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2026 Statistics

Key Facts: PHECC Paramedic Exam

100

MCQ Questions

PHECC

75 min

Exam Duration

PHECC

80%

Passing Score

PHECC

€200

Examination Fee

PHECC

2026 CPGs

Guideline Standard

PHECC 8th Edition

Prometric

Test Provider

PHECC Partner

The PHECC Paramedic MCQ exam consists of 100 questions with a 75-minute limit and costs €200. It requires a high passing score of 80%. The exam is strictly based on the latest PHECC Clinical Practice Guidelines (CPGs) and is delivered via Prometric test centres. Key domains include airway, drug doses/routes, ECG/ALS cardiology, trauma hemorrhage/decompression, medical emergencies, and operational triage/consent.

Sample PHECC Paramedic Practice Questions

Try these sample questions to test your PHECC Paramedic exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 110+ question experience with AI tutoring.

1Which of the following is the primary indication for the insertion of a supraglottic airway device (such as the i-gel) by a Paramedic under PHECC guidelines?

A.Conscious patients requiring supplementary oxygen therapy

B.Unconscious patients in cardiac arrest who lack protective airway reflexes

C.Patients with severe asthma who are wheezing but talking in sentences

D.Conscious patients presenting with acute foreign body airway obstruction

Explanation: Under PHECC Clinical Practice Guidelines, a supraglottic airway device (SAD) like the i-gel is indicated for unconscious patients in cardiac arrest who lack protective airway reflexes. This allows for rapid airway management and passive oxygenation or ventilation without requiring laryngoscopy. It is strictly contraindicated in conscious or semi-conscious patients with an active gag reflex.

2Under PHECC guidelines, which of the following is considered the gold standard for confirming and continuously monitoring the placement of an advanced airway device?

A.Auscultation of bilateral breath sounds and epigastrium

B.Observation of chest rise and fall during ventilation

C.Continuous waveform capnography

D.Presence of condensation in the tube

Explanation: Continuous waveform capnography is the gold standard for confirming and monitoring advanced airway placement. It provides real-time objective data showing the presence of carbon dioxide, confirming the tube or device is in the trachea/hypopharynx rather than the esophagus. While clinical signs (auscultation, chest rise) are important, they can be misleading; waveform capnography is mandatory under PHECC guidelines.

3In a 'cannot intubate, cannot ventilate' situation where a patient's airway is completely obstructed and basic techniques have failed, which of the following is the recognised emergency rescue airway procedure used in the pre-hospital setting?

A.Surgical tracheostomy

B.Needle cricothyroidotomy

C.Retrograde intubation

D.Digital intubation

Explanation: Needle cricothyroidotomy is the recognised emergency rescue airway technique for a 'cannot intubate, cannot ventilate' scenario with complete airway obstruction. It involves inserting a large-bore cannula through the cricothyroid membrane to provide a temporary pathway for oxygenation. In the PHECC system this is an advanced practitioner (Advanced Paramedic) skill rather than a base Paramedic skill, but it remains the correct rescue procedure of the options listed. Surgical tracheostomy is a complex theatre procedure outside the pre-hospital scope.

4When performing bag-mask ventilation on an adult patient with a bag-valve-mask (BVM) and an oxygen reservoir, what flow rate of oxygen should be delivered to the bag?

A.2 to 4 L/min

B.6 to 8 L/min

C.10 to 12 L/min

D.15 L/min or higher

Explanation: To deliver near 100% oxygen concentration, a BVM with an oxygen reservoir must be connected to an oxygen source supplying at least 15 L/min. This flow rate ensures that the reservoir bag remains inflated and provides adequate oxygen for each ventilation. Lower flow rates will cause the reservoir bag to collapse and reduce the fractional concentration of inspired oxygen (FiO2).

5Which anatomical landmarks should a Paramedic use to correctly measure the size of a nasopharyngeal airway (NPA) before insertion?

A.From the tip of the nose to the angle of the jaw

B.From the tip of the nose to the earlobe

C.From the corner of the mouth to the earlobe

D.From the center of the incisors to the angle of the jaw

Explanation: To size a nasopharyngeal airway (NPA) correctly, measure from the tip of the patient's nose to the earlobe (or the tragus of the ear). This measurement estimates the correct length needed to reach the pharynx without entering the larynx or being too short to clear the tongue. Using an incorrectly sized NPA can lead to mucosal damage, bleeding, or airway obstruction.

