Mobile Intensive Care Nurse (MICN) — Los Angeles County
The base hospital nurse on the other end of the radio — giving paramedics online medical direction under LA County's protocols.
About the exam
The MICN is a Los Angeles County certification for registered nurses who give paramedics online medical direction from a base hospital. The Medical Director of the LA County EMS Agency authorizes MICNs to practice only within Los Angeles County. After the approved MICN Development Course, candidates take the county's certifying examination and then complete a radio internship.
Our questions follow the LA County Prehospital Care Manual: the 1200-series treatment protocols, the 1300-series medical control guidelines and 1317 drug references, and the base hospital, destination and field policies. The EMS Agency revises the manual several times a year, and the current manual always governs. Other California counties run their own MICN programs on their own protocols, so this prep is for LA County only.
LA County doesn't publish the exam's length or passing score. We practice at 100 questions in 2 hours. The exam is given after the approved MICN course, so confirm the current format with your course director.
How we track your progress
Every blueprint domain moves through five levels as you study:
- Not startedNo questions answered in this domain yet.
- Getting startedFirst questions answered — not enough yet to judge.
- DevelopingAt least 5 answered and 50% or better on your recent questions.
- ProficientAt least 15 answered and 70% or better on your recent questions.
- Exam readyAt least 25 answered, 80% or better recently, and holding up on hard questions.
The exam blueprint
Built from the LA County Prehospital Care Manual — treatment protocols and drug references as revised through October 1, 2026 — 100 scored items across 8 domains. Tap a domain to see its topics.
1 Base Hospital, MICN Role and Medical Control 14 items · 14%
42 practice questions in this domain so far
2 Cardiac and Resuscitation 16 items · 16%
48 practice questions in this domain so far
3 Respiratory and Airway 11 items · 11%
33 practice questions in this domain so far
4 Medical, Neuro, Tox and Environmental 15 items · 15%
45 practice questions in this domain so far
5 Trauma, Triage and Destination 13 items · 13%
39 practice questions in this domain so far
6 Obstetrics, Newborn and Pediatrics 10 items · 10%
30 practice questions in this domain so far
7 Policies, Destination and Documentation 10 items · 10%
30 practice questions in this domain so far
8 Pharmacology and the LA County Formulary 11 items · 11%
33 practice questions in this domain so far
What you get when you access this exam
Free with your QuizMe account.
Base hospital scenarios aligned to the protocols
Every question is tagged to one of 8 MICN areas and to the protocol or policy behind it. Each puts you on the radio: the paramedic's report, and the order you give.
Base radio call drills
Listen to paramedic reports over a simulated base radio, then give orders, confirm doses and choose destinations. It's a separate drill from the question bank, organized by call type.
Exam-critical hints
Stuck? Reveal the hint: the base-contact rule, the dose limit or the destination criterion that settles the question. Every answer explains its reasoning and names the protocol it's based on.
Adaptive testing
Questions steer toward your weakest areas, weighted by how much each one counts, and get harder as you get stronger.
Timed practice exams
Exams weighted by area, at 100 questions in 2 hours, with no feedback until you finish. Then you get a full review.
Flashcards, case simulations and guides
Flashcards for LA County doses and base contact criteria, plus radio cases that unfold, where the field picture changes with every order you give.
Progress for every area
Each area moves from Not started to Getting started, Developing, Proficient and Exam ready, so you always know what to study next.
Test at home or at a center
MICN certification in Los Angeles County runs in three stages, all managed through your sponsoring agency and the LA County EMS Agency (Ref. 1010).
MICN Development Course
- Taken through an EMS Agency-approved program, usually at a base hospital, with sponsorship from a base hospital, the EMS Agency or a paramedic provider.
- Taught to the LA County MICN Development Core Objectives, with base-contact simulations and field care audits.
- Ends in a course final; the recommended minimum passing score is 80% (Ref. 904).
- You also need at least 8 hours of field observation with an LA County ALS unit (Ref. 1011).
