PARAMEDIC FISDAP FINAL EXAM AND PRACTICE EXAM 2026 NEWEST
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS/NEWEST
UPDATE!!!
Question 1
A 30-year-old climber is experiencing severe shortness of breath after reaching an elevation of
12,000 feet. The patient is very anxious and has rales noted in all quadrants but is otherwise
healthy. He is not accustomed to high altitudes. What should you do?
A) Administer albuterol via nebulizer and stay at the current altitude.
B) Perform needle chest decompression for a suspected tension pneumothorax.
C) Administer oxygen while descending to a lower altitude.
D) Initiate CPAP at 10 cmH2O and continue the climb slowly.
E) Administer 40mg of Furosemide IV.
Correct Answer: C) Administer oxygen while descending to a lower altitude.
Rationale: This patient is presenting with High Altitude Pulmonary Edema (HAPE). Rales
and anxiety at high altitude in an unacclimatized person are classic signs. The definitive
treatment for HAPE is immediate descent and high-flow oxygen. Nebulizers and diuretics
are not the primary treatments for this environment-induced condition.
Question 2
A 26-year-old female does not respond to verbal stimuli but moans in response to pain. A friend
states the patient has ingested approximately 150 amitriptyline tablets. Vital signs are BP 88/50,
R 16. You establish IV access and administer a fluid challenge. En route to the hospital, her ECG
shows a widening QRS complex. You should administer:
A) Amiodarone 150mg IV.
B) Atropine 1mg IV.
C) Sodium Bicarbonate.
D) Magnesium Sulfate 2g IV.
E) Activated Charcoal via NG tube.
Correct Answer: C) Sodium Bicarbonate.
Rationale: Amitriptyline is a Tricyclic Antidepressant (TCA). TCA toxicity causes sodium
channel blockade, leading to QRS widening and cardiac instability. Sodium Bicarbonate is
the antidote as it increases the extracellular sodium concentration and alkalizes the blood,
which helps pull the drug off the sodium channels.
Question 3
A patient experienced major trauma yesterday and you are transferring her to a larger facility.
She has been experiencing progressive hypoxia. You notice coarse crackles in all lung fields
during ventilation. Vital signs are BP 90/50 and SpO2 90%. You should:
A) Discontinue ventilation and switch to a non-rebreather mask.
B) Administer high-dose steroids for spinal protection.
C) Transport emergency and continue ventilation.
D) Administer nitroglycerin to reduce pulmonary edema.
, 2
E) Perform a needle thoracostomy on the left side.
Correct Answer: C) Transport emergency and continue ventilation.
Rationale: Progressive hypoxia and coarse crackles 24 hours after major trauma suggest
Acute Respiratory Distress Syndrome (ARDS) or severe pulmonary contusions. These
patients require ventilatory support and rapid transport to a definitive care center for
advanced management.
Question 4
An alert 22-year-old male was just disentangled from debris in a house collapse. He denies head
or neck pain but complains of severe hip pain. Vital signs are BP 88/40, P 120, R 16. You should
administer:
A) Morphine 5mg IV for pain.
B) Dextrose 50% for potential hypoglycemia.
C) Sodium Bicarbonate.
D) Dopamine infusion at 5mcg/kg/min.
E) Furosemide to prevent kidney damage.
Correct Answer: C) Sodium Bicarbonate.
Rationale: This patient is at risk for Crush Syndrome. When crushed muscle is released,
toxins like potassium and myoglobin enter the bloodstream (reperfusion injury). Sodium
Bicarbonate helps treat the resulting metabolic acidosis and protects the kidneys from
myoglobin cast formation.
Question 5
Which statement is correct regarding Braxton Hicks contractions?
A) They indicate the start of the third stage of labor.
B) They usually occur in the second trimester and represent false labor.
C) They are characterized by regular, increasing intensity.
D) They are always associated with cervical dilation.
E) They require immediate administration of Oxytocin.
Correct Answer: B) They usually occur in the second trimester and represent false labor.
Rationale: Braxton Hicks contractions are sporadic uterine contractions that can start as
early as the second trimester. Unlike true labor, they are irregular, do not increase in
frequency or intensity, and do not result in cervical dilation.
Question 6
A 40-year-old male crashed his motorcycle. He had a brief loss of consciousness, woke up, and
walked home. You find him 2 hours later at home unconscious. You should suspect:
A) Concussion.
