FISDAP MEDICAL PRACTICE EXAM TIPS QUESTIONS AND
ANSWERS MARKED A+
✔✔You are dispatched to a residence for a 20-year-old man with respiratory distress.
When you arrive, you find that the patient has a
tracheostomy tube and is ventilator dependent. His mother tells you that he was doing
fine, but then suddenly began experiencing
breathing difficulty. You should:
A) remove him from the mechanical ventilator and ventilate him manually.
B) check the settings on the ventilator to ensure that it is functioning properly.
C) detach the ventilator, suction the tracheostomy tube, and reassess the patient.
D) remove the ventilator tubing and place an oxygen mask over the tracheostomy tube.
- ✔✔A) remove him from the mechanical ventilator and ventilate him manually.
If a ventilator-dependent patient experiences a sudden onset of respiratory distress, you
should first remove him or her from the mechanical ventilator and
begin manual ventilation with a bag-mask device; attach the bag directly to the
tracheostomy tube. If the patient improves, you will know that the problem
was a malfunction with the mechanical ventilator. If the patient does not improve, the
tracheostomy tube is likely plugged with thick mucus secretions and
requires suctioning. Unless you are familiar with the mechanical ventilator (most EMTs
are not), do not attempt to troubleshoot the device by checking the
settings; this simply wastes time and could harm the patient if you do not know what you
are doing.
✔✔When treating an unresponsive man who was struck by lightning, you should:
A) begin CPR at once if he is apneic and pulseless.
B) apply full spinal precautions before moving him.
C) ensure that you and the patient are in a safe place.
D) manually stabilize his head and open his airway. - ✔✔C) ensure that you and the
patient are in a safe place.
Contrary to popular belief, lightning can (and does) strike in the same place twice. After
lightning strikes, the ground remains electrically charged for a period
of time; this increases the chance of a second strike within a short period of time. You
must first ensure that you and the patient are safe by moving to a
sheltered area, preferably indoors. After you have ensured the safety of yourself and the
patient, begin treatment as dictated by the patient's condition. Do
not let the life you save, or attempt to save, TAKE your own!
✔✔A 23-year-old woman with sickle cell disease reports a sudden onset of severe pain
in her lower extremities. Which of the following is the
MOST likely cause of her symptoms?
A) Red blood cells are being destroyed at an abnormal rate.
B) Spontaneous bleeding is occurring within the muscles.
C) Blood flow is diminished because of vascular occlusion.
,D) Blood clots have formed because of excessive platelets. - ✔✔C) Blood flow is
diminished because of vascular occlusion.
Sickle cell disease is an inherited blood disorder in which the red blood cells are
misshapen and take on a sickle appearance. The sharp and misshapen red
blood cells lead to dysfunction in oxygen binding and unintentional clot formation. These
unintentional clots may lead to a condition called vasoocclusive
crisis. The patient's symptoms indicate that this is what has happened in her lower
extremities. The blood clots in her lower extremities did not form because
of an excessive platelet count (thrombocythemia) because sickle cell disease is not a
condition of excessive platelet production. Spontaneous bleeding is not the cause of her
symptoms because sickle cell disease is not a condition of low platelets
(thrombocytopenia). Sickle cell disease is not a condition of abnormal red blood cell
destruction.
✔✔You are at the scene where a man panicked while swimming in a small lake. Your
initial attempt to rescue him should include:
A) throwing a rope to the victim.
B) rowing a small raft to the victim.
C) swimming to the victim to rescue him.
D) reaching for the victim with a long object. - ✔✔D) reaching for the victim with a long
object.
General rules to fo llow when attempting to rescue a patient from the water include
"reach, throw, row, and then go." In this case, you should attempt to reach
the victim by having him grab hold of a long object, such as a stick or pole. If this is not
possible or unsuccessful, throw the victim a rope or flotation device (if available). If
these are not available, row to the patient in a small raft (if available). Going into the
water to retrieve the victim is a last resort. The rescuer must
be a strong swimmer because patients who are in danger of drowning are in a state of
blind panic and will make every attempt to keep themselves afloat,
even if it means forcing the rescuer underwater.
✔✔Which of the following is a later sign of hepatitis?
A) Fatigue
B) Jaundice
C) Loss of appetite
D) Fever and vomiting - ✔✔B) Jaundice
Early signs and symptoms of viral hepatitis include loss of appetite (anorexia), vomiting,
fever, fatigue, and muscle and joint pain. Jaundice (yellow sclera and
skin) and right upper quadrant abdominal pain are not common early manifestations of
hepatitis; they usually develop within 1 to 2 weeks into the disease
process.
,✔✔A 48-year-old man became acutely hypoxic, experienced a seizure, and is now
postictal. The MOST effective way to prevent another seizure
is to:
A) place him in the recovery position.
