FISDAP EMS Readiness Exam — Questions and Answers

Question 1: In FISDAP, documenting 'refusal of care' for a patient encounter requires the student to record which key data element?

That the patient was informed of risks and signed a refusal (Correct answer)
Hospital destination even if patient refused
Reason the crew did not want to transport
Patient's insurance information

Correct answer: That the patient was informed of risks and signed a refusal

A valid refusal of care requires documentation that the patient was informed of potential consequences and voluntarily declined treatment or transport.

Question 2: A patient on warfarin presents with a major GI bleed. Which reversal agent is most appropriate?

Vitamin K and/or fresh frozen plasma (Correct answer)
Flumazenil
Naloxone
Protamine sulfate

Correct answer: Vitamin K and/or fresh frozen plasma

Warfarin antagonizes vitamin K-dependent clotting factors; reversal is achieved with vitamin K and/or FFP to restore clotting factor activity rapidly.

Question 3: A 7-year-old is brought in after a seizure lasting approximately 5 minutes. The child is now postictal, breathing adequately, and SpO2 is 98%. Your priority assessment should focus on:

Performing 12-lead ECG
Immediately inserting a nasopharyngeal airway
Administering benzodiazepines prophylactically
Identifying and treating potential underlying causes (Correct answer)

Correct answer: Identifying and treating potential underlying causes

After a seizure in a postictal child with adequate breathing, identifying underlying causes (glucose, fever, trauma, toxins) guides further management.

Question 4: A student notices that a previously submitted patient care report in FISDAP contains an error in the vitals section. What is the appropriate action?

Edit the record directly without notifying anyone
Delete the entry and resubmit from scratch
Contact the program coordinator to correct the record through proper channels (Correct answer)
Leave it as-is since submissions cannot be changed

Correct answer: Contact the program coordinator to correct the record through proper channels

Corrections to submitted records should follow program protocols and involve program coordinators to maintain data integrity and audit trails.

Question 5: Which of the following is the MOST reliable early indicator of shock in a pediatric patient?

Hypotension
Tachycardia (Correct answer)
Altered mental status
Absent peripheral pulses

Correct answer: Tachycardia

Tachycardia is the earliest and most reliable compensatory sign of shock in pediatric patients, as hypotension is a late and ominous sign.

Question 6: A FISDAP 'hours by site type' report shows a student has 80% of their hours at a single hospital ED. Why might a program director use this report?

To verify the student's schedule for payroll
To calculate the student's GPA contribution
To track ambulance vehicle maintenance schedules
To ensure the student is gaining diverse clinical exposure across multiple site types (Correct answer)

Correct answer: To ensure the student is gaining diverse clinical exposure across multiple site types

Accreditation standards require students to obtain varied clinical experiences, and this report helps identify over-reliance on one site type.

Question 7: A patient in cardiac arrest is found in a confined space with suspected CO exposure. What is the FIRST action the EMS crew should take?

Request a confined space rescue team and ensure scene safety before entry (Correct answer)
Don SCBA and enter to retrieve the patient
Enter and begin CPR immediately
Lower an AED into the space using a rope

Correct answer: Request a confined space rescue team and ensure scene safety before entry

EMS personnel should not enter a confined space with suspected CO until properly trained confined space rescue personnel arrive and the atmosphere is confirmed safe.

Question 8: What is the relationship between theory and practice in Trauma Management?

Theory provides the foundation; practice applies it to real situations (Correct answer)
Theory is unnecessary
Practice is unnecessary if you know theory
They are completely separate

Correct answer: Theory provides the foundation; practice applies it to real situations

Theory provides the conceptual foundation and principles, while practice involves applying those concepts to real-world situations. Both are essential for competence.

Question 9: A 45-year-old male sustains blunt chest trauma and presents with paradoxical chest wall movement. Which condition does this indicate?

Open pneumothorax
Tension pneumothorax
Cardiac tamponade
Flail chest (Correct answer)

Correct answer: Flail chest

Flail chest occurs when three or more consecutive ribs are fractured in two or more places, causing a free-floating segment that moves paradoxically (inward on inspiration, outward on expiration).

Question 10: Which vital sign parameter is used to calculate shock index, and what value suggests hemodynamic compromise?

Respiratory rate divided by heart rate; >1.5 is concerning
Heart rate divided by systolic BP; >1.0 is concerning (Correct answer)
SpO2 divided by systolic BP; >0.5 is concerning
Diastolic BP divided by heart rate; <0.8 is concerning

Correct answer: Heart rate divided by systolic BP; >1.0 is concerning

Shock index = heart rate ÷ systolic BP; a value greater than 1.0 suggests significant hemodynamic compromise and shock.

Question 11: When performing a rapid trauma assessment, which mnemonic helps guide evaluation of each body region?

AVPU
DCAP-BTLS (Correct answer)
SAMPLE
OPQRST

Correct answer: DCAP-BTLS

DCAP-BTLS (Deformities, Contusions, Abrasions, Punctures/Penetrations, Burns, Tenderness, Lacerations, Swelling) guides systematic physical assessment of each body region.

Question 12: Atropine is indicated for symptomatic bradycardia. What is the initial adult dose?

0.5 mg IV (Correct answer)
0.1 mg IV
1.0 mg IV
2.0 mg IV

Correct answer: 0.5 mg IV

The initial dose of atropine for symptomatic bradycardia is 0.5 mg IV, which may be repeated every 3-5 minutes to a maximum of 3 mg.

Question 13: When assessing a patient for acute abdomen, which finding is MOST concerning for a surgical emergency requiring rapid transport?

