Paramedic FISDAP Final Exam – 190 Multiple Choice
Questions with Correct Answers & Detailed Rationales
2026/2027 (Airway, Cardiology, Trauma, Medical, OB/Peds,
Pharmacology) pdf
Master Airway, Cardiology, Trauma, Medical Emergencies, OB/Peds,
Pharmacology & Operations
Coverage Overview
Prepare for the Paramedic FISDAP Final Exam with this comprehensive set
of 190 multiple-choice questions. Each question includes the correct answer
in italic bold and a detailed rationale. Covers all high-yield domains:
Airway & Respiratory – Intubation, pneumothorax, CPAP, anaphylaxis,
croup
Cardiology & ECG – STEMI, SVT, bradycardia, V-fib, pacemakers,
hyperkalemia
Trauma – Tension pneumothorax, epidural hematoma, shock,
decompression, flail chest
Medical Emergencies – DKA, overdose, status epilepticus, Cushing's triad,
Wernicke's
Obstetrics & Pediatrics – Eclampsia, placenta previa, neonatal
resuscitation, croup, epiglottitis
Pharmacology – Epinephrine, naloxone, amiodarone, adenosine, calcium,
sodium bicarbonate
EMS Operations – START triage, MCI, helicopter LZ, incident command,
decontamination
,Airway & Respiratory Emergencies (Questions 1–20)
1. A 30-year-old climber experiences severe shortness of breath after reaching
12,000 feet. He is anxious with rales in all quadrants. What should you do?
a) Coach the patient to slow his respirations
b) Apply CPAP while the patient adapts to elevation
c) Administer oxygen while descending to a lower altitude
d) Evacuate the patient to a hyperbaric chamber
Explanation: High-altitude pulmonary edema (HAPE) requires immediate descent
and supplemental oxygen; staying at altitude or CPAP without descent does not
address the underlying hypobaric hypoxia.
2. A patient with suspected tuberculosis requires transport. What PPE is
essential?
a) Surgical mask only
b) N95 mask with eye protection
c) HEPA respirator (N95 or higher)
d) Full hazmat suit with SCBA
Explanation: TB is an airborne disease requiring particulate respirators (N95 or
PAPR); surgical masks do not filter airborne droplet nuclei.
3. To successfully accomplish nasotracheal intubation, you should advance the
tube through the glottic opening during:
a) Expiration
b) Inspiration
c) Swallowing
d) Cough reflex
Explanation: During inspiration the vocal cords are abducted (open), providing the
widest passage for tube advancement through the glottic opening.
4. A 73-year-old male has right-sided fractured ribs, unequal chest wall
movement, dyspnea, and BP 80/30. What should you suspect?
a) Simple pneumothorax
b) Tension pneumothorax
c) Hemothorax
d) Pulmonary contusion
,Explanation: Hypotension with absent breath sounds and unequal chest
movement after trauma indicates tension pneumothorax requiring immediate
needle decompression.
5. A 19-year-old male has blunt left chest trauma, severe dyspnea, and
diminished left breath sounds. BP 92/60. You should:
a) Perform needle thoracostomy
b) Endotracheally intubate
c) Initiate two large-bore IVs
d) Perform pericardiocentesis
Explanation: Absent breath sounds after trauma with hypotension suggests
tension pneumothorax; needle decompression at the second intercostal space,
midclavicular line is indicated.
6. A 27-year-old male was stabbed with a pen in the supraclavicular area. He is
pale with BP 80/42, lung sounds absent on the right. First responders sealed the
wound. What should you do?
a) Perform needle decompression
b) Lift a corner of the occlusive dressing
c) Establish two large-bore IVs
d) Transport with high-flow oxygen
Explanation: Absent breath sounds after penetrating chest trauma suggests
tension physiology; definitive treatment is needle decompression, not simply lifting
the dressing.
