1|Page
**FTECH 144 FISDAP MEDICAL EXAM – 150+
QUESTIONS WITH ANSWERS & RATIONALES
(COMPLETE STUDY GUIDE)**
# SECTION 1: CARDIOLOGY (Questions 1–25)
**1.** A 68-year-old male complains of substernal chest pressure
radiating to the jaw, diaphoresis, and nausea. His blood pressure is
110/70 mmHg, pulse 110, respirations 22, SpO2 94% on room air. What
is the most appropriate initial intervention?
A) Aspirin 324 mg PO
B) Nitroglycerin 0.4 mg SL
C) Oxygen at 15 L/min via non-rebreather
D) Morphine 4 mg IV
**Correct Answer:** A – Aspirin 324 mg PO
**Rationale:** Aspirin (160–325 mg chewed) reduces mortality in acute
coronary syndrome (ACS) by inhibiting platelet aggregation. Oxygen is
given only if SpO2 <90%. Nitroglycerin and morphine are given after
aspirin and pain assessment.
**2.** A 72-year-old female with a history of heart failure presents with
acute shortness of breath, crackles in both lung bases, and an S3 gallop.
,2|Page
Her BP is 160/90 mmHg, heart rate 110. Which medication is most
appropriate?
A) Nitroglycerin 0.4 mg SL
B) Furosemide 40 mg IV
C) Morphine 4 mg IV
D) Albuterol 2.5 mg nebulized
**Correct Answer:** B – Furosemide 40 mg IV
**Rationale:** IV furosemide (loop diuretic) rapidly reduces preload in
acute decompensated heart failure with pulmonary edema. Nitroglycerin
also reduces preload and afterload. Both are indicated, but furosemide is
specific for fluid removal.
**3.** A 55-year-old male with sudden-onset tearing chest pain
radiating to his back. Blood pressure is 100/60 mmHg in the right arm
and 140/90 mmHg in the left arm. What is the most likely diagnosis?
A) Acute myocardial infarction
B) Pulmonary embolism
C) Thoracic aortic dissection
D) Pericarditis
**Correct Answer:** C – Thoracic aortic dissection
**Rationale:** Aortic dissection presents with tearing chest pain
radiating to the back and unequal upper extremity blood pressures.
,3|Page
Immediate transport with high-flow oxygen and IV access is indicated.
Avoid nitroglycerin.
**4.** A patient with a history of atrial fibrillation presents with acute-
onset left-sided weakness, facial droop, and slurred speech. Last known
normal was 2 hours ago. Blood pressure is 185/100 mmHg. What is the
most appropriate prehospital intervention?
A) Administer aspirin 324 mg
B) Administer labetalol 10 mg IV to lower blood pressure
C) Transport emergently to a stroke center
D) Administer 15 L oxygen via non-rebreather
**Correct Answer:** C – Transport emergently to a stroke center
**Rationale:** Time is brain. Prehospital providers should rapidly
identify stroke, determine last known well, and transport to a stroke
center for possible thrombolytics. Lowering blood pressure in the field is
contraindicated unless extremes (e.g., >220/120).
**5.** A 60-year-old male with chest pain has an ECG showing ST-
segment elevation in leads II, III, and aVF. Which coronary artery is
most likely occluded?
A) Left anterior descending (LAD)
B) Left circumflex (LCx)
C) Right coronary artery (RCA)
, 4|Page
D) Ramus intermedius
**Correct Answer:** C – Right coronary artery (RCA)
**Rationale:** Inferior wall STEMI (leads II, III, aVF) is most
commonly due to RCA occlusion. It may be associated with bradycardia
and hypotension due to right ventricular involvement.
**6.** A patient with a heart rate of 200 bpm, palpable radial pulses,
and a wide QRS complex on the monitor. The patient is stable. What is
the most appropriate treatment?
A) Adenosine 6 mg rapid IV push
B) Amiodarone 150 mg IV over 10 minutes
C) Synchronized cardioversion
D) Magnesium sulfate 2 g IV
**Correct Answer:** A – Adenosine 6 mg rapid IV push
**Rationale:** Wide complex tachycardia that is regular and
monomorphic in a stable patient is likely ventricular tachycardia (or
SVT with aberrancy). Adenosine is safe and may terminate re-entrant
tachycardias. If no response, amiodarone or cardioversion is next.
**7.** A 70-year-old female with chest pain has an ECG showing
STEMI in leads V1–V4. Which finding should be expected on physical
exam?
