PARAMEDIC FISDAP FINAL EXAM 2026: 200 COMPREHENSIVE
PRACTICE QUESTIONS WITH CORRECT ANSWERS AND
RATIONALES
1. A 45-year-old male with a history of hypertension complains of a
sudden, severe "thunderclap" headache and nausea. He is alert but
anxious. Vital signs are BP 220/110, P 65, R 18. There is no focal
neurological deficit. What is the most likely diagnosis and the
appropriate initial management?
A) Ischemic stroke; administer tPA if within the window.
B) Hypertensive emergency; administer sublingual nifedipine.
C) Subarachnoid hemorrhage; maintain airway and control
hypertension.
D) Cluster headache; administer high-flow oxygen.
Correct Answer: C) Subarachnoid hemorrhage; maintain airway and
control hypertension.
Rationale: A "thunderclap" headache is the classic presentation for a
subarachnoid hemorrhage. While the blood pressure is severely
elevated, the priority is to avoid rapid correction to prevent further
ischemia. The main goal is to maintain the airway and transport for
definitive CT imaging.
2. A 6-year-old child is in cardiac arrest. The parent states the child has a
history of asthma. The cardiac monitor shows a narrow-complex
pulseless electrical activity (PEA) at a rate of 40. What is the most
appropriate next step?
,A) Administer a shock at 2 J/kg.
B) Start CPR and administer epinephrine.
C) Administer a fluid bolus of 20 ml/kg of normal saline.
D) Insert an advanced airway and provide continuous ventilations.
Correct Answer: B) Start CPR and administer epinephrine.
Rationale: The patient is in cardiac arrest. PEA is a non-shockable
rhythm. The immediate treatment is high-quality CPR and the
administration of epinephrine every 3-5 minutes. Fluid boluses are
considered if hypovolemia is suspected, but CPR and epinephrine are
the primary interventions.
3. A 35-year-old female is 32 weeks pregnant and is experiencing a
seizure. Her family reports she has had high blood pressure. Vital signs
are BP 170/110, P 100, R 20. What is the priority medication for this
patient?
A) Magnesium Sulfate.
B) Diazepam.
C) Lorazepam.
D) Phenytoin.
Correct Answer: A) Magnesium Sulfate.
Rationale: This patient is presenting with eclampsia, which is a seizure
occurring in a preeclamptic patient. Magnesium sulfate is the first-line
treatment to prevent and control seizures in this patient population,
unlike standard benzodiazepines used for other seizure types.
4. A 50-year-old male complains of severe chest pain radiating to his
back. He describes it as a "tearing" sensation. Vital signs are BP 140/80
in the right arm and 100/60 in the left arm. What should you suspect?
,A) Myocardial infarction.
B) Pericarditis.
C) Aortic dissection.
D) Pulmonary embolism.
Correct Answer: C) Aortic dissection.
Rationale: A "tearing" chest pain radiating to the back, combined with
a significant blood pressure differential between the arms, is the
classic presentation for an aortic dissection. This is a life-threatening
emergency requiring rapid transport and surgical intervention.
5. A 22-year-old male is found unresponsive in a dorm room with empty
pill bottles. His pupils are pinpoint and his respiratory rate is 6 per
minute. What is the most appropriate initial intervention?
A) Administer Naloxone 0.4 mg IV.
B) Provide bag-valve-mask ventilation.
C) Administer Dextrose 50% IV.
D) Perform a jaw-thrust maneuver.
Correct Answer: B) Provide bag-valve-mask ventilation.
Rationale: While pinpoint pupils and respiratory depression are classic
signs of an opioid overdose, the immediate threat to life is hypoxia.
Airway management and ventilation are the first priority, followed by
the administration of Naloxone.
6. A 68-year-old female complains of weakness and dizziness. Her ECG
reveals an irregular rhythm with no discernible P waves. The ventricular
rate is 160. What is the correct initial management for a conscious
patient with these findings?
A) Immediate synchronized cardioversion at 50 J.
B) Administer Adenosine 6 mg rapid IV push.
, C) Administer Diltiazem 20 mg IV.
D) Administer Amiodarone 150 mg IV over 10 minutes.
Correct Answer: C) Administer Diltiazem 20 mg IV.
Rationale: The ECG shows Atrial Fibrillation with a rapid ventricular
response. For a stable patient with rapid atrial fibrillation, the heart
rate is controlled with a rate-controlling agent like Diltiazem,
Metoprolol, or Digoxin. Synchronized cardioversion is for unstable
patients.
7. A 4-year-old child has a sudden onset of a barking cough and stridor.
He is sitting upright and drooling. What is the most likely diagnosis and
correct management?
A) Epiglottitis; prepare for immediate intubation.
B) Croup; administer nebulized racemic epinephrine.
C) Foreign body aspiration; perform abdominal thrusts.
D) Anaphylaxis; administer epinephrine.
Correct Answer: A) Epiglottitis; prepare for immediate intubation.
Rationale: The presentation of stridor, drooling, and a sudden onset in
a child is highly suspicious for epiglottitis. This is a life-threatening
airway emergency. While a nebulized epinephrine can help, these
patients require highly controlled airway management, often in an OR
setting, and should not be agitated.
8. A paramedic is preparing an IV infusion of Dopamine. The
concentration is 400 mg in 250 mL of D5W. The patient weighs 70 kg.
The order is to infuse at 5 mcg/kg/min. What is the drip rate in mL/hr?
A) 13.1 mL/hr.
B) 17.5 mL/hr.
