EMT FISDAP PARAMEDIC ENTRANCE EXAM 200
ACTUAL QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH RATIONALE ALREADY GRADED A+
200 questions covering the core content of the EMT FISDAP Paramedic Entrance
Exam. The questions span cardiac rhythms and management (including
defibrillation, antiarrhythmics, and synchronized cardioversion), respiratory
emergencies (asthma, COPD, pulmonary embolism, and pneumothorax), trauma
(spinal injuries, flail chest, burns, and hemorrhage control), pharmacology
(epinephrine, amiodarone, naloxone, and benzodiazepines), neurology (seizures,
stroke, and head injuries), and medical emergencies (anaphylaxis, diabetic
emergencies, and electrolyte disturbances). Each question includes a correct
answer and a detailed rationale explaining the clinical reasoning, pathophysiology,
or treatment algorithm behind it. The questions are designed to reflect the actual
exam's difficulty and subject distribution, with no duplication of clinical scenarios,
numerical values, medications, ECG rhythms, or treatment protocols across the
entire set.
1. A 45-year-old male complains of sudden, severe "tearing" chest pain radiating to
his back. His blood pressure is 160/90 mmHg in the right arm and 110/70 mmHg
in the left arm. What is the most likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Tension pneumothorax
Answer: C
Rationale: Aortic dissection classically presents with sudden, severe tearing chest
pain that radiates to the back, along with a differential blood pressure (≥20 mmHg
difference) between arms. This is a true emergency requiring immediate transport.
2. A 6-year-old child is choking and cannot speak or cough. What maneuver
should you perform?
A. Back blows and chest thrusts
B. Abdominal thrusts (Heimlich)
C. Finger sweep of the mouth
D. Blind finger sweep
Answer: A
,Rationale: For a conscious choking child under 8 years, the American Heart
Association recommends back blows followed by chest thrusts. Abdominal thrusts
are for adults/older children and can cause organ injury in young children.
3. A patient with a history of diabetes is found unresponsive with a blood glucose
of 32 mg/dL. You are unable to establish IV access. What medication should you
administer?
A. Oral glucose paste
B. Glucagon 1 mg IM
C. D50W IV push
D. Insulin 10 units IV
Answer: B
Rationale: Glucagon is given IM when IV access cannot be obtained. It stimulates
glycogen breakdown in the liver to raise blood glucose. Oral glucose is
contraindicated in unresponsive patients due to aspiration risk.
4. What is the normal end-tidal CO2 (EtCO2) range for a healthy adult?
A. 15-25 mmHg
B. 25-35 mmHg
C. 35-45 mmHg
D. 45-55 mmHg
Answer: C
Rationale: Normal EtCO2 is 35-45 mmHg. Values below indicate hyperventilation
or poor perfusion; above indicate hypoventilation or respiratory depression.
5. A patient has a crush injury to the chest with paradoxical chest wall movement.
This is most consistent with:
A. Simple pneumothorax
B. Flail chest
C. Cardiac tamponade
D. Hemothorax
Answer: B
Rationale: Flail chest occurs when two or more adjacent ribs are fractured in two
or more places, creating a free-floating segment that moves opposite to the rest of
the chest during respiration (paradoxical movement).
6. You are treating a patient with severe anaphylaxis. What is the first-line
medication?
A. Albuterol nebulizer
B. Diphenhydramine IV
,C. Epinephrine 1:1000 IM
D. Methylprednisolone IV
Answer: C
Rationale: Epinephrine is the first-line treatment for anaphylaxis. The IM route
(0.3 mg of 1:1000) is preferred because it is rapidly absorbed even in the setting of
poor perfusion.
7. A patient presents with a heart rate of 220 bpm, wide QRS complexes, and is
hypotensive. What is the appropriate immediate action?
A. Vagal maneuvers
B. Adenosine 6 mg rapid IV push
C. Synchronized cardioversion
D. Defibrillation
Answer: C
Rationale: A wide-complex tachycardia with hemodynamic instability
(hypotension) requires immediate synchronized cardioversion. Adenosine is for
narrow-complex regular tachycardias; defibrillation is for pulseless rhythms.
8. A 30-year-old female is 8 months pregnant and has a tonic-clonic seizure. She
has no history of seizures. What is the most likely cause?
A. Eclampsia
B. Epilepsy
C. Brain tumor
D. Hypoglycemia
Answer: A
Rationale: Eclampsia is defined as new-onset seizures in a pregnant woman with
pre-eclampsia (hypertension and proteinuria). It typically occurs after 20 weeks
gestation.
