PARAMEDIC FISDAP EXAM /APPROVED FISDAP PARAMEDIC FINAL
EXAM 2026/2027 PRACTICE QUESTIONS & STUDY GUIDE ACCURATE
EXAM ACTUAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (COMPLETE VERIFIED SOLUTIONS) LATEST UPDATED
VERSION 2026 EDITION |GUARANTEED SUCCESS A+ (MOST RECENT!)
|INSTANT DOWNLOAD PDF
A 45-year-old male is found unresponsive with agonal respirations at a rate of 6
breaths per minute. His oxygen saturation is 70% on room air. What is the MOST
appropriate initial airway intervention?
A. Insert an oropharyngeal airway and administer oxygen via non-rebreather mask
at 15 L/min
B. Perform immediate endotracheal intubation without prior bag-valve-mask
ventilation
C. Begin positive pressure ventilation with a bag-valve-mask and 100% oxygen at
a rate of 10-12 breaths per minute
D. Apply a supraglottic airway device and ventilate once every 6 seconds
CORRECT ANSWER: C. Begin positive pressure ventilation with a bag-valve-
mask and 100% oxygen at a rate of 10-12 breaths per minute
Rationale: The patient has agonal respirations and severe hypoxemia, indicating
inadequate ventilation. The immediate priority is to provide positive pressure
ventilation with high-flow oxygen via BVM to improve oxygenation and
ventilation. Endotracheal intubation may follow but is not the first step; BVM
ventilation should never be delayed for intubation. Oropharyngeal airway alone
does not provide ventilation. Supraglottic devices are acceptable but BVM is the
standard initial rescue ventilation method.
Which of the following findings is MOST consistent with a tension pneumothorax
in a mechanically ventilated patient?
,A. Absent breath sounds on the affected side with hypotension and distended neck
veins
B. Bilateral crackles and jugular venous distention that improves with upright
positioning
C. Hyper resonance on percussion over the liver and tracheal deviation toward the
affected side
D. Subcutaneous emphysema and sudden onset of hypoxemia that resolves with
increased FiO2
CORRECT ANSWER: A. Absent breath sounds on the affected side with
hypotension and distended neck veins
Rationale: Tension pneumothorax causes absent breath sounds on the affected side,
hypotension (from decreased preload), and distended neck veins (impaired venous
return due to increased intrathoracic pressure). Tracheal deviation typically shifts
away from the affected side. Subcutaneous emphysema may be present but is not
the classic triad. Immediate needle decompression is required.
A paramedic administers adenosine 6 mg IV push for a narrow-complex
tachycardia. The patient’s rhythm converts to asystole for 8 seconds then returns to
a sinus rhythm at 80 bpm. What is the BEST interpretation?
A. Expected adverse effect; continue monitoring and administer fluid bolus
B. Indication of underlying sick sinus syndrome; prepare for transcutaneous pacing
C. Successful conversion; the asystole is a common post-conversion finding and
usually self-limiting
D. Evidence of inadvertent vagal overstimulation; administer atropine 0.5 mg
CORRECT ANSWER: C. Successful conversion; the asystole is a common post-
conversion finding and usually self-limiting
Rationale: Adenosine causes transient atrioventricular block, and a brief period of
asystole (often up to 6-10 seconds) is expected after conversion of reentrant
tachycardia’s. This does not require treatment unless prolonged. The return of
sinus rhythm indicates successful termination of the reentry circuit.
,A 28-year-old female with a history of asthma presents with respiratory distress.
She is speaking in 2-3 word sentences, has diffuse wheezing, and an initial peak
expiratory flow of 35% of predicted. After three albuterol/ipratropium nebulizer
treatments and IV magnesium, her condition worsens, and breath sounds become
markedly diminished. What is the NEXT priority?
A. Administer epinephrine 0.3 mg IM
B. Initiate continuous positive airway pressure (CPAP) at 10 cm H2O
C. Prepare for immediate endotracheal intubation with rapid sequence induction
D. Repeat magnesium sulfate 2 grams IV over 20 minutes
CORRECT ANSWER: C. Prepare for immediate endotracheal intubation with
rapid sequence induction
Rationale: Diminished or absent breath sounds in a severe asthma exacerbation
after maximal therapy indicates impending respiratory failure (silent chest). This is
a critical sign requiring immediate intubation and mechanical ventilation. Delaying
intubation for further medication risks cardiac arrest. CPAP may be used earlier
but is not definitive when breath sounds are absent and the patient is tiring.
Which of the following ECG findings is most specific for acute pericarditis?
