PARAMEDIC FISDAP AIRWAY ACTUAL EXAM
PREP 2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK |NEW AND REVISED
Question 1
Which structure is the most common site of foreign body airway obstruction in
adults?
A) Trachea
B) Bronchus
C) Larynx
D) Pharynx
Correct Answer: C – Larynx
Rationale: The larynx, specifically the glottic opening, is the narrowest part of
the adult airway. Foreign bodies often lodge at the vocal cords or in the
laryngeal inlet, causing complete or partial obstruction. The pharynx is wider
and less likely to trap objects.
Question 2
During a respiratory assessment, you note that a patient has a patent airway but is
breathing at a rate of 8 breaths per minute with shallow tidal volume. This
condition is best described as:
A) Eupnea
B) Tachypnea
C) Bradypnea with hypoventilation
D) Hyperventilation
Correct Answer: C – Bradypnea with hypoventilation
Rationale: Bradypnea is a respiratory rate less than 12 breaths per minute.
Hypoventilation means inadequate alveolar ventilation, often due to shallow
tidal volume. This combination leads to hypercapnia and hypoxia.
Question 3
The primary muscle of inspiration in a resting adult is the:
A) Abdominal muscles
,B) Sternocleidomastoid
C) Diaphragm
D) Intercostals
Correct Answer: C – Diaphragm
Rationale: The diaphragm is the primary inspiratory muscle. It contracts and
flattens, increasing thoracic volume and creating negative pressure. Accessory
muscles (sternocleidomastoid, scalenes, intercostals) are recruited during
labored breathing or respiratory distress.
Question 4
You are ventilating a 6-year-old child with a bag-valve mask (BVM) and notice
that the chest does not rise despite a good mask seal. Your immediate action should
be to:
A) Increase the ventilation rate
B) Switch to a larger mask
C) Reposition the airway (head tilt-chin lift or jaw thrust)
D) Intubate immediately
Correct Answer: C – Reposition the airway (head tilt-chin lift or jaw thrust)
Rationale: The most common cause of ineffective BVM ventilation is airway
obstruction due to improper head positioning. Repositioning to open the airway
is the first step. After repositioning, reassess chest rise.
Question 5
Capnography waveform monitoring is most valuable during endotracheal
intubation to:
A) Measure oxygen saturation
B) Confirm tracheal placement of the endotracheal tube
C) Monitor blood pressure
D) Determine the need for suctioning
Correct Answer: B – Confirm tracheal placement of the endotracheal tube
Rationale: Continuous waveform capnography (ETCO₂) is the gold standard for
confirming endotracheal tube placement in a perfusing patient. A sustained
waveform with exhalation confirms tracheal placement. Absence of waveform
indicates esophageal intubation (unless cardiac arrest).
Question 6
A patient with a suspected opioid overdose is apneic. After opening the airway and
attempting BVM ventilation, you note significant resistance. You should:
,A) Immediately intubate
B) Insert an oropharyngeal airway (OPA) and reattempt ventilation
C) Administer naloxone intranasally before ventilating
D) Perform a surgical cricothyrotomy
Correct Answer: B – Insert an oropharyngeal airway (OPA) and reattempt
ventilation
Rationale: Opioid overdose often causes loss of pharyngeal tone, leading to
airway obstruction by the tongue. An OPA lifts the tongue off the posterior
pharynx and is often sufficient to allow effective BVM ventilation. Intubation or
surgical airway is not the first step.
Question 7
The volume of air that remains in the lungs after a maximal exhalation is called:
A) Tidal volume
B) Inspiratory reserve volume
C) Residual volume
D) Vital capacity
Correct Answer: C – Residual volume
Rationale: Residual volume is the air that remains in the lungs after forced
exhalation, preventing lung collapse. Tidal volume is the volume of one normal
breath. Vital capacity is the total volume that can be exhaled after maximal
inspiration.
Question 8
Which of the following is an absolute contraindication to nasopharyngeal airway
(NPA) insertion?