9. A patient has an open pneumothorax with a 2 cm wound. What is the best initial
intervention?
A. Apply an occlusive dressing taped on three sides
B. Apply a sterile gauze dressing with pressure
C. Insert a 14-gauge needle into the 2nd intercostal space
D. Apply an occlusive dressing taped on all four sides
Answer: A
Rationale: A three-sided occlusive dressing allows air to escape on exhalation but
prevents air from entering on inhalation, converting an open pneumothorax to a
simple one. A four-sided seal can create a tension pneumothorax.
, 10. What is the dose of epinephrine for cardiac arrest in a 70 kg adult?
A. 0.1 mg every 3-5 minutes
B. 0.5 mg every 3-5 minutes
C. 1 mg every 3-5 minutes
D. 5 mg every 3-5 minutes
Answer: C
Rationale: The adult cardiac arrest dose of epinephrine is 1 mg (1:10,000
concentration) IV/IO every 3-5 minutes. Higher doses have not been shown to
improve outcomes.
11. A patient is found down in a hot room with hot, dry skin, and a core
temperature of 105°F. What is the priority treatment?
A. Give oral fluids with electrolytes
B. Apply ice packs to the groin and axillae
C. Administer antipyretics
D. Wrap the patient in warm blankets
Answer: B
Rationale: This is heat stroke. Immediate cooling with ice packs to the groin,
axillae, and neck, combined with cold IV fluids, is priority. Antipyretics are
ineffective for heat stroke.
12. A patient has a suspected spinal injury. Which airway maneuver is safest?
A. Head tilt-chin lift
B. Jaw-thrust maneuver
C. Neck extension
D. Sellick maneuver
Answer: B
Rationale: The jaw-thrust maneuver opens the airway without moving the cervical
spine, making it the preferred method for patients with suspected spinal injury.
13. A patient is in a motor vehicle crash and has a "steering wheel" bruise on the
chest. He is now tachycardic, hypotensive, and has jugular venous distension.
What condition is most likely?
A. Tension pneumothorax
B. Cardiac tamponade
C. Massive hemothorax
D. Pericardial effusion
Answer: B
ACTUAL QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH RATIONALE ALREADY GRADED A+
200 questions covering the core content of the EMT FISDAP Paramedic Entrance
Exam. The questions span cardiac rhythms and management (including
defibrillation, antiarrhythmics, and synchronized cardioversion), respiratory
emergencies (asthma, COPD, pulmonary embolism, and pneumothorax), trauma
(spinal injuries, flail chest, burns, and hemorrhage control), pharmacology
(epinephrine, amiodarone, naloxone, and benzodiazepines), neurology (seizures,
stroke, and head injuries), and medical emergencies (anaphylaxis, diabetic
emergencies, and electrolyte disturbances). Each question includes a correct
answer and a detailed rationale explaining the clinical reasoning, pathophysiology,
or treatment algorithm behind it. The questions are designed to reflect the actual
exam's difficulty and subject distribution, with no duplication of clinical scenarios,
numerical values, medications, ECG rhythms, or treatment protocols across the
entire set.
1. A 45-year-old male complains of sudden, severe "tearing" chest pain radiating to
his back. His blood pressure is 160/90 mmHg in the right arm and 110/70 mmHg
in the left arm. What is the most likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Tension pneumothorax
Answer: C
Rationale: Aortic dissection classically presents with sudden, severe tearing chest
pain that radiates to the back, along with a differential blood pressure (≥20 mmHg
difference) between arms. This is a true emergency requiring immediate transport.
2. A 6-year-old child is choking and cannot speak or cough. What maneuver
should you perform?
A. Back blows and chest thrusts
B. Abdominal thrusts (Heimlich)
C. Finger sweep of the mouth
D. Blind finger sweep
Answer: A
,Rationale: For a conscious choking child under 8 years, the American Heart
Association recommends back blows followed by chest thrusts. Abdominal thrusts
are for adults/older children and can cause organ injury in young children.
3. A patient with a history of diabetes is found unresponsive with a blood glucose
of 32 mg/dL. You are unable to establish IV access. What medication should you
administer?