6During CPR, what is the clinical consequence of ventilating a patient too rapidly or with excessive volume (hyperventilation)?

A.Increased coronary perfusion pressure due to thoracic expansion

B.Decreased intrathoracic pressure leading to increased venous return

C.Increased intrathoracic pressure leading to decreased venous return and cardiac output

D.Improved gas exchange and higher arterial carbon dioxide levels

Explanation: Hyperventilation during CPR increases intrathoracic pressure. This positive pressure compresses the low-pressure vena cava, reducing venous return (preload) to the heart. Consequently, cardiac output and coronary perfusion pressure fall, significantly decreasing the likelihood of return of spontaneous circulation (ROSC). Excessive ventilation also causes gastric inflation, increasing the risk of regurgitation and aspiration.

7During the transport of an intubated cardiac arrest patient, the EtCO2 waveform on the monitor suddenly drops from 35 mmHg to near zero. What should be the Paramedic's first suspicion and action?

A.The patient has achieved ROSC; immediately stop compressions to check a pulse.

B.The endotracheal tube has become displaced or extubated; immediately assess tube placement.

C.The monitor is malfunctioning; continue ventilating and ignore the capnography.

D.The patient's body temperature has dropped; increase room heating.

Explanation: A sudden drop in EtCO2 to near zero in an intubated patient is a critical warning sign that either the airway device has become displaced (e.g., extubated or migrated to the esophagus), or there has been a complete cessation of pulmonary blood flow (such as ventilator disconnection or circulator failure). The Paramedic must immediately assess airway patency, tube placement, and ventilator connection. ROSC would cause a sudden *increase* in EtCO2, not a drop.

8What is the maximum recommended duration for a single suctioning attempt of an adult patient's airway to minimize the risk of hypoxia?

A.5 seconds

B.15 seconds

C.30 seconds

D.45 seconds

Explanation: Suctioning removes both secretions and air from the respiratory tract, leading to rapid hypoxia. Therefore, a single suctioning attempt in an adult should not exceed 15 seconds. The patient should be pre-oxygenated before suctioning, and suction should only be applied while withdrawing the catheter in a circular motion, never during insertion.

9Which of the following is an absolute contraindication to the insertion of an oropharyngeal airway (OPA)?

A.An unconscious patient without a gag reflex

B.A semi-conscious patient with an active gag reflex

C.A patient presenting with a suspected basilar skull fracture

D.A patient in cardiorespiratory arrest

Explanation: An oropharyngeal airway (OPA) is contraindicated in any patient with an active gag reflex. Inserting an OPA in a patient who is conscious or semi-conscious can stimulate the gag reflex, leading to vomiting, laryngospasm, and subsequent aspiration. A suspected basilar skull fracture is a contraindication for a *nasopharyngeal* airway (NPA) due to the risk of intracranial entry, but not for an OPA.

10In a ventilated adult patient with a severe traumatic brain injury, what is the target End-Tidal CO2 (EtCO2) range under PHECC guidelines to avoid secondary brain injury?

A.20 to 25 mmHg (2.6 to 3.3 kPa)

B.35 to 40 mmHg (4.6 to 5.3 kPa)

C.45 to 50 mmHg (5.9 to 6.6 kPa)

D.55 to 60 mmHg (7.2 to 7.9 kPa)

Explanation: In patients with severe head injuries, target EtCO2 is kept strictly between 35-40 mmHg (4.6-5.3 kPa). Hypocapnia (EtCO2 < 35 mmHg) caused by hyperventilation induces cerebral vasoconstriction, reducing blood flow and worsening ischemia. Hypercapnia (EtCO2 > 40 mmHg) causes cerebral vasodilation, increasing intracranial pressure (ICP). Prophylactic hyperventilation is avoided unless there are active clinical signs of herniation.

