EMT FISDAP TRAUMA CERTIFICATION EXAM 2026.2027
| FULL-SPECTRUM QUESTION BANK COVERING ALL
TESTED TOPICS
1. A 45-year-old construction worker falls from a two-story scaffold,
landing on his feet. He is alert and complaining of severe bilateral heel
pain and mild lower back pain. His vital signs are BP 118/78, P 92, R
18. What is the most significant injury you should suspect based on
the mechanism of injury?
A) Pelvic fracture
B) Lumbar spine fracture
C) Bilateral calcaneus fractures
D) Femoral neck fractures
Correct Answer: B) Lumbar spine fracture
Rationale: Axial loading injuries, such as landing on the feet from a
significant height, transmit force up the skeletal system. While
calcaneus fractures are common, the force is often concentrated on the
lumbar spine, resulting in compression fractures. The absence of pelvic
instability and the mild back pain in the setting of a significant fall point
toward a spinal injury as the primary concern.
2. A 30-year-old male is involved in a high-speed motor vehicle
collision. He is complaining of shortness of breath and has a flail
segment on the left side of his chest. His trachea is midline, and
,breath sounds are equal bilaterally. Which of the following is the most
appropriate immediate intervention?
A) Needle decompression of the left chest
B) Positive pressure ventilation with a bag-valve mask
C) Application of an occlusive dressing over the flail segment
D) Assisting ventilations with a non-rebreather mask at 15 L/min
Correct Answer: B) Positive pressure ventilation with a bag-valve mask
Rationale: Flail chest, especially with shortness of breath, indicates
significant chest wall trauma and underlying pulmonary contusion. The
patient needs ventilation support. Positive pressure ventilation helps to
stabilize the flail segment by pushing the chest wall outward during
inspiration. An occlusive dressing is used for a sucking chest wound, not
flail chest. Needle decompression is for tension pneumothorax, which is
not indicated here.
3. A 22-year-old female is stabbed in the right side of her chest at the
midclavicular line, fifth intercostal space. She is anxious and
tachypneic. You note diminished breath sounds on the right side.
What is the immediate priority in managing this patient?
A) Applying a vented chest seal over the wound
B) Performing a needle decompression
C) Placing an occlusive dressing taped on three sides
D) Beginning chest compressions
Correct Answer: A) Applying a vented chest seal over the wound
Rationale: This is a classic presentation for an open pneumothorax or
"sucking chest wound." The immediate treatment is to apply an
occlusive dressing that is vented to allow air to escape but not re-enter
the pleural space. A standard occlusive dressing taped on three sides
,acts as a flutter valve, but a vented chest seal is now the standard of
care as it is designed for this purpose.
4. A 60-year-old male is ejected from his vehicle. He is found
unresponsive, with a GCS of 6. He has a large contusion over his right
flank. His blood pressure is 88/54, heart rate 118, and respirations 24.
What is the most likely cause of his hypotension?
A) Neurogenic shock
B) Cardiogenic shock
C) Hypovolemic shock from intra-abdominal bleeding
D) Obstructive shock from pericardial tamponade
Correct Answer: C) Hypovolemic shock from intra-abdominal bleeding
Rationale: The contusion over the right flank (Grey-Turner sign) is a late
sign of retroperitoneal or intra-abdominal bleeding. In a trauma patient,
hypotension with tachycardia and signs of injury to the torso is
hypovolemic shock until proven otherwise. Neurogenic shock would
present with hypotension and bradycardia.
5. A 16-year-old male sustains a penetrating injury to the left side of
his chest. On assessment, you note JVD, muffled heart sounds, and a
narrowing pulse pressure. His blood pressure is 82/66. Which of the
following interventions is most appropriate?
A) Needle decompression at the second intercostal space
B) Fluid resuscitation with a 20 mL/kg bolus
C) Application of a nasal cannula
D) Placement of a tourniquet on the left arm
Correct Answer: B) Fluid resuscitation with a 20 mL/kg bolus
Rationale: This patient is presenting with Beck's Triad (hypotension,
, JVD, muffled heart sounds), which is indicative of pericardial
tamponade. The treatment in the prehospital setting is to maintain
preload through fluid administration while rapidly transporting for
surgical intervention. Needle decompression is for tension
pneumothorax.
6. A 55-year-old male has a large, deep laceration to his forearm from
a broken window. He is awake and alert but has a large pool of blood
under him. You apply direct pressure, but the wound continues to
bleed briskly. What is your next action?
A) Apply a tourniquet proximal to the wound
B) Elevate the arm above the heart
C) Apply pressure to the brachial artery pressure point
D) Pack the wound with sterile gauze and apply a pressure dressing
Correct Answer: A) Apply a tourniquet proximal to the wound
Rationale: When direct pressure fails to control life-threatening
extremity hemorrhage, the next step is to apply a tourniquet. This is a
critical intervention to prevent exsanguination. A tourniquet should be
applied 2-3 inches proximal to the wound but over a single bone
(humerus or femur) if possible.
7. A 48-year-old male is involved in a motorcycle accident. He is
complaining of severe pain in his left thigh, which is shortened and
externally rotated. He has a weak distal pulse. What is the most
appropriate splinting device for this injury?
