Prometric Exam Questions for Paramedics and EMTs 2026: 15 Practice MCQs with Answers and Rationale

The paramedic (PMD7003), advanced care paramedic (ACP7002) and EMT (EMT7004) Prometric papers are written in the style of NREMT and HCPC exams: a scene, a patient and a decision. Expect 80–100 MCQs over 2 hours for EMT and 100–150 over 2.5–3 hours for paramedic titles, with a pass mark of about 60%.

The fifteen questions below follow the paramedic blueprint, with the first few at EMT level. Allow about 70 seconds each. The exam rewards candidates who think in priorities: scene safety, primary survey, life threats first.

For the EMS title ladder, requirements by authority and the full syllabus, read the Prometric exam for paramedics and EMTs guide. For timed papers use the Paramedic bank, the EMT bank or the Advanced Care Paramedic bank.

Scene assessment and airway

Question 1

You arrive at a road traffic collision on a highway at night. Your first priority is:

1. Begin the primary survey on the nearest patient
2. Scene safety: position the vehicle, assess hazards and use protective equipment
3. Count the number of patients
4. Request a helicopter

Answer: B. Scene safety always comes first. An injured responder helps nobody. Hazards, traffic protection and personal protective equipment are assessed before patient contact, then the number of patients and need for extra resources.

Question 2

An unresponsive adult has snoring respirations after a fall from height. The correct way to open the airway is:

1. Head-tilt, chin-lift
2. Jaw thrust with manual in-line stabilisation of the cervical spine
3. Place the patient in the recovery position
4. Sit the patient upright

Answer: B. With a mechanism for spinal injury, the jaw thrust opens the airway without extending the neck. If the jaw thrust fails, a head tilt is still used because airway comes before spine. An oropharyngeal airway can be added if there is no gag reflex.

Question 3

The correct size for an oropharyngeal airway is measured from:

1. The tip of the nose to the earlobe
2. The corner of the mouth to the angle of the jaw or earlobe
3. The chin to the sternal notch
4. The lips to the epiglottis

Answer: B. An oropharyngeal airway is sized from the corner of the mouth to the angle of the jaw. A nasopharyngeal airway is sized from the nostril to the earlobe. A wrong size can push the tongue back and worsen obstruction.

Cardiology and resuscitation

Question 4

In adult cardiac arrest with a shockable rhythm, adrenaline is given:

1. Before the first shock
2. After the third shock, then every 3–5 minutes
3. Only after return of spontaneous circulation
4. Never in a shockable rhythm

Answer: B. Current ALS guidance gives adrenaline 1 mg IV or IO after the third shock in VF or pulseless VT, repeated every 3–5 minutes, with amiodarone 300 mg after the third shock. In non-shockable rhythms adrenaline is given as soon as access is obtained.

Question 5

A 12-lead ECG shows ST elevation in leads II, III and aVF. The infarct territory is:

1. Anterior
2. Lateral
3. Inferior
4. Posterior

Answer: C. Leads II, III and aVF look at the inferior wall, usually supplied by the right coronary artery. Right-sided leads (V4R) are then checked for right ventricular involvement, where nitrates can cause severe hypotension.

Question 6

For high-quality adult chest compressions the rate and depth are:

1. 60–80 per minute, 3 cm
2. 100–120 per minute, 5–6 cm
3. 140 per minute, 4 cm
4. 80–100 per minute, 7 cm

Answer: B. Compress at 100–120 per minute to a depth of 5–6 cm, allowing full recoil and minimising interruptions. Rotate the compressor every two minutes, and use waveform capnography to monitor quality once an advanced airway is in place.

Question 7

A conscious adult has a narrow-complex regular tachycardia at 180/min with a blood pressure of 70/40 mmHg and chest pain. The treatment of choice is:

1. Vagal manoeuvres and wait
2. Synchronised cardioversion
3. Oral beta blocker
4. Defibrillation (unsynchronised)

Answer: B. A tachycardia with adverse features (hypotension, chest pain, heart failure, altered consciousness) is treated with synchronised cardioversion, with sedation if time allows. Adenosine and vagal manoeuvres are for stable patients. Unsynchronised shocks are for pulseless rhythms.

Trauma

Question 8

A patient has life-threatening bleeding from a leg wound that does not stop with direct pressure. The next step is:

1. Elevate the leg and wait
2. Apply a tourniquet proximal to the wound, note the time and tighten until bleeding stops
3. Apply ice
4. Give aspirin

Answer: B. Catastrophic limb haemorrhage is controlled with a tourniquet applied 5–7 cm above the wound, not over a joint, tightened until bleeding stops, with the time recorded. Wound packing with haemostatic gauze is used for junctional wounds where a tourniquet cannot be placed.

