FISDAP Paramedic Final Exam 2026 | Comprehensive Practice
Questions with Answers & Rationales | Exam Prep Study Guide
Prepare for the FISDAP Paramedic Final Exam with this comprehensive study guide featuring original
practice questions, correct answers, and detailed rationales covering key paramedic concepts. Topics
include airway management, cardiology, trauma, medical emergencies, obstetrics, pediatrics,
pharmacology, EMS operations, and patient assessment. Designed to reinforce critical thinking,
strengthen clinical knowledge, and help you prepare confidently for the FISDAP Paramedic Final Exam.
QUESTION 1
A 30-year-old climber is experiencing severe shortness of breath after reaching an
elevation of 12,000 feet. The patient is very anxious and has rales noted to all quadrants
but is otherwise healthy. He is not accustomed to high altitudes. What should you do?
A) Administer oxygen while descending to a lower altitude
B) Coach the patient to slow his respirations
C) Apply CPAP while the patient adapts to the elevations
D) Evacuate the patient to a hyperbaric chamber
ANSWER: A) Administer oxygen while descending to a lower altitude
Rationale: High-altitude pulmonary edema (HAPE) is a life-threatening condition caused
by hypoxia-induced pulmonary vasoconstriction. The priority treatment is supplemental
oxygen and immediate descent to a lower altitude. CPAP may be temporizing, but descent
is definitive. Hyperbaric chambers are not typically available in the field.
,QUESTION 2
A 26-year-old female does not respond to verbal stimuli but moans in response to pain.
A friend states the patient has ingested approximately 150 amitriptyline tablets. Vital
signs are BP 88/50, R 16. You establish IV access and administer a fluid challenge. En
route to the hospital, her ECG shows a widening QRS. You should administer:
A) Amiodarone
B) Another fluid challenge
C) Calcium chloride
D) Sodium bicarbonate
ANSWER: D) Sodium bicarbonate
Rationale: Tricyclic antidepressant (TCA) toxicity causes sodium channel blockade, leading
to QRS widening. Sodium bicarbonate is the specific antidote, as it increases serum pH and
reduces protein binding of TCAs. It is indicated for QRS >100 ms or ventricular
arrhythmias. Amiodarone is not the primary treatment for TCA toxicity.
QUESTION 3
Your patient experienced trauma yesterday and you are transferring her to a larger
facility. She has been experiencing progressive hypoxia. You notice coarse crackles in all
lung fields on ventilation. Vital signs are BP 90/50, SpO2 90%. You should:
A) Increase IV fluid administration rate
B) Extubate and re-intubate the patient
C) Transport emergently and continue ventilation
D) Perform bilateral chest decompression and reassess
,ANSWER: C) Transport emergently and continue ventilation
Rationale: This patient is in respiratory distress with signs of pulmonary edema (crackles in
all fields, hypoxia). The priority is to transport emergently while maintaining ventilation
and oxygenation. Extubation would worsen the situation, and fluid boluses may
exacerbate pulmonary edema. Bilateral decompression is not indicated without signs of
pneumothorax.
QUESTION 4
A 45-year-old male is found unresponsive with gurgling respirations. What is your FIRST
action?
A) Insert an OPA
B) Suction the oropharynx
C) Bag-valve-mask ventilations
D) Nasotracheal intubation
ANSWER: B) Suction the oropharynx
Rationale: Gurgling indicates fluid in the airway. Suctioning must precede any airway
adjunct or ventilation to prevent aspiration. Airway first: clear the airway before securing
it.
QUESTION 5
, Which breath sound is typically heard FIRST in a developing tension pneumothorax?
A) Absent breath sounds bilaterally
B) Diminished breath sounds on the affected side
C) Rhonchi on the affected side
D) Wheezing on the unaffected side
ANSWER: B) Diminished breath sounds on the affected side
Rationale: As air accumulates in the pleural space, ventilation is reduced on that side.
Diminished breath sounds are an early sign. Absent sounds occur later in severe tension
pneumothorax. Rhonchi and wheezing are associated with airway obstruction, not
pneumothorax.