A. Diffuse ST-segment elevation with PR-segment depression
B. ST-segment elevation in leads II, III, and if with reciprocal changes
C. Deep Q waves in leads V1-V4 with T-wave inversion
D. ST-segment elevation in V1-V4 with a hyper acute T wave
CORRECT ANSWER: A. Diffuse ST-segment elevation with PR-segment
depression
Rationale: Acute pericarditis characteristically shows diffuse concave ST elevation
(often in all leads except aver and V1) and PR segment depression. The PR
depression reflects atrial inflammation. STEMI shows localized ST elevation with
reciprocal changes, not PR depression. Deep Q waves suggest prior infarction.
, A paramedic is assessing a patient with altered mental status, bradycardia, and
hypotension. The monitor shows a sinus bradycardia at 42 bpm with occasional
premature ventricular complexes. Which medication is indicated as FIRST-line
therapy?
A. Epinephrine 2-10 mcg/min continuous infusion
B. Dopamine 5-20 mcg/kg/min infusion
C. Atropine 0.5 mg IV push, may repeat every 3-5 minutes to a total of 3 mg
D. Transcutaneous pacing without medication
CORRECT ANSWER: C. Atropine 0.5 mg IV push, may repeat every 3-5 minutes
to a total of 3 mg
Rationale: For symptomatic bradycardia (altered mental status and hypotension),
atropine is the first-line medication to increase heart rate by blocking vagal tone.
Atropine is effective in most causes except second-degree type II or third-degree
AV block. If atropine fails, transcutaneous pacing or dopamine/epinephrine
infusion is indicated.
A 55-year-old male complains of tearing chest pain radiating to his back. His blood
pressure is 180/100 mmHg in the right arm and 110/70 mmHg in the left arm. His
heart rate is 110 bpm. What is the MOST appropriate prehospital management?
A. Administer nitroglycerin 0.4 mg sublingual and morphine 4 mg IV
B. Give aspirin 324 mg chewable and transport with high-flow oxygen
C. Control heart rate with metoprolol 5 mg IV and blood pressure with nicardipine
infusion, avoiding nitroglycerin
D. Immediate load with heparin 5000 units IV and transport for thrombolytic
CORRECT ANSWER: C. Control heart rate with metoprolol 5 mg IV and blood
pressure with nicardipine infusion, avoiding nitroglycerin
Rationale: The presentation is classic for acute aortic dissection (tearing pain, pulse
deficit, hypertension). The goal is to reduce blood pressure and decrease dip/dot
(force of contraction) to prevent extension. Beta-blockers (e.g., metoprolol) are
first-line to lower heart rate and contractility, followed by vasodilators like
EXAM 2026/2027 PRACTICE QUESTIONS & STUDY GUIDE ACCURATE
EXAM ACTUAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (COMPLETE VERIFIED SOLUTIONS) LATEST UPDATED
VERSION 2026 EDITION |GUARANTEED SUCCESS A+ (MOST RECENT!)
|INSTANT DOWNLOAD PDF
A 45-year-old male is found unresponsive with agonal respirations at a rate of 6
breaths per minute. His oxygen saturation is 70% on room air. What is the MOST
appropriate initial airway intervention?
A. Insert an oropharyngeal airway and administer oxygen via non-rebreather mask
at 15 L/min
B. Perform immediate endotracheal intubation without prior bag-valve-mask
ventilation
C. Begin positive pressure ventilation with a bag-valve-mask and 100% oxygen at
a rate of 10-12 breaths per minute
D. Apply a supraglottic airway device and ventilate once every 6 seconds
CORRECT ANSWER: C. Begin positive pressure ventilation with a bag-valve-
mask and 100% oxygen at a rate of 10-12 breaths per minute
Rationale: The patient has agonal respirations and severe hypoxemia, indicating
inadequate ventilation. The immediate priority is to provide positive pressure
ventilation with high-flow oxygen via BVM to improve oxygenation and
ventilation. Endotracheal intubation may follow but is not the first step; BVM
ventilation should never be delayed for intubation. Oropharyngeal airway alone
does not provide ventilation. Supraglottic devices are acceptable but BVM is the
standard initial rescue ventilation method.
Which of the following findings is MOST consistent with a tension pneumothorax
in a mechanically ventilated patient?
,A. Absent breath sounds on the affected side with hypotension and distended neck
veins
B. Bilateral crackles and jugular venous distention that improves with upright
positioning
C. Hyper resonance on percussion over the liver and tracheal deviation toward the
affected side
D. Subcutaneous emphysema and sudden onset of hypoxemia that resolves with
increased FiO2
CORRECT ANSWER: A. Absent breath sounds on the affected side with
hypotension and distended neck veins
Rationale: Tension pneumothorax causes absent breath sounds on the affected side,
hypotension (from decreased preload), and distended neck veins (impaired venous
return due to increased intrathoracic pressure). Tracheal deviation typically shifts
away from the affected side. Subcutaneous emphysema may be present but is not
the classic triad. Immediate needle decompression is required.