**FTECH 144 FISDAP MEDICAL EXAM – 150+
QUESTIONS WITH ANSWERS & RATIONALES
(COMPLETE STUDY GUIDE)**
# SECTION 1: CARDIOLOGY (Questions 1–25)
**1.** A 68-year-old male complains of substernal chest pressure
radiating to the jaw, diaphoresis, and nausea. His blood pressure is
110/70 mmHg, pulse 110, respirations 22, SpO2 94% on room air. What
is the most appropriate initial intervention?
A) Aspirin 324 mg PO
B) Nitroglycerin 0.4 mg SL
C) Oxygen at 15 L/min via non-rebreather
D) Morphine 4 mg IV
**Correct Answer:** A – Aspirin 324 mg PO
**Rationale:** Aspirin (160–325 mg chewed) reduces mortality in acute
coronary syndrome (ACS) by inhibiting platelet aggregation. Oxygen is
given only if SpO2 <90%. Nitroglycerin and morphine are given after
aspirin and pain assessment.
**2.** A 72-year-old female with a history of heart failure presents with
acute shortness of breath, crackles in both lung bases, and an S3 gallop.
,2|Page
Her BP is 160/90 mmHg, heart rate 110. Which medication is most
appropriate?
A) Nitroglycerin 0.4 mg SL
B) Furosemide 40 mg IV
C) Morphine 4 mg IV
D) Albuterol 2.5 mg nebulized
**Correct Answer:** B – Furosemide 40 mg IV
**Rationale:** IV furosemide (loop diuretic) rapidly reduces preload in
acute decompensated heart failure with pulmonary edema. Nitroglycerin
also reduces preload and afterload. Both are indicated, but furosemide is
specific for fluid removal.
**3.** A 55-year-old male with sudden-onset tearing chest pain
radiating to his back. Blood pressure is 100/60 mmHg in the right arm
and 140/90 mmHg in the left arm. What is the most likely diagnosis?
A) Acute myocardial infarction
B) Pulmonary embolism
C) Thoracic aortic dissection
D) Pericarditis
**Correct Answer:** C – Thoracic aortic dissection
**Rationale:** Aortic dissection presents with tearing chest pain
radiating to the back and unequal upper extremity blood pressures.
,3|Page
Immediate transport with high-flow oxygen and IV access is indicated.
Avoid nitroglycerin.
**4.** A patient with a history of atrial fibrillation presents with acute-
onset left-sided weakness, facial droop, and slurred speech. Last known
normal was 2 hours ago. Blood pressure is 185/100 mmHg. What is the
most appropriate prehospital intervention?
A) Administer aspirin 324 mg
B) Administer labetalol 10 mg IV to lower blood pressure
C) Transport emergently to a stroke center
D) Administer 15 L oxygen via non-rebreather
**Correct Answer:** C – Transport emergently to a stroke center
**Rationale:** Time is brain. Prehospital providers should rapidly
identify stroke, determine last known well, and transport to a stroke
center for possible thrombolytics. Lowering blood pressure in the field is
contraindicated unless extremes (e.g., >220/120).
**5.** A 60-year-old male with chest pain has an ECG showing ST-
segment elevation in leads II, III, and aVF. Which coronary artery is
most likely occluded?
A) Left anterior descending (LAD)
B) Left circumflex (LCx)
C) Right coronary artery (RCA)
, 4|Page
D) Ramus intermedius
**Correct Answer:** C – Right coronary artery (RCA)
**Rationale:** Inferior wall STEMI (leads II, III, aVF) is most
commonly due to RCA occlusion. It may be associated with bradycardia
and hypotension due to right ventricular involvement.
**6.** A patient with a heart rate of 200 bpm, palpable radial pulses,
and a wide QRS complex on the monitor. The patient is stable. What is
the most appropriate treatment?
A) Adenosine 6 mg rapid IV push
B) Amiodarone 150 mg IV over 10 minutes
C) Synchronized cardioversion
D) Magnesium sulfate 2 g IV
**Correct Answer:** A – Adenosine 6 mg rapid IV push
**Rationale:** Wide complex tachycardia that is regular and
monomorphic in a stable patient is likely ventricular tachycardia (or
SVT with aberrancy). Adenosine is safe and may terminate re-entrant
tachycardias. If no response, amiodarone or cardioversion is next.
**7.** A 70-year-old female with chest pain has an ECG showing
STEMI in leads V1–V4. Which finding should be expected on physical
exam?