A) Air splint
B) Board splint
C) Hare traction splint
D) Vacuum splint
| FULL-SPECTRUM QUESTION BANK COVERING ALL
TESTED TOPICS
1. A 45-year-old construction worker falls from a two-story scaffold,
landing on his feet. He is alert and complaining of severe bilateral heel
pain and mild lower back pain. His vital signs are BP 118/78, P 92, R
18. What is the most significant injury you should suspect based on
the mechanism of injury?
A) Pelvic fracture
B) Lumbar spine fracture
C) Bilateral calcaneus fractures
D) Femoral neck fractures
Correct Answer: B) Lumbar spine fracture
Rationale: Axial loading injuries, such as landing on the feet from a
significant height, transmit force up the skeletal system. While
calcaneus fractures are common, the force is often concentrated on the
lumbar spine, resulting in compression fractures. The absence of pelvic
instability and the mild back pain in the setting of a significant fall point
toward a spinal injury as the primary concern.
2. A 30-year-old male is involved in a high-speed motor vehicle
collision. He is complaining of shortness of breath and has a flail
segment on the left side of his chest. His trachea is midline, and
,breath sounds are equal bilaterally. Which of the following is the most
appropriate immediate intervention?
A) Needle decompression of the left chest
B) Positive pressure ventilation with a bag-valve mask
C) Application of an occlusive dressing over the flail segment
D) Assisting ventilations with a non-rebreather mask at 15 L/min
Correct Answer: B) Positive pressure ventilation with a bag-valve mask
Rationale: Flail chest, especially with shortness of breath, indicates
significant chest wall trauma and underlying pulmonary contusion. The
patient needs ventilation support. Positive pressure ventilation helps to
stabilize the flail segment by pushing the chest wall outward during
inspiration. An occlusive dressing is used for a sucking chest wound, not
flail chest. Needle decompression is for tension pneumothorax, which is
not indicated here.
3. A 22-year-old female is stabbed in the right side of her chest at the
midclavicular line, fifth intercostal space. She is anxious and
tachypneic. You note diminished breath sounds on the right side.
What is the immediate priority in managing this patient?
A) Applying a vented chest seal over the wound
B) Performing a needle decompression
C) Placing an occlusive dressing taped on three sides
D) Beginning chest compressions
Correct Answer: A) Applying a vented chest seal over the wound
Rationale: This is a classic presentation for an open pneumothorax or
"sucking chest wound." The immediate treatment is to apply an
occlusive dressing that is vented to allow air to escape but not re-enter
the pleural space. A standard occlusive dressing taped on three sides
,acts as a flutter valve, but a vented chest seal is now the standard of
care as it is designed for this purpose.
4. A 60-year-old male is ejected from his vehicle. He is found
unresponsive, with a GCS of 6. He has a large contusion over his right
flank. His blood pressure is 88/54, heart rate 118, and respirations 24.
What is the most likely cause of his hypotension?
A) Neurogenic shock
B) Cardiogenic shock
C) Hypovolemic shock from intra-abdominal bleeding
D) Obstructive shock from pericardial tamponade
Correct Answer: C) Hypovolemic shock from intra-abdominal bleeding
Rationale: The contusion over the right flank (Grey-Turner sign) is a late
sign of retroperitoneal or intra-abdominal bleeding. In a trauma patient,
hypotension with tachycardia and signs of injury to the torso is
hypovolemic shock until proven otherwise. Neurogenic shock would
present with hypotension and bradycardia.
5. A 16-year-old male sustains a penetrating injury to the left side of
his chest. On assessment, you note JVD, muffled heart sounds, and a
narrowing pulse pressure. His blood pressure is 82/66. Which of the
following interventions is most appropriate?
A) Needle decompression at the second intercostal space
B) Fluid resuscitation with a 20 mL/kg bolus
C) Application of a nasal cannula
D) Placement of a tourniquet on the left arm
Correct Answer: B) Fluid resuscitation with a 20 mL/kg bolus
Rationale: This patient is presenting with Beck's Triad (hypotension,
, JVD, muffled heart sounds), which is indicative of pericardial
tamponade. The treatment in the prehospital setting is to maintain
preload through fluid administration while rapidly transporting for
surgical intervention. Needle decompression is for tension
pneumothorax.
6. A 55-year-old male has a large, deep laceration to his forearm from
a broken window. He is awake and alert but has a large pool of blood
under him. You apply direct pressure, but the wound continues to
bleed briskly. What is your next action?
A) Apply a tourniquet proximal to the wound
B) Elevate the arm above the heart
C) Apply pressure to the brachial artery pressure point
D) Pack the wound with sterile gauze and apply a pressure dressing
Correct Answer: A) Apply a tourniquet proximal to the wound
Rationale: When direct pressure fails to control life-threatening
extremity hemorrhage, the next step is to apply a tourniquet. This is a
critical intervention to prevent exsanguination. A tourniquet should be
applied 2-3 inches proximal to the wound but over a single bone
(humerus or femur) if possible.
7. A 48-year-old male is involved in a motorcycle accident. He is
complaining of severe pain in his left thigh, which is shortened and
externally rotated. He has a weak distal pulse. What is the most
appropriate splinting device for this injury?
A) Air splint
B) Board splint
C) Hare traction splint
D) Vacuum splint
