1|Page
FISDAP MEDICAL EXAM PRACTICE
QUESTION BANK
## 2026-2027 ACADEMIC YEAR EDITION
### COMPREHENSIVE REVIEW WITH 200+
MULTIPLE-CHOICE QUESTIONS &
DETAILED RATIONALES
ITSJEREGUIDES
# SECTION I: AIRWAY MANAGEMENT & RESPIRATORY EMERGENCIES
-
**Question 1**
A 68-year-old male presents with sudden-onset severe dyspnea, audible stridor, and cyanosis
around the lips. He is sitting upright in a tripod position, leaning forward with his arms braced on
his knees. He is unable to speak in full sentences. Which of the following is the MOST
appropriate initial intervention?
A. Administer high-flow oxygen via non-rebreather mask at 15 L/min
B. Perform a head-tilt, chin-lift maneuver and assist ventilations with a BVM
C. Prepare for immediate needle cricothyrotomy
D. Administer racemic epinephrine via nebulizer
**Correct Answer: C**
,2|Page
**Rationale:** This patient is presenting with signs of **upper airway obstruction** with
**impending respiratory failure**—stridor, tripod positioning, cyanosis, and inability to speak
indicate a critical airway compromise that cannot be managed with oxygen alone. **Needle
cricothyrotomy** is indicated when a patient has a complete or near-complete upper airway
obstruction and bag-valve-mask ventilation is ineffective or impossible. The tripod position and
stridor suggest a **foreign body airway obstruction** or **severe epiglottitis** that requires
immediate surgical airway intervention.
**Why the other answers are incorrect:**
- **A** is incorrect: While high-flow oxygen is important, it will not bypass the upper airway
obstruction. Oxygen administration alone cannot resolve the underlying mechanical blockage,
and this patient requires an immediate definitive airway.
- **B** is incorrect: Head-tilt, chin-lift is contraindicated in cases of suspected **cervical spine
injury** or when the obstruction is **supraglottic**. Furthermore, BVM ventilation will be
ineffective if the obstruction is complete and cannot be bypassed.
- **D** is incorrect: Racemic epinephrine is indicated for **croup** (viral
laryngotracheobronchitis) in pediatric patients, not for acute upper airway obstruction in an adult.
This would delay critical intervention.
---
**Question 2**
A 45-year-old female with a history of asthma presents with severe respiratory distress. She is
using accessory muscles and has diminished breath sounds with prolonged expiratory wheezing.
Her SpO₂ is 88% on room air. After administering high-flow oxygen, which medication should
be administered FIRST?
A. Albuterol via nebulizer
B. Ipratropium bromide via nebulizer
C. Methylprednisolone IV
D. Epinephrine 1:1000 IM
,3|Page
**Correct Answer: A**
**Rationale:** This patient is experiencing an **acute severe asthma exacerbation**. The initial
treatment of choice is a **short-acting beta-2 agonist (SABA)** , such as **albuterol**, which
causes rapid bronchodilation by relaxing bronchial smooth muscle. Albuterol should be
administered via nebulizer or MDI with a spacer. The patient's hypoxia (SpO₂ 88%) requires
supplemental oxygen, but bronchodilation is the priority to address the underlying
pathophysiology of bronchoconstriction.
**Why the other answers are incorrect:**
- **B** is incorrect: Ipratropium bromide (Atrovent) is an **anticholinergic** that provides
bronchodilation but has a slower onset of action (15–20 minutes) compared to albuterol (5–15
minutes). It is used as an **adjunct therapy** in severe asthma, not as the first-line agent.
- **C** is incorrect: Methylprednisolone is a **corticosteroid** that reduces airway
inflammation but has an onset of action of **4–6 hours**. It is an important part of asthma
management but is not the first medication to administer in an acute exacerbation.
- **D** is incorrect: Epinephrine is indicated for **anaphylaxis** or **severe bronchospasm**
when the patient is in **extremis** (e.g., impending respiratory arrest). In a patient who is still
conscious and breathing, albuterol is the preferred first-line agent.
