FINAL PARAMEDIC FISDAP COMPLETE 2026/2027 Ultimate
Comprehensive Guide | Actual Questions & Verified Answers | All
Domains: Trauma, Medical, Airway, Cardiology, OBGYN,
Operations, Pediatrics, Geriatrics | Pass Guarantee
TRAUMA (Questions 1–25)
1. Dispatch: 19:40 – MVC, single car vs tree, driver trapped, airbags deployed.
Scene: Safe, fuel leak controlled. Pt: 22-year-old male, belted, GCS 14 (confused
speech), HR 118, RR 28, BP 92/60, SpO₂ 96 % RA. Findings: Steering wheel
deformity, abdominal seat-belt sign, pelvis stable, bilateral femurs tender, no
obvious external bleeding. Most likely source of hypotension?
A. Pelvic fracture
B. Bilateral femur fractures
C. Intra-abdominal hemorrhage
D. Tension pneumothorax
Correct Answer: C
Rationale: Seat-belt sign + shock suggests mesenteric or solid-organ injury. Pelvis
stable; femur fractures alone rarely drop SBP < 100 mmHg.
2. Same patient. After 2 L NS, BP 88/58, HR 120, still confused. Next fluid strategy?
A. 2 L more NS wide open
B. 1 L LR + initiate TXA 1 g over 10 min
C. 250 mL bolus, allow permissive hypotension
D. 2 units PRBC if available, limit crystalloid
Correct Answer: D
Rationale: PHTLS recommends balanced resuscitation with blood products when
bleeding suspected; avoid hemodilution.
, 3. Dispatch: 14:20 – Motorcycle vs SUV, 45 mph, helmet on. Scene: Helmet cracked,
patient supine, GCS 6. Vitals: HR 44, RR 8, BP 180/100, SpO₂ 86 % RA. Breath
sounds: equal, no chest rise. Most immediate intervention?
A. Apply C-collar, log-roll
B. Oropharyngeal airway + BVM
C. Bilateral needle decompression
D. Rapid sequence intubation
Correct Answer: B
Rationale: GCS 6 mandates airway protection; current ventilatory failure (RR 8, low SpO₂)
takes priority over intubation sequence.
4. Mechanism: 30-foot fall onto feet. Pt alert, HR 110, BP 100/70, pelvis stable, no
femur fractures. Which occult injury is MOST likely?
A. Calcaneal fracture
B. Lumbar burst fracture
C. Scaphoid fracture
D. Pneumothorax
Correct Answer: B
Rationale: Axial load transmits to spine; burst fracture common with foot-first fall.
5. Penetrating: Stab to right 5th ICS mid-clavicular line, HR 110, BP 80/50, neck
veins flat, trachea midline, breath sounds equal. Most likely cause of shock?
A. Cardiac tamponade
B. Tension pneumothorax
C. Massive hemothorax
D. Flail chest
Correct Answer: A
Rationale: Beck’s triad may be subtle; penetrating anterior chest + hypotension warrants
pericardiocentesis prep.
, 6. Burn: 70-kg adult, partial-thickness burns entire anterior trunk, entire right arm,
half of left thigh. TBSA?
A. 27 %
B. 31 %
C. 36 %
D. 40 %
Correct Answer: A
Rationale: Rule of 9s: anterior trunk 18 %, R arm 9 %, half L thigh 4.5 % ≈ 27 %.
7. Same burn. Using Parkland (4 mL × kg × %TBSA), half in first 8 h, calculate total
fluid for first 8 h.
A. 3 780 mL
B. 4 725 mL
C. 5 400 mL
D. 6 050 mL
Correct Answer: A
Rationale: 4 × 70 × 27 = 7 560 mL total; half = 3 780 mL over first 8 h from time of burn.
8. Pediatric fall: 3-year-old, 8 ft fall, altered, GCS 10, no external bleed. Which vital
sign change is EARLIEST indicator of shock?
A. SBP 70 mmHg
B. HR 150
C. RR 30
D. Cap refill 3 s
Correct Answer: B
Rationale: Pediatric compensation ↑ HR first; hypotension is late.
9. Tension pneumothorax: HR 130, RR 36, BP 70/40, trachea deviated left, absent
right breath sounds, neck veins distended. Needle decompression site?
, A. 2nd ICS mid-clavicular
B. 4th ICS anterior-axillary
C. 5th ICS mid-axillary
D. Suprasternal notch
Correct Answer: A
Rationale: 2nd ICS mid-clavicular line is standard; avoids vessels.
10. Flail chest: Segments 4–6 right, paradoxical motion, HR 110, RR 28, SpO₂ 90 %
NRB, BP 130/80. Primary concern?
A. Pain control
B. Underlying pulmonary contusion
C. Rib plating
D. Pneumothorax
Correct Answer: B
Rationale: Contusion, not instability, causes hypoxia; treat pain & monitor ventilation.
11. Spine: 45-year-old unrestrained driver, rear-impact, ambulatory at scene, denies
pain, GCS 15. NEXUS criteria: midline tenderness C5, no neuro deficit. Next?
A. No collar needed
B. Manual stabilization, transport for imaging
C. Remove collar after 30 min
D. Apply rigid collar only
Correct Answer: B
Rationale: Midline tenderness = criterion for spinal motion restriction per NEXUS.