Right upper quadrant pain after fatty meal
Rigid abdomen with rebound tenderness (Correct answer)
Crampy periumbilical pain with diarrhea
Diffuse tenderness with voluntary guarding

Correct answer: Rigid abdomen with rebound tenderness

A rigid abdomen with rebound tenderness indicates peritoneal irritation from perforation or hemorrhage, which requires immediate surgical intervention.

Question 14: A trauma patient has an SpO2 of 88% despite a high-flow non-rebreather mask. You suspect a tension pneumothorax. Which assessment finding would BEST confirm this?

Bilateral equal breath sounds and normal tracheal position
Absent breath sounds on one side with tracheal deviation away from that side (Correct answer)
Diminished sounds bilaterally with hypotension
Crackles bilaterally with JVD

Correct answer: Absent breath sounds on one side with tracheal deviation away from that side

Absent unilateral breath sounds with tracheal deviation away from the affected side is the classic presentation of tension pneumothorax, indicating mediastinal shift from air accumulation.

Question 15: How does documentation support quality in Airway Management?

It creates records, ensures consistency, and enables improvement (Correct answer)
It is only for billing
Documentation is unnecessary overhead
It only serves administrative purposes

Correct answer: It creates records, ensures consistency, and enables improvement

Proper documentation creates accountability, ensures consistency, supports quality improvement, and provides legal protection.

Question 16: A FISDAP student responds to a patient with hyperthermia after prolonged outdoor exposure. Which environmental emergency category applies?

Sepsis
Exertional rhabdomyolysis
Febrile seizure
Heat stroke (Correct answer)

Correct answer: Heat stroke

Heat stroke is an environmental emergency tracked in FISDAP where prolonged heat exposure causes dangerous core body temperature elevation.

Question 17: A patient with a known seizure disorder has been seizing for 12 minutes continuously. Which term best describes this presentation?

Absence seizure
Focal seizure
Post-ictal state
Status epilepticus (Correct answer)

Correct answer: Status epilepticus

Status epilepticus is defined as a single seizure lasting more than 5 minutes or recurrent seizures without recovery of consciousness between episodes.

Question 18: In permissive hypotension strategy for penetrating trauma patients without TBI, what is the target systolic BP during transport?

100–110 mmHg
120 mmHg
60 mmHg or less
70–90 mmHg (Correct answer)

Correct answer: 70–90 mmHg

Permissive hypotension targets a systolic BP of 70–90 mmHg to maintain minimal organ perfusion while avoiding aggressive fluid resuscitation that can worsen coagulopathy and clot disruption.

Question 19: What should you do when encountering a difficult question?

Skip it permanently
Guess immediately without reading
Stare at it until you figure it out
Mark it, move on, and return to it later (Correct answer)

Correct answer: Mark it, move on, and return to it later

Mark difficult questions and move on to avoid wasting time. After completing easier questions, return with fresh perspective and remaining time.

Question 20: A patient presents with regular narrow-complex tachycardia at a rate of 180 bpm. Vagal maneuvers fail. What is the drug of choice for terminating this rhythm?

Amiodarone 150 mg IV
Metoprolol 5 mg IV
Adenosine 6 mg rapid IV push (Correct answer)
Lidocaine 1-1.5 mg/kg IV

Correct answer: Adenosine 6 mg rapid IV push

Adenosine 6 mg given as a rapid IV push is the first-line pharmacological treatment for stable SVT unresponsive to vagal maneuvers.

Question 21: During assessment of a patient in respiratory distress, you note tracheal deviation to the right. This MOST likely indicates:

Bilateral pneumonia
Left-sided tension pneumothorax (Correct answer)
Right-sided pleural effusion
Right-sided atelectasis

Correct answer: Left-sided tension pneumothorax

A left-sided tension pneumothorax creates pressure that pushes the trachea and mediastinum toward the right.

Question 22: A preceptor refuses to complete FISDAP evaluations for a student during a clinical rotation. What is the appropriate next step?

The student should complete the evaluation themselves
The program director should contact the clinical site to resolve the issue and ensure documentation requirements are met (Correct answer)
The rotation should be deleted from the student's record
No action is needed if the student verbally passed the rotation

Correct answer: The program director should contact the clinical site to resolve the issue and ensure documentation requirements are met

Program directors must ensure preceptors fulfill their documentation obligations, as incomplete evaluations jeopardize accreditation compliance.

Question 23: Which study approach is most effective for Cardiac Emergencies material?

Studying for very long sessions without breaks
Highlighting all text
Passive re-reading of notes
Active recall with practice questions (Correct answer)

Correct answer: Active recall with practice questions

Active recall through practice questions is the most effective study method, as it strengthens memory retrieval pathways.

Question 24: In pediatric patients, which formula is used to estimate a weight-based medication dose when scale weight is unavailable?

Broselow tape (Correct answer)
CUPS assessment
APGAR scoring
Glasgow Coma Scale

Correct answer: Broselow tape

The Broselow tape uses patient length to estimate weight and provides color-coded drug dosing for pediatric emergencies.

Question 25: Which class of drugs is ketamine, and what is its primary advantage in prehospital RSI?

Opioid; provides profound analgesia without sedation
Dissociative anesthetic; maintains airway reflexes and hemodynamic stability (Correct answer)
Benzodiazepine; provides muscle relaxation
Barbiturate; reduces ICP

Correct answer: Dissociative anesthetic; maintains airway reflexes and hemodynamic stability

Ketamine is a dissociative anesthetic that preserves protective airway reflexes and maintains or increases blood pressure, making it ideal for hemodynamically unstable patients.