Question 9

A trauma patient has severe respiratory distress, absent breath sounds on the right, tracheal deviation to the left and hypotension. The immediate treatment is:

1. Needle decompression of the right chest
2. Intubation and positive pressure ventilation first
3. Rapid transport with no intervention
4. Chest compressions

Answer: A. This is a tension pneumothorax. Decompress immediately with a large-bore needle in the second intercostal space mid-clavicular line, or the fourth or fifth intercostal space anterior axillary line, then transport for a chest drain. Positive pressure ventilation before decompression makes it worse.

Question 10

Using the START triage system, an adult who is walking is tagged:

1. Red (immediate)
2. Yellow (delayed)
3. Green (minor)
4. Black (deceased)

Answer: C. In START, all walking patients are tagged green and moved to a safe area first. The remaining patients are triaged on respirations, perfusion and mental status (the 30-2-can-do rule).

Question 11

An adult has burns to the whole of the front of the trunk and the whole of one arm. Using the rule of nines, the total body surface area burned is about:

1. 9%
2. 18%
3. 27%
4. 36%

Answer: C. The anterior trunk is 18% and each whole arm is 9%, giving 27%. Burns over 20% in adults need formal fluid resuscitation, and all significant burns need cooling, covering, analgesia and transfer to a burns service.

Medical emergencies and pharmacology

Question 12

An adult has sudden facial droop, arm weakness and slurred speech that began 40 minutes ago. The most important action is:

1. Give aspirin and observe at home
2. Record the time of onset, check blood glucose and transport rapidly to a stroke-capable centre with pre-alert
3. Give oxygen at high flow regardless of saturation
4. Wait to see if symptoms resolve

Answer: B. Time is brain. Confirm with a stroke scale, exclude hypoglycaemia, record the last-known-well time and pre-alert the receiving stroke centre so thrombolysis or thrombectomy is not delayed. Aspirin is not given before imaging excludes haemorrhage.

Question 13

An adult with anaphylaxis after a bee sting has stridor and a blood pressure of 80/50 mmHg. The first-line drug and dose is:

1. Adrenaline 0.5 mg intramuscularly into the anterolateral thigh
2. Adrenaline 1 mg intravenously
3. Chlorphenamine 10 mg intravenously
4. Hydrocortisone 200 mg intravenously

Answer: A. Intramuscular adrenaline 0.5 mg (0.5 mL of 1 mg/mL) in the thigh, repeated after 5 minutes if there is no improvement, with high-flow oxygen and a fluid bolus. Intravenous adrenaline boluses are reserved for cardiac arrest or experienced providers with monitoring.

Question 14

A 20 kg child needs an adrenaline dose of 0.01 mg/kg for cardiac arrest. Using a 1:10,000 solution, the volume to give is:

1. 0.2 mL
2. 2 mL
3. 20 mL
4. 0.02 mL

Answer: B. 0.01 mg/kg multiplied by 20 kg is 0.2 mg. A 1:10,000 solution contains 0.1 mg/mL, so 0.2 mg is 2 mL. Paediatric doses by weight appear in every paramedic paper.

Operations and the Gulf environment

Question 15

A construction worker collapses outdoors in July with a core temperature of 41 °C, confusion and hot dry skin. The priority is:

1. Give paracetamol and transport slowly
2. Rapid active cooling (cold water immersion or evaporative cooling with ice packs) while protecting the airway, then transport
3. Wrap the patient in blankets to prevent shivering
4. Oral fluids only

Answer: B. This is exertional heat stroke, common in Gulf summers. Cooling must begin immediately and continue during transport, aiming to bring the core temperature below about 39 °C quickly. Antipyretics do not work in heat stroke.

How to use these questions

• Memorise the algorithms. ALS, tachycardia and bradycardia algorithms, the primary survey and START triage should be reproducible from memory.
• Drill doses by weight. Thirty calculation problems a week until they feel automatic.
• Practise under time in the Paramedic bank or EMT bank, and read how to pass on the first attempt.

Keep BLS, ACLS and PHTLS or ITLS current, because most ambulance services require them at the licence stage (life support requirements). Pay by country is in paramedic salary in the UAE, Saudi Arabia and Qatar. To be seen by Gulf ambulance services, join the GCC medical talent pool.

Frequently asked questions

How many questions are in the Prometric paramedic exam?

Usually 100 to 150 MCQs over 2.5 to 3 hours for paramedic and advanced care titles, and 80 to 100 over 2 hours for EMT.

What is the pass mark for the paramedic exam?

About 60% for most Gulf authorities.

Which guidelines does the exam follow?

Questions are written to current international resuscitation and trauma guidelines, such as those used in ACLS, PALS and PHTLS courses. Where guidelines differ, the exam follows the widely accepted version.

Are there scenario questions?

Yes. Most items describe a scene and a patient and ask for the next best action, in the NREMT style.

Are these real exam questions?

No. They are original practice questions written to the published blueprint. Real exam content is confidential.