B) Subdural hematoma.
C) Epidural hematoma.
D) Subarachnoid hemorrhage.
, 3
E) Diffuse axonal injury.
Correct Answer: C) Epidural hematoma.
Rationale: A "lucid interval"—where a patient loses consciousness, regains it, and then
rapidly deteriorates—is the classic hallmark of an epidural hematoma. This is usually
caused by an arterial bleed, often from the middle meningeal artery.
Question 7
A 47-year-old male who was found unconscious on the side of the road responds only to painful
stimuli. When you attempt to establish IV access, he stiffens his arms and legs (decerebrate
posturing). Vital signs are BP 178/122, P 56, R irregular, ETCO2 30. What should you do?
A) Hyperventilate the patient at 25 breaths per minute.
B) Administer high-flow oxygen via a non-rebreather mask.
C) Assist ventilations at 12 breaths per minute.
D) Administer Nitroprusside to lower the blood pressure.
E) Administer 25g of Dextrose IV.
Correct Answer: C) Assist ventilations at 12 breaths per minute.
Rationale: The patient is exhibiting Cushing's Triad (hypertension, bradycardia, irregular
respirations), which indicates increased intracranial pressure. While ETCO2 target is often
30-35 mmHg, the primary goal is maintaining oxygenation and providing controlled
ventilation. 10-12 breaths/min is the standard unless herniation is imminent.
Question 8
A 28-year-old female has a sudden onset of chest tightness and severe difficulty breathing. Her
tongue, face, and neck appear swollen, and she has red itchy hives on her torso. Her vital signs
are BP 80/40, P 130. You should administer:
A) Albuterol 2.5mg via nebulizer.
B) Diphenhydramine 50mg IV.
C) Epinephrine 0.3mg IM.
D) Methylprednisolone 125mg IV.
E) Glucagon 1mg IV.
Correct Answer: C) Epinephrine 0.3mg IM.
Rationale: This patient is in anaphylactic shock (hypotension, airway swelling, hives).
Epinephrine is the first-line treatment and should be administered immediately to cause
vasoconstriction (increasing BP) and bronchodilation.
Question 9
You are asked to set up a patient treatment area after a box labeled "radioactive" was found
unattended in a park. Which of the following would be the best location?
A) Downwind from the box in a low-lying ditch.
B) Immediately adjacent to the box to minimize transit time.
C) A building in the park that provides distance and shielding.
, 4
D) The local playground near the park entrance.
E) On top of a hill 10 feet from the box.
Correct Answer: C) A building in the park that provides distance and shielding.
Rationale: Radiation safety relies on three factors: Time, Distance, and Shielding. A
building provides both distance from the source and physical shielding (walls) to protect
medical staff and patients from exposure.
Question 10
You are at a house fire with multiple patients. Which patient should be transported FIRST to a
burn center?
A) 25-year-old with first-degree burns to the entire back.
B) 10-year-old with a fractured arm and minor smoke inhalation.
C) 52-year-old with second-degree burns to the face and right hand.
D) 80-year-old with a small third-degree burn on the leg.
E) 30-year-old with soot around the nose but stable vitals.
Correct Answer: C) 52-year-old with second-degree burns to the face and right hand.
Rationale: Burns to the face, hands, feet, genitalia, or major joints are considered major
burns regardless of the percentage of Body Surface Area (BSA). Face burns imply a high
risk for airway compromise, and hand burns risk long-term disability, necessitating
specialized burn center care.
Question 11
What is the most common cause of status epilepticus in adults?
A) High fever (Febrile).
B) Failure to take prescribed seizure medications.
C) New-onset brain tumor.
D) Hypoglycemia.
E) Excessive alcohol consumption.
Correct Answer: B) Failure to take prescribed seizure medications.
Rationale: While there are many triggers for seizures, the most frequent reason an adult
patient enters status epilepticus (prolonged seizure activity) is non-compliance with their
maintenance anticonvulsant medications.
Question 12
A 58-year-old male with a history of renal failure complains of dizziness, lethargy, and difficulty
breathing. He says he missed his last dialysis appointment. Vital signs are BP 160/90, P 100, R
28 with rales heard in the bases. SpO2 is 92%. You should suspect:
A) Acute myocardial infarction.
B) Pulmonary embolism.
