Paramedic FISDAP Final Exam 2025–2026 – 200
Questions and Correct Answers – Latest Compreh
1. A 34-year-old male is unresponsive, apneic, and pulseless. You insert an OPA and begin BVM
ventilations. Which finding best confirms adequate ventilation?
A. Visible chest rise with each squeeze
B. Chest rise and fall with each ventilation
C. Audible air escaping around the mask
D. Gastric distention
Rationale: Adequate BVM ventilation is confirmed by visible chest rise and fall. Gastric
distention indicates air entering the stomach (excessive pressure/volume or poor airway
positioning). Air escaping around the mask indicates a leak.
2. Which of the following are signs of inadequate oxygenation? (Select All That Apply)
A. Cyanosis
B. Altered mental status
C. Warm, dry skin
D. Restlessness and anxiety
E. SpO₂ of 88% on room air
Rationale: Hypoxia presents with cyanosis, AMS, restlessness, and low SpO₂. Warm, dry skin
is not a sign of hypoxia.
3. You are ventilating an adult with a BVM. The most appropriate rate is:
A. 6–8 breaths/min
B. 10–12 breaths/min
C. 20–24 breaths/min
D. 30 breaths/min
Rationale: For an adult with a pulse but not breathing adequately, ventilate 10–12
breaths/min (one every 5–6 seconds). Excessive rates cause gastric insufflation and decreased
cardiac output.
,4. A patient with a severe asthma attack has audible wheezing and accessory muscle use. Which
medication is indicated FIRST?
A. Oral prednisone
B. Albuterol via nebulizer
C. Ipratropium only
D. Epinephrine IM
Rationale: Albuterol (short-acting beta-2 agonist) is first-line for acute bronchospasm.
Ipratropium is often added but is not the initial monotherapy. IM epi is reserved for
severe/refractory cases.
5. Which of the following are contraindications to oropharyngeal airway (OPA) insertion? (Select
All That Apply)
A. Intact gag reflex
B. Conscious, alert patient
C. Unresponsive patient without gag reflex
D. Severe facial trauma with distorted anatomy
E. Apneic patient
Rationale: OPAs require an absent gag reflex. They are contraindicated in conscious
patients, those with intact gag, and facial trauma where insertion could worsen injury.
Apneic/unresponsive patients without gag are candidates.
6. Capnography on an intubated patient suddenly shows a waveform that drops to zero. What is
the MOST likely cause?
A. Hyperventilation
B. Tube dislodgement
C. Hypothermia
D. Metabolic alkalosis
Rationale: A sudden loss of ETCO₂ waveform indicates the tube is no longer in the trachea
(dislodgement or esophageal placement). Confirm with direct visualization and auscultation.
7. A 68-year-old with COPD has an SpO₂ of 84%. What is the target SpO₂?
,A. 100%
B. 88–92%
C. 80–85%
D. 94–98%
Rationale: In COPD patients with chronic CO₂ retention, target SpO₂ 88–92% to avoid
suppressing hypoxic drive and worsening hypercapnia.
8. Which device delivers the highest concentration of oxygen?
A. Nasal cannula at 6 LPM
B. Simple face mask at 10 LPM
C. Non-rebreather mask at 15 LPM
D. Venturi mask at 40%
Rationale: A non-rebreather at 15 LPM delivers ~90–100% FiO₂, the highest of these
options.
9. A patient is in respiratory failure with shallow respirations at 6/min and SpO₂ 82%. What is
the priority intervention?
A. Apply a nasal cannula
B. Assist ventilations with a BVM
C. Start CPAP
D. Insert an OPA
Rationale: Inadequate rate/depth with hypoxia requires assisted ventilation. CPAP is for
patients with adequate respiratory drive. BVM support is the immediate priority.
10. Which of the following are complications of over-ventilation with a BVM? (Select All That
Apply)
A. Gastric distention
B. Decreased venous return
C. Vomiting and aspiration
D. Improved cardiac output
E. Hyperventilation-induced hypocapnia
, Rationale: Over-ventilation increases intrathoracic pressure (decreasing venous return/CO),
causes gastric insufflation (vomiting/aspiration risk), and blows off CO₂ (hypocapnia). It does not
improve cardiac output.
11. A patient with a tracheostomy is in respiratory distress. The stoma is patent but the patient
is cyanotic. What should you do FIRST?
A. Perform oral intubation
B. Suction the tracheostomy tube
C. Remove the tube immediately
D. Apply a nasal cannula
Rationale: A common cause of tracheostomy distress is mucus plugging. Suction first. If
unsuccessful, consider tube exchange.
12. Which statement about CPAP is correct?
A. It is contraindicated in pulmonary edema
B. It provides positive pressure to keep alveoli open
C. It requires an advanced airway
D. It should be used in patients who are apneic
Rationale: CPAP provides continuous positive airway pressure, improving oxygenation and
reducing work of breathing. It is indicated in pulmonary edema, not apneic patients.
13. A 22-year-old is choking and unable to speak or cough. What is the immediate action?
A. Encourage forceful coughing
B. Deliver abdominal thrusts (Heimlich)
C. Perform a blind finger sweep
D. Begin rescue breaths
Rationale: Complete airway obstruction in a conscious adult is managed with abdominal
thrusts. Blind finger sweeps are contraindicated.