QUESTION 6
An alert 22-year-old male was just disentangled from debris in a house collapse. He
denies head or neck pain, but complains of severe hip pain. Vital signs: BP 88/40, P 120,
R 16. You should administer:
A) Epinephrine
B) Lidocaine
C) Sodium bicarbonate
D) Morphine sulfate
ANSWER: C) Sodium bicarbonate
Questions with Answers & Rationales | Exam Prep Study Guide
Prepare for the FISDAP Paramedic Final Exam with this comprehensive study guide featuring original
practice questions, correct answers, and detailed rationales covering key paramedic concepts. Topics
include airway management, cardiology, trauma, medical emergencies, obstetrics, pediatrics,
pharmacology, EMS operations, and patient assessment. Designed to reinforce critical thinking,
strengthen clinical knowledge, and help you prepare confidently for the FISDAP Paramedic Final Exam.
QUESTION 1
A 30-year-old climber is experiencing severe shortness of breath after reaching an
elevation of 12,000 feet. The patient is very anxious and has rales noted to all quadrants
but is otherwise healthy. He is not accustomed to high altitudes. What should you do?
A) Administer oxygen while descending to a lower altitude
B) Coach the patient to slow his respirations
C) Apply CPAP while the patient adapts to the elevations
D) Evacuate the patient to a hyperbaric chamber
ANSWER: A) Administer oxygen while descending to a lower altitude
Rationale: High-altitude pulmonary edema (HAPE) is a life-threatening condition caused
by hypoxia-induced pulmonary vasoconstriction. The priority treatment is supplemental
oxygen and immediate descent to a lower altitude. CPAP may be temporizing, but descent
is definitive. Hyperbaric chambers are not typically available in the field.
,QUESTION 2
A 26-year-old female does not respond to verbal stimuli but moans in response to pain.
A friend states the patient has ingested approximately 150 amitriptyline tablets. Vital
signs are BP 88/50, R 16. You establish IV access and administer a fluid challenge. En
route to the hospital, her ECG shows a widening QRS. You should administer:
A) Amiodarone
B) Another fluid challenge
C) Calcium chloride
D) Sodium bicarbonate
ANSWER: D) Sodium bicarbonate
Rationale: Tricyclic antidepressant (TCA) toxicity causes sodium channel blockade, leading
to QRS widening. Sodium bicarbonate is the specific antidote, as it increases serum pH and
reduces protein binding of TCAs. It is indicated for QRS >100 ms or ventricular
arrhythmias. Amiodarone is not the primary treatment for TCA toxicity.
QUESTION 3
Your patient experienced trauma yesterday and you are transferring her to a larger
facility. She has been experiencing progressive hypoxia. You notice coarse crackles in all
lung fields on ventilation. Vital signs are BP 90/50, SpO2 90%. You should:
A) Increase IV fluid administration rate
B) Extubate and re-intubate the patient
C) Transport emergently and continue ventilation
D) Perform bilateral chest decompression and reassess
,ANSWER: C) Transport emergently and continue ventilation
Rationale: This patient is in respiratory distress with signs of pulmonary edema (crackles in
all fields, hypoxia). The priority is to transport emergently while maintaining ventilation
and oxygenation. Extubation would worsen the situation, and fluid boluses may
exacerbate pulmonary edema. Bilateral decompression is not indicated without signs of
pneumothorax.
QUESTION 4
A 45-year-old male is found unresponsive with gurgling respirations. What is your FIRST
action?
A) Insert an OPA
B) Suction the oropharynx
C) Bag-valve-mask ventilations
D) Nasotracheal intubation
ANSWER: B) Suction the oropharynx
Rationale: Gurgling indicates fluid in the airway. Suctioning must precede any airway
adjunct or ventilation to prevent aspiration. Airway first: clear the airway before securing
it.
QUESTION 5
, Which breath sound is typically heard FIRST in a developing tension pneumothorax?
A) Absent breath sounds bilaterally
B) Diminished breath sounds on the affected side
C) Rhonchi on the affected side
D) Wheezing on the unaffected side
ANSWER: B) Diminished breath sounds on the affected side
Rationale: As air accumulates in the pleural space, ventilation is reduced on that side.
Diminished breath sounds are an early sign. Absent sounds occur later in severe tension
pneumothorax. Rhonchi and wheezing are associated with airway obstruction, not
pneumothorax.
QUESTION 6
An alert 22-year-old male was just disentangled from debris in a house collapse. He
denies head or neck pain, but complains of severe hip pain. Vital signs: BP 88/40, P 120,
R 16. You should administer:
A) Epinephrine
B) Lidocaine
C) Sodium bicarbonate
D) Morphine sulfate
ANSWER: C) Sodium bicarbonate