7. A 47-year-old male found unconscious only responds to pain. When
attempting IV access, he stiffens arms/legs. BP 178/122, P56, ETCO2 30. What
should you do?
a) Mildly hypoventilate with BVM
b) Assist ventilations at 12 breaths per minute
c) Administer 250 mL normal saline bolus
d) Administer 25g dextrose
Explanation: ETCO2 of 30 indicates hypocapnia; assisted ventilation at a normal
rate helps maintain appropriate cerebral perfusion pressure in possible
intracranial pathology.
, 8. A patient in respiratory distress has diffuse bilateral crackles and wheezing
with blood-tinged sputum. BP 170/70, P72 irregular. Which intervention is most
important?
a) Endotracheal intubation
b) Restoring normal sinus rhythm
c) Decreasing preload
d) Increasing preload
Explanation: Findings indicate acute cardiogenic pulmonary edema; decreasing
preload with nitrates and diuretics reduces pulmonary congestion before
considering intubation.
9. Which of the following is indicated for a severe asthma exacerbation
refractory to nebulized albuterol?
a) Oral corticosteroids
b) IM epinephrine
c) IV diphenhydramine
d) Inhaled ipratropium only
Explanation: Severe bronchospasm with inadequate response to nebulized beta-
agonists may require subcutaneous or IM epinephrine for additional
bronchodilation and anti-inflammatory effect.
10. A 66-year-old male with long smoking history has severe dyspnea,
diminished left breath sounds, BP 80/30, SpO2 88%. What should you suspect?
a) Emphysema exacerbation with possible pneumothorax
b) Pneumonia
c) Pulmonary embolism
d) Acute myocardial infarction
Explanation: Unilateral diminished breath sounds in a COPD patient with
hypotension suggests spontaneous pneumothorax superimposed on underlying
emphysema.
11. A 2-year-old male has a "seal bark" cough, stridor, and accessory muscle use
for 48 hours. SpO2 92%. How should you treat?
a) Humidified oxygen and transport
b) Oxygen plus nebulized racemic epinephrine
Questions with Correct Answers & Detailed Rationales
2026/2027 (Airway, Cardiology, Trauma, Medical, OB/Peds,
Pharmacology) pdf
Master Airway, Cardiology, Trauma, Medical Emergencies, OB/Peds,
Pharmacology & Operations
Coverage Overview
Prepare for the Paramedic FISDAP Final Exam with this comprehensive set
of 190 multiple-choice questions. Each question includes the correct answer
in italic bold and a detailed rationale. Covers all high-yield domains:
Airway & Respiratory – Intubation, pneumothorax, CPAP, anaphylaxis,
croup
Cardiology & ECG – STEMI, SVT, bradycardia, V-fib, pacemakers,
hyperkalemia
Trauma – Tension pneumothorax, epidural hematoma, shock,
decompression, flail chest
Medical Emergencies – DKA, overdose, status epilepticus, Cushing's triad,
Wernicke's
Obstetrics & Pediatrics – Eclampsia, placenta previa, neonatal
resuscitation, croup, epiglottitis
Pharmacology – Epinephrine, naloxone, amiodarone, adenosine, calcium,
sodium bicarbonate
EMS Operations – START triage, MCI, helicopter LZ, incident command,
decontamination
,Airway & Respiratory Emergencies (Questions 1–20)
1. A 30-year-old climber experiences severe shortness of breath after reaching
12,000 feet. He is anxious with rales in all quadrants. What should you do?
a) Coach the patient to slow his respirations
b) Apply CPAP while the patient adapts to elevation
c) Administer oxygen while descending to a lower altitude
d) Evacuate the patient to a hyperbaric chamber
Explanation: High-altitude pulmonary edema (HAPE) requires immediate descent
and supplemental oxygen; staying at altitude or CPAP without descent does not
address the underlying hypobaric hypoxia.