A) Gag reflex present
B) Conscious patient
C) Suspected basilar skull fracture
D) Oral trauma
Correct Answer: C – Suspected basilar skull fracture
Rationale: NPA insertion in a patient with a basilar skull fracture can pass
through the cribriform plate into the cranial cavity, causing brain injury. Signs
include raccoon eyes, Battle’s sign, and CSF otorrhea/rhinorrhea. OPA is
preferred in this situation if the patient is unconscious.
Question 9
During rapid sequence intubation (RSI), the induction agent etomidate is preferred
, in hemodynamically unstable patients because it:
A) Causes significant hypotension
B) Provides cardiovascular stability
C) Has a long duration of action
D) Requires no sedation after administration
Correct Answer: B – Provides cardiovascular stability
Rationale: Etomidate has a favorable hemodynamic profile with minimal effects
on blood pressure and heart rate, making it the induction agent of choice in
shock or trauma. Propofol and thiopental cause hypotension; ketamine may
increase heart rate but is also hemodynamically stable.
Question 10
The normal adult ETCO₂ (end-tidal carbon dioxide) value in a patient with
adequate perfusion is:
A) 20–25 mmHg
B) 35–45 mmHg
C) 50–60 mmHg
D) 10–15 mmHg
Correct Answer: B – 35–45 mmHg
Rationale: Normal ETCO₂ is 35–45 mmHg, which approximates arterial PaCO₂
in patients with normal lung function. Lower values indicate hyperventilation or
low cardiac output; higher values indicate hypoventilation or increased CO₂
production.
Question 11
You are intubating an adult male with a Macintosh 3 blade. The tip of the blade
should be placed in the:
A) Esophagus
B) Vallecula
C) Glottic opening
D) Pyriform sinus
Correct Answer: B – Vallecula
Rationale: The Macintosh blade is a curved laryngoscope blade. The tip is placed
in the vallecula (the space between the base of the tongue and the epiglottis).
Lifting the blade indirectly lifts the epiglottis to expose the glottis. A Miller blade
is placed directly under the epiglottis.
PREP 2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK |NEW AND REVISED
Question 1
Which structure is the most common site of foreign body airway obstruction in
adults?
A) Trachea
B) Bronchus
C) Larynx
D) Pharynx
Correct Answer: C – Larynx
Rationale: The larynx, specifically the glottic opening, is the narrowest part of
the adult airway. Foreign bodies often lodge at the vocal cords or in the
laryngeal inlet, causing complete or partial obstruction. The pharynx is wider
and less likely to trap objects.
Question 2
During a respiratory assessment, you note that a patient has a patent airway but is
breathing at a rate of 8 breaths per minute with shallow tidal volume. This
condition is best described as:
A) Eupnea
B) Tachypnea
C) Bradypnea with hypoventilation
D) Hyperventilation
Correct Answer: C – Bradypnea with hypoventilation
Rationale: Bradypnea is a respiratory rate less than 12 breaths per minute.
Hypoventilation means inadequate alveolar ventilation, often due to shallow
tidal volume. This combination leads to hypercapnia and hypoxia.
Question 3
The primary muscle of inspiration in a resting adult is the:
A) Abdominal muscles
,B) Sternocleidomastoid
C) Diaphragm
D) Intercostals
Correct Answer: C – Diaphragm
Rationale: The diaphragm is the primary inspiratory muscle. It contracts and
flattens, increasing thoracic volume and creating negative pressure. Accessory
muscles (sternocleidomastoid, scalenes, intercostals) are recruited during
labored breathing or respiratory distress.
Question 4
You are ventilating a 6-year-old child with a bag-valve mask (BVM) and notice
that the chest does not rise despite a good mask seal. Your immediate action should
be to:
A) Increase the ventilation rate
B) Switch to a larger mask
C) Reposition the airway (head tilt-chin lift or jaw thrust)
D) Intubate immediately
Correct Answer: C – Reposition the airway (head tilt-chin lift or jaw thrust)
Rationale: The most common cause of ineffective BVM ventilation is airway
obstruction due to improper head positioning. Repositioning to open the airway
is the first step. After repositioning, reassess chest rise.