Question 26: During a mass casualty incident, a patient with a femur fracture, open airway, and weak radial pulse is classified as which triage category using START?

Black (expectant)
Green (minor)
Red (immediate)
Yellow (delayed) (Correct answer)

Correct answer: Yellow (delayed)

In START triage, a patient who is walking or has a patent airway, adequate respirations, and a radial pulse with only a long-bone fracture is classified Yellow (delayed).

Question 27: A 70-year-old patient is in complete (third-degree) AV block with a ventricular rate of 32 bpm and is hypotensive. Atropine fails to improve the rate. What is the next step?

Adenosine 6 mg rapid IV push
Transcutaneous pacing (TCP) (Correct answer)
Increase atropine to 3 mg IV
Amiodarone 300 mg IV push

Correct answer: Transcutaneous pacing (TCP)

When atropine fails in symptomatic complete AV block, transcutaneous pacing is the next intervention to maintain hemodynamically adequate ventricular rates.

Question 28: Which type of hemorrhage is characterized by dark red blood that flows steadily and does not pulsate?

Capillary hemorrhage
Venous hemorrhage (Correct answer)
Arterial hemorrhage
Occult hemorrhage

Correct answer: Venous hemorrhage

Venous blood is dark red and flows steadily due to lower pressure in veins, unlike arterial hemorrhage which is bright red and pulsatile.

Question 29: How does documentation support quality in Trauma Management?

It only serves administrative purposes
It is only for billing
Documentation is unnecessary overhead
It creates records, ensures consistency, and enables improvement (Correct answer)

Correct answer: It creates records, ensures consistency, and enables improvement

Proper documentation creates accountability, ensures consistency, supports quality improvement, and provides legal protection.

Question 30: Which of the following best describes the role of the precordial thump in cardiac arrest management?

Only considered for witnessed monitored pulseless VT when a defibrillator is not immediately available (Correct answer)
Routinely used for all shockable rhythms
Contraindicated in all prehospital settings
Used after every failed defibrillation attempt

Correct answer: Only considered for witnessed monitored pulseless VT when a defibrillator is not immediately available

The precordial thump may be considered only for witnessed, monitored pulseless VT when defibrillation is not immediately available, as its benefit is uncertain.

Question 31: During spinal motion restriction of a standing patient with suspected cervical spine injury, which sequence is correct?

Apply head immobilizer first, then cervical collar, then move to board
Apply cervical collar, move to long board, apply head immobilizer (Correct answer)
Move to long board, then apply cervical collar and head immobilizer
Secure torso to board first, then apply cervical collar

Correct answer: Apply cervical collar, move to long board, apply head immobilizer

The correct sequence is to apply the cervical collar first to stabilize the cervical spine, then transfer to the long board, and finally apply the head immobilizer.

Question 32: A 45-year-old male presents with sudden onset of tearing chest pain radiating to his back. Blood pressure is 190/110 in the right arm and 150/90 in the left arm. You MOST suspect:

Myocardial infarction
Pulmonary embolism
Aortic dissection (Correct answer)
Pneumothorax

Correct answer: Aortic dissection

Tearing chest pain radiating to the back with unequal bilateral blood pressures is the hallmark presentation of aortic dissection.

Question 33: A 4-year-old patient requires bag-valve-mask ventilation. Which BVM size is most appropriate?

Infant 250 mL
Neonatal 150 mL
Adult 1600 mL
Child 500 mL (Correct answer)

Correct answer: Child 500 mL

A pediatric (child) BVM of approximately 500 mL is appropriate for children to avoid over-ventilation.

Question 34: In FISDAP EMS operations, which skill is measured when a student correctly decontaminates equipment after a patient contact?

PPE donning
Post-call infection control (Correct answer)
Biohazard documentation
Scene safety entry

Correct answer: Post-call infection control

Post-call infection control is a tracked FISDAP operations skill ensuring students follow decontamination protocols after patient care.

Question 35: In FISDAP, documenting care for a patient experiencing a behavioral emergency where the patient is a danger to themselves or others falls under which category?

Psychiatric and behavioral emergency (Correct answer)
EMS operations
Special needs care
Substance use emergency

Correct answer: Psychiatric and behavioral emergency

Psychiatric and behavioral emergencies are tracked in FISDAP as a distinct category covering patients with mental health crises who may pose safety risks.

Question 36: A conscious adult patient refuses treatment after a thorough assessment. Which action is MOST appropriate?

Call medical direction and then leave without documentation
Administer treatment without consent
Restrain the patient and transport
Document the refusal and have the patient sign an AMA form (Correct answer)

Correct answer: Document the refusal and have the patient sign an AMA form

A competent adult has the right to refuse care; EMTs must document the refusal thoroughly and obtain a signed against medical advice (AMA) form.

Question 37: A patient involved in a high-speed MVC is ambulatory at the scene and denies pain. Based on mechanism alone, your assessment priority should be:

Moderate — assess only if patient requests help
Low — patient is walking and talking
Deferred — reassess if symptoms develop
High — significant mechanism warrants thorough assessment (Correct answer)

Correct answer: High — significant mechanism warrants thorough assessment

A significant mechanism of injury such as high-speed MVC warrants a high index of suspicion and thorough assessment regardless of the patient's current complaints.

Question 38: A patient receives a vasopressor infusion of norepinephrine. Its primary hemodynamic effect is mediated by which receptor?

Beta-2 only
Beta-1 only
Alpha-1 (with some Beta-1) (Correct answer)
Dopaminergic

Correct answer: Alpha-1 (with some Beta-1)

Norepinephrine acts primarily on alpha-1 receptors causing vasoconstriction, with moderate beta-1 effects increasing contractility, making it ideal for vasodilatory shock.

