Free COPR Advanced Care Paramedic (ACP) Examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the COPR Advanced Care Paramedic (ACP) Examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1An ACP in British Columbia assesses an adult who has mild dementia and declines transport. Which finding is central to determining whether the patient can make this decision?

   1. A.The patient can accurately name the date and current location.
   2. B.The patient understands the advice and how it applies personally.Correct answer: B
   3. C.The patient agrees with the clinician's preferred transport plan.
   4. D.The patient has previously signed a health care representation form.

   Explanation: Section 7 requires that "the adult demonstrates that the adult understands (a) the information given by the health care provider under section 6 (e), and (b) that the information applies to the situation of the adult for whom the health care is proposed." The patient must understand the information and its personal application. Orientation, agreement with the ACP, and an existing representation form do not establish these two decision-specific abilities.

   Reference: British Columbia — Health Care (Consent) and Care Facility (Admission) Act — s. 7, How incapability is determined

2. 2A BCEHS ACP calls CliniCall to summarize a patient's current condition and obtain recommendations for ongoing care. Which structured communication tool is preferred for this consultation?

   1. A.ATMIST AMBO
   2. B.OPQRST
   3. C.SBARCorrect answer: C
   4. D.SAMPLE

   Explanation: The guideline states: "During consultations – such as those with CliniCall – an alternative format is preferred: SBAR." ATMIST AMBO is the transition-of-care tool, while OPQRST and SAMPLE structure history taking rather than this consultation.

   Reference: BCEHS — A03 Clinical Handover and Communication — SBAR

3. 3A BCEHS ACP is preparing to assess an adult with suspected active pulmonary tuberculosis. Which transmission-based precaution category should guide respiratory protection?

   1. A.Contact precautions
   2. B.Droplet precautions
   3. C.Airborne precautionsCorrect answer: C
   4. D.Bloodborne precautions

   Explanation: The TB section states: "It is important to perform a point of care risk assessment – does the patient have symptoms consistent with TB? If yes apply airborne precautions:" Suspected active pulmonary TB therefore requires airborne precautions rather than relying on contact, droplet or blood-exposure precautions.

   Reference: BCEHS — K01 Infectious Diseases (General) — Tuberculosis, point-of-care risk assessment

4. 4At first contact with an injured adult, the ACP sees rapidly pooling blood from a limb wound. The patient is awake and speaking. Which step should occur before a formal primary survey?

   1. A.Complete a focused limb history
   2. B.Measure a full set of vital signs
   3. C.Perform a rapid head-to-toe examination
   4. D.Control the life-threatening hemorrhageCorrect answer: D

   Explanation: BCEHS states: "Prior to beginning a formal primary survey, life-threatening hemorrhage must be controlled." The visible major hemorrhage takes priority over history, vital signs and physical examination. Those assessment tasks follow or are delegated without delaying control.

   Reference: BCEHS — A02 Patient Assessment — Initial and Primary Survey

5. 5A hypoxic adult requires a PEEP valve during bag-valve-mask ventilation. Under BCEHS airway guidance, what starting PEEP level is described as a low initial setting?

   1. A.2 cm H2O
   2. B.5 cm H2OCorrect answer: B
   3. C.10 cm H2O
   4. D.15 cm H2O

   Explanation: BCEHS states: "The application of PEEP is generally safe at low levels (starting at 5cmH2O) but can be harmful at any level, particularly in patients experiencing shock physiology and those experiencing dynamic hyperinflation." The starting setting is 5 cm H2O. Monitoring remains important because this is not a guarantee of safety in shock or dynamic hyperinflation.

   Reference: BCEHS — B01 Airway Management — General Information, PEEP

6. 6A BCEHS ACP is adjusting oxygen and ventilation after sustained return of spontaneous circulation. Which paired targets match the post-arrest guideline?

   1. A.SpO2 88–92% and EtCO2 20–30 mmHg
   2. B.SpO2 94–100% and EtCO2 45–55 mmHg
   3. C.SpO2 98–100% and EtCO2 20–30 mmHg
   4. D.SpO2 92–98% and EtCO2 30–40 mmHgCorrect answer: D

   Explanation: BCEHS states: "Target oxygenation and ventilation to an SpO2 of 92-98% and EtCO2 of 30-40 mmHg." These targets balance adequate oxygenation and ventilation after circulation returns. Targets for other contexts or unnecessary hyperoxia/hypocapnia do not match this post-arrest instruction.

   Reference: BCEHS — N03 Return of Spontaneous Circulation — Essentials, oxygenation and ventilation

7. 7Before an interfacility transfer, a BCEHS ACP must positively identify the patient. Which pair provides the two separate patient data points described in the transfer guideline?

   1. A.Patient name and ward name
   2. B.Patient name and room number
   3. C.Patient name and bed number
   4. D.Patient name and date of birthCorrect answer: D

   Explanation: BCEHS A08: Interfacility Transfers states: "Patients must be positively identified using two separate data points (e.g., name, date of birth, personal health number) prior to being transferred between facilities." Name and date of birth are separate patient identifiers. Locations and destinations identify places in the transfer process and cannot replace two patient data points.

   Reference: BCEHS A08: Interfacility Transfers — Essentials, positive patient identification

8. 8During take-home naloxone teaching in British Columbia, the ACP explains repeat dosing. After a first dose, breathing has not returned to normal; rescue breaths and the 9-1-1 response are underway. According to HealthLink BC, how long after that dose should a second dose be given?

   1. A.After 1 minute
   2. B.After 3 minutesCorrect answer: B
   3. C.After 2 minutes
   4. D.After 5 minutes

   Explanation: HealthLink BC states: "A second dose of naloxone may be needed if the first dose does not restore normal breathing after 3 minutes." Teach the community rescuer to reassess and repeat at three minutes while continuing rescue breathing and awaiting emergency assistance. The other intervals do not match this public instruction.

   Reference: HealthLink BC: Naloxone—Treating Opioid Poisoning — How does naloxone work?, repeat dosing

9. 9A British Columbia adult lacks capacity for a non-emergency treatment decision. There is no authorized personal guardian, representative, or applicable advance directive. The spouse, adult child, parent, and sibling are all available and qualify under section 16. Who has first priority to provide temporary substitute consent?

   1. A.The patient's adult child
   2. B.The patient's adult sibling
   3. C.The patient's adult parent
   4. D.The patient's adult spouseCorrect answer: D

   Explanation: Section 16 says the provider "must choose the first, in listed order, of the following who is available and qualifies under subsection (2): (a) the adult's spouse;" The spouse is listed first, before the child, parent and sibling. Since all are qualified and available in this scenario, the spouse has priority.

   Reference: British Columbia — Health Care (Consent) and Care Facility (Admission) Act — s. 16(1)(a)-(d), Temporary substitute decision makers

10. 10A critical patient has reached the emergency department, and the receiving team can safely pause activities for the ACP's initial structured handover. What interval does BCEHS recommend for the initial hands-off, eyes-on exchange?

    1. A.About 10 seconds
    2. B.20 to 30 secondsCorrect answer: B
    3. C.45 to 60 seconds
    4. D.About 120 seconds

    Explanation: The guideline says: "Clinical handovers of critical patients should, ideally, include a 20-30 second period" for the initial focused exchange. The condition in the stem permits this pause. The 45–60-second figure concerns a complete handover, not this initial phase.

    Reference: BCEHS — A03 Clinical Handover and Communication — Essentials, critical-patient handover