FISDAP Paramedic Final Exam 2026/2027 Complete
Actual Exam |Questions & Verified Answers | Pass
Guarantee
TRAMA (Questions 1-20)
1. You are dispatched to a motorcycle versus guardrail on a rural highway. Law
enforcement on scene reports the rider was ejected 30 feet. The patient is a 28-year-old
male found supine in tall grass, unconscious with snoring respirations. You note
obvious deformity to the right femur, blood pooling beneath the head, and an intact
helmet. Primary assessment reveals: Airway: obstructed by blood and vomit; Breathing:
agonal, 6/min; Circulation: weak radial pulse, 140 bpm; Skin: pale, diaphoretic; GCS: 6
(E1V2M3). Vitals: BP 88/54, SpO2 78%, RR 6. What is your immediate priority
intervention?
A. Apply cervical collar and log-roll onto long backboard
B. Perform rapid sequence intubation with inline stabilization
C. Control scalp hemorrhage with pressure dressing
D. Administer 1 liter normal saline wide open
2. A 45-year-old construction worker fell 20 feet from scaffolding, landing on his left
side. He is awake and alert, complaining of left chest pain and dyspnea. You observe
paradoxical movement of the left chest wall with respiratory effort. Breath sounds are
diminished on the left with jugular vein distention. Vitals: BP 82/60, HR 130, RR 32,
SpO2 85%. Which intervention is most critical?
,A. Needle decompression at the second intercostal space, midclavicular line
B. Administration of 15 LPM O2 via non-rebreather mask
C. Stabilization of the flail segment with bulky dressings
D. Rapid sequence intubation with positive pressure ventilation
3. You respond to a single-vehicle MVC at 0200 hours. The 19-year-old restrained driver
struck a tree at approximately 45 mph. Airbags deployed. The patient is alert, oriented,
and complains of bilateral wrist pain. No chest, abdominal, or head pain. No loss of
consciousness. Vitals: BP 118/74, HR 88, RR 16, SpO2 98%, GCS 15. Physical exam
reveals bilateral distal radius deformities only. Which statement regarding spinal motion
restriction is most accurate?
A. Full spinal immobilization is mandatory due to mechanism of injury
B. Spinal motion restriction can be deferred based on NEXUS or Canadian C-spine
criteria
C. C-collar only is sufficient given no neurological complaints
D. Patient self-extrication eliminates need for any spinal precautions
4. A 55-year-old male was struck by a car at 35 mph. He has an obvious open fracture of
the right tibia with arterial bleeding. After failing to control bleeding with direct pressure,
you apply a combat application tourniquet (CAT) 3 inches proximal to the wound. The
patient screams in pain, becomes combative, and vitals are now: BP 76/40, HR 148, RR
28, SpO2 92%. What is your next appropriate action?
A. Loosen the tourniquet to assess for distal pulses
B. Apply a second tourniquet proximal to the first
C. Administer morphine sulfate 4 mg IV for pain management
D. Initiate a 250 mL normal saline bolus while preparing for rapid transport
5. A 34-year-old female, 32 weeks pregnant, is the restrained driver in a frontal impact
MVC at 40 mph. She complains of abdominal pain and vaginal bleeding. Vitals: BP
,94/62, HR 115, RR 24, SpO2 96%. Fetal heart tones are 110 bpm. Her uterus is firm and
tender. Which statement best describes your management priority?
A. Administer 2 liters crystalloid to target a BP of 120/80
B. Place patient in left lateral recumbent position and avoid spinal immobilization
C. Transport to closest hospital regardless of trauma center designation
D. Position patient supine with manual left uterine displacement for airway
management
6. You arrive on scene of a house fire where a 67-year-old male self-extricated. He has
singed nasal hairs, facial burns, and is coughing up carbonaceous sputum. He is
confused and agitated. Vitals: BP 104/68, HR 124, RR 36, SpO2 89%, Temp 99.1°F. You
note hoarseness and audible stridor. Which intervention is most appropriate?