Question 39: In FISDAP documentation, which patient population requires the student to consider lower normal vital sign ranges when interpreting assessment findings?

Athletes and physically conditioned adults (Correct answer)
Bariatric patients
Pediatric patients
Geriatric patients

Correct answer: Athletes and physically conditioned adults

Conditioned athletes often have resting heart rates and blood pressures that appear abnormally low, a special population consideration tracked in FISDAP.

Question 40: What is a key feature of the FISDAP reporting system for instructors?

Ability to track student performance over multiple cohorts and academic years (Correct answer)
Access to real-time data on the program’s financial health
Ability to create marketing strategies for internship programs
Capability to access and modify student grades for all assignments

Correct answer: Ability to track student performance over multiple cohorts and academic years

A key feature of FISDAP's reporting system for instructors is its ability to analyze data across different student cohorts and academic years. This allows programs to identify trends in student performance, evaluate the effectiveness of curriculum changes, and make data-driven decisions for continuous program improvement and resource allocation.

Question 41: A patient sustains a crush injury to the forearm for 45 minutes. Upon extrication, which systemic complication is the highest priority concern?

Hypercalcemia
Respiratory alkalosis
Hyponatremia
Hyperkalemia causing cardiac dysrhythmia (Correct answer)

Correct answer: Hyperkalemia causing cardiac dysrhythmia

Crush syndrome releases intracellular potassium into the bloodstream, causing life-threatening hyperkalemia and potentially fatal cardiac dysrhythmias upon reperfusion.

Question 42: When should you change an answer on a test?

Always change your first answer
Only when you have a clear reason the new answer is better (Correct answer)
Change every answer you doubt
Never change answers

Correct answer: Only when you have a clear reason the new answer is better

Research shows changing answers is beneficial only when you have a specific reason, such as recalling new information or catching a misread question.

Question 43: What is the relationship between theory and practice in Cardiac Emergencies?

Theory is unnecessary
Theory provides the foundation; practice applies it to real situations (Correct answer)
They are completely separate
Practice is unnecessary if you know theory

Correct answer: Theory provides the foundation; practice applies it to real situations

Theory provides the conceptual foundation and principles, while practice involves applying those concepts to real-world situations. Both are essential for competence.

Question 44: Which of the following is the MOST reliable prehospital sign of imminent delivery?

Rupture of membranes within the last hour
Patient's report of urge to push
Contractions every 5 minutes lasting 45 seconds
Crowning of the presenting part (Correct answer)

Correct answer: Crowning of the presenting part

Crowning — visible bulging of the presenting part at the vaginal introitus — is the definitive sign that delivery is imminent and transport should be halted.

Question 45: When a new EMS program seeks initial accreditation, what status does CoAEMSP award that allows it to enroll students before full accreditation is granted?

Emergency interim accreditation
Temporary NREMT approval
Provisional licensure
Candidate status (Developing Program status) (Correct answer)

Correct answer: Candidate status (Developing Program status)

Candidate or developing program status allows a new program to enroll students while it works toward meeting all standards for full accreditation.

Question 46: How should you manage time during a timed test?

Rush through the entire test
Only work on hard questions
Divide total time by questions and pace yourself, spending less on easy ones (Correct answer)
Spend equal time on every question

Correct answer: Divide total time by questions and pace yourself, spending less on easy ones

Calculate time per question, spend less on easy questions to bank time for harder ones, and check your pace periodically.

Question 47: Which FISDAP-tracked competency is demonstrated when a student modifies their communication approach for a hearing-impaired patient?

Transport decision-making
Special populations communication adaptation (Correct answer)
Scene safety
Patient history taking

Correct answer: Special populations communication adaptation

FISDAP tracks communication adaptation for special populations to ensure students can effectively assess patients with sensory or cognitive impairments.

Question 48: Which medication should be avoided in a patient with suspected epiglottitis who is maintaining their airway?

Dexamethasone
Anything that may agitate the patient (Correct answer)
Epinephrine nebulized
Racemic epinephrine nebulized

Correct answer: Anything that may agitate the patient

Any intervention that agitates the patient with epiglottitis risks complete airway obstruction; the priority is calm, gentle transport to definitive care.

Question 49: A patient has a laryngeal mask airway (LMA) in place. Which of the following is a known limitation of the LMA?

It cannot deliver positive pressure ventilation
It does not protect against aspiration (Correct answer)
It requires visualization of the vocal cords
It cannot be used in cardiac arrest

Correct answer: It does not protect against aspiration

The LMA sits above the glottis and does not create a tracheal seal, so it does not reliably prevent aspiration.

Question 50: Sodium bicarbonate is indicated in the prehospital setting for which condition?

Hypernatremia
Diabetic ketoacidosis
Respiratory acidosis from COPD
Tricyclic antidepressant overdose with widened QRS (Correct answer)

Correct answer: Tricyclic antidepressant overdose with widened QRS

Sodium bicarbonate alkalinizes the serum, which reduces sodium channel blockade from TCAs and narrows the QRS complex.

Question 51: Which finding during auscultation of a pediatric patient's chest is MOST consistent with foreign body aspiration?

Bilateral expiratory wheezing
High-pitched inspiratory stridor
Diffuse crackles bilaterally
Unilateral decreased breath sounds (Correct answer)

Correct answer: Unilateral decreased breath sounds

Unilateral decreased breath sounds suggest a foreign body lodged in one mainstem bronchus, causing air trapping on that side.