B) give him oral glucose if he can swallow.
C) administer high-flow supplemental oxygen.
D) dim the lights in the back of the ambulance. - ✔✔C) administer high-flow
supplemental oxygen.
You should administer high-flow oxygen to all patients who are actively seizing and to
patients who experienced a seizure and are postictal. This is especially true if the
seizure was caused by hypoxia. Increasing the oxygen content of the blood, which
minimizes hypoxia, may prevent another seizure. The recovery position is appropriate
for uninjured patients with a decreased level of consciousness and adequate breathing;
it will help maintain the airway and facilitate
drainage of secretions from the mouth, but will not prevent another seizure. Oral
glucose may prevent another seizure if hypoglycemia was the cause of the
seizure. You should dim the lights in the back of the ambulance to help prevent any
seizure, not just those that are caused by hypoxia.
✔✔What is the correct dose, concentration, and route of epinephrine via EpiPen for
anaphylactic shock in an adult?
A) 0.3 mg; 1:1,000; intramuscular
B) 0.15 mg; 1:1,000; intravascular
C) 0.3 mg; 1:10,000; intramuscular
D) 0.15 mg; 1:10,000; intravascular - ✔✔A) 0.3 mg; 1:1,000; intramuscular
In some EMS systems, EM Ts are trained to draw up and administer epinephrine from
an ampule or a vial. In this case, the dose is 0.2 to 0.5 mg of a n ,000
solution (1 mg/mL) for adults and 0.01 mg/kg for children. Other systems carry
epinephrine auto-injectors, or assist patients who have a prescription. The
adult EpiPen delivers 0.3 mg of a J:1 ,000 solution, and the pediatric EpiPen delivers
0.15 mg of a J:2 ,000 solution. Whether drawn from an ampule or vial or
delivered via EpiPen, the drug is administered via the intramuscular route. The J:1 ,000
concentration is very concentrated compared to J:10 ,000, and is
therefore NOT administered by the intravascular route.
✔✔A woman with type 1 diabetes presents with deep, rapid breathing; tachycardia,
dehydration; and an altered mental status. Which of the
following would MOST likely explain her clinical presentation?
A) Her blood sugar level is less than 60 mg/dL.
B) She has not taken her insulin in several days.
C) She took her insulin but has not eaten today.
D) She has an infection that lead to dehydration. - ✔✔B) She has not taken her insulin
in several days.
, The patient's clinical presentation is consistent with hyperglycemic ketoacidosis. Of the
options listed, the only logical explanation is that she has not taken
her insulin in several days. Without insulin, glucose cannot enter the cell to make
energy, so it pools in the blood to excessive levels (hyperglycemia). Excess
blood glucose levels cause the body to eliminate large amounts of water via the
kidneys, resulting in dehydration. In the absence of glucose, the cells will
metabolize fat, which produces ketoacids. The respiratory system will attempt to
eliminate these ketoacids from the body by increasing the rate and depth of breathing
(Kussmaul respirations). Had she taken her insulin but did not eat, her blood glucose
level would be lower than normal. Although an underlying infection cannot be ruled out,
the primary cause of her problem is failure to take her prescribed insulin.
✔✔A 32-year-old man who was stung by a bee has diffuse hives, facial swelling, and
difficulty breathing. When he breathes, you hear audible
stridor. What does this indicate?
A) Swelling of the upper airway structures
B) Swelling of the lower airway structures
C) Narrowing of the two mainstem bronchi
D) Narrowing of the bronchioles in the lungs - ✔✔A) Swelling of the upper airway
structures
This patient is experiencing a severe allergic reaction (anaphylaxis). Strid or, which is a
high-pitched sound heard on inhalation, indicates swelling of the
structures and tissues of the upper airway. If not promptly treated, the patient's airway
may close completely, resulting in respiratory arrest. Narrowing of
the bronchioles in the lungs causes wheezing, a whistling sound that may be heard
during inhalation, exhalation, or both.
✔✔Which of the following drugs can cause or worsen excited delirium?
A) Heroin
B) Cocaine
C) Ketamine
D) Marijuana - ✔✔B) Cocaine
Excited delirium, also referred to as agitated delirium, is a condition caused by a severe
increase in the metabolic rate, combined with impairment of
cognitive function. The symptoms of excited delirium include hyperactive irrational
behavior with possible vivid hallucinations, which can create the
potential for violence. Common physical manifestations include hypertension,
tachycardia, diaphoresis, hyperthermia, and dilated pupils. Drugs that increase
metabolism, such as cocaine or methamphetamine (sympathomimetics), can cause or
worsen excited delirium. The condition can lead to sudden death,
usually from metabolic acidosis. Heroin, an opioid, depresses metabolism; therefore, it
would not cause or worsen excited delirium. Ketamine, a sedativehypnotic,
ANSWERS MARKED A+
✔✔You are dispatched to a residence for a 20-year-old man with respiratory distress.