A. Immediate nasotracheal intubation while patient is still breathing
B. High-concentration oxygen via non-rebreather mask while preparing for definitive
airway
C. Humidified cool mist oxygen via aerosol mask
D. CPAP at 10 cm H2O with 100% FiO2
7. A 23-year-old male sustained a single gunshot wound to the right lower quadrant of
the abdomen. He is pale, diaphoretic, and complains of severe abdominal pain. Vitals:
BP 88/50, HR 132, RR 28, SpO2 91%. Breath sounds are clear bilaterally. Chest x-ray
shows bilateral hemidiaphragms intact. Which statement about your management is
most accurate?
A. Observe abdomen for evisceration before covering with saline-moistened dressing
B. Perform FAST exam in the field to confirm intra-abdominal bleeding
C. Initiate permissive hypotension with 500 mL boluses to maintain SBP 80-90 mmHg
D. Insert nasogastric tube to decompress stomach before transport
, 8. During a mass casualty incident, you encounter a 30-year-old trauma patient with the
following: Airway open, breathing 28/min with diminished left-sided breath sounds,
radial pulse present at 110 bpm, follows commands, large chest wound with air leak.
Using START triage principles, what is the appropriate triage category?
A. Immediate (Red tag)
B. Delayed (Yellow tag)
C. Minor (Green tag)
D. Deceased (Black tag)
9. A 78-year-old female fell down 12 stairs, striking her head. She is on warfarin for atrial
fibrillation. She has a large occipital hematoma, is alert but confused, and complains of
headache. Vitals: BP 168/92, HR 88, RR 16, SpO2 95%, GCS 14 (E4V4M6). Which finding
would be most concerning for imminent decompensation?
A. Systolic blood pressure of 168 mmHg
B. Heart rate of 88 beats per minute
C. Development of bradycardia and widened pulse pressure
D. Confusion with GCS of 14
10. A 40-year-old male has 55% total body surface area full-thickness burns from a flash
fire in an industrial accident. Using the Rule of Nines, which fluid resuscitation
calculation for the first 8 hours is correct for a patient weighing 80 kg?
A. 7,040 mL of crystalloid
B. 8,800 mL of crystalloid
C. 10,560 mL of crystalloid
D. 12,320 mL of crystalloid
11. You are managing a multi-system trauma patient post-rollover MVC. The patient is
intubated, BP is 110/70 after 1 liter crystalloid, HR is 95, but you note distended neck
Actual Exam |Questions & Verified Answers | Pass
Guarantee
TRAMA (Questions 1-20)
1. You are dispatched to a motorcycle versus guardrail on a rural highway. Law
enforcement on scene reports the rider was ejected 30 feet. The patient is a 28-year-old
male found supine in tall grass, unconscious with snoring respirations. You note
obvious deformity to the right femur, blood pooling beneath the head, and an intact
helmet. Primary assessment reveals: Airway: obstructed by blood and vomit; Breathing:
agonal, 6/min; Circulation: weak radial pulse, 140 bpm; Skin: pale, diaphoretic; GCS: 6
(E1V2M3). Vitals: BP 88/54, SpO2 78%, RR 6. What is your immediate priority
intervention?
A. Apply cervical collar and log-roll onto long backboard
B. Perform rapid sequence intubation with inline stabilization
C. Control scalp hemorrhage with pressure dressing
D. Administer 1 liter normal saline wide open
2. A 45-year-old construction worker fell 20 feet from scaffolding, landing on his left
side. He is awake and alert, complaining of left chest pain and dyspnea. You observe
paradoxical movement of the left chest wall with respiratory effort. Breath sounds are
diminished on the left with jugular vein distention. Vitals: BP 82/60, HR 130, RR 32,
SpO2 85%. Which intervention is most critical?
,A. Needle decompression at the second intercostal space, midclavicular line
B. Administration of 15 LPM O2 via non-rebreather mask
C. Stabilization of the flail segment with bulky dressings
D. Rapid sequence intubation with positive pressure ventilation
3. You respond to a single-vehicle MVC at 0200 hours. The 19-year-old restrained driver
struck a tree at approximately 45 mph. Airbags deployed. The patient is alert, oriented,
and complains of bilateral wrist pain. No chest, abdominal, or head pain. No loss of
consciousness. Vitals: BP 118/74, HR 88, RR 16, SpO2 98%, GCS 15. Physical exam
reveals bilateral distal radius deformities only. Which statement regarding spinal motion
restriction is most accurate?