Question 52: During a heat wave, a 72-year-old man is found confused in a non-air-conditioned apartment with a core temperature of 40.6°C (105°F) and anhidrosis. Which cooling method is most appropriate in the field?

Immersion in ice water bath
Passive cooling by moving to shade only
Ice packs to groin and axillae combined with misting and fanning (Correct answer)
Oral hydration with cold sports drinks

Correct answer: Ice packs to groin and axillae combined with misting and fanning

For classic heat stroke, evaporative cooling (misting and fanning) combined with ice packs to high-blood-flow areas (groin, axillae, neck) is the preferred prehospital method due to practical feasibility.

Question 53: A 70 kg adult patient requires dopamine at 5 mcg/kg/min. The solution is 400 mg in 250 mL. What is the correct infusion rate in mL/hr?

26.25 mL/hr
21.0 mL/hr
13.1 mL/hr (Correct answer)
10.5 mL/hr

Correct answer: 13.1 mL/hr

Concentration = 1600 mcg/mL; dose = 5 × 70 = 350 mcg/min; rate = 350/1600 × 60 = 13.125 mL/hr.

Question 54: Why is continuing education important in Trauma Management?

To stay current with evolving standards and practices (Correct answer)
To network only
It is not important after certification
Only for re-certification requirements

Correct answer: To stay current with evolving standards and practices

Continuing education keeps professionals updated with the latest developments, standards, and best practices in their field.

Question 55: What does FISDAP use the 'assessment findings' section to document?

Hospital triage category assigned on arrival
Objective and subjective findings gathered during patient assessment (Correct answer)
Billing and insurance information
The student's personal reflections on the call

Correct answer: Objective and subjective findings gathered during patient assessment

Assessment findings capture the objective exam results and subjective patient complaints that form the basis of the student's clinical decision-making documentation.

Question 56: Which of the following best describes Cushing's triad, indicating increased intracranial pressure?

Hypertension, bradycardia, and irregular respirations (Correct answer)
Bradycardia, hypotension, and Cheyne-Stokes breathing
Tachycardia, hypotension, and irregular respirations
Hypertension, tachycardia, and deep slow respirations

Correct answer: Hypertension, bradycardia, and irregular respirations

Cushing's triad consists of hypertension (widened pulse pressure), bradycardia, and irregular respirations, signaling herniation-level ICP.

Question 57: A patient in pulseless VT does not respond to defibrillation. Which antiarrhythmic is given first per ACLS?

Procainamide 20 mg/min
Magnesium 2 g IV
Amiodarone 300 mg IV push (Correct answer)
Lidocaine 1.5 mg/kg

Correct answer: Amiodarone 300 mg IV push

Amiodarone 300 mg IV push is the first-line antiarrhythmic for shock-refractory VF/pulseless VT in the ACLS algorithm.

Question 58: What is the relationship between theory and practice in Medical Emergencies?

Practice is unnecessary if you know theory
Theory provides the foundation; practice applies it to real situations (Correct answer)
They are completely separate
Theory is unnecessary

Correct answer: Theory provides the foundation; practice applies it to real situations

Theory provides the conceptual foundation and principles, while practice involves applying those concepts to real-world situations. Both are essential for competence.

Question 59: Which of the following correctly describes the Mallampati classification?

A visual assessment predicting difficult intubation based on oral anatomy (Correct answer)
A scoring system for pediatric airway obstruction
A post-intubation tube depth reference guide
A radiographic scoring system for cervical spine injury

Correct answer: A visual assessment predicting difficult intubation based on oral anatomy

The Mallampati classification scores visibility of the soft palate, fauces, uvula, and pillars to predict difficult intubation.

Question 60: During transport of a hypotensive trauma patient, which IV fluid is preferred for initial resuscitation according to current trauma guidelines?

D5W at 250 mL bolus
Normal saline at 2 L bolus
Hypertonic saline 7.5% at 1 L
Warmed crystalloid with early blood products when available (Correct answer)

Correct answer: Warmed crystalloid with early blood products when available

Current TCCC and ATLS guidelines favor warmed crystalloids at controlled volumes combined with early blood products (plasma and packed RBCs) to reduce dilutional coagulopathy.

Question 61: How does documentation support quality in Cardiac Emergencies?

Documentation is unnecessary overhead
It creates records, ensures consistency, and enables improvement (Correct answer)
It is only for billing
It only serves administrative purposes

Correct answer: It creates records, ensures consistency, and enables improvement

Proper documentation creates accountability, ensures consistency, supports quality improvement, and provides legal protection.

Question 62: A patient in ventricular fibrillation receives a defibrillation shock. What is the FIRST action after shock delivery?

Resume CPR immediately (Correct answer)
Recheck the rhythm on the monitor
Administer epinephrine 1 mg IV
Check for a pulse immediately

Correct answer: Resume CPR immediately

After defibrillation, CPR should be resumed immediately for 2 minutes before pausing to recheck rhythm, as perfusion may not be restored instantly.

Question 63: A patient with chest pain and diaphoresis has ST depression in V1-V3 with dominant R waves. Which condition does this pattern suggest?

Digitalis toxicity
Anterior STEMI
Posterior STEMI (posterior wall MI) (Correct answer)
Benign early repolarization

Correct answer: Posterior STEMI (posterior wall MI)

ST depression with tall R waves in V1-V3 represents the reciprocal mirror image of a posterior STEMI and should prompt acquisition of posterior leads V7-V9.

Question 64: During a cardiac arrest resuscitation, what is the recommended dose and frequency of epinephrine administration?