12. TBI: GCS 10, blown R pupil, HR 50, BP 180/100. Which herniation syndrome?
A. Central
B. Uncal
C. Cingulate
D. Tonsillar
Comprehensive Guide | Actual Questions & Verified Answers | All
Domains: Trauma, Medical, Airway, Cardiology, OBGYN,
Operations, Pediatrics, Geriatrics | Pass Guarantee
TRAUMA (Questions 1–25)
1. Dispatch: 19:40 – MVC, single car vs tree, driver trapped, airbags deployed.
Scene: Safe, fuel leak controlled. Pt: 22-year-old male, belted, GCS 14 (confused
speech), HR 118, RR 28, BP 92/60, SpO₂ 96 % RA. Findings: Steering wheel
deformity, abdominal seat-belt sign, pelvis stable, bilateral femurs tender, no
obvious external bleeding. Most likely source of hypotension?
A. Pelvic fracture
B. Bilateral femur fractures
C. Intra-abdominal hemorrhage
D. Tension pneumothorax
Correct Answer: C
Rationale: Seat-belt sign + shock suggests mesenteric or solid-organ injury. Pelvis
stable; femur fractures alone rarely drop SBP < 100 mmHg.
2. Same patient. After 2 L NS, BP 88/58, HR 120, still confused. Next fluid strategy?
A. 2 L more NS wide open
B. 1 L LR + initiate TXA 1 g over 10 min
C. 250 mL bolus, allow permissive hypotension
D. 2 units PRBC if available, limit crystalloid
Correct Answer: D
Rationale: PHTLS recommends balanced resuscitation with blood products when
bleeding suspected; avoid hemodilution.
, 3. Dispatch: 14:20 – Motorcycle vs SUV, 45 mph, helmet on. Scene: Helmet cracked,
patient supine, GCS 6. Vitals: HR 44, RR 8, BP 180/100, SpO₂ 86 % RA. Breath
sounds: equal, no chest rise. Most immediate intervention?
A. Apply C-collar, log-roll
B. Oropharyngeal airway + BVM
C. Bilateral needle decompression
D. Rapid sequence intubation
Correct Answer: B
Rationale: GCS 6 mandates airway protection; current ventilatory failure (RR 8, low SpO₂)
takes priority over intubation sequence.
4. Mechanism: 30-foot fall onto feet. Pt alert, HR 110, BP 100/70, pelvis stable, no
femur fractures. Which occult injury is MOST likely?
A. Calcaneal fracture
B. Lumbar burst fracture
C. Scaphoid fracture
D. Pneumothorax
Correct Answer: B
Rationale: Axial load transmits to spine; burst fracture common with foot-first fall.
5. Penetrating: Stab to right 5th ICS mid-clavicular line, HR 110, BP 80/50, neck
veins flat, trachea midline, breath sounds equal. Most likely cause of shock?
A. Cardiac tamponade
B. Tension pneumothorax
C. Massive hemothorax
D. Flail chest
Correct Answer: A
Rationale: Beck’s triad may be subtle; penetrating anterior chest + hypotension warrants
pericardiocentesis prep.
, 6. Burn: 70-kg adult, partial-thickness burns entire anterior trunk, entire right arm,
half of left thigh. TBSA?
A. 27 %
B. 31 %
C. 36 %
D. 40 %
Correct Answer: A
Rationale: Rule of 9s: anterior trunk 18 %, R arm 9 %, half L thigh 4.5 % ≈ 27 %.
7. Same burn. Using Parkland (4 mL × kg × %TBSA), half in first 8 h, calculate total
fluid for first 8 h.
A. 3 780 mL
B. 4 725 mL
C. 5 400 mL
D. 6 050 mL
Correct Answer: A
Rationale: 4 × 70 × 27 = 7 560 mL total; half = 3 780 mL over first 8 h from time of burn.
8. Pediatric fall: 3-year-old, 8 ft fall, altered, GCS 10, no external bleed. Which vital
sign change is EARLIEST indicator of shock?
A. SBP 70 mmHg
B. HR 150
C. RR 30
D. Cap refill 3 s
Correct Answer: B
Rationale: Pediatric compensation ↑ HR first; hypotension is late.
9. Tension pneumothorax: HR 130, RR 36, BP 70/40, trachea deviated left, absent
right breath sounds, neck veins distended. Needle decompression site?
, A. 2nd ICS mid-clavicular
B. 4th ICS anterior-axillary
C. 5th ICS mid-axillary
D. Suprasternal notch
Correct Answer: A
Rationale: 2nd ICS mid-clavicular line is standard; avoids vessels.
10. Flail chest: Segments 4–6 right, paradoxical motion, HR 110, RR 28, SpO₂ 90 %
NRB, BP 130/80. Primary concern?
A. Pain control
B. Underlying pulmonary contusion
C. Rib plating
D. Pneumothorax
Correct Answer: B
Rationale: Contusion, not instability, causes hypoxia; treat pain & monitor ventilation.
11. Spine: 45-year-old unrestrained driver, rear-impact, ambulatory at scene, denies
pain, GCS 15. NEXUS criteria: midline tenderness C5, no neuro deficit. Next?
A. No collar needed
B. Manual stabilization, transport for imaging
C. Remove collar after 30 min
D. Apply rigid collar only
Correct Answer: B
Rationale: Midline tenderness = criterion for spinal motion restriction per NEXUS.
12. TBI: GCS 10, blown R pupil, HR 50, BP 180/100. Which herniation syndrome?
A. Central
B. Uncal
C. Cingulate
D. Tonsillar