---
**Question 3**
A 72-year-old male is found unresponsive with agonal respirations at a rate of 6 breaths per
minute. His airway is patent, and you note gurgling sounds. What is the MOST appropriate initial
action?
A. Insert an oropharyngeal airway and begin BVM ventilations
B. Perform a jaw-thrust maneuver and suction the oropharynx
C. Intubate the patient immediately
, 4|Page
D. Administer oxygen via non-rebreather mask
**Correct Answer: B**
**Rationale:** The gurgling sounds indicate the presence of **secretions or vomitus** in the
airway, which must be cleared before any other interventions. The **most appropriate initial
action** is to perform a **jaw-thrust maneuver** (to open the airway while protecting the
cervical spine) and **suction the oropharynx** to remove the obstruction. After clearing the
airway, the patient's respiratory rate of 6 breaths per minute indicates **respiratory failure**, and
BVM ventilations should be initiated.
**Why the other answers are incorrect:**
- **A** is incorrect: Inserting an oropharyngeal airway without first suctioning the airway can
push secretions or foreign material deeper into the airway, potentially causing a complete
obstruction. The airway must be cleared first.
- **C** is incorrect: Intubation is a **definitive airway** intervention that requires proper
preparation, equipment, and skilled personnel. In this scenario, the priority is to clear the airway
and provide basic ventilatory support.
- **D** is incorrect: A non-rebreather mask requires spontaneous breathing. This patient has
agonal respirations and requires **positive-pressure ventilation**, not just supplemental oxygen.
---
**Question 4**
A 55-year-old male with COPD presents with worsening shortness of breath over the past 2 days.
He has a barrel-shaped chest, uses pursed-lip breathing, and has a cough with thick yellow
sputum. His SpO₂ is 91% on 2 L/min nasal cannula. Which of the following is the MOST
appropriate oxygen delivery method?
A. Increase to 4 L/min via nasal cannula
B. Non-rebreather mask at 15 L/min
FISDAP MEDICAL EXAM PRACTICE
QUESTION BANK
## 2026-2027 ACADEMIC YEAR EDITION
### COMPREHENSIVE REVIEW WITH 200+
MULTIPLE-CHOICE QUESTIONS &
DETAILED RATIONALES
ITSJEREGUIDES
# SECTION I: AIRWAY MANAGEMENT & RESPIRATORY EMERGENCIES
-
**Question 1**
A 68-year-old male presents with sudden-onset severe dyspnea, audible stridor, and cyanosis
around the lips. He is sitting upright in a tripod position, leaning forward with his arms braced on
his knees. He is unable to speak in full sentences. Which of the following is the MOST
appropriate initial intervention?
A. Administer high-flow oxygen via non-rebreather mask at 15 L/min
B. Perform a head-tilt, chin-lift maneuver and assist ventilations with a BVM
C. Prepare for immediate needle cricothyrotomy
D. Administer racemic epinephrine via nebulizer
**Correct Answer: C**
,2|Page
**Rationale:** This patient is presenting with signs of **upper airway obstruction** with
**impending respiratory failure**—stridor, tripod positioning, cyanosis, and inability to speak
indicate a critical airway compromise that cannot be managed with oxygen alone. **Needle
cricothyrotomy** is indicated when a patient has a complete or near-complete upper airway
obstruction and bag-valve-mask ventilation is ineffective or impossible. The tripod position and
stridor suggest a **foreign body airway obstruction** or **severe epiglottitis** that requires
immediate surgical airway intervention.
**Why the other answers are incorrect:**
- **A** is incorrect: While high-flow oxygen is important, it will not bypass the upper airway
obstruction. Oxygen administration alone cannot resolve the underlying mechanical blockage,
and this patient requires an immediate definitive airway.
- **B** is incorrect: Head-tilt, chin-lift is contraindicated in cases of suspected **cervical spine
injury** or when the obstruction is **supraglottic**. Furthermore, BVM ventilation will be
ineffective if the obstruction is complete and cannot be bypassed.
