FISDAP Paramedic Final Exam 2026/2027 Complete
Actual Exam |Questions & Verified Answers | Pass
Guarantee
TRAUMA (Questions 1 – 20)
1. 0430 hrs. EMS dispatched to a single-vehicle MVC, car vs. tree. 30 mph speed
zone, significant front-end intrusion. Airbags deployed.
Scene: 29-year-old restrained driver still seated, airbag soot on face. Windows blown
out.
Pt: Anxious, repeatedly asking what happened.
Vitals: RR 24, SpO₂ 94 % on room air, HR 118, BP 94/60, GCS 14 (E4 V4 M6). Chest
wall bruising seat-belt pattern.
Which finding BEST predicts this patient will require massive transfusion protocol
activation?
A. GCS 14
B. Heart rate 118
C. Systolic BP < 100 mmHg
,D. SpO₂ 94 % on room air
Correct Answer: C
Rationale: SBP < 100 mmHg is the first tier of the ABC score and the “lethal triad”
trigger used by most regional massive-transfusion protocols (PHTLS 10th ed.).
Tachycardia supports shock but is not protocol-specific; GCS and SpO₂ do not predict
coagulopathic bleeding.
2. You are the first-in medic on a motorcycle vs. guardrail crash. The 22-year-old rider
was ejected 15 ft. Helmet is cracked.
Pt: Supine, spontaneously breathing.
Primary survey: DCAP-BTLS reveals paradoxical chest wall motion over left lateral ribs
5–8 with crepitus.
Vitals: RR 28, shallow, SpO₂ 89 % NRBM @ 15 L min⁻¹, HR 132, BP 82/50, GCS 12 (E3
V4 M5).
Most appropriate NEXT intervention after high-flow O₂?
A. Apply PASG and inflate all compartments
B. Needle decompress left chest
C. 1000 mL warm isotonic crystalloid bolus
,D. Assist ventilations with BVM
Correct Answer: D
Rationale: Flail chest with respiratory failure (SpO₂ 89 %, ↑RR, ↓GCS) mandates
ventilatory support before any other action. Needle decompression is indicated for
tension pneumothorax—no tracheal shift or ↳JVD yet. Hypotension is likely
hypovolemic; however, oxygenation/ventilation failure takes precedence per PHTLS
ABCs.
3. A 6-year-old is backed over by a slow-moving SUV.
Primary survey: GCS 15, RR 40, SpO₂ 97 %, HR 140, BP 80/50.
FAST exam negative; no external bleeding. Lower-extremity fractures noted.
Estimated weight 22 kg.
According to PALS/PHTLS, which volume of isotonic crystalloid is MOST appropriate for
initial shock resuscitation?
A. 220 mL
B. 440 mL
C. 660 mL
D. 880 mL
, Correct Answer: B
Rationale: Pediatric shock dose is 20 mL kg⁻¹. 22 kg × 20 = 440 mL. Repeat up to 60
mL kg⁻¹ if no improvement. Over-aggressive initial volumes (≥ 40 mL kg⁻¹) risk
hemodilution.
4. Which spinal-motion-restriction strategy is BEST supported by current evidence for a
55-year-old who fell 8 ft from a ladder, GCS 15, denies neck pain, and meets NEXUS
low-risk criteria?
A. Long backboard with cervical collar
B. Cervical collar only, transport to stretcher with padding
C. No collar; allow seated position for comfort
D. Vacuum splint to entire spine
Correct Answer: B
Rationale: NEXUS & CDC 2022 guidelines: if low-risk & reliable exam, use cervical
collar alone and remove from hard board as soon as feasible to prevent pressure injury.
No device (C) is inappropriate until full assessment completed.
Actual Exam |Questions & Verified Answers | Pass
Guarantee
TRAUMA (Questions 1 – 20)
1. 0430 hrs. EMS dispatched to a single-vehicle MVC, car vs. tree. 30 mph speed
zone, significant front-end intrusion. Airbags deployed.
Scene: 29-year-old restrained driver still seated, airbag soot on face. Windows blown
out.
Pt: Anxious, repeatedly asking what happened.
Vitals: RR 24, SpO₂ 94 % on room air, HR 118, BP 94/60, GCS 14 (E4 V4 M6). Chest
wall bruising seat-belt pattern.
Which finding BEST predicts this patient will require massive transfusion protocol
activation?
A. GCS 14
B. Heart rate 118
C. Systolic BP < 100 mmHg
,D. SpO₂ 94 % on room air
Correct Answer: C
Rationale: SBP < 100 mmHg is the first tier of the ABC score and the “lethal triad”
trigger used by most regional massive-transfusion protocols (PHTLS 10th ed.).
Tachycardia supports shock but is not protocol-specific; GCS and SpO₂ do not predict
coagulopathic bleeding.
2. You are the first-in medic on a motorcycle vs. guardrail crash. The 22-year-old rider
was ejected 15 ft. Helmet is cracked.
Pt: Supine, spontaneously breathing.
Primary survey: DCAP-BTLS reveals paradoxical chest wall motion over left lateral ribs
5–8 with crepitus.
Vitals: RR 28, shallow, SpO₂ 89 % NRBM @ 15 L min⁻¹, HR 132, BP 82/50, GCS 12 (E3
V4 M5).
Most appropriate NEXT intervention after high-flow O₂?
A. Apply PASG and inflate all compartments
B. Needle decompress left chest
C. 1000 mL warm isotonic crystalloid bolus
,D. Assist ventilations with BVM
Correct Answer: D
Rationale: Flail chest with respiratory failure (SpO₂ 89 %, ↑RR, ↓GCS) mandates
ventilatory support before any other action. Needle decompression is indicated for
tension pneumothorax—no tracheal shift or ↳JVD yet. Hypotension is likely
hypovolemic; however, oxygenation/ventilation failure takes precedence per PHTLS
ABCs.
3. A 6-year-old is backed over by a slow-moving SUV.
Primary survey: GCS 15, RR 40, SpO₂ 97 %, HR 140, BP 80/50.
FAST exam negative; no external bleeding. Lower-extremity fractures noted.
Estimated weight 22 kg.
According to PALS/PHTLS, which volume of isotonic crystalloid is MOST appropriate for
initial shock resuscitation?
A. 220 mL
B. 440 mL
C. 660 mL
D. 880 mL
, Correct Answer: B
Rationale: Pediatric shock dose is 20 mL kg⁻¹. 22 kg × 20 = 440 mL. Repeat up to 60
mL kg⁻¹ if no improvement. Over-aggressive initial volumes (≥ 40 mL kg⁻¹) risk
hemodilution.
4. Which spinal-motion-restriction strategy is BEST supported by current evidence for a
55-year-old who fell 8 ft from a ladder, GCS 15, denies neck pain, and meets NEXUS
low-risk criteria?
A. Long backboard with cervical collar
B. Cervical collar only, transport to stretcher with padding
C. No collar; allow seated position for comfort
D. Vacuum splint to entire spine
Correct Answer: B
Rationale: NEXUS & CDC 2022 guidelines: if low-risk & reliable exam, use cervical
collar alone and remove from hard board as soon as feasible to prevent pressure injury.
No device (C) is inappropriate until full assessment completed.