C) Fluid Overload.
D) Diabetic ketoacidosis.
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS/NEWEST
UPDATE!!!
Question 1
A 30-year-old climber is experiencing severe shortness of breath after reaching an elevation of
12,000 feet. The patient is very anxious and has rales noted in all quadrants but is otherwise
healthy. He is not accustomed to high altitudes. What should you do?
A) Administer albuterol via nebulizer and stay at the current altitude.
B) Perform needle chest decompression for a suspected tension pneumothorax.
C) Administer oxygen while descending to a lower altitude.
D) Initiate CPAP at 10 cmH2O and continue the climb slowly.
E) Administer 40mg of Furosemide IV.
Correct Answer: C) Administer oxygen while descending to a lower altitude.
Rationale: This patient is presenting with High Altitude Pulmonary Edema (HAPE). Rales
and anxiety at high altitude in an unacclimatized person are classic signs. The definitive
treatment for HAPE is immediate descent and high-flow oxygen. Nebulizers and diuretics
are not the primary treatments for this environment-induced condition.
Question 2
A 26-year-old female does not respond to verbal stimuli but moans in response to pain. A friend
states the patient has ingested approximately 150 amitriptyline tablets. Vital signs are BP 88/50,
R 16. You establish IV access and administer a fluid challenge. En route to the hospital, her ECG
shows a widening QRS complex. You should administer:
A) Amiodarone 150mg IV.
B) Atropine 1mg IV.
C) Sodium Bicarbonate.
D) Magnesium Sulfate 2g IV.
E) Activated Charcoal via NG tube.
Correct Answer: C) Sodium Bicarbonate.
Rationale: Amitriptyline is a Tricyclic Antidepressant (TCA). TCA toxicity causes sodium
channel blockade, leading to QRS widening and cardiac instability. Sodium Bicarbonate is
the antidote as it increases the extracellular sodium concentration and alkalizes the blood,
which helps pull the drug off the sodium channels.
Question 3
A patient experienced major trauma yesterday and you are transferring her to a larger facility.
She has been experiencing progressive hypoxia. You notice coarse crackles in all lung fields
during ventilation. Vital signs are BP 90/50 and SpO2 90%. You should:
A) Discontinue ventilation and switch to a non-rebreather mask.
B) Administer high-dose steroids for spinal protection.
C) Transport emergency and continue ventilation.
D) Administer nitroglycerin to reduce pulmonary edema.
, 2
E) Perform a needle thoracostomy on the left side.
Correct Answer: C) Transport emergency and continue ventilation.
Rationale: Progressive hypoxia and coarse crackles 24 hours after major trauma suggest
Acute Respiratory Distress Syndrome (ARDS) or severe pulmonary contusions. These
patients require ventilatory support and rapid transport to a definitive care center for
advanced management.
Question 4
An alert 22-year-old male was just disentangled from debris in a house collapse. He denies head
or neck pain but complains of severe hip pain. Vital signs are BP 88/40, P 120, R 16. You should
administer:
A) Morphine 5mg IV for pain.
B) Dextrose 50% for potential hypoglycemia.
C) Sodium Bicarbonate.
D) Dopamine infusion at 5mcg/kg/min.
E) Furosemide to prevent kidney damage.
Correct Answer: C) Sodium Bicarbonate.
Rationale: This patient is at risk for Crush Syndrome. When crushed muscle is released,
toxins like potassium and myoglobin enter the bloodstream (reperfusion injury). Sodium
Bicarbonate helps treat the resulting metabolic acidosis and protects the kidneys from
myoglobin cast formation.
Question 5
Which statement is correct regarding Braxton Hicks contractions?
A) They indicate the start of the third stage of labor.
B) They usually occur in the second trimester and represent false labor.
C) They are characterized by regular, increasing intensity.
D) They are always associated with cervical dilation.
E) They require immediate administration of Oxytocin.
Correct Answer: B) They usually occur in the second trimester and represent false labor.
Rationale: Braxton Hicks contractions are sporadic uterine contractions that can start as
early as the second trimester. Unlike true labor, they are irregular, do not increase in
frequency or intensity, and do not result in cervical dilation.
Question 6
A 40-year-old male crashed his motorcycle. He had a brief loss of consciousness, woke up, and
walked home. You find him 2 hours later at home unconscious. You should suspect:
A) Concussion.
