FISDAP PARAMEDIC FINAL LATEST
EXAM Paramedic FISDAP Final Exam Test
Bank | Real Exam 600+ Questions | A+ Grade
| Complete 2025/2026
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: The patient is showing signs of High Altitude Pulmonary Edema
(HAPE), indicated by rales in all lung fields and severe dyspnea after rapid ascent.
The definitive treatment for HAPE is immediate descent to a lower altitude
combined with high-flow oxygen. CPAP may help temporarily but does not
address the underlying cause. Hyperbaric chambers are not typically available in
the field, and descent remains the priority intervention.
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: Amitriptyline is a tricyclic antidepressant (TCA) that causes
sodium channel blockade in overdose, leading to widened QRS complex and risk
of ventricular dysrhythmias. Sodium bicarbonate is the treatment of choice for
TCA overdose with wide QRS because it increases serum pH, which dissociates
the drug from sodium channels. Amiodarone is not indicated and could worsen the
condition.
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 and 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: Coarse crackles in all lung fields following trauma suggest
developing acute respiratory distress syndrome (ARDS) or pulmonary contusion.
The priority is rapid transport to a definitive care facility while maintaining
adequate ventilation. Bilateral chest decompression is not indicated without signs
of tension pneumothorax. Increasing fluids could worsen pulmonary edema in this
context.
,QUESTION 4
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 are BP
88/40, P 120, R 16. You should administer:
A) Epinephrine
B) Lidocaine
C) Sodium bicarbonate
D) Morphine sulfate
ANSWER: C) Sodium bicarbonate
RATIONALE: Crush injury from entrapment can cause rhabdomyolysis and
release of intracellular contents, leading to metabolic acidosis and hyperkalemia.
Sodium bicarbonate helps correct acidosis and drives potassium back into cells.
The hypotension is likely due to distributive shock from reperfusion injury.
Morphine could worsen hypotension.
QUESTION 5
Braxton Hicks contractions:
A) Are mild and signal the beginning of labor
B) Occur in the second trimester and are false labor
C) Cause extreme back and abdominal discomfort
D) Cause dilation and effacement of the cervix
ANSWER: B) Occur in the second trimester and are false labor
RATIONALE: Braxton Hicks contractions are irregular, painless uterine
contractions that occur during the second and third trimesters but do not cause
cervical change. They are often described as "false labor" and typically resolve
with position change or hydration. True labor contractions become regular,
increase in intensity, and cause progressive cervical dilation and effacement.
, QUESTION 6
A 40-year-old male crashed his motorcycle. He had a brief loss of consciousness,
woke up and walked home. You find him 2 hours later at home unconscious. You
should suspect:
A) Subdural hematoma
B) Subarachnoid bleed
C) Basilar skull fracture
D) Epidural hematoma
ANSWER: D) Epidural hematoma
RATIONALE: Epidural hematoma classically presents with a lucid interval
following head trauma, where the patient briefly regains consciousness before
deteriorating neurologically. This occurs because arterial bleeding (typically from
the middle meningeal artery) accumulates rapidly between the skull and dura
mater. Subdural hematoma typically has a slower onset without a lucid interval in
elderly or alcoholic patients.
QUESTION 7
A 47-year-old male who was found unconscious on the side of the road responds
only to painful stimulus. When you attempt to establish IV access he stiffens his
arms and legs. He has minor abrasions all over his body. Vital signs are BP
178/122, P 56, R irregular, ETCO2 30. What should you do?
A) Mildly hypoventilate with a bag valve mask
B) Assist ventilations at 12 breaths per minute
C) Administer a 250 mL normal saline bolus
D) Administer 25 g of dextrose
ANSWER: B) Assist ventilations at 12 breaths per minute
RATIONALE: The patient has signs of increased intracranial pressure (Cushing's
triad: hypertension, bradycardia, irregular respirations). The low ETCO2 (30
mmHg) indicates hyperventilation and potential cerebral ischemia. The goal is to
EXAM Paramedic FISDAP Final Exam Test
Bank | Real Exam 600+ Questions | A+ Grade
| Complete 2025/2026
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: The patient is showing signs of High Altitude Pulmonary Edema
(HAPE), indicated by rales in all lung fields and severe dyspnea after rapid ascent.