C) 26.2 mL/hr.
PRACTICE QUESTIONS WITH CORRECT ANSWERS AND
RATIONALES
1. A 45-year-old male with a history of hypertension complains of a
sudden, severe "thunderclap" headache and nausea. He is alert but
anxious. Vital signs are BP 220/110, P 65, R 18. There is no focal
neurological deficit. What is the most likely diagnosis and the
appropriate initial management?
A) Ischemic stroke; administer tPA if within the window.
B) Hypertensive emergency; administer sublingual nifedipine.
C) Subarachnoid hemorrhage; maintain airway and control
hypertension.
D) Cluster headache; administer high-flow oxygen.
Correct Answer: C) Subarachnoid hemorrhage; maintain airway and
control hypertension.
Rationale: A "thunderclap" headache is the classic presentation for a
subarachnoid hemorrhage. While the blood pressure is severely
elevated, the priority is to avoid rapid correction to prevent further
ischemia. The main goal is to maintain the airway and transport for
definitive CT imaging.
2. A 6-year-old child is in cardiac arrest. The parent states the child has a
history of asthma. The cardiac monitor shows a narrow-complex
pulseless electrical activity (PEA) at a rate of 40. What is the most
appropriate next step?
,A) Administer a shock at 2 J/kg.
B) Start CPR and administer epinephrine.
C) Administer a fluid bolus of 20 ml/kg of normal saline.
D) Insert an advanced airway and provide continuous ventilations.
Correct Answer: B) Start CPR and administer epinephrine.
Rationale: The patient is in cardiac arrest. PEA is a non-shockable
rhythm. The immediate treatment is high-quality CPR and the
administration of epinephrine every 3-5 minutes. Fluid boluses are
considered if hypovolemia is suspected, but CPR and epinephrine are
the primary interventions.
3. A 35-year-old female is 32 weeks pregnant and is experiencing a
seizure. Her family reports she has had high blood pressure. Vital signs
are BP 170/110, P 100, R 20. What is the priority medication for this
patient?
A) Magnesium Sulfate.
B) Diazepam.
C) Lorazepam.
D) Phenytoin.
Correct Answer: A) Magnesium Sulfate.
Rationale: This patient is presenting with eclampsia, which is a seizure
occurring in a preeclamptic patient. Magnesium sulfate is the first-line
treatment to prevent and control seizures in this patient population,
unlike standard benzodiazepines used for other seizure types.
4. A 50-year-old male complains of severe chest pain radiating to his
back. He describes it as a "tearing" sensation. Vital signs are BP 140/80
in the right arm and 100/60 in the left arm. What should you suspect?
,A) Myocardial infarction.
B) Pericarditis.
C) Aortic dissection.
D) Pulmonary embolism.
Correct Answer: C) Aortic dissection.
Rationale: A "tearing" chest pain radiating to the back, combined with
a significant blood pressure differential between the arms, is the
classic presentation for an aortic dissection. This is a life-threatening
emergency requiring rapid transport and surgical intervention.
5. A 22-year-old male is found unresponsive in a dorm room with empty
pill bottles. His pupils are pinpoint and his respiratory rate is 6 per
minute. What is the most appropriate initial intervention?
A) Administer Naloxone 0.4 mg IV.
B) Provide bag-valve-mask ventilation.
C) Administer Dextrose 50% IV.
D) Perform a jaw-thrust maneuver.
Correct Answer: B) Provide bag-valve-mask ventilation.
Rationale: While pinpoint pupils and respiratory depression are classic
signs of an opioid overdose, the immediate threat to life is hypoxia.
Airway management and ventilation are the first priority, followed by
the administration of Naloxone.
6. A 68-year-old female complains of weakness and dizziness. Her ECG
reveals an irregular rhythm with no discernible P waves. The ventricular
rate is 160. What is the correct initial management for a conscious
patient with these findings?
A) Immediate synchronized cardioversion at 50 J.
B) Administer Adenosine 6 mg rapid IV push.
, C) Administer Diltiazem 20 mg IV.
D) Administer Amiodarone 150 mg IV over 10 minutes.
Correct Answer: C) Administer Diltiazem 20 mg IV.
Rationale: The ECG shows Atrial Fibrillation with a rapid ventricular
response. For a stable patient with rapid atrial fibrillation, the heart
rate is controlled with a rate-controlling agent like Diltiazem,
Metoprolol, or Digoxin. Synchronized cardioversion is for unstable
patients.
7. A 4-year-old child has a sudden onset of a barking cough and stridor.
He is sitting upright and drooling. What is the most likely diagnosis and
correct management?
A) Epiglottitis; prepare for immediate intubation.
B) Croup; administer nebulized racemic epinephrine.
C) Foreign body aspiration; perform abdominal thrusts.
D) Anaphylaxis; administer epinephrine.
Correct Answer: A) Epiglottitis; prepare for immediate intubation.
Rationale: The presentation of stridor, drooling, and a sudden onset in
a child is highly suspicious for epiglottitis. This is a life-threatening
airway emergency. While a nebulized epinephrine can help, these
patients require highly controlled airway management, often in an OR
setting, and should not be agitated.
8. A paramedic is preparing an IV infusion of Dopamine. The
concentration is 400 mg in 250 mL of D5W. The patient weighs 70 kg.
The order is to infuse at 5 mcg/kg/min. What is the drip rate in mL/hr?
A) 13.1 mL/hr.
B) 17.5 mL/hr.
C) 26.2 mL/hr.
