FISDAP PARAMEDIC READINESS EXAM– QUESTIONS AND
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1. A 58-year-old male presents with acute onset crushing chest pain radiating to his left
arm and diaphoresis. Vital signs are BP 100/60, HR 118, RR 22, SpO2 91% on room air. A
12-lead ECG reveals ST-segment elevation in leads II, III, and aVF. Which of the following
coronary arteries is most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Circumflex artery
D. Left main coronary artery
ANSWER: B. Right coronary artery
The inferior wall of the left ventricle is supplied by the right coronary artery (RCA) in
approximately 85 to 90 percent of individuals. ST-segment elevation in leads II, III, and aVF
specifically points to an inferior wall myocardial infarction, which is classically associated
with RCA occlusion. The left anterior descending artery supplies the anterior wall (leads V1
through V4), the circumflex artery supplies the lateral wall (leads I, aVL, V5, and V6), and the
left main coronary artery typically causes extensive anterior and lateral ischemia or sudden
cardiogenic shock.
2. Paramedics arrive at an industrial site where a 34-year-old male was exposed to an
unknown chemical powder. The patient is coughing, dyspneic, and covered in a gray dust.
What is the immediate priority for the crew?
A. Administer high-flow oxygen via non-rebreather mask
B. Establish IV access and administer albuterol via nebulizer
C. Perform a rapid trauma assessment and apply a cervical collar
D. Ensure proper personal protective equipment (PPE) and initiate gross decontamination
ANSWER: D. Ensure proper personal protective equipment (PPE) and initiate gross
decontamination
,Scene safety and personal protection are the absolute first priorities in hazardous material
incidents. Entering a scene with an unknown toxic substance without appropriate PPE
endangers the crew. Decontamination of dry chemical powders requires brushing or washing
the agent off before medical treatment can safely and effectively proceed. Treating the patient
before gross decontamination risks secondary exposure to the EMS providers and worsening
cutaneous absorption.
3. A 68-year-old female with a history of chronic obstructive pulmonary disease (COPD)
presents with severe shortness of breath, tripod positioning, and pursed-lip breathing.
Auscultation reveals diminished breath sounds bilaterally with prolonged expiratory
phases. Vital signs are BP 140/88, HR 112, RR 28, SpO2 84% on room air. Which
intervention should be performed first?
A. Immediate endotracheal intubation
B. Administration of continuous nebulized albuterol and ipratropium
C. Initiation of non-invasive positive pressure ventilation (NPPV)
D. Administration of IV methylprednisolone
ANSWER: C. Initiation of non-invasive positive pressure ventilation (NPPV)
Non-invasive positive pressure ventilation, such as CPAP or BiPAP, is the gold standard for
managing acute exacerbations of COPD in patients experiencing respiratory fatigue and
hypoxia. NPPV decreases the work of breathing, reduces hypercarbia, and frequently avoids
the complications associated with invasive endotracheal intubation. While bronchodilators
and steroids are critical adjunctive treatments, correcting hypoventilation and respiratory
fatigue via NPPV is the immediate priority. Intubation is reserved for profound hemodynamic
instability or complete respiratory failure.
4. You are managing a 24-year-old motor vehicle collision victim who is unresponsive.
During your primary survey, you note absent breath sounds on the right side of the chest,
jugular venous distension, tracheal deviation to the left, and absent radial pulses. What is
the most appropriate immediate field intervention?
A. Needle decompression of the right 2nd intercostal space
B. Application of a three-sided occlusive dressing
C. Rapid fluid resuscitation via two large-bore IV lines
D. Immediate endotracheal intubation
ANSWER: A. Needle decompression of the right 2nd intercostal space
,The patient is presenting with classic signs of a life-threatening tension pneumothorax: absent
unilateral breath sounds, tracheal deviation, jugular venous distension, and signs of
obstructive shock (absent pulses). A tension pneumothorax requires immediate relief of intra-
thoracic pressure via needle decompression (typically at the second intercostal space at the
mid-clavicular line or the fifth intercostal space at the mid-axillary line) prior to or concurrent
with chest tube insertion. An occlusive dressing is used for open pneumothoraxes (sucking
chest wounds), and fluid resuscitation alone will not resolve obstructive shock caused by
elevated intrathoracic pressure.