The definitive treatment for HAPE is immediate descent to a lower altitude
combined with high-flow oxygen. CPAP may help temporarily but does not
address the underlying cause. Hyperbaric chambers are not typically available in
the field, and descent remains the priority intervention.
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: Amitriptyline is a tricyclic antidepressant (TCA) that causes
sodium channel blockade in overdose, leading to widened QRS complex and risk
of ventricular dysrhythmias. Sodium bicarbonate is the treatment of choice for
TCA overdose with wide QRS because it increases serum pH, which dissociates
the drug from sodium channels. Amiodarone is not indicated and could worsen the
condition.
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 and 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: Coarse crackles in all lung fields following trauma suggest
developing acute respiratory distress syndrome (ARDS) or pulmonary contusion.
The priority is rapid transport to a definitive care facility while maintaining
adequate ventilation. Bilateral chest decompression is not indicated without signs
of tension pneumothorax. Increasing fluids could worsen pulmonary edema in this
context.
,QUESTION 4
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 are BP
88/40, P 120, R 16. You should administer:
A) Epinephrine
B) Lidocaine
C) Sodium bicarbonate
D) Morphine sulfate
ANSWER: C) Sodium bicarbonate
RATIONALE: Crush injury from entrapment can cause rhabdomyolysis and
release of intracellular contents, leading to metabolic acidosis and hyperkalemia.
Sodium bicarbonate helps correct acidosis and drives potassium back into cells.
The hypotension is likely due to distributive shock from reperfusion injury.
Morphine could worsen hypotension.
QUESTION 5
Braxton Hicks contractions:
A) Are mild and signal the beginning of labor
B) Occur in the second trimester and are false labor
C) Cause extreme back and abdominal discomfort
D) Cause dilation and effacement of the cervix
ANSWER: B) Occur in the second trimester and are false labor
RATIONALE: Braxton Hicks contractions are irregular, painless uterine
contractions that occur during the second and third trimesters but do not cause
cervical change. They are often described as "false labor" and typically resolve
with position change or hydration. True labor contractions become regular,
increase in intensity, and cause progressive cervical dilation and effacement.
, QUESTION 6
A 40-year-old male crashed his motorcycle. He had a brief loss of consciousness,
woke up and walked home. You find him 2 hours later at home unconscious. You
should suspect:
A) Subdural hematoma
B) Subarachnoid bleed
C) Basilar skull fracture
D) Epidural hematoma
ANSWER: D) Epidural hematoma
RATIONALE: Epidural hematoma classically presents with a lucid interval
following head trauma, where the patient briefly regains consciousness before
deteriorating neurologically. This occurs because arterial bleeding (typically from
the middle meningeal artery) accumulates rapidly between the skull and dura
mater. Subdural hematoma typically has a slower onset without a lucid interval in
elderly or alcoholic patients.
QUESTION 7
A 47-year-old male who was found unconscious on the side of the road responds
only to painful stimulus. When you attempt to establish IV access he stiffens his
arms and legs. He has minor abrasions all over his body. Vital signs are BP
178/122, P 56, R irregular, ETCO2 30. What should you do?
A) Mildly hypoventilate with a bag valve mask
B) Assist ventilations at 12 breaths per minute
C) Administer a 250 mL normal saline bolus
D) Administer 25 g of dextrose
ANSWER: B) Assist ventilations at 12 breaths per minute
RATIONALE: The patient has signs of increased intracranial pressure (Cushing's
triad: hypertension, bradycardia, irregular respirations). The low ETCO2 (30
mmHg) indicates hyperventilation and potential cerebral ischemia. The goal is to