2. A patient with suspected tuberculosis requires transport. What PPE is
essential?
a) Surgical mask only
b) N95 mask with eye protection
c) HEPA respirator (N95 or higher)
d) Full hazmat suit with SCBA
Explanation: TB is an airborne disease requiring particulate respirators (N95 or
PAPR); surgical masks do not filter airborne droplet nuclei.
3. To successfully accomplish nasotracheal intubation, you should advance the
tube through the glottic opening during:
a) Expiration
b) Inspiration
c) Swallowing
d) Cough reflex
Explanation: During inspiration the vocal cords are abducted (open), providing the
widest passage for tube advancement through the glottic opening.
4. A 73-year-old male has right-sided fractured ribs, unequal chest wall
movement, dyspnea, and BP 80/30. What should you suspect?
a) Simple pneumothorax
b) Tension pneumothorax
c) Hemothorax
d) Pulmonary contusion
,Explanation: Hypotension with absent breath sounds and unequal chest
movement after trauma indicates tension pneumothorax requiring immediate
needle decompression.
5. A 19-year-old male has blunt left chest trauma, severe dyspnea, and
diminished left breath sounds. BP 92/60. You should:
a) Perform needle thoracostomy
b) Endotracheally intubate
c) Initiate two large-bore IVs
d) Perform pericardiocentesis
Explanation: Absent breath sounds after trauma with hypotension suggests
tension pneumothorax; needle decompression at the second intercostal space,
midclavicular line is indicated.
6. A 27-year-old male was stabbed with a pen in the supraclavicular area. He is
pale with BP 80/42, lung sounds absent on the right. First responders sealed the
wound. What should you do?
a) Perform needle decompression
b) Lift a corner of the occlusive dressing
c) Establish two large-bore IVs
d) Transport with high-flow oxygen
Explanation: Absent breath sounds after penetrating chest trauma suggests
tension physiology; definitive treatment is needle decompression, not simply lifting
the dressing.
7. A 47-year-old male found unconscious only responds to pain. When
attempting IV access, he stiffens arms/legs. BP 178/122, P56, ETCO2 30. What
should you do?
a) Mildly hypoventilate with BVM
b) Assist ventilations at 12 breaths per minute
c) Administer 250 mL normal saline bolus
d) Administer 25g dextrose
Explanation: ETCO2 of 30 indicates hypocapnia; assisted ventilation at a normal
rate helps maintain appropriate cerebral perfusion pressure in possible
intracranial pathology.
, 8. A patient in respiratory distress has diffuse bilateral crackles and wheezing
with blood-tinged sputum. BP 170/70, P72 irregular. Which intervention is most
important?
a) Endotracheal intubation
b) Restoring normal sinus rhythm
c) Decreasing preload
d) Increasing preload
Explanation: Findings indicate acute cardiogenic pulmonary edema; decreasing
preload with nitrates and diuretics reduces pulmonary congestion before
considering intubation.
9. Which of the following is indicated for a severe asthma exacerbation
refractory to nebulized albuterol?
a) Oral corticosteroids
b) IM epinephrine
c) IV diphenhydramine
d) Inhaled ipratropium only
Explanation: Severe bronchospasm with inadequate response to nebulized beta-
agonists may require subcutaneous or IM epinephrine for additional
bronchodilation and anti-inflammatory effect.
10. A 66-year-old male with long smoking history has severe dyspnea,
diminished left breath sounds, BP 80/30, SpO2 88%. What should you suspect?
a) Emphysema exacerbation with possible pneumothorax
b) Pneumonia
c) Pulmonary embolism
d) Acute myocardial infarction
Explanation: Unilateral diminished breath sounds in a COPD patient with
hypotension suggests spontaneous pneumothorax superimposed on underlying
emphysema.
11. A 2-year-old male has a "seal bark" cough, stridor, and accessory muscle use
for 48 hours. SpO2 92%. How should you treat?
a) Humidified oxygen and transport
b) Oxygen plus nebulized racemic epinephrine