5. A paramedic is assessing an 82-year-old nursing home resident with altered mental
status. Staff report the patient has been increasingly lethargic and confused over the past
24 hours. Vital signs are BP 82/50, HR 126, RR 24, Temperature 38.9°C (100.2°F), SpO2
92% on room air. Blood glucose is 110 mg/dL. What is the most likely underlying
pathophysiology?
A. Hypoglycemic crisis
B. Distributive shock secondary to sepsis
C. Cardiogenic shock secondary to acute myocardial infarction
D. Hypovolemic shock secondary to diabetic ketoacidosis
ANSWER: B. Distributive shock secondary to sepsis
The constellation of fever, tachycardia, hypotension, and altered mental status in an elderly
patient points strongly toward sepsis resulting in distributive shock. Systemic vasodilation and
capillary leak lead to profound relative hypovolemia and inadequate tissue perfusion.
Hypoglycemia is ruled out by the normal blood glucose reading, and there are no specific
markers for acute coronary syndrome or diabetic ketoacidosis provided. Prompt fluid
resuscitation and identification of the infection source are essential.
6. An unresponsive 45-year-old male is found by bystanders. The rhythm check on the
monitor shows coarse ventricular fibrillation. After confirming cardiac arrest and
initiating high-quality CPR, what is the next critical step in management?
A. Administer 1 mg of epinephrine IV push
B. Perform immediate synchronized cardioversion
C. Deliver a single defibrillation shock and resume CPR
D. Insert an advanced airway immediately
ANSWER: C. Deliver a single defibrillation shock and resume CPR
, Coarse ventricular fibrillation is a shockable cardiac arrest rhythm. Current resuscitation
guidelines emphasize early defibrillation with a single shock, followed immediately by high-
quality CPR for two minutes before checking the rhythm again. Epinephrine is administered
after initial shocks in refractory VF/pulseless VT. Immediate advanced airway placement
should not interrupt chest compressions or delay defibrillation. Synchronized cardioversion is
reserved for unstable patients with a pulse and an organized tachyarrhythmia, not cardiac
arrest.
7. A paramedic administers IV metoprolol to a patient experiencing rapid atrial
fibrillation. Ten minutes later, the patient becomes pale, diaphoretic, and complains of
dizziness. Vital signs show BP 70/40 and HR 45. What is the most appropriate
management?
A. Administer a repeat dose of metoprolol
B. Administer IV atropine and prepare for transcutaneous pacing
C. Perform synchronized cardioversion at 100 joules
D. Administer 500 mL normal saline fluid bolus only
ANSWER: B. Administer IV atropine and prepare for transcutaneous pacing
The patient is experiencing symptomatic bradycardia and hypotension resulting from beta-
blocker administration. The standard treatment algorithm for unstable symptomatic
bradycardia includes IV atropine. If atropine is ineffective, the paramedic must immediately
prepare for transcutaneous pacing and consider vasopressor infusions such as dopamine or
epinephrine. A fluid bolus alone is insufficient to manage profound drug-induced
symptomatic bradycardia.
8. You are managing a 7-year-old pediatric patient who was rescued from a residential
swimming pool. The child is apneic, pulseless, and cool to the touch. What is the
recommended compression-to-ventilation ratio for two-rescuer pediatric CPR?