Question 5
Capnography waveform monitoring is most valuable during endotracheal
intubation to:
A) Measure oxygen saturation
B) Confirm tracheal placement of the endotracheal tube
C) Monitor blood pressure
D) Determine the need for suctioning
Correct Answer: B – Confirm tracheal placement of the endotracheal tube
Rationale: Continuous waveform capnography (ETCO₂) is the gold standard for
confirming endotracheal tube placement in a perfusing patient. A sustained
waveform with exhalation confirms tracheal placement. Absence of waveform
indicates esophageal intubation (unless cardiac arrest).
Question 6
A patient with a suspected opioid overdose is apneic. After opening the airway and
attempting BVM ventilation, you note significant resistance. You should:
,A) Immediately intubate
B) Insert an oropharyngeal airway (OPA) and reattempt ventilation
C) Administer naloxone intranasally before ventilating
D) Perform a surgical cricothyrotomy
Correct Answer: B – Insert an oropharyngeal airway (OPA) and reattempt
ventilation
Rationale: Opioid overdose often causes loss of pharyngeal tone, leading to
airway obstruction by the tongue. An OPA lifts the tongue off the posterior
pharynx and is often sufficient to allow effective BVM ventilation. Intubation or
surgical airway is not the first step.
Question 7
The volume of air that remains in the lungs after a maximal exhalation is called:
A) Tidal volume
B) Inspiratory reserve volume
C) Residual volume
D) Vital capacity
Correct Answer: C – Residual volume
Rationale: Residual volume is the air that remains in the lungs after forced
exhalation, preventing lung collapse. Tidal volume is the volume of one normal
breath. Vital capacity is the total volume that can be exhaled after maximal
inspiration.
Question 8
Which of the following is an absolute contraindication to nasopharyngeal airway
(NPA) insertion?
A) Gag reflex present
B) Conscious patient
C) Suspected basilar skull fracture
D) Oral trauma
Correct Answer: C – Suspected basilar skull fracture
Rationale: NPA insertion in a patient with a basilar skull fracture can pass
through the cribriform plate into the cranial cavity, causing brain injury. Signs
include raccoon eyes, Battle’s sign, and CSF otorrhea/rhinorrhea. OPA is
preferred in this situation if the patient is unconscious.
Question 9
During rapid sequence intubation (RSI), the induction agent etomidate is preferred
, in hemodynamically unstable patients because it:
A) Causes significant hypotension
B) Provides cardiovascular stability
C) Has a long duration of action
D) Requires no sedation after administration
Correct Answer: B – Provides cardiovascular stability
Rationale: Etomidate has a favorable hemodynamic profile with minimal effects
on blood pressure and heart rate, making it the induction agent of choice in
shock or trauma. Propofol and thiopental cause hypotension; ketamine may
increase heart rate but is also hemodynamically stable.
Question 10
The normal adult ETCO₂ (end-tidal carbon dioxide) value in a patient with
adequate perfusion is:
A) 20–25 mmHg
B) 35–45 mmHg
C) 50–60 mmHg
D) 10–15 mmHg
Correct Answer: B – 35–45 mmHg
Rationale: Normal ETCO₂ is 35–45 mmHg, which approximates arterial PaCO₂
in patients with normal lung function. Lower values indicate hyperventilation or
low cardiac output; higher values indicate hypoventilation or increased CO₂
production.
Question 11
You are intubating an adult male with a Macintosh 3 blade. The tip of the blade
should be placed in the:
A) Esophagus
B) Vallecula
C) Glottic opening
D) Pyriform sinus
Correct Answer: B – Vallecula
Rationale: The Macintosh blade is a curved laryngoscope blade. The tip is placed
in the vallecula (the space between the base of the tongue and the epiglottis).
Lifting the blade indirectly lifts the epiglottis to expose the glottis. A Miller blade
is placed directly under the epiglottis.