1 mg IV every 2 minutes
2 mg IV every 10 minutes
0.5 mg IV every 5 minutes
1 mg IV every 3-5 minutes (Correct answer)

Correct answer: 1 mg IV every 3-5 minutes

The standard dose of epinephrine during cardiac arrest is 1 mg IV/IO administered every 3-5 minutes throughout the resuscitation.

Question 65: A 2-year-old presents with sudden onset inconsolable crying, drawing up of the legs, and intermittent periods of lethargy between episodes. Stool is described as currant jelly. This presentation is MOST consistent with:

Appendicitis
Meckel's diverticulum
Hirschsprung's disease
Intussusception (Correct answer)

Correct answer: Intussusception

Intussusception classically presents in toddlers with episodic abdominal pain, currant jelly stool (blood and mucus), and alternating distress and lethargy.

Question 66: Dopamine is ordered for a patient in cardiogenic shock. At which dose range does dopamine primarily exert beta-1 adrenergic effects to increase cardiac output?

1-3 mcg/kg/min
Greater than 20 mcg/kg/min
5-10 mcg/kg/min (Correct answer)
10-20 mcg/kg/min

Correct answer: 5-10 mcg/kg/min

At 5-10 mcg/kg/min, dopamine primarily stimulates beta-1 receptors, increasing heart rate and myocardial contractility to improve cardiac output.

Question 67: A patient presents with chest pain and his ECG shows a new right bundle branch block (RBBB) with ST elevation in V1-V4. This pattern suggests occlusion of which vessel?

Right coronary artery proximal segment
Left circumflex artery
Posterior descending artery
Proximal left anterior descending artery (Correct answer)

Correct answer: Proximal left anterior descending artery

New RBBB with anterior ST elevation strongly suggests a proximal LAD occlusion, which can interrupt blood flow to the right bundle branch and the anterior wall.

Question 68: Which of the following FISDAP fields would be used to document that a student performed an IV attempt that was unsuccessful?

Log it as a medication administration error
Skill performed: IV access — failed attempt (Correct answer)
Skip the skill entry since it was unsuccessful
Document under 'complications' field only

Correct answer: Skill performed: IV access — failed attempt

FISDAP tracks both successful and failed skill attempts to give a complete picture of a student's procedural experience and learning curve.

Question 69: A patient with anaphylaxis is rapidly developing stridor and hoarseness. Which airway intervention is most immediately indicated?

Nasopharyngeal airway
Surgical cricothyrotomy
Orotracheal intubation (Correct answer)
Supplemental oxygen by non-rebreather mask

Correct answer: Orotracheal intubation

Rapidly progressing angioedema from anaphylaxis may cause complete obstruction, so early orotracheal intubation is preferred before the airway closes.

Question 70: When responding to a potential suicide by hanging, the EMS crew should:

Document and leave if the patient appears deceased
Cut the patient down and assess responsiveness before calling for police
Stage until police secure the scene if the patient may be a crime scene (Correct answer)
Immediately enter and begin CPR without waiting for police

Correct answer: Stage until police secure the scene if the patient may be a crime scene

EMS should coordinate with law enforcement at potential crime scenes; in cases of obvious death, the scene must be preserved and police must be on scene before EMS alters the environment.

Question 71: How does documentation support quality in OB/GYN Emergencies?

It only serves administrative purposes
It creates records, ensures consistency, and enables improvement (Correct answer)
Documentation is unnecessary overhead
It is only for billing

Correct answer: It creates records, ensures consistency, and enables improvement

Proper documentation creates accountability, ensures consistency, supports quality improvement, and provides legal protection.

Question 72: A 4-year-old is found unresponsive after possible submersion. After establishing unresponsiveness, your first action should be:

Start chest compressions immediately
Apply an AED
Check for a carotid pulse
Open the airway and check for breathing (Correct answer)

Correct answer: Open the airway and check for breathing

For pediatric patients, after confirming unresponsiveness, open the airway and assess breathing before initiating CPR.

Question 73: An impaled object is found in a patient's left chest. What is the appropriate prehospital management?

Shorten the object and apply direct pressure around it
Stabilize the object in place and transport immediately (Correct answer)
Remove the object and apply an occlusive dressing
Leave it and apply pressure directly on top of the object

Correct answer: Stabilize the object in place and transport immediately

Impaled objects should be stabilized in place to prevent further injury, as removal can cause uncontrolled hemorrhage or worsen injury.

Question 74: When applying gentle pressure to the newborn's head during delivery to prevent explosive delivery, the EMT should:

Apply gentle, palm-flat counter-pressure to prevent rapid expulsion while guiding the head (Correct answer)
Apply firm backward pressure against the occiput to stop crowning
Instruct the mother to push harder to complete delivery faster
Pull the head downward toward the floor to deliver the anterior shoulder first

Correct answer: Apply gentle, palm-flat counter-pressure to prevent rapid expulsion while guiding the head

Gentle counterpressure on the emerging head prevents explosive delivery and perineal lacerations while allowing controlled, gradual expulsion.

Question 75: Which route of administration provides the fastest onset of action in a conscious patient with hypoglycemia who is unable to swallow?

Oral glucose gel rubbed on gums
Subcutaneous glucagon
Intramuscular glucagon (Correct answer)
Rectal dextrose suppository

Correct answer: Intramuscular glucagon

IM glucagon is rapidly absorbed and stimulates hepatic glycogenolysis, making it appropriate when IV access is unavailable and the patient cannot swallow safely.

Question 76: A 5-year-old with suspected meningitis presents with fever, stiff neck, and a non-blanching petechial rash. The rash characteristic that is MOST alarming is:

The associated fever above 39°C
Its distribution on the trunk
That it is non-blanching (purpuric) (Correct answer)
That it appeared within 24 hours

Correct answer: That it is non-blanching (purpuric)

A non-blanching purpuric rash in a febrile child suggests meningococcemia with septic emboli, which is a life-threatening emergency.

