terminal bronchioes due to edema
✔✔Causes of wheezing - ✔✔Asthma and allergic reactions
✔✔Right upper quadrant - ✔✔-Liver
-Gallbladder
-Stomach
✔✔Left upper quadrant - ✔✔-Spleen
-Liver
-Stomach
-Pancreas
✔✔Right Lower Quadrant (RLQ) - ✔✔-Appendix
-Right ovary & tube
-Bladder if distended
✔✔Left Lower Quadrant (LLQ) - ✔✔-Left ovary & tube
-Bladder if distended
,✔✔Somatic pain - ✔✔-irritation of peritoneal lining
-sharp, localized, throbbing, deep breath increases pain
✔✔Referred pain - ✔✔Discomfort perceived in other parts of body, such as cardiac pain
referred to jaw or arm
✔✔Cullen's sign - ✔✔Ecchymosis around umbilicus, bleeding in abdominal cavity
✔✔Grey Turner's sign - ✔✔-ecchymosis involving the flanks.
-Indication for bleeding from kidneys, hemorrhagic pancreatitis
✔✔Kehr's sign - ✔✔Refereed pain to shoulder
Ectopic or spleen injury, blood under diaphragm
✔✔Murphy's sign - ✔✔Right upper quadrant pain
✔✔Cause of Murphy's sign - ✔✔Cholecystitis
✔✔Homan's sign - ✔✔Pain in calf on dorsiflexing foot while leg is straight, results from
DVT
✔✔Clubbing of fingers - ✔✔flattening of the nail angle mean chronic hypoxemia found
in conditions such as COPD
✔✔How to calculate blood pressure - ✔✔cardiac output x systemic vascular resistance
✔✔Pulse pressure - ✔✔difference between systolic and diastolic pressure
✔✔Pulse pressure widen or narrows? - ✔✔pulse pressure narrows in shock
widens in increased ICP
✔✔Orthostatic vital signs / tilt test - ✔✔-supine, sitting and standing
-decrease of systolic B/P 20 mm Hg
-increase diastolic 10 mm Hg
-increase heart rate of 20 suggests hypovolemia
✔✔MAP (mean arterial pressure) - ✔✔normally between 70-110 mm Hg
, DBP + 1/3 pulse pressure
✔✔Osteoporosis - ✔✔atrophy of muscles, degenerative bone loss
✔✔How to do a head to two assessment on a infant? - ✔✔-exam toe to head
-outside to inside
✔✔Hydrocephalus - ✔✔a condition in which excess cerebrospinal fluid (CSF) builds up
within the ventricles (fluid-containing cavities) of the brain and may increase pressure
within the head.
✔✔ECG lead placements for V1 - ✔✔4th intercostal space to the right of the sternum
✔✔ECG placement for V2 - ✔✔4th intercostal space to the left of the sternum
✔✔ECG placement for V3 - ✔✔directly between V2 and V4
✔✔ECG placement for V4 - ✔✔5th intercostal space at midclaviclar line
✔✔ECG placement for V5 - ✔✔Level with V4 at left anterior axillary line
✔✔ECG placement for V6 - ✔✔level wth V5 at left midaxiallry line
(Under the midpoint of the armpit)
✔✔Normal blood glucose - ✔✔80-140 mg/dL
✔✔pulse oximeter limitations - ✔✔-Hypoperfusion
-Dehydration
-Cold
-Vasopressors
-Anemia
-CO
-Nail polish
-Methemogobinemia
-Cyanide poisoning
✔✔Methmeglocinemia - ✔✔is a blood disorder in which an abnormal amount of
methemoglobin is produced. Hemoglobin is the protein in red blood cells (RBCs) that
carries and distributes oxygen to the body.
✔✔Co binds with hemoglobin to form? - ✔✔carboxyhemoglobin
✔✔CO exposure causes? - ✔✔-CNS depression
-Headache