A. 30:2
B. 15:2
C. 5:1
D. 10:1
ANSWER: B. 15:2
For two-rescuer CPR in infants and children (from birth through puberty), the recommended
compression-to-ventilation ratio is 15:2. This ratio optimizes oxygenation and ventilation for
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS PLUS
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE |
EXAM PREP | STUDY GUIDE | PRACTICE TEST| DOWNLOAD
INSTANT PDF
1. A 58-year-old male presents with acute onset crushing chest pain radiating to his left
arm and diaphoresis. Vital signs are BP 100/60, HR 118, RR 22, SpO2 91% on room air. A
12-lead ECG reveals ST-segment elevation in leads II, III, and aVF. Which of the following
coronary arteries is most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Circumflex artery
D. Left main coronary artery
ANSWER: B. Right coronary artery
The inferior wall of the left ventricle is supplied by the right coronary artery (RCA) in
approximately 85 to 90 percent of individuals. ST-segment elevation in leads II, III, and aVF
specifically points to an inferior wall myocardial infarction, which is classically associated
with RCA occlusion. The left anterior descending artery supplies the anterior wall (leads V1
through V4), the circumflex artery supplies the lateral wall (leads I, aVL, V5, and V6), and the
left main coronary artery typically causes extensive anterior and lateral ischemia or sudden
cardiogenic shock.
2. Paramedics arrive at an industrial site where a 34-year-old male was exposed to an
unknown chemical powder. The patient is coughing, dyspneic, and covered in a gray dust.
What is the immediate priority for the crew?
A. Administer high-flow oxygen via non-rebreather mask
B. Establish IV access and administer albuterol via nebulizer
C. Perform a rapid trauma assessment and apply a cervical collar
D. Ensure proper personal protective equipment (PPE) and initiate gross decontamination
ANSWER: D. Ensure proper personal protective equipment (PPE) and initiate gross
decontamination
,Scene safety and personal protection are the absolute first priorities in hazardous material
incidents. Entering a scene with an unknown toxic substance without appropriate PPE
endangers the crew. Decontamination of dry chemical powders requires brushing or washing
the agent off before medical treatment can safely and effectively proceed. Treating the patient
before gross decontamination risks secondary exposure to the EMS providers and worsening
cutaneous absorption.
3. A 68-year-old female with a history of chronic obstructive pulmonary disease (COPD)
presents with severe shortness of breath, tripod positioning, and pursed-lip breathing.
Auscultation reveals diminished breath sounds bilaterally with prolonged expiratory
phases. Vital signs are BP 140/88, HR 112, RR 28, SpO2 84% on room air. Which
intervention should be performed first?
A. Immediate endotracheal intubation
B. Administration of continuous nebulized albuterol and ipratropium
C. Initiation of non-invasive positive pressure ventilation (NPPV)
D. Administration of IV methylprednisolone
ANSWER: C. Initiation of non-invasive positive pressure ventilation (NPPV)
Non-invasive positive pressure ventilation, such as CPAP or BiPAP, is the gold standard for
managing acute exacerbations of COPD in patients experiencing respiratory fatigue and
hypoxia. NPPV decreases the work of breathing, reduces hypercarbia, and frequently avoids
the complications associated with invasive endotracheal intubation. While bronchodilators
and steroids are critical adjunctive treatments, correcting hypoventilation and respiratory
fatigue via NPPV is the immediate priority. Intubation is reserved for profound hemodynamic
instability or complete respiratory failure.
4. You are managing a 24-year-old motor vehicle collision victim who is unresponsive.
During your primary survey, you note absent breath sounds on the right side of the chest,
jugular venous distension, tracheal deviation to the left, and absent radial pulses. What is
the most appropriate immediate field intervention?
A. Needle decompression of the right 2nd intercostal space
B. Application of a three-sided occlusive dressing
C. Rapid fluid resuscitation via two large-bore IV lines
D. Immediate endotracheal intubation
ANSWER: A. Needle decompression of the right 2nd intercostal space
,The patient is presenting with classic signs of a life-threatening tension pneumothorax: absent
unilateral breath sounds, tracheal deviation, jugular venous distension, and signs of
obstructive shock (absent pulses). A tension pneumothorax requires immediate relief of intra-
thoracic pressure via needle decompression (typically at the second intercostal space at the
mid-clavicular line or the fifth intercostal space at the mid-axillary line) prior to or concurrent
with chest tube insertion. An occlusive dressing is used for open pneumothoraxes (sucking
chest wounds), and fluid resuscitation alone will not resolve obstructive shock caused by
elevated intrathoracic pressure.