Question 77: What is the correct pediatric dose of epinephrine 1:10,000 for cardiac arrest?

0.5 mg/kg IV/IO
0.01 mg/kg IV/IO (Correct answer)
0.1 mg/kg IV/IO
1 mg flat dose IV/IO

Correct answer: 0.01 mg/kg IV/IO

The PALS recommended dose is 0.01 mg/kg (0.1 mL/kg of the 1:10,000 concentration) IV or IO for pediatric cardiac arrest.

Question 78: Which pediatric anatomical difference makes airway management more challenging during trauma resuscitation?

A larger glottic opening relative to body size
A lower-positioned larynx compared to adults
Thicker, more rigid airway cartilages
A proportionally larger occiput causing natural neck flexion when supine (Correct answer)

Correct answer: A proportionally larger occiput causing natural neck flexion when supine

A child's larger occiput causes the neck to flex forward when supine, which can obstruct the airway; a folded towel under the shoulders helps achieve a neutral position.

Question 79: At a structure fire scene, EMS staging areas should be located:

Downwind to avoid blocking the command post
Upwind and uphill from the incident, outside the hot zone (Correct answer)
Immediately adjacent to the fire suppression vehicles
Inside the perimeter to allow rapid patient access

Correct answer: Upwind and uphill from the incident, outside the hot zone

EMS staging upwind and uphill keeps providers and equipment away from smoke, hazardous gases, and structural collapse zones.

Question 80: A 22-year-old female presents with sharp, pleuritic chest pain and shortness of breath. She is on oral contraceptives and returned from a long flight yesterday. You MOST suspect:

Pericarditis
Pulmonary embolism (Correct answer)
Musculoskeletal chest pain
Spontaneous pneumothorax

Correct answer: Pulmonary embolism

Oral contraceptive use combined with prolonged immobility during travel creates significant risk for deep vein thrombosis and subsequent pulmonary embolism.

Question 81: A patient presents with signs of cardiac tamponade including hypotension, distended jugular veins, and muffled heart sounds. What is this classic triad called?

Murphy's triad
Virchow's triad
Beck's triad (Correct answer)
Cushing's triad

Correct answer: Beck's triad

Beck's triad — hypotension, jugular venous distension, and muffled heart sounds — is the classic presentation of cardiac tamponade.

Question 82: You arrive on scene and find an adult patient with complete airway obstruction who is unconscious. After activating EMS, your next step is:

Begin CPR starting with chest compressions (Correct answer)
Insert an OPA and begin BVM ventilation
Perform a blind finger sweep immediately
Attempt back blows in the supine position

Correct answer: Begin CPR starting with chest compressions

For an unconscious patient with suspected FBAO, begin CPR with chest compressions; each time you open the airway, look for the object before attempting ventilation.

Question 83: A patient presents with sudden onset of severe, tearing chest pain radiating to the back. BP is 190/110 in the right arm and 140/90 in the left arm. What is the most likely diagnosis?

Hypertensive crisis with pulmonary edema
Tension pneumothorax
Acute anterior STEMI
Aortic dissection (Correct answer)

Correct answer: Aortic dissection

Tearing chest pain radiating to the back with blood pressure differential between arms is the classic presentation of aortic dissection, a life-threatening emergency.

Question 84: When assessing a 3-year-old using the Pediatric Assessment Triangle (PAT), which component evaluates skin color, moisture, and temperature?

Appearance
Mental status
Work of breathing
Circulation to skin (Correct answer)

Correct answer: Circulation to skin

Circulation to skin in the PAT evaluates pallor, mottling, cyanosis, and skin temperature to assess perfusion.

Question 85: You are assessing a trauma patient and notice that a segment of the chest wall moves inward during inhalation and outward during exhalation. This is called:

Cheyne-Stokes respiration
Paradoxical chest movement (Correct answer)
Kussmaul breathing
Agonal breathing

Correct answer: Paradoxical chest movement

Paradoxical chest movement occurs with flail chest, where multiple rib fractures cause a segment to move opposite to the rest of the chest wall.

Question 86: Under FISDAP's special populations framework, which consideration is most important when treating a bariatric patient requiring extrication?

Spinal precaution protocol
Equipment weight limits and additional crew resources (Correct answer)
Medication dosing by weight
IV access site selection

Correct answer: Equipment weight limits and additional crew resources

FISDAP documents bariatric patient care, including recognition that standard equipment may be inadequate and additional resources are often required.

Question 87: What is the purpose of the 'Five Rights' in medication administration?

To determine pricing
To organize inventory
To classify medications
To prevent medication errors: right patient, drug, dose, route, time (Correct answer)

Correct answer: To prevent medication errors: right patient, drug, dose, route, time

The Five Rights serve as a safety checklist to prevent medication errors during every administration.

Question 88: Which FISDAP module is specifically designed to help students track their own progress toward clinical competency benchmarks?

Shift scheduler
Skills lab inventory
Preceptor portal
Student dashboard (Correct answer)

Correct answer: Student dashboard

The student dashboard in FISDAP provides a real-time view of completed hours, skill counts, and benchmark progress so students can self-monitor.

Question 89: During a focused physical exam of a trauma patient with a mechanism of injury suggesting spinal involvement, which area should be assessed first?

Abdomen
Lower extremities
Chest
Cervical spine (Correct answer)

Correct answer: Cervical spine

The cervical spine is assessed first in trauma patients with a suspicious mechanism to detect tenderness, deformity, or instability before moving the patient.