A. Oral glucose paste
B. Glucagon 1 mg IM
C. D50W IV push
D. Insulin 10 units IV
Answer: B
Rationale: Glucagon is given IM when IV access cannot be obtained. It stimulates
glycogen breakdown in the liver to raise blood glucose. Oral glucose is
contraindicated in unresponsive patients due to aspiration risk.
4. What is the normal end-tidal CO2 (EtCO2) range for a healthy adult?
A. 15-25 mmHg
B. 25-35 mmHg
C. 35-45 mmHg
D. 45-55 mmHg
Answer: C
Rationale: Normal EtCO2 is 35-45 mmHg. Values below indicate hyperventilation
or poor perfusion; above indicate hypoventilation or respiratory depression.
5. A patient has a crush injury to the chest with paradoxical chest wall movement.
This is most consistent with:
A. Simple pneumothorax
B. Flail chest
C. Cardiac tamponade
D. Hemothorax
Answer: B
Rationale: Flail chest occurs when two or more adjacent ribs are fractured in two
or more places, creating a free-floating segment that moves opposite to the rest of
the chest during respiration (paradoxical movement).
6. You are treating a patient with severe anaphylaxis. What is the first-line
medication?
A. Albuterol nebulizer
B. Diphenhydramine IV
,C. Epinephrine 1:1000 IM
D. Methylprednisolone IV
Answer: C
Rationale: Epinephrine is the first-line treatment for anaphylaxis. The IM route
(0.3 mg of 1:1000) is preferred because it is rapidly absorbed even in the setting of
poor perfusion.
7. A patient presents with a heart rate of 220 bpm, wide QRS complexes, and is
hypotensive. What is the appropriate immediate action?
A. Vagal maneuvers
B. Adenosine 6 mg rapid IV push
C. Synchronized cardioversion
D. Defibrillation
Answer: C
Rationale: A wide-complex tachycardia with hemodynamic instability
(hypotension) requires immediate synchronized cardioversion. Adenosine is for
narrow-complex regular tachycardias; defibrillation is for pulseless rhythms.
8. A 30-year-old female is 8 months pregnant and has a tonic-clonic seizure. She
has no history of seizures. What is the most likely cause?
A. Eclampsia
B. Epilepsy
C. Brain tumor
D. Hypoglycemia
Answer: A
Rationale: Eclampsia is defined as new-onset seizures in a pregnant woman with
pre-eclampsia (hypertension and proteinuria). It typically occurs after 20 weeks
gestation.
9. A patient has an open pneumothorax with a 2 cm wound. What is the best initial
intervention?
A. Apply an occlusive dressing taped on three sides
B. Apply a sterile gauze dressing with pressure
C. Insert a 14-gauge needle into the 2nd intercostal space
D. Apply an occlusive dressing taped on all four sides
Answer: A
Rationale: A three-sided occlusive dressing allows air to escape on exhalation but
prevents air from entering on inhalation, converting an open pneumothorax to a
simple one. A four-sided seal can create a tension pneumothorax.
, 10. What is the dose of epinephrine for cardiac arrest in a 70 kg adult?
A. 0.1 mg every 3-5 minutes
B. 0.5 mg every 3-5 minutes
C. 1 mg every 3-5 minutes
D. 5 mg every 3-5 minutes
Answer: C
Rationale: The adult cardiac arrest dose of epinephrine is 1 mg (1:10,000
concentration) IV/IO every 3-5 minutes. Higher doses have not been shown to
improve outcomes.
11. A patient is found down in a hot room with hot, dry skin, and a core
temperature of 105°F. What is the priority treatment?
A. Give oral fluids with electrolytes
B. Apply ice packs to the groin and axillae
C. Administer antipyretics
D. Wrap the patient in warm blankets
Answer: B
Rationale: This is heat stroke. Immediate cooling with ice packs to the groin,
axillae, and neck, combined with cold IV fluids, is priority. Antipyretics are
ineffective for heat stroke.
12. A patient has a suspected spinal injury. Which airway maneuver is safest?
A. Head tilt-chin lift
B. Jaw-thrust maneuver
C. Neck extension
D. Sellick maneuver
Answer: B
Rationale: The jaw-thrust maneuver opens the airway without moving the cervical
spine, making it the preferred method for patients with suspected spinal injury.
13. A patient is in a motor vehicle crash and has a "steering wheel" bruise on the
chest. He is now tachycardic, hypotensive, and has jugular venous distension.
What condition is most likely?
A. Tension pneumothorax
B. Cardiac tamponade
C. Massive hemothorax
D. Pericardial effusion
Answer: B