About the PHECC Paramedic Exam

The NQEMT Paramedic Written Examination is the theoretical assessment required to obtain paramedic registration in Ireland. Administered by PHECC, this computer-based MCQ exam tests candidates on the application of the official Clinical Practice Guidelines (CPGs) and Education Standards. It covers critical domains including advanced airway management, pharmacology and drug administration, cardiology and advanced life support (ALS), major trauma care, acute medical emergencies, and ambulance operations/legal ethics.

Assessment

100 multiple-choice questions (MCQ)

Time Limit

75 minutes

Passing Score

80% (80 correct answers out of 100)

Exam Fee

€200 (Pre-Hospital Emergency Care Council (PHECC))

PHECC Paramedic Exam Content Outline

12%

Advanced Airway

i-gel insertion, airway anatomy, pre-oxygenation, waveform capnography, suctioning limits, and needle cricothyroidotomy.

13%

Pharmacology

Paramedic formulary (aspirin, adrenaline, amiodarone, midazolam, TXA), drug doses, routes (IV/IO/IM/IN/buccal), indications, and contraindications.

20%

Cardiology

12-lead ECG interpretation, STEMI criteria, cardiac arrest algorithms (ALS), shockable vs. non-shockable rhythms, and post-resuscitation care (ROSC).

20%

Trauma Care

Hemorrhage control (tourniquets), spinal motion restriction, needle chest decompression, flail chest, pelvic binders, and burn surface area/fluids.

25%

Medical Emergencies

Respiratory distress, diabetic emergencies (hypoglycemia vs. DKA), anaphylaxis, sepsis (qSOFA), seizures, hypothermia, drowning, and obstetric/neonatal care.

10%

Operations

Consent, capacity, refusal of care, Patient Care Report (PCR) documentation, IMIST-AMBO handover, HAZMAT zones, and mass casualty triage sieve.

How to Pass the PHECC Paramedic Exam

What You Need to Know

Passing score: 80% (80 correct answers out of 100)
Assessment: 100 multiple-choice questions (MCQ)
Time limit: 75 minutes
Exam fee: €200

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

PHECC Paramedic Study Tips from Top Performers

1Memorize the Paramedic Medication Formulary, paying close attention to exact pediatric and adult doses, concentrations, routes, and contraindications.

2Understand the ALS cardiac arrest algorithm, focusing on the timing of shocks, chest compression fraction, and drug administration (Adrenaline and Amiodarone).

3Learn to identify STEMI on a 12-lead ECG, including contiguous lead groupings and anatomical infarct locations (anterior, inferior, septal, lateral).

4Be clear on the difference between simple pneumothorax, open pneumothorax, and tension pneumothorax, and their respective pre-hospital interventions.

5Review pediatric assessment criteria, including GCS, APGAR score calculation, and signs of severe dehydration.

6Understand the legal principles of consent, capacity, and refusal of care under Irish law, and the requirements for completing a Patient Care Report (PCR).

Frequently Asked Questions

What is the PHECC Paramedic written exam?

It is the theoretical Multiple Choice Question (MCQ) component of the National Qualification in Emergency Medical Technology (NQEMT) exam at the Paramedic level in Ireland. It assesses the candidate's understanding and clinical application of the PHECC Clinical Practice Guidelines (CPGs) and Education Standards.

What is the passing score for the PHECC Paramedic MCQ?

The passing score is 80%. Candidates must answer at least 80 out of the 100 multiple-choice questions correctly to pass. Anyone scoring 79% or less is deemed unsuccessful and must retake the exam.

How much does the exam cost?

The standard fee for the NQEMT Paramedic examination is €200. If a candidate needs to repeat the MCQ component, the repeat examination fee is €100.

What is the time limit and format of the exam?

The exam consists of 100 multiple-choice questions, each with 4 options. Candidates have 75 minutes to complete the exam. It is computer-based and administered at Prometric test centres in Ireland.

Which guidelines are tested on the exam?

The exam is strictly based on the latest edition of the PHECC Clinical Practice Guidelines (currently the 2026 8th Edition) and the companion Practitioner Medication Formulary.

What happens if I fail the MCQ?

Candidates who do not pass the MCQ component can apply to repeat the exam. The fee for a repeat examination is €100. PHECC also allows candidates to request a viewing of their script/result profile for a €30 fee.