NREMT PARAMEDIC EXAM 2026/2027 NATIONAL REGISTRY EXAM
TESTBANK COMPLETE ACCURATE TEST ACTUAL QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES (100% CORRECT
VERIFIED SOLUTIONS) NEWEST UPDATED VERSION 2026 EDITION
|GUARANTEED SUCCESS A+ (BRAND NEW!) |FULL REVISED NREMT
PARAMEDIC NATIONAL REGISTRY APPROVED EXAM
1. A 45-year-old male is found unresponsive with agonal respirations. You note no
palpable carotid pulse. What is your immediate next action?
A. Insert an oropharyngeal airway
B. Provide two rescue breaths
C. Begin chest compressions
D. Attach the automated external defibrillator
CORRECT ANSWER: C
Rationale: In an unresponsive patient with no pulse and agonal breathing, the
cardiac arrest algorithm prioritizes high-quality chest compressions immediately.
Compressions should begin within 10 seconds of pulse check, followed by
defibrillation if indicated. Airway and breathing interventions come after starting
compressions.
2. Which of the following is the most reliable indicator of proper endotracheal tube
placement in a perusing patient?
A. Equal breath sounds bilaterally
B. Condensation inside the tube
C. End-tidal CO₂ waveform scenography
D. Absence of sounds over the epigastrium
CORRECT ANSWER: C
,Rationale: Continuous waveform scenography is the gold standard for confirming
ET tube placement in a patient with cardiac output. It provides real-time evidence
of exhaled CO₂. Bilateral breath sounds and absence of epigastric sounds can be
misleading, and condensation is unreliable.
3. A 28-year-old female with a history of asthma presents with severe respiratory
distress, minimal air movement, and silent chest. She is lethargic. Heart rate is 130,
respiratory rate 32, oxygen saturation 86% on room air. Initial management should
include:
A. Inhaled albuterol via nebulizer
B. Immediate endotracheal intubation
C. High-flow oxygen and continuous positive airway pressure (CPAP)
D. Intravenous magnesium sulfate
CORRECT ANSWER: C
Rationale: The patient has status asthmatics with impending respiratory failure
(silent chest, lethargy, hypoxia). CPAP with high-flow oxygen can improve
ventilation and oxygenation while preparing for possible intubation. Albuterol may
be ineffective with poor air movement; magnesium can be given but CPAP is
immediate priority to prevent arrest.
4. Which of the following is a contraindication to the administration of
nitroglycerin in a patient with chest pain?
A. Systolic blood pressure of 110 mmHg
B. Heart rate of 110 beats per minute
C. Use of a phosphodiesterase inhibitor within 48 hours
D. History of gastroesophageal reflux disease
CORRECT ANSWER: C
,Rationale: Nitroglycerin is contraindicated within 24–48 hours (depending on
agent) of phosphodiesterase inhibitors (e.g., sildenafil, tadalafil) due to risk of
profound, refractory hypotension. Other options are not absolute contraindications.
5. During resuscitation of a 6-year-old child in cardiac arrest, you administer a
dose of epinephrine intraosseous. What is the correct dose?
A. 0.01 mg/kg
B. 0.1 mg/kg
C. 0.1 mg (fixed dose)
D. 1 mg (fixed dose)
CORRECT ANSWER: A
Rationale: Pediatric epinephrine dose for cardiac arrest is 0.01 mg/kg (0.1 mL/kg
of 1: 10,000 solution), maximum 1 mg per dose. The same dose is used for IV or
IO routes. Option B is ten times too high and dangerous.
6. A paramedic is assessing a patient with suspected opioid overdose. The patient
has pinpoint pupils, respiratory rate of 6, and snoring respirations. After
establishing an airway and providing bag-valve-mask ventilation, what is the most
appropriate next step?
A. Administer intranasal naloxone 2 mg
B. Perform or tracheal intubation
C. Insert a nasopharyngeal airway
D. Administer intramuscular epinephrine 0.3 mg
CORRECT ANSWER: A
Rationale: After ventilator support, naloxone should be administered to reverse
opioid toxicity. Intranasal route is acceptable. Intubation is not first-line if BVM
, ventilation is effective. Nasopharyngeal airway may help but does not treat the
overdose. Epinephrine is not indicated.
7. A 55-year-old male complains of sudden-onset tearing chest pain radiating to his
back. His blood pressure is 100/60 in the right arm and 70/40 in the left arm. Heart
rate is 110. Which of the following is the most likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
CORRECT ANSWER: C
Rationale: Tearing chest pain radiating to the back with differential blood pressures
between arms is classic for aortic dissection. This is a time-sensitive emergency
requiring rapid transport and prehospital notification.
8. In a patient with suspected tension pneumothorax, you would expect to find:
A. Hyper resonance to percussion on the affected side
B. Subcutaneous emphysema in all cases
C. Ipsilateral tracheal deviation
D. Bilateral absent breath sounds
CORRECT ANSWER: A
Rationale: Tension pneumothorax causes hyper resonance on percussion due to
trapped air. Tracheal deviation occurs contralateral (away from affected side), not
ipsilateral. Subcutaneous emphysema may be present but not universal. Breath
sounds are absent on the affected side only.