Question 90: What is the primary purpose of professional certification in Cardiac Emergencies?

To replace practical experience
To meet legal requirements only
To increase salary automatically
To validate competency and knowledge in the field (Correct answer)

Correct answer: To validate competency and knowledge in the field

Certification validates that a professional has met established standards of knowledge and competency in Cardiac Emergencies.

Question 91: Which of the following is the preferred initial airway maneuver in an unresponsive trauma patient with a suspected cervical spine injury?

Orotracheal intubation
Head-tilt chin-lift
Jaw-thrust maneuver (Correct answer)
Nasopharyngeal airway insertion

Correct answer: Jaw-thrust maneuver

The jaw-thrust maneuver opens the airway without extending the neck, making it the preferred technique in suspected C-spine injury.

Question 92: Which document outlines the minimum number of patient contacts required for paramedic students to meet CoAEMSP accreditation standards?

OSHA 29 CFR 1910.1030 Bloodborne Pathogen Standard
The NREMT Psychomotor Examination Skill Sheets
Standards and Guidelines for the Accreditation of Educational Programs in the EMS Professions (Correct answer)
The Federal EMS Scope of Practice Model

Correct answer: Standards and Guidelines for the Accreditation of Educational Programs in the EMS Professions

The Standards and Guidelines for Accreditation of Educational Programs in the EMS Professions, published by CoAEMSP, defines minimum clinical experience requirements.

Question 93: A 32-year-old woman at 38 weeks gestation presents with a sudden gush of fluid and you observe the umbilical cord protruding from the vagina. Your FIRST priority is to:

Place the patient supine and transport rapidly
Elevate the presenting part off the cord and keep the cord moist (Correct answer)
Apply firm pressure to the cord to slow blood flow
Clamp and cut the cord immediately

Correct answer: Elevate the presenting part off the cord and keep the cord moist

In cord prolapse, the EMT must manually elevate the presenting part off the cord to relieve compression while keeping the exposed cord moist and warm.

Question 94: A 35-year-old male with a history of depression ingested an unknown quantity of tricyclic antidepressants (TCAs). He is now unresponsive with a wide QRS complex on ECG. Which treatment is most immediately indicated?

Magnesium sulfate IV for torsades prevention
Sodium bicarbonate IV to narrow the QRS (Correct answer)
Physostigmine IV to reverse anticholinergic effects
Activated charcoal via nasogastric tube

Correct answer: Sodium bicarbonate IV to narrow the QRS

Sodium bicarbonate alkalinizes the blood, reducing TCA binding to sodium channels and narrowing the QRS complex in TCA-induced cardiotoxicity.

Question 95: A patient with a history of COPD presents with increased work of breathing, pursed-lip breathing, and barrel chest. These findings are associated with which underlying condition?

Asthma
Emphysema (Correct answer)
Pulmonary edema
Pneumonia

Correct answer: Emphysema

Barrel chest and pursed-lip breathing are classic chronic physical findings of emphysema, a component of COPD caused by air trapping.

Question 96: A patient is found apneic with dentures present. What is the best action regarding the dentures during BVM ventilation?

Leave well-fitting dentures in place to maintain mask seal (Correct answer)
Remove only the upper denture
Remove only the lower denture
Always remove them immediately

Correct answer: Leave well-fitting dentures in place to maintain mask seal

Well-fitting dentures help maintain facial contour and improve mask seal during BVM ventilation; remove them only if they become dislodged.

Question 97: During a vehicle rescue, a patient has a positive Seat Belt Sign (bruising across the abdomen). This finding is associated with which injury pattern?

Cardiac contusion and sternal fracture
Isolated rib fractures
Hollow organ injury, lumbar spine fracture (Chance fracture) (Correct answer)
Femoral artery laceration

Correct answer: Hollow organ injury, lumbar spine fracture (Chance fracture)

The Seat Belt Sign indicates significant deceleration force transmitted through the lap belt, commonly causing hollow organ rupture and Chance fractures of the lumbar spine.

Question 98: What is the relationship between theory and practice in Airway Management?

They are completely separate
Practice is unnecessary if you know theory
Theory provides the foundation; practice applies it to real situations (Correct answer)
Theory is unnecessary

Correct answer: Theory provides the foundation; practice applies it to real situations

Theory provides the conceptual foundation and principles, while practice involves applying those concepts to real-world situations. Both are essential for competence.

Question 99: A patient with a suspected foreign body upper airway obstruction is coughing forcefully. The correct immediate action is to:

Encourage continued coughing and monitor closely (Correct answer)
Perform a blind finger sweep
Attempt laryngoscopy
Perform abdominal thrusts immediately

Correct answer: Encourage continued coughing and monitor closely

A patient with a forceful cough still has adequate airflow; allow them to continue coughing as it is the most effective way to clear the obstruction.

Question 100: A trauma patient has a GCS score calculated as: Eye opening to voice (3) + Verbal response confused (4) + Motor response withdraws to pain (4). What is the total GCS?

13
8
9
11 (Correct answer)

Correct answer: 11

GCS = Eye (3) + Verbal (4) + Motor (4) = 11; this indicates moderate traumatic brain injury.

FISDAP EMS Readiness Exam

The FISDAP (Field Internship Student Data Acquisition Project) EMS Readiness Exam assesses EMT and paramedic student competency in patient assessment, airway management, cardiac emergencies, trauma management, medical emergencies, OB/GYN emergencies, pediatric assessment, pharmacology, EMS operations, and special populations.

100

Questions

120 min

Time Limit

70%

To Pass

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