Paramedic Certificate Program Entrance Exam Preparation

Important Study Note

The study guide serves as a template to guide your study efforts, but it is not inclusive of all the material you will be tested on. General knowledge and understanding of all content included in the 2021 EMS Education Standards is required.

  • Written Exam (Multiple Choice)

    The written exam evaluates general knowledge using the following content distribution. Use the tips below to prepare.

    Key Study Topics

    • Medical terminology (prefixes, suffixes, directional)
    • Patient consent and legal basics
    • Emergency pharmacology (BLS scope)
    • Anatomy: Major bones, Thoracic/Abdominal, Upper/Lower Airway
    • Patient Care Reports (Subjective vs Objective)
    • Incident Command System (ICS) and START Triage
    • Signs/Symptoms: Stroke, Diabetic Emergencies, Shock, Hypovolemia
    • Mental Status Assessment (AVPU/GCS)
    • Vital Signs: Normal ranges and Assessment methods
    • Airway: Flow rates, Adjuncts, Sounds, Obstructions
    • Blood: Major components and functions
    • Pupil Assessment and causes
    • Trauma: Soft tissue injuries, Spinal cord signs, Bleeding types
    • Pneumothorax vs Hemothorax
    • Pediatrics and OB: Seizures, Pre-delivery, Neonatal resuscitation

    Exam Content Category Distribution
    Category Total Questions Bloom 1 and 2 (50%) Bloom 3 and 4 (30%) Bloom 5 and 6 (20%)
    Preparatory 10 5 3 2
    EMS Operations 5 3 1 1
    Assessment 15 8 5 2
    Airway and Ventilation 20 10 6 4
    Medicine 20 10 6 4
    Shock, Resuscitation, Trauma 20 10 6 4
    Special Populations 10 5 3 2
  • Math Supplement

    The math supplement evaluates problem-solving, including decimals, fractions, and basic medical math. All necessary formulas and conversion tables are provided on the test.

    Weight Conversions

    • 1 mg = 1,000 mcg
    • 1 g = 1,000 mg
    • 1 kg = 1,000 g
    • 1 kg = 2.2 lbs

    Volume and Concentration

    • 1 L = 1,000 ml
    • gtt = "1 drop"
    • Concentration: Weight / Volume (e.g., 5 mg / 10 ml)

      For many medications, the active ingredient is measured in units of weight. The medication is then dissolved in sterile water. The solution is then packaged for use. The ratio of medication (weight) to water (volume) is depicted as a concentration. A vial of medication in which 5 mg of the medication is dissolved in 10 ml of water has a concentration of 5 mg/10 ml. That concentration can be simplified to 1 mg/5 ml.

    Sample Math Problems

    The following problems are representative of what you will solve on the test. Find the closest answer. Some answers may be rounded.

    1. Weight Conversion: Which answer provides the proper instructions on how to convert weight in pounds (lbs) to kilograms (kgs)?
      • a. Multiple lbs by 2.2
      • b. Divide lbs by 2.2
      • c. Subtract 2.2 from lbs
      • d. Add 2.2 to lbs
    2. Dosage Volume: A medication is packaged at 10 mg/50 ml. You are instructed to administer 2 mg. What volume should be administered? 
      • a. 5 ml
      • b. 10 ml
      • c. 20 ml
      • d. 25 ml
    3. Drip Rate: 15 drops (gtt) = 1 ml. You count 30 drops in 1 minute. How many ml of fluid will be administered over 5 minutes? 
      • a. 3 ml
      • b. 10 ml
      • c. 15 ml
      • d. 50 ml
    4. Weight-Based Dosage: Protocol: 2 mg/kg. Patient weight: 45 kg. How much medication should be administered? 
      • a. 22.5 mg
      • b. 41 kg
      • c. 45 kg
      • d. 90 mg
    5. You are administering a medication intramuscularly. Your protocol requires that 0.02 mg be administered each minute for 5 minutes. What is the total amount of medication administered?
      • a. 0.10 mg
      • b. 1.0 mg
      • c. 1.10 mg
      • d. 10.0 mg
    6. You must administer 100 mL of fluid gradually over 10 minutes. You are helping to spike the IV bag while the paramedic calculates the drip rate. The IV tubing used indicates 5 gtt/mL. What drip rate should the paramedic set?
      • a. 5 gtts/min
      • b. 10 gtts/min
      • c. 20 gtts/min
      • d. 50 gtts/min
    7. A patient weighs 130 lbs. Your protocol indicates Medication X to manage your patient, dosed at 2 mg/kg. How much medication should you administer?
      • a. 29 mg
      • b. 59 mg
      • c. 118 mg
      • d. 260 mg
  • Psychomotor Exam Skills

    Applicants must demonstrate proper technique, normal findings, indications, contraindications, and potential complications for the following interventions.

    1. Patient Assessment (Adult, Pediatric)
    2. Airway Management and Oxygen Delivery
      • Manual airway manipulation
      • Oral and nasal adjuncts
      • Suctioning and patient positioning
      • Appropriate oxygen delivery rates based on patient age, condition, and delivery device
      • Oxygen tank assembly and regulator use
      • Device use: Nasal cannula, Non-rebreather mask, Bag-valve mask (positive pressure ventilation)
    3. Trauma Care
      • Splinting (joints and long bones)
      • Hemorrhage control (Direct pressure, Tourniquets, Hemostatic agents)
    4. Medical Care (Pharmacology)
      • Epinephrine
      • Narcan
      • Oral Glucose
      • Glucagon
      • Aspirin
      • Nitroglycerin
    5. Assessment of Vital Signs
      • Palpation of pulse points (Rate, Regularity, Quality)
      • Lung sound identification (Auscultation)
      • Respiratory rate and effort
      • Pupil assessment
      • Blood pressure (Auscultation and Palpation)
      • Blood glucose, EtCO2, and SpO2 monitoring

Paramedic Certificate Program Entrance Exam Rationale

The paramedic entrance exam is designed to evaluate your knowledge of EMT-level content as an entry-level paramedic student. The exam is based solely on the content of the EMT scope-of-practice model set forth in the EMS Education Standards.

If you are employed by an Advanced Life Support (ALS) provider and assigned to work on an ALS crew, you may find it challenging to discern between the ALS and BLS scopes of practice. Additionally, the use of cardiac monitors and other diagnostic tools in ALS care may limit you from refining your skills. You must demonstrate competency in obtaining manual vital signs through palpation and auscultation, and performing a hands-on patient assessment. Further, it is strongly encouraged that you be placed in leadership roles, to the extent permissible within your scope of practice, even when assigned to an ALS crew. This helps you develop critical communication and critical thinking skills, which will be evaluated during the application process.