FISDAP Paramedic Final Exam QBank 2026/2027 80 Questions and
Answers Actual Exam | Complete Exam-Style Questions with
Detailed Rationales | Pass Guaranteed – A+ Graded
Section 1: Airway & Ventilation
Question 1
A 34-year-old male was struck in the face with a baseball bat. He is supine, responsive
to pain, and has significant oral bleeding with gurgling respirations at 6 breaths per
minute. His SpO2 is 82% on room air. What is the immediate priority intervention?
A. Apply a non-rebreather mask at 15 LPM and reassess in 2 minutes.
B. Perform a jaw-thrust maneuver and suction the oropharynx for no more than 15
seconds.
C. Insert an oropharyngeal airway and ventilate with a BVM at 10 breaths per minute.
D. Prepare for immediate nasotracheal intubation without preoxygenation.
Correct Answer: B
Rationale: The patient has a compromised airway due to blood and decreased mental
status. The immediate priority is opening the airway with a jaw-thrust (spinal precaution
due to mechanism) and suctioning to clear the oropharynx. Option A does not address
the airway obstruction. Option C is inappropriate because an OPA may cause
gagging/vomiting in a patient responsive to pain. Option D is incorrect because
nasotracheal intubation is contraindicated in apneic patients, and preoxygenation is
mandatory before any intubation attempt.
,Question 2
A 68-year-old female with a history of COPD presents with respiratory distress. Her
SpO2 is 88% on room air, respiratory rate is 28, and she is using accessory muscles.
Breath sounds are diminished bilaterally with prolonged expiration. What is the most
appropriate initial oxygen delivery strategy?
A. Apply a non-rebreather mask at 15 LPM to achieve an SpO2 of 94-98%.
B. Administer oxygen via nasal cannula at 2 LPM and titrate to an SpO2 of 88-92%.
C. Withhold oxygen entirely and administer only bronchodilator therapy.
D. Initiate CPAP at 10 cmH2O with 100% FiO2 immediately.
Correct Answer: B
Rationale: COPD patients with chronic CO2 retention are at risk for hypoventilation with
high-flow oxygen. The target SpO2 for COPD patients is 88-92% per current guidelines.
Option A risks suppressing the hypoxic drive. Option C is dangerous as the patient is
hypoxemic. Option D may be indicated later but is not the initial oxygen strategy; CPAP
requires adequate blood pressure and should follow initial bronchodilator therapy.
Question 3
During intubation of a 45-year-old male in cardiac arrest, you visualize the vocal cords
and pass the endotracheal tube. Upon auscultation, breath sounds are absent over the
,left chest and present only over the right. The capnography waveform is flat. What is the
most likely cause and immediate corrective action?
A. The tube is in the right mainstem bronchus; withdraw the tube 2-3 cm and reassess.
B. The patient has developed a tension pneumothorax; perform immediate needle
decompression.
C. The tube is in the esophagus; remove the tube and reattempt intubation with
waveform capnography confirmation.
D. The patient has a mucus plug obstructing the left bronchus; perform deep suctioning.
Correct Answer: C
Rationale: A flat capnography waveform indicates no CO2 exchange, confirming
esophageal intubation. Unilateral breath sounds in this context are misleading and do
not indicate mainstem intubation. The tube must be removed and reinserted. Option A
describes right mainstem intubation, which would still produce a capnography
waveform. Option B would present with different findings (tracheal deviation, JVD,
hypotension). Option D would not produce a flat capnography waveform.
Question 4
A 5-year-old child is in respiratory failure secondary to an asthma exacerbation. The
child is lethargic, has poor air movement, and a respiratory rate of 46. The SpO2 is 84%
despite nebulized albuterol. What is the most appropriate next intervention?
A. Administer subcutaneous epinephrine 0.01 mg/kg and continue nebulizer
treatments.
B. Initiate high-flow nasal cannula at 2 L/kg/min up to maximum flow.
C. Prepare for rapid sequence intubation using ketamine and rocuronium.
, D. Administer magnesium sulfate 50 mg/kg IV over 20 minutes and prepare for BVM
ventilation.
Correct Answer: D
Rationale: This child is in status asthmaticus with impending respiratory failure.
Magnesium sulfate is indicated for severe asthma unresponsive to beta-agonists. BVM
ventilation must be prepared as the child may require assisted ventilation. Option A is
less effective in severe cases. Option B (high-flow nasal cannula) is not appropriate for
imminent respiratory failure. Option C (RSI) may ultimately be needed but magnesium
and BVM preparation are the immediate next steps before intubation.
Question 5
You are managing a trauma patient with a suspected basilar skull fracture who requires
definitive airway management. The patient has bilateral periorbital ecchymosis and
clear fluid draining from the ears. Which airway adjunct is relatively contraindicated?