B) Subdural hematoma.
C) Epidural hematoma.
D) Subarachnoid hemorrhage.
, 3
E) Diffuse axonal injury.
Correct Answer: C) Epidural hematoma.
Rationale: A "lucid interval"—where a patient loses consciousness, regains it, and then
rapidly deteriorates—is the classic hallmark of an epidural hematoma. This is usually
caused by an arterial bleed, often from the middle meningeal artery.
Question 7
A 47-year-old male who was found unconscious on the side of the road responds only to painful
stimuli. When you attempt to establish IV access, he stiffens his arms and legs (decerebrate
posturing). Vital signs are BP 178/122, P 56, R irregular, ETCO2 30. What should you do?
A) Hyperventilate the patient at 25 breaths per minute.
B) Administer high-flow oxygen via a non-rebreather mask.
C) Assist ventilations at 12 breaths per minute.
D) Administer Nitroprusside to lower the blood pressure.
E) Administer 25g of Dextrose IV.
Correct Answer: C) Assist ventilations at 12 breaths per minute.
Rationale: The patient is exhibiting Cushing's Triad (hypertension, bradycardia, irregular
respirations), which indicates increased intracranial pressure. While ETCO2 target is often
30-35 mmHg, the primary goal is maintaining oxygenation and providing controlled
ventilation. 10-12 breaths/min is the standard unless herniation is imminent.
Question 8
A 28-year-old female has a sudden onset of chest tightness and severe difficulty breathing. Her
tongue, face, and neck appear swollen, and she has red itchy hives on her torso. Her vital signs
are BP 80/40, P 130. You should administer:
A) Albuterol 2.5mg via nebulizer.
B) Diphenhydramine 50mg IV.
C) Epinephrine 0.3mg IM.
D) Methylprednisolone 125mg IV.
E) Glucagon 1mg IV.
Correct Answer: C) Epinephrine 0.3mg IM.
Rationale: This patient is in anaphylactic shock (hypotension, airway swelling, hives).
Epinephrine is the first-line treatment and should be administered immediately to cause
vasoconstriction (increasing BP) and bronchodilation.
Question 9
You are asked to set up a patient treatment area after a box labeled "radioactive" was found
unattended in a park. Which of the following would be the best location?
A) Downwind from the box in a low-lying ditch.
B) Immediately adjacent to the box to minimize transit time.
C) A building in the park that provides distance and shielding.
, 4
D) The local playground near the park entrance.
E) On top of a hill 10 feet from the box.
Correct Answer: C) A building in the park that provides distance and shielding.
Rationale: Radiation safety relies on three factors: Time, Distance, and Shielding. A
building provides both distance from the source and physical shielding (walls) to protect
medical staff and patients from exposure.
Question 10
You are at a house fire with multiple patients. Which patient should be transported FIRST to a
burn center?
A) 25-year-old with first-degree burns to the entire back.
B) 10-year-old with a fractured arm and minor smoke inhalation.
C) 52-year-old with second-degree burns to the face and right hand.
D) 80-year-old with a small third-degree burn on the leg.
E) 30-year-old with soot around the nose but stable vitals.
Correct Answer: C) 52-year-old with second-degree burns to the face and right hand.
Rationale: Burns to the face, hands, feet, genitalia, or major joints are considered major
burns regardless of the percentage of Body Surface Area (BSA). Face burns imply a high
risk for airway compromise, and hand burns risk long-term disability, necessitating
specialized burn center care.
Question 11
What is the most common cause of status epilepticus in adults?
A) High fever (Febrile).
B) Failure to take prescribed seizure medications.
C) New-onset brain tumor.
D) Hypoglycemia.
E) Excessive alcohol consumption.
Correct Answer: B) Failure to take prescribed seizure medications.
Rationale: While there are many triggers for seizures, the most frequent reason an adult
patient enters status epilepticus (prolonged seizure activity) is non-compliance with their
maintenance anticonvulsant medications.
Question 12
A 58-year-old male with a history of renal failure complains of dizziness, lethargy, and difficulty
breathing. He says he missed his last dialysis appointment. Vital signs are BP 160/90, P 100, R
28 with rales heard in the bases. SpO2 is 92%. You should suspect:
A) Acute myocardial infarction.
B) Pulmonary embolism.
C) Fluid Overload.
D) Diabetic ketoacidosis.