A. Full spinal immobilization is mandatory due to mechanism of injury
B. Spinal motion restriction can be deferred based on NEXUS or Canadian C-spine
criteria
C. C-collar only is sufficient given no neurological complaints
D. Patient self-extrication eliminates need for any spinal precautions
4. A 55-year-old male was struck by a car at 35 mph. He has an obvious open fracture of
the right tibia with arterial bleeding. After failing to control bleeding with direct pressure,
you apply a combat application tourniquet (CAT) 3 inches proximal to the wound. The
patient screams in pain, becomes combative, and vitals are now: BP 76/40, HR 148, RR
28, SpO2 92%. What is your next appropriate action?
A. Loosen the tourniquet to assess for distal pulses
B. Apply a second tourniquet proximal to the first
C. Administer morphine sulfate 4 mg IV for pain management
D. Initiate a 250 mL normal saline bolus while preparing for rapid transport
5. A 34-year-old female, 32 weeks pregnant, is the restrained driver in a frontal impact
MVC at 40 mph. She complains of abdominal pain and vaginal bleeding. Vitals: BP
,94/62, HR 115, RR 24, SpO2 96%. Fetal heart tones are 110 bpm. Her uterus is firm and
tender. Which statement best describes your management priority?
A. Administer 2 liters crystalloid to target a BP of 120/80
B. Place patient in left lateral recumbent position and avoid spinal immobilization
C. Transport to closest hospital regardless of trauma center designation
D. Position patient supine with manual left uterine displacement for airway
management
6. You arrive on scene of a house fire where a 67-year-old male self-extricated. He has
singed nasal hairs, facial burns, and is coughing up carbonaceous sputum. He is
confused and agitated. Vitals: BP 104/68, HR 124, RR 36, SpO2 89%, Temp 99.1°F. You
note hoarseness and audible stridor. Which intervention is most appropriate?
A. Immediate nasotracheal intubation while patient is still breathing
B. High-concentration oxygen via non-rebreather mask while preparing for definitive
airway
C. Humidified cool mist oxygen via aerosol mask
D. CPAP at 10 cm H2O with 100% FiO2
7. A 23-year-old male sustained a single gunshot wound to the right lower quadrant of
the abdomen. He is pale, diaphoretic, and complains of severe abdominal pain. Vitals:
BP 88/50, HR 132, RR 28, SpO2 91%. Breath sounds are clear bilaterally. Chest x-ray
shows bilateral hemidiaphragms intact. Which statement about your management is
most accurate?
A. Observe abdomen for evisceration before covering with saline-moistened dressing
B. Perform FAST exam in the field to confirm intra-abdominal bleeding
C. Initiate permissive hypotension with 500 mL boluses to maintain SBP 80-90 mmHg
D. Insert nasogastric tube to decompress stomach before transport
, 8. During a mass casualty incident, you encounter a 30-year-old trauma patient with the
following: Airway open, breathing 28/min with diminished left-sided breath sounds,
radial pulse present at 110 bpm, follows commands, large chest wound with air leak.
Using START triage principles, what is the appropriate triage category?
A. Immediate (Red tag)
B. Delayed (Yellow tag)
C. Minor (Green tag)
D. Deceased (Black tag)
9. A 78-year-old female fell down 12 stairs, striking her head. She is on warfarin for atrial
fibrillation. She has a large occipital hematoma, is alert but confused, and complains of
headache. Vitals: BP 168/92, HR 88, RR 16, SpO2 95%, GCS 14 (E4V4M6). Which finding
would be most concerning for imminent decompensation?
A. Systolic blood pressure of 168 mmHg
B. Heart rate of 88 beats per minute
C. Development of bradycardia and widened pulse pressure
D. Confusion with GCS of 14
10. A 40-year-old male has 55% total body surface area full-thickness burns from a flash
fire in an industrial accident. Using the Rule of Nines, which fluid resuscitation
calculation for the first 8 hours is correct for a patient weighing 80 kg?
A. 7,040 mL of crystalloid
B. 8,800 mL of crystalloid
C. 10,560 mL of crystalloid
D. 12,320 mL of crystalloid
11. You are managing a multi-system trauma patient post-rollover MVC. The patient is
intubated, BP is 110/70 after 1 liter crystalloid, HR is 95, but you note distended neck