5. A paramedic is assessing an 82-year-old nursing home resident with altered mental
status. Staff report the patient has been increasingly lethargic and confused over the past
24 hours. Vital signs are BP 82/50, HR 126, RR 24, Temperature 38.9°C (100.2°F), SpO2
92% on room air. Blood glucose is 110 mg/dL. What is the most likely underlying
pathophysiology?
A. Hypoglycemic crisis
B. Distributive shock secondary to sepsis
C. Cardiogenic shock secondary to acute myocardial infarction
D. Hypovolemic shock secondary to diabetic ketoacidosis
ANSWER: B. Distributive shock secondary to sepsis
The constellation of fever, tachycardia, hypotension, and altered mental status in an elderly
patient points strongly toward sepsis resulting in distributive shock. Systemic vasodilation and
capillary leak lead to profound relative hypovolemia and inadequate tissue perfusion.
Hypoglycemia is ruled out by the normal blood glucose reading, and there are no specific
markers for acute coronary syndrome or diabetic ketoacidosis provided. Prompt fluid
resuscitation and identification of the infection source are essential.
6. An unresponsive 45-year-old male is found by bystanders. The rhythm check on the
monitor shows coarse ventricular fibrillation. After confirming cardiac arrest and
initiating high-quality CPR, what is the next critical step in management?
A. Administer 1 mg of epinephrine IV push
B. Perform immediate synchronized cardioversion
C. Deliver a single defibrillation shock and resume CPR
D. Insert an advanced airway immediately
ANSWER: C. Deliver a single defibrillation shock and resume CPR
, Coarse ventricular fibrillation is a shockable cardiac arrest rhythm. Current resuscitation
guidelines emphasize early defibrillation with a single shock, followed immediately by high-
quality CPR for two minutes before checking the rhythm again. Epinephrine is administered
after initial shocks in refractory VF/pulseless VT. Immediate advanced airway placement
should not interrupt chest compressions or delay defibrillation. Synchronized cardioversion is
reserved for unstable patients with a pulse and an organized tachyarrhythmia, not cardiac
arrest.
7. A paramedic administers IV metoprolol to a patient experiencing rapid atrial
fibrillation. Ten minutes later, the patient becomes pale, diaphoretic, and complains of
dizziness. Vital signs show BP 70/40 and HR 45. What is the most appropriate
management?
A. Administer a repeat dose of metoprolol
B. Administer IV atropine and prepare for transcutaneous pacing
C. Perform synchronized cardioversion at 100 joules
D. Administer 500 mL normal saline fluid bolus only
ANSWER: B. Administer IV atropine and prepare for transcutaneous pacing
The patient is experiencing symptomatic bradycardia and hypotension resulting from beta-
blocker administration. The standard treatment algorithm for unstable symptomatic
bradycardia includes IV atropine. If atropine is ineffective, the paramedic must immediately
prepare for transcutaneous pacing and consider vasopressor infusions such as dopamine or
epinephrine. A fluid bolus alone is insufficient to manage profound drug-induced
symptomatic bradycardia.
8. You are managing a 7-year-old pediatric patient who was rescued from a residential
swimming pool. The child is apneic, pulseless, and cool to the touch. What is the
recommended compression-to-ventilation ratio for two-rescuer pediatric CPR?
A. 30:2
B. 15:2
C. 5:1
D. 10:1
ANSWER: B. 15:2
For two-rescuer CPR in infants and children (from birth through puberty), the recommended
compression-to-ventilation ratio is 15:2. This ratio optimizes oxygenation and ventilation for