When you arrive, you find that the patient has a
tracheostomy tube and is ventilator dependent. His mother tells you that he was doing
fine, but then suddenly began experiencing
breathing difficulty. You should:
A) remove him from the mechanical ventilator and ventilate him manually.
B) check the settings on the ventilator to ensure that it is functioning properly.
C) detach the ventilator, suction the tracheostomy tube, and reassess the patient.
D) remove the ventilator tubing and place an oxygen mask over the tracheostomy tube.
- ✔✔A) remove him from the mechanical ventilator and ventilate him manually.
If a ventilator-dependent patient experiences a sudden onset of respiratory distress, you
should first remove him or her from the mechanical ventilator and
begin manual ventilation with a bag-mask device; attach the bag directly to the
tracheostomy tube. If the patient improves, you will know that the problem
was a malfunction with the mechanical ventilator. If the patient does not improve, the
tracheostomy tube is likely plugged with thick mucus secretions and
requires suctioning. Unless you are familiar with the mechanical ventilator (most EMTs
are not), do not attempt to troubleshoot the device by checking the
settings; this simply wastes time and could harm the patient if you do not know what you
are doing.
✔✔When treating an unresponsive man who was struck by lightning, you should:
A) begin CPR at once if he is apneic and pulseless.
B) apply full spinal precautions before moving him.
C) ensure that you and the patient are in a safe place.
D) manually stabilize his head and open his airway. - ✔✔C) ensure that you and the
patient are in a safe place.
Contrary to popular belief, lightning can (and does) strike in the same place twice. After
lightning strikes, the ground remains electrically charged for a period
of time; this increases the chance of a second strike within a short period of time. You
must first ensure that you and the patient are safe by moving to a
sheltered area, preferably indoors. After you have ensured the safety of yourself and the
patient, begin treatment as dictated by the patient's condition. Do
not let the life you save, or attempt to save, TAKE your own!
✔✔A 23-year-old woman with sickle cell disease reports a sudden onset of severe pain
in her lower extremities. Which of the following is the
MOST likely cause of her symptoms?
A) Red blood cells are being destroyed at an abnormal rate.
B) Spontaneous bleeding is occurring within the muscles.
C) Blood flow is diminished because of vascular occlusion.
,D) Blood clots have formed because of excessive platelets. - ✔✔C) Blood flow is
diminished because of vascular occlusion.
Sickle cell disease is an inherited blood disorder in which the red blood cells are
misshapen and take on a sickle appearance. The sharp and misshapen red
blood cells lead to dysfunction in oxygen binding and unintentional clot formation. These
unintentional clots may lead to a condition called vasoocclusive
crisis. The patient's symptoms indicate that this is what has happened in her lower
extremities. The blood clots in her lower extremities did not form because
of an excessive platelet count (thrombocythemia) because sickle cell disease is not a
condition of excessive platelet production. Spontaneous bleeding is not the cause of her
symptoms because sickle cell disease is not a condition of low platelets
(thrombocytopenia). Sickle cell disease is not a condition of abnormal red blood cell
destruction.
✔✔You are at the scene where a man panicked while swimming in a small lake. Your
initial attempt to rescue him should include:
A) throwing a rope to the victim.
B) rowing a small raft to the victim.
C) swimming to the victim to rescue him.
D) reaching for the victim with a long object. - ✔✔D) reaching for the victim with a long
object.
General rules to fo llow when attempting to rescue a patient from the water include
"reach, throw, row, and then go." In this case, you should attempt to reach
the victim by having him grab hold of a long object, such as a stick or pole. If this is not
possible or unsuccessful, throw the victim a rope or flotation device (if available). If
these are not available, row to the patient in a small raft (if available). Going into the
water to retrieve the victim is a last resort. The rescuer must
be a strong swimmer because patients who are in danger of drowning are in a state of
blind panic and will make every attempt to keep themselves afloat,
even if it means forcing the rescuer underwater.
✔✔Which of the following is a later sign of hepatitis?
A) Fatigue
B) Jaundice
C) Loss of appetite
D) Fever and vomiting - ✔✔B) Jaundice
Early signs and symptoms of viral hepatitis include loss of appetite (anorexia), vomiting,
fever, fatigue, and muscle and joint pain. Jaundice (yellow sclera and
skin) and right upper quadrant abdominal pain are not common early manifestations of
hepatitis; they usually develop within 1 to 2 weeks into the disease
process.
,✔✔A 48-year-old man became acutely hypoxic, experienced a seizure, and is now
postictal. The MOST effective way to prevent another seizure
is to:
A) place him in the recovery position.
B) give him oral glucose if he can swallow.