A paramedic administers adenosine 6 mg IV push for a narrow-complex
tachycardia. The patient’s rhythm converts to asystole for 8 seconds then returns to
a sinus rhythm at 80 bpm. What is the BEST interpretation?
A. Expected adverse effect; continue monitoring and administer fluid bolus
B. Indication of underlying sick sinus syndrome; prepare for transcutaneous pacing
C. Successful conversion; the asystole is a common post-conversion finding and
usually self-limiting
D. Evidence of inadvertent vagal overstimulation; administer atropine 0.5 mg
CORRECT ANSWER: C. Successful conversion; the asystole is a common post-
conversion finding and usually self-limiting
Rationale: Adenosine causes transient atrioventricular block, and a brief period of
asystole (often up to 6-10 seconds) is expected after conversion of reentrant
tachycardia’s. This does not require treatment unless prolonged. The return of
sinus rhythm indicates successful termination of the reentry circuit.
,A 28-year-old female with a history of asthma presents with respiratory distress.
She is speaking in 2-3 word sentences, has diffuse wheezing, and an initial peak
expiratory flow of 35% of predicted. After three albuterol/ipratropium nebulizer
treatments and IV magnesium, her condition worsens, and breath sounds become
markedly diminished. What is the NEXT priority?
A. Administer epinephrine 0.3 mg IM
B. Initiate continuous positive airway pressure (CPAP) at 10 cm H2O
C. Prepare for immediate endotracheal intubation with rapid sequence induction
D. Repeat magnesium sulfate 2 grams IV over 20 minutes
CORRECT ANSWER: C. Prepare for immediate endotracheal intubation with
rapid sequence induction
Rationale: Diminished or absent breath sounds in a severe asthma exacerbation
after maximal therapy indicates impending respiratory failure (silent chest). This is
a critical sign requiring immediate intubation and mechanical ventilation. Delaying
intubation for further medication risks cardiac arrest. CPAP may be used earlier
but is not definitive when breath sounds are absent and the patient is tiring.
Which of the following ECG findings is most specific for acute pericarditis?
A. Diffuse ST-segment elevation with PR-segment depression
B. ST-segment elevation in leads II, III, and if with reciprocal changes
C. Deep Q waves in leads V1-V4 with T-wave inversion
D. ST-segment elevation in V1-V4 with a hyper acute T wave
CORRECT ANSWER: A. Diffuse ST-segment elevation with PR-segment
depression
Rationale: Acute pericarditis characteristically shows diffuse concave ST elevation
(often in all leads except aver and V1) and PR segment depression. The PR
depression reflects atrial inflammation. STEMI shows localized ST elevation with
reciprocal changes, not PR depression. Deep Q waves suggest prior infarction.
, A paramedic is assessing a patient with altered mental status, bradycardia, and
hypotension. The monitor shows a sinus bradycardia at 42 bpm with occasional
premature ventricular complexes. Which medication is indicated as FIRST-line
therapy?
A. Epinephrine 2-10 mcg/min continuous infusion
B. Dopamine 5-20 mcg/kg/min infusion
C. Atropine 0.5 mg IV push, may repeat every 3-5 minutes to a total of 3 mg
D. Transcutaneous pacing without medication
CORRECT ANSWER: C. Atropine 0.5 mg IV push, may repeat every 3-5 minutes
to a total of 3 mg
Rationale: For symptomatic bradycardia (altered mental status and hypotension),
atropine is the first-line medication to increase heart rate by blocking vagal tone.
Atropine is effective in most causes except second-degree type II or third-degree
AV block. If atropine fails, transcutaneous pacing or dopamine/epinephrine
infusion is indicated.
A 55-year-old male complains of tearing chest pain radiating to his back. His blood
pressure is 180/100 mmHg in the right arm and 110/70 mmHg in the left arm. His
heart rate is 110 bpm. What is the MOST appropriate prehospital management?
A. Administer nitroglycerin 0.4 mg sublingual and morphine 4 mg IV
B. Give aspirin 324 mg chewable and transport with high-flow oxygen
C. Control heart rate with metoprolol 5 mg IV and blood pressure with nicardipine
infusion, avoiding nitroglycerin
D. Immediate load with heparin 5000 units IV and transport for thrombolytic
CORRECT ANSWER: C. Control heart rate with metoprolol 5 mg IV and blood
pressure with nicardipine infusion, avoiding nitroglycerin
Rationale: The presentation is classic for acute aortic dissection (tearing pain, pulse
deficit, hypertension). The goal is to reduce blood pressure and decrease dip/dot
(force of contraction) to prevent extension. Beta-blockers (e.g., metoprolol) are
first-line to lower heart rate and contractility, followed by vasodilators like