14. Which of the following are advantages of a supraglottic airway (e.g., King LT) over
endotracheal intubation? (Select All That Apply)
Questions and Correct Answers – Latest Compreh
1. A 34-year-old male is unresponsive, apneic, and pulseless. You insert an OPA and begin BVM
ventilations. Which finding best confirms adequate ventilation?
A. Visible chest rise with each squeeze
B. Chest rise and fall with each ventilation
C. Audible air escaping around the mask
D. Gastric distention
Rationale: Adequate BVM ventilation is confirmed by visible chest rise and fall. Gastric
distention indicates air entering the stomach (excessive pressure/volume or poor airway
positioning). Air escaping around the mask indicates a leak.
2. Which of the following are signs of inadequate oxygenation? (Select All That Apply)
A. Cyanosis
B. Altered mental status
C. Warm, dry skin
D. Restlessness and anxiety
E. SpO₂ of 88% on room air
Rationale: Hypoxia presents with cyanosis, AMS, restlessness, and low SpO₂. Warm, dry skin
is not a sign of hypoxia.
3. You are ventilating an adult with a BVM. The most appropriate rate is:
A. 6–8 breaths/min
B. 10–12 breaths/min
C. 20–24 breaths/min
D. 30 breaths/min
Rationale: For an adult with a pulse but not breathing adequately, ventilate 10–12
breaths/min (one every 5–6 seconds). Excessive rates cause gastric insufflation and decreased
cardiac output.
,4. A patient with a severe asthma attack has audible wheezing and accessory muscle use. Which
medication is indicated FIRST?
A. Oral prednisone
B. Albuterol via nebulizer
C. Ipratropium only
D. Epinephrine IM
Rationale: Albuterol (short-acting beta-2 agonist) is first-line for acute bronchospasm.
Ipratropium is often added but is not the initial monotherapy. IM epi is reserved for
severe/refractory cases.
5. Which of the following are contraindications to oropharyngeal airway (OPA) insertion? (Select
All That Apply)
A. Intact gag reflex
B. Conscious, alert patient
C. Unresponsive patient without gag reflex
D. Severe facial trauma with distorted anatomy
E. Apneic patient
Rationale: OPAs require an absent gag reflex. They are contraindicated in conscious
patients, those with intact gag, and facial trauma where insertion could worsen injury.
Apneic/unresponsive patients without gag are candidates.
6. Capnography on an intubated patient suddenly shows a waveform that drops to zero. What is
the MOST likely cause?
A. Hyperventilation
B. Tube dislodgement
C. Hypothermia
D. Metabolic alkalosis
Rationale: A sudden loss of ETCO₂ waveform indicates the tube is no longer in the trachea
(dislodgement or esophageal placement). Confirm with direct visualization and auscultation.
7. A 68-year-old with COPD has an SpO₂ of 84%. What is the target SpO₂?
,A. 100%
B. 88–92%
C. 80–85%
D. 94–98%
Rationale: In COPD patients with chronic CO₂ retention, target SpO₂ 88–92% to avoid
suppressing hypoxic drive and worsening hypercapnia.
8. Which device delivers the highest concentration of oxygen?
A. Nasal cannula at 6 LPM
B. Simple face mask at 10 LPM
C. Non-rebreather mask at 15 LPM
D. Venturi mask at 40%
Rationale: A non-rebreather at 15 LPM delivers ~90–100% FiO₂, the highest of these
options.
9. A patient is in respiratory failure with shallow respirations at 6/min and SpO₂ 82%. What is
the priority intervention?
A. Apply a nasal cannula
B. Assist ventilations with a BVM
C. Start CPAP
D. Insert an OPA
Rationale: Inadequate rate/depth with hypoxia requires assisted ventilation. CPAP is for
patients with adequate respiratory drive. BVM support is the immediate priority.
10. Which of the following are complications of over-ventilation with a BVM? (Select All That
Apply)
A. Gastric distention
B. Decreased venous return
C. Vomiting and aspiration
D. Improved cardiac output
E. Hyperventilation-induced hypocapnia
, Rationale: Over-ventilation increases intrathoracic pressure (decreasing venous return/CO),
causes gastric insufflation (vomiting/aspiration risk), and blows off CO₂ (hypocapnia). It does not
improve cardiac output.
11. A patient with a tracheostomy is in respiratory distress. The stoma is patent but the patient
is cyanotic. What should you do FIRST?
A. Perform oral intubation
B. Suction the tracheostomy tube
C. Remove the tube immediately
D. Apply a nasal cannula
Rationale: A common cause of tracheostomy distress is mucus plugging. Suction first. If
unsuccessful, consider tube exchange.
12. Which statement about CPAP is correct?
A. It is contraindicated in pulmonary edema
B. It provides positive pressure to keep alveoli open
C. It requires an advanced airway
D. It should be used in patients who are apneic
Rationale: CPAP provides continuous positive airway pressure, improving oxygenation and
reducing work of breathing. It is indicated in pulmonary edema, not apneic patients.
13. A 22-year-old is choking and unable to speak or cough. What is the immediate action?
A. Encourage forceful coughing
B. Deliver abdominal thrusts (Heimlich)
C. Perform a blind finger sweep
D. Begin rescue breaths
Rationale: Complete airway obstruction in a conscious adult is managed with abdominal
thrusts. Blind finger sweeps are contraindicated.
14. Which of the following are advantages of a supraglottic airway (e.g., King LT) over
endotracheal intubation? (Select All That Apply)