- **D** is incorrect: Racemic epinephrine is indicated for **croup** (viral
laryngotracheobronchitis) in pediatric patients, not for acute upper airway obstruction in an adult.
This would delay critical intervention.
---
**Question 2**
A 45-year-old female with a history of asthma presents with severe respiratory distress. She is
using accessory muscles and has diminished breath sounds with prolonged expiratory wheezing.
Her SpO₂ is 88% on room air. After administering high-flow oxygen, which medication should
be administered FIRST?
A. Albuterol via nebulizer
B. Ipratropium bromide via nebulizer
C. Methylprednisolone IV
D. Epinephrine 1:1000 IM
,3|Page
**Correct Answer: A**
**Rationale:** This patient is experiencing an **acute severe asthma exacerbation**. The initial
treatment of choice is a **short-acting beta-2 agonist (SABA)** , such as **albuterol**, which
causes rapid bronchodilation by relaxing bronchial smooth muscle. Albuterol should be
administered via nebulizer or MDI with a spacer. The patient's hypoxia (SpO₂ 88%) requires
supplemental oxygen, but bronchodilation is the priority to address the underlying
pathophysiology of bronchoconstriction.
**Why the other answers are incorrect:**
- **B** is incorrect: Ipratropium bromide (Atrovent) is an **anticholinergic** that provides
bronchodilation but has a slower onset of action (15–20 minutes) compared to albuterol (5–15
minutes). It is used as an **adjunct therapy** in severe asthma, not as the first-line agent.
- **C** is incorrect: Methylprednisolone is a **corticosteroid** that reduces airway
inflammation but has an onset of action of **4–6 hours**. It is an important part of asthma
management but is not the first medication to administer in an acute exacerbation.
- **D** is incorrect: Epinephrine is indicated for **anaphylaxis** or **severe bronchospasm**
when the patient is in **extremis** (e.g., impending respiratory arrest). In a patient who is still
conscious and breathing, albuterol is the preferred first-line agent.
---
**Question 3**
A 72-year-old male is found unresponsive with agonal respirations at a rate of 6 breaths per
minute. His airway is patent, and you note gurgling sounds. What is the MOST appropriate initial
action?
A. Insert an oropharyngeal airway and begin BVM ventilations
B. Perform a jaw-thrust maneuver and suction the oropharynx
C. Intubate the patient immediately
, 4|Page
D. Administer oxygen via non-rebreather mask
**Correct Answer: B**
**Rationale:** The gurgling sounds indicate the presence of **secretions or vomitus** in the
airway, which must be cleared before any other interventions. The **most appropriate initial
action** is to perform a **jaw-thrust maneuver** (to open the airway while protecting the
cervical spine) and **suction the oropharynx** to remove the obstruction. After clearing the
airway, the patient's respiratory rate of 6 breaths per minute indicates **respiratory failure**, and
BVM ventilations should be initiated.
**Why the other answers are incorrect:**
- **A** is incorrect: Inserting an oropharyngeal airway without first suctioning the airway can
push secretions or foreign material deeper into the airway, potentially causing a complete
obstruction. The airway must be cleared first.
- **C** is incorrect: Intubation is a **definitive airway** intervention that requires proper
preparation, equipment, and skilled personnel. In this scenario, the priority is to clear the airway
and provide basic ventilatory support.
- **D** is incorrect: A non-rebreather mask requires spontaneous breathing. This patient has
agonal respirations and requires **positive-pressure ventilation**, not just supplemental oxygen.
---
**Question 4**
A 55-year-old male with COPD presents with worsening shortness of breath over the past 2 days.
He has a barrel-shaped chest, uses pursed-lip breathing, and has a cough with thick yellow
sputum. His SpO₂ is 91% on 2 L/min nasal cannula. Which of the following is the MOST
appropriate oxygen delivery method?
A. Increase to 4 L/min via nasal cannula
B. Non-rebreather mask at 15 L/min