County certification exam
- Scheduled by the EMS Agency once your application and documents are in: letter of recommendation, RN license, ACLS card, field observation and course certificate.
- Must be passed within 1 year of finishing the course.
- One retake is allowed, after 7 days but within 30 days. A no-show counts as a failure, and failing the retake means repeating the course.
- The EMS Agency doesn't publish the exam's length or passing score, so check with your course director before exam day.
Radio internship
- Completed within 6 months of passing the exam.
- At least 10 base hospital ALS runs, supervised by a certified MICN or base physician.
- At least one run each in neurology, respiratory, trauma, cardiac arrest, cardiac chest pain or dysrhythmia, general medical, and pediatrics.
- Certification is then issued for 2 years from the end of the month in which you finish.
Exam-day game plan
How to walk in ready — and how to pace 100 questions in 2 hours.
Pacing checkpoints
Hit these and you finish with time to revisit your flagged questions. Our timed practice exams run at this same pace.
The week before
- Download the current Prehospital Care Manual documents again. Protocols change on the 1st of the month, so check the revised date on each one.
- Drill the base contact list, the concurrent-notification list and the prior-authorization list from Ref. 1200.2.
- Review LA County doses and limits: epinephrine routes and concentrations, adenosine 12 mg, amiodarone, midazolam, fentanyl and dextrose 10%.
- Take one full timed practice exam 3–5 days out, then review rather than cram.
Exam morning
- Eat a real breakfast and go easy on caffeine.
- Bring whatever ID and paperwork your course or the EMS Agency asked for.
- Arrive early and use the restroom before you start.
During the exam
- Read the stem the way you'd hear a radio report: provider impression, vitals, perfusion, then what has already been given.
- Ask what the protocol allows the paramedic to do on standing order, and what needs you.
- Watch for the age cutoffs (pediatric means 14 and under), the 30-minute destination rules and the maximum doses before base contact.
- Eliminate two answers, then pick between the last two on the LA County protocol, not on habit from another system.
- Flag hard questions and come back; answer every question.
Keep your head
- If you freeze, take three slow breaths and reread the stem.
- Your ED and ACLS knowledge is the base, and the county's protocols are the tiebreaker.
- Change an answer only when you find a real reason in the stem, not a feeling.
Keeping your MICN
- Certification lasts 2 years.
- Keep your California RN license, ACLS and sponsorship current.
- Complete 40 hours of EMS CE every 2 years, including at least 12 hours of field care audits. At most 12 hours a day count, and at most half can be restricted CE such as teaching or media-based courses.
- 4–8 hours of structured field observation is required at your first renewal.
- Submit your application at least 30 days before expiry. Lapses over 6 months add CE, the exam and a radio internship, and lapses of 24 months or more mean starting over (Ref. 1010).
Official sources and further reading
- Ref. 1010 — MICN Certification ↗Official certification, exam, internship and renewal rules (revised 10-01-25).
- Ref. 904 — MICN Development Program Requirements ↗What approved MICN courses must cover.
- LA County EMS Agency — MICN Info and forms ↗Application, CE statement, field observation and internship forms.
- Prehospital Care Manual — Ref. 1200 Treatment Protocols ↗Current protocols, each with its last-updated date and change log.
- Prehospital Care Manual — Ref. 1300 Medical Control Guidelines ↗MCGs and the 1317 drug references.
- Ref. 1200.2 — Base Contact Requirements ↗When paramedics must contact the base, and what needs prior authorization.
Ready to start?
300 questions and scenarios across the blueprint — and growing.
QuizMe and thinQtank Learning are not affiliated with or endorsed by the Los Angeles County Department of Health Services or its EMS Agency. Questions are written from the LA County Prehospital Care Manual as published at the time of writing. The manual changes often and the current version always governs. Other counties' MICN programs use their own protocols. This prep is not a substitute for an approved MICN Development Course, base hospital training or medical direction. The county doesn't publish the exam's length or passing score: we practice at 100 questions in 2 hours, and our Exam ready level asks for 80% or better.