Updated for 2026-2027
PARAMEDIC AIRWAY FISDAP REVIEW 2026/2027 – 100 ADVANCED
QUESTIONS & ANSWERS (VERIFIED) 100% CORRECT, ALREADY
GRADED A+
1.
You arrive at the scene of a 45-year-old male found unresponsive after a suspected
overdose. He has shallow respirations at 6 breaths/min, SpO₂ 82% on room air,
and gurgling sounds are heard on inspiration. What should you do first?
A. Begin bag-valve-mask ventilations with 100% oxygen
B. Insert a nasopharyngeal airway and suction as needed
C. Perform a head-tilt chin-lift and suction the airway
D. Intubate immediately to secure the airway
Correct Answer: C — Perform a head-tilt chin-lift and suction the airway.
Rationale: You must clear and open the airway before any advanced
intervention. Suctioning removes obstruction, and opening the airway improves
ventilation effectiveness. Intubation before clearing risks aspiration.
2.
A 62-year-old woman in respiratory distress is sitting upright, speaking in short
phrases, and using accessory muscles. Breath sounds are diminished bilaterally.
Her SpO₂ is 88% on nasal cannula. Which intervention should you perform next?
A. Switch to a non-rebreather mask at 15 L/min
B. Immediately intubate due to poor oxygenation
C. Begin CPAP to improve oxygenation and reduce work of breathing
D. Administer bronchodilators via nebulizer and reassess later
Correct Answer: C — Begin CPAP to improve oxygenation and reduce work of
breathing.
,Updated for 2026-2027
Rationale: CPAP is ideal for conscious patients with increased work of
breathing and hypoxemia. It recruits alveoli and reduces fatigue, often preventing
the need for intubation.
3.
You’re preparing to intubate a trauma patient with severe facial injuries. Blood is
pooling in the oropharynx and visibility is poor. Despite suctioning, the airway
remains contaminated. What is the most appropriate strategy?
A. Attempt standard direct laryngoscopy quickly before the airway swells
B. Use video laryngoscopy to visualize around the obstruction
C. Perform a rapid surgical cricothyrotomy as the primary airway
D. Use the SALAD technique for continuous suction during intubation
Correct Answer: D — Use the SALAD technique for continuous suction during
intubation.
Rationale: SALAD (Suction Assisted Laryngoscopy and Airway
Decontamination) is the best option in massively contaminated airways, allowing
ongoing suction and improved visualization during intubation.
4.
During rapid sequence intubation of a 28-year-old trauma patient, you confirm
tube placement with ETCO₂ and bilateral breath sounds. Within minutes, the
patient’s SpO₂ begins dropping and you hear diminished breath sounds on the left.
What is the most likely cause?
A. Right mainstem intubation
B. Esophageal intubation
C. Mucus plug obstruction
D. Equipment disconnection
Correct Answer: A — Right mainstem intubation.
Rationale: Advancing the tube too far commonly causes right mainstem
,Updated for 2026-2027
placement, leading to poor left-sided ventilation and desaturation. Withdrawing
the tube slightly typically restores bilateral ventilation.
5.
A 34-year-old male with severe asthma is being ventilated after intubation. You
note high peak pressures, prolonged expiratory phase, and rising ETCO₂. What is
the most appropriate ventilation adjustment?
A. Increase the respiratory rate to blow off CO₂
B. Decrease tidal volume and increase expiratory time
C. Increase PEEP to recruit alveoli
D. Switch to pressure control mode to reduce barotrauma
Correct Answer: B — Decrease tidal volume and increase expiratory time.
Rationale: Asthmatic patients are prone to air trapping and auto-PEEP.
Lowering tidal volume and allowing more expiratory time prevents hyperinflation
and improves CO₂ clearance.
6.
You are managing a 70-year-old male with severe CHF and pulmonary edema. He
is conscious but struggling to breathe, with pink frothy sputum and SpO₂ 76% on
high-flow oxygen. What is the best airway intervention?
A. Endotracheal intubation with RSI
B. Immediate CPAP initiation
C. Manual BVM ventilation with PEEP valve
D. Oropharyngeal airway and suction
Correct Answer: B — Immediate CPAP initiation.
Rationale: CPAP improves oxygenation and reduces preload and afterload,
often reversing acute pulmonary edema without invasive intubation. Early use is
key for conscious, cooperative patients.
, Updated for 2026-2027
7.
While ventilating an intubated patient with a bag-valve mask, you suddenly feel
increased resistance, and the patient’s chest is not rising well. SpO₂ begins to fall.
What is your next step?
A. Increase the rate and force of ventilation
B. Disconnect from the BVM and check the tube and airway for obstruction
C. Deflate the cuff and reposition the tube
D. Administer a paralytic to improve ventilation compliance
Correct Answer: B — Disconnect from the BVM and check the tube and airway
for obstruction.
Rationale: Sudden resistance may indicate kinking, obstruction, mucus plug, or
tension pneumothorax. Quickly disconnecting allows you to troubleshoot and
avoid worsening hypoxia.
8.
A 25-year-old unconscious trauma patient is being bagged. The airway is difficult
to maintain due to a suspected mandibular fracture. Which adjunct is most
appropriate to help maintain airway patency before intubation?
A. Nasopharyngeal airway
B. Oropharyngeal airway
C. Jaw thrust with cervical stabilization only
D. Two-hand BVM technique with OPA and NPAs as tolerated
Correct Answer: D — Two-hand BVM technique with OPA and NPAs as
tolerated.
Rationale: Mandibular fractures compromise manual positioning. Using both
OPA and NPA plus two-hand mask seal improves ventilation while preparing for
definitive airway.