C) administer high-flow supplemental oxygen.
D) dim the lights in the back of the ambulance. - ✔✔C) administer high-flow
supplemental oxygen.
You should administer high-flow oxygen to all patients who are actively seizing and to
patients who experienced a seizure and are postictal. This is especially true if the
seizure was caused by hypoxia. Increasing the oxygen content of the blood, which
minimizes hypoxia, may prevent another seizure. The recovery position is appropriate
for uninjured patients with a decreased level of consciousness and adequate breathing;
it will help maintain the airway and facilitate
drainage of secretions from the mouth, but will not prevent another seizure. Oral
glucose may prevent another seizure if hypoglycemia was the cause of the
seizure. You should dim the lights in the back of the ambulance to help prevent any
seizure, not just those that are caused by hypoxia.
✔✔What is the correct dose, concentration, and route of epinephrine via EpiPen for
anaphylactic shock in an adult?
A) 0.3 mg; 1:1,000; intramuscular
B) 0.15 mg; 1:1,000; intravascular
C) 0.3 mg; 1:10,000; intramuscular
D) 0.15 mg; 1:10,000; intravascular - ✔✔A) 0.3 mg; 1:1,000; intramuscular
In some EMS systems, EM Ts are trained to draw up and administer epinephrine from
an ampule or a vial. In this case, the dose is 0.2 to 0.5 mg of a n ,000
solution (1 mg/mL) for adults and 0.01 mg/kg for children. Other systems carry
epinephrine auto-injectors, or assist patients who have a prescription. The
adult EpiPen delivers 0.3 mg of a J:1 ,000 solution, and the pediatric EpiPen delivers
0.15 mg of a J:2 ,000 solution. Whether drawn from an ampule or vial or
delivered via EpiPen, the drug is administered via the intramuscular route. The J:1 ,000
concentration is very concentrated compared to J:10 ,000, and is
therefore NOT administered by the intravascular route.
✔✔A woman with type 1 diabetes presents with deep, rapid breathing; tachycardia,
dehydration; and an altered mental status. Which of the
following would MOST likely explain her clinical presentation?
A) Her blood sugar level is less than 60 mg/dL.
B) She has not taken her insulin in several days.
C) She took her insulin but has not eaten today.
D) She has an infection that lead to dehydration. - ✔✔B) She has not taken her insulin
in several days.
, The patient's clinical presentation is consistent with hyperglycemic ketoacidosis. Of the
options listed, the only logical explanation is that she has not taken
her insulin in several days. Without insulin, glucose cannot enter the cell to make
energy, so it pools in the blood to excessive levels (hyperglycemia). Excess
blood glucose levels cause the body to eliminate large amounts of water via the
kidneys, resulting in dehydration. In the absence of glucose, the cells will
metabolize fat, which produces ketoacids. The respiratory system will attempt to
eliminate these ketoacids from the body by increasing the rate and depth of breathing
(Kussmaul respirations). Had she taken her insulin but did not eat, her blood glucose
level would be lower than normal. Although an underlying infection cannot be ruled out,
the primary cause of her problem is failure to take her prescribed insulin.
✔✔A 32-year-old man who was stung by a bee has diffuse hives, facial swelling, and
difficulty breathing. When he breathes, you hear audible
stridor. What does this indicate?
A) Swelling of the upper airway structures
B) Swelling of the lower airway structures
C) Narrowing of the two mainstem bronchi
D) Narrowing of the bronchioles in the lungs - ✔✔A) Swelling of the upper airway
structures
This patient is experiencing a severe allergic reaction (anaphylaxis). Strid or, which is a
high-pitched sound heard on inhalation, indicates swelling of the
structures and tissues of the upper airway. If not promptly treated, the patient's airway
may close completely, resulting in respiratory arrest. Narrowing of
the bronchioles in the lungs causes wheezing, a whistling sound that may be heard
during inhalation, exhalation, or both.
✔✔Which of the following drugs can cause or worsen excited delirium?
A) Heroin
B) Cocaine
C) Ketamine
D) Marijuana - ✔✔B) Cocaine
Excited delirium, also referred to as agitated delirium, is a condition caused by a severe
increase in the metabolic rate, combined with impairment of
cognitive function. The symptoms of excited delirium include hyperactive irrational
behavior with possible vivid hallucinations, which can create the
potential for violence. Common physical manifestations include hypertension,
tachycardia, diaphoresis, hyperthermia, and dilated pupils. Drugs that increase
metabolism, such as cocaine or methamphetamine (sympathomimetics), can cause or
worsen excited delirium. The condition can lead to sudden death,
usually from metabolic acidosis. Heroin, an opioid, depresses metabolism; therefore, it
would not cause or worsen excited delirium. Ketamine, a sedativehypnotic,