TESTBANK COMPLETE ACCURATE TEST ACTUAL QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES (100% CORRECT
VERIFIED SOLUTIONS) NEWEST UPDATED VERSION 2026 EDITION
|GUARANTEED SUCCESS A+ (BRAND NEW!) |FULL REVISED NREMT
PARAMEDIC NATIONAL REGISTRY APPROVED EXAM
1. A 45-year-old male is found unresponsive with agonal respirations. You note no
palpable carotid pulse. What is your immediate next action?
A. Insert an oropharyngeal airway
B. Provide two rescue breaths
C. Begin chest compressions
D. Attach the automated external defibrillator
CORRECT ANSWER: C
Rationale: In an unresponsive patient with no pulse and agonal breathing, the
cardiac arrest algorithm prioritizes high-quality chest compressions immediately.
Compressions should begin within 10 seconds of pulse check, followed by
defibrillation if indicated. Airway and breathing interventions come after starting
compressions.
2. Which of the following is the most reliable indicator of proper endotracheal tube
placement in a perusing patient?
A. Equal breath sounds bilaterally
B. Condensation inside the tube
C. End-tidal CO₂ waveform scenography
D. Absence of sounds over the epigastrium
CORRECT ANSWER: C
,Rationale: Continuous waveform scenography is the gold standard for confirming
ET tube placement in a patient with cardiac output. It provides real-time evidence
of exhaled CO₂. Bilateral breath sounds and absence of epigastric sounds can be
misleading, and condensation is unreliable.
3. A 28-year-old female with a history of asthma presents with severe respiratory
distress, minimal air movement, and silent chest. She is lethargic. Heart rate is 130,
respiratory rate 32, oxygen saturation 86% on room air. Initial management should
include:
A. Inhaled albuterol via nebulizer
B. Immediate endotracheal intubation
C. High-flow oxygen and continuous positive airway pressure (CPAP)
D. Intravenous magnesium sulfate
CORRECT ANSWER: C
Rationale: The patient has status asthmatics with impending respiratory failure
(silent chest, lethargy, hypoxia). CPAP with high-flow oxygen can improve
ventilation and oxygenation while preparing for possible intubation. Albuterol may
be ineffective with poor air movement; magnesium can be given but CPAP is
immediate priority to prevent arrest.
4. Which of the following is a contraindication to the administration of
nitroglycerin in a patient with chest pain?
A. Systolic blood pressure of 110 mmHg
B. Heart rate of 110 beats per minute
C. Use of a phosphodiesterase inhibitor within 48 hours
D. History of gastroesophageal reflux disease
CORRECT ANSWER: C
,Rationale: Nitroglycerin is contraindicated within 24–48 hours (depending on
agent) of phosphodiesterase inhibitors (e.g., sildenafil, tadalafil) due to risk of
profound, refractory hypotension. Other options are not absolute contraindications.
5. During resuscitation of a 6-year-old child in cardiac arrest, you administer a
dose of epinephrine intraosseous. What is the correct dose?
A. 0.01 mg/kg
B. 0.1 mg/kg
C. 0.1 mg (fixed dose)
D. 1 mg (fixed dose)
CORRECT ANSWER: A
Rationale: Pediatric epinephrine dose for cardiac arrest is 0.01 mg/kg (0.1 mL/kg
of 1: 10,000 solution), maximum 1 mg per dose. The same dose is used for IV or
IO routes. Option B is ten times too high and dangerous.
6. A paramedic is assessing a patient with suspected opioid overdose. The patient
has pinpoint pupils, respiratory rate of 6, and snoring respirations. After
establishing an airway and providing bag-valve-mask ventilation, what is the most
appropriate next step?
A. Administer intranasal naloxone 2 mg
B. Perform or tracheal intubation
C. Insert a nasopharyngeal airway
D. Administer intramuscular epinephrine 0.3 mg
CORRECT ANSWER: A
Rationale: After ventilator support, naloxone should be administered to reverse
opioid toxicity. Intranasal route is acceptable. Intubation is not first-line if BVM
, ventilation is effective. Nasopharyngeal airway may help but does not treat the
overdose. Epinephrine is not indicated.
7. A 55-year-old male complains of sudden-onset tearing chest pain radiating to his
back. His blood pressure is 100/60 in the right arm and 70/40 in the left arm. Heart
rate is 110. Which of the following is the most likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
CORRECT ANSWER: C
Rationale: Tearing chest pain radiating to the back with differential blood pressures
between arms is classic for aortic dissection. This is a time-sensitive emergency
requiring rapid transport and prehospital notification.
8. In a patient with suspected tension pneumothorax, you would expect to find:
A. Hyper resonance to percussion on the affected side
B. Subcutaneous emphysema in all cases
C. Ipsilateral tracheal deviation
D. Bilateral absent breath sounds
CORRECT ANSWER: A
Rationale: Tension pneumothorax causes hyper resonance on percussion due to
trapped air. Tracheal deviation occurs contralateral (away from affected side), not
ipsilateral. Subcutaneous emphysema may be present but not universal. Breath
sounds are absent on the affected side only.