9.
PARAMEDIC AIRWAY FISDAP REVIEW 2026/2027 – 100 ADVANCED
QUESTIONS & ANSWERS (VERIFIED) 100% CORRECT, ALREADY
GRADED A+
1.
You arrive at the scene of a 45-year-old male found unresponsive after a suspected
overdose. He has shallow respirations at 6 breaths/min, SpO₂ 82% on room air,
and gurgling sounds are heard on inspiration. What should you do first?
A. Begin bag-valve-mask ventilations with 100% oxygen
B. Insert a nasopharyngeal airway and suction as needed
C. Perform a head-tilt chin-lift and suction the airway
D. Intubate immediately to secure the airway
Correct Answer: C — Perform a head-tilt chin-lift and suction the airway.
Rationale: You must clear and open the airway before any advanced
intervention. Suctioning removes obstruction, and opening the airway improves
ventilation effectiveness. Intubation before clearing risks aspiration.
2.
A 62-year-old woman in respiratory distress is sitting upright, speaking in short
phrases, and using accessory muscles. Breath sounds are diminished bilaterally.
Her SpO₂ is 88% on nasal cannula. Which intervention should you perform next?
A. Switch to a non-rebreather mask at 15 L/min
B. Immediately intubate due to poor oxygenation
C. Begin CPAP to improve oxygenation and reduce work of breathing
D. Administer bronchodilators via nebulizer and reassess later
Correct Answer: C — Begin CPAP to improve oxygenation and reduce work of
breathing.
,Updated for 2026-2027
Rationale: CPAP is ideal for conscious patients with increased work of
breathing and hypoxemia. It recruits alveoli and reduces fatigue, often preventing
the need for intubation.
3.
You’re preparing to intubate a trauma patient with severe facial injuries. Blood is
pooling in the oropharynx and visibility is poor. Despite suctioning, the airway
remains contaminated. What is the most appropriate strategy?
A. Attempt standard direct laryngoscopy quickly before the airway swells
B. Use video laryngoscopy to visualize around the obstruction
C. Perform a rapid surgical cricothyrotomy as the primary airway
D. Use the SALAD technique for continuous suction during intubation
Correct Answer: D — Use the SALAD technique for continuous suction during
intubation.
Rationale: SALAD (Suction Assisted Laryngoscopy and Airway
Decontamination) is the best option in massively contaminated airways, allowing
ongoing suction and improved visualization during intubation.
4.
During rapid sequence intubation of a 28-year-old trauma patient, you confirm
tube placement with ETCO₂ and bilateral breath sounds. Within minutes, the
patient’s SpO₂ begins dropping and you hear diminished breath sounds on the left.
What is the most likely cause?
A. Right mainstem intubation
B. Esophageal intubation
C. Mucus plug obstruction
D. Equipment disconnection
Correct Answer: A — Right mainstem intubation.
Rationale: Advancing the tube too far commonly causes right mainstem
,Updated for 2026-2027
placement, leading to poor left-sided ventilation and desaturation. Withdrawing
the tube slightly typically restores bilateral ventilation.
5.
A 34-year-old male with severe asthma is being ventilated after intubation. You
note high peak pressures, prolonged expiratory phase, and rising ETCO₂. What is
the most appropriate ventilation adjustment?
A. Increase the respiratory rate to blow off CO₂
B. Decrease tidal volume and increase expiratory time
C. Increase PEEP to recruit alveoli
D. Switch to pressure control mode to reduce barotrauma
Correct Answer: B — Decrease tidal volume and increase expiratory time.
Rationale: Asthmatic patients are prone to air trapping and auto-PEEP.
Lowering tidal volume and allowing more expiratory time prevents hyperinflation
and improves CO₂ clearance.
6.
You are managing a 70-year-old male with severe CHF and pulmonary edema. He
is conscious but struggling to breathe, with pink frothy sputum and SpO₂ 76% on
high-flow oxygen. What is the best airway intervention?
A. Endotracheal intubation with RSI
B. Immediate CPAP initiation
C. Manual BVM ventilation with PEEP valve
D. Oropharyngeal airway and suction
Correct Answer: B — Immediate CPAP initiation.
Rationale: CPAP improves oxygenation and reduces preload and afterload,
often reversing acute pulmonary edema without invasive intubation. Early use is
key for conscious, cooperative patients.
, Updated for 2026-2027
7.
While ventilating an intubated patient with a bag-valve mask, you suddenly feel
increased resistance, and the patient’s chest is not rising well. SpO₂ begins to fall.
What is your next step?
A. Increase the rate and force of ventilation
B. Disconnect from the BVM and check the tube and airway for obstruction
C. Deflate the cuff and reposition the tube
D. Administer a paralytic to improve ventilation compliance
Correct Answer: B — Disconnect from the BVM and check the tube and airway
for obstruction.
Rationale: Sudden resistance may indicate kinking, obstruction, mucus plug, or
tension pneumothorax. Quickly disconnecting allows you to troubleshoot and
avoid worsening hypoxia.
8.
A 25-year-old unconscious trauma patient is being bagged. The airway is difficult
to maintain due to a suspected mandibular fracture. Which adjunct is most
appropriate to help maintain airway patency before intubation?
A. Nasopharyngeal airway
B. Oropharyngeal airway
C. Jaw thrust with cervical stabilization only
D. Two-hand BVM technique with OPA and NPAs as tolerated
Correct Answer: D — Two-hand BVM technique with OPA and NPAs as
tolerated.
Rationale: Mandibular fractures compromise manual positioning. Using both
OPA and NPA plus two-hand mask seal improves ventilation while preparing for
definitive airway.
9.