A. Oropharyngeal airway
B. Nasopharyngeal airway
C. Supraglottic airway (King LT)
D. Endotracheal intubation via orotracheal route
Correct Answer: B
Rationale: A nasopharyngeal airway is relatively contraindicated in suspected basilar
skull fracture due to the risk of entering the cranial vault through a fractured cribriform
plate. Option A (OPA) is safe if the patient is unconscious. Option C (King LT) is a
Answers Actual Exam | Complete Exam-Style Questions with
Detailed Rationales | Pass Guaranteed – A+ Graded
Section 1: Airway & Ventilation
Question 1
A 34-year-old male was struck in the face with a baseball bat. He is supine, responsive
to pain, and has significant oral bleeding with gurgling respirations at 6 breaths per
minute. His SpO2 is 82% on room air. What is the immediate priority intervention?
A. Apply a non-rebreather mask at 15 LPM and reassess in 2 minutes.
B. Perform a jaw-thrust maneuver and suction the oropharynx for no more than 15
seconds.
C. Insert an oropharyngeal airway and ventilate with a BVM at 10 breaths per minute.
D. Prepare for immediate nasotracheal intubation without preoxygenation.
Correct Answer: B
Rationale: The patient has a compromised airway due to blood and decreased mental
status. The immediate priority is opening the airway with a jaw-thrust (spinal precaution
due to mechanism) and suctioning to clear the oropharynx. Option A does not address
the airway obstruction. Option C is inappropriate because an OPA may cause
gagging/vomiting in a patient responsive to pain. Option D is incorrect because
nasotracheal intubation is contraindicated in apneic patients, and preoxygenation is
mandatory before any intubation attempt.
,Question 2
A 68-year-old female with a history of COPD presents with respiratory distress. Her
SpO2 is 88% on room air, respiratory rate is 28, and she is using accessory muscles.
Breath sounds are diminished bilaterally with prolonged expiration. What is the most
appropriate initial oxygen delivery strategy?
A. Apply a non-rebreather mask at 15 LPM to achieve an SpO2 of 94-98%.
B. Administer oxygen via nasal cannula at 2 LPM and titrate to an SpO2 of 88-92%.
C. Withhold oxygen entirely and administer only bronchodilator therapy.
D. Initiate CPAP at 10 cmH2O with 100% FiO2 immediately.
Correct Answer: B
Rationale: COPD patients with chronic CO2 retention are at risk for hypoventilation with
high-flow oxygen. The target SpO2 for COPD patients is 88-92% per current guidelines.
Option A risks suppressing the hypoxic drive. Option C is dangerous as the patient is
hypoxemic. Option D may be indicated later but is not the initial oxygen strategy; CPAP
requires adequate blood pressure and should follow initial bronchodilator therapy.
Question 3
During intubation of a 45-year-old male in cardiac arrest, you visualize the vocal cords
and pass the endotracheal tube. Upon auscultation, breath sounds are absent over the
,left chest and present only over the right. The capnography waveform is flat. What is the
most likely cause and immediate corrective action?
A. The tube is in the right mainstem bronchus; withdraw the tube 2-3 cm and reassess.
B. The patient has developed a tension pneumothorax; perform immediate needle
decompression.
C. The tube is in the esophagus; remove the tube and reattempt intubation with
waveform capnography confirmation.
D. The patient has a mucus plug obstructing the left bronchus; perform deep suctioning.
Correct Answer: C
Rationale: A flat capnography waveform indicates no CO2 exchange, confirming
esophageal intubation. Unilateral breath sounds in this context are misleading and do
not indicate mainstem intubation. The tube must be removed and reinserted. Option A
describes right mainstem intubation, which would still produce a capnography
waveform. Option B would present with different findings (tracheal deviation, JVD,
hypotension). Option D would not produce a flat capnography waveform.
Question 4
A 5-year-old child is in respiratory failure secondary to an asthma exacerbation. The
child is lethargic, has poor air movement, and a respiratory rate of 46. The SpO2 is 84%
despite nebulized albuterol. What is the most appropriate next intervention?
A. Administer subcutaneous epinephrine 0.01 mg/kg and continue nebulizer
treatments.
B. Initiate high-flow nasal cannula at 2 L/kg/min up to maximum flow.
C. Prepare for rapid sequence intubation using ketamine and rocuronium.
, D. Administer magnesium sulfate 50 mg/kg IV over 20 minutes and prepare for BVM
ventilation.
Correct Answer: D
Rationale: This child is in status asthmaticus with impending respiratory failure.
Magnesium sulfate is indicated for severe asthma unresponsive to beta-agonists. BVM
ventilation must be prepared as the child may require assisted ventilation. Option A is
less effective in severe cases. Option B (high-flow nasal cannula) is not appropriate for
imminent respiratory failure. Option C (RSI) may ultimately be needed but magnesium
and BVM preparation are the immediate next steps before intubation.
Question 5
You are managing a trauma patient with a suspected basilar skull fracture who requires
definitive airway management. The patient has bilateral periorbital ecchymosis and
clear fluid draining from the ears. Which airway adjunct is relatively contraindicated?
A. Oropharyngeal airway
B. Nasopharyngeal airway
C. Supraglottic airway (King LT)
D. Endotracheal intubation via orotracheal route
Correct Answer: B
Rationale: A nasopharyngeal airway is relatively contraindicated in suspected basilar
skull fracture due to the risk of entering the cranial vault through a fractured cribriform
plate. Option A (OPA) is safe if the patient is unconscious. Option C (King LT) is a
