MEDICAL PARAMEDIC FISDAP
EXAM 2024
Question 1:
A 45-year-old male presents with acute onset chest pain radiating to his left
arm. He has a history of hypertension and diabetes. Upon arrival, his vital
signs are BP 160/90 mmHg, HR 110 bpm, RR 20 breaths per minute, and
SpO2 94% on room air. ECG shows ST elevation in leads II, III, and aVF.
What is the most appropriate initial management for this patient?
A) Administer 0.4 mg sublingual nitroglycerin, initiate high-flow oxygen, and
prepare for rapid transport.
B) Administer 324 mg chewable aspirin, establish IV access, administer 0.4
mg sublingual nitroglycerin, and prepare for rapid transport.
C) Establish IV access, administer 5 mg morphine IV, and observe for pain relief
before transport.
D) Initiate high-flow oxygen, administer 0.4 mg sublingual nitroglycerin, and
monitor vitals every 5 minutes.
Question 2:
A 32-year-old female presents with severe shortness of breath, wheezing, and
chest tightness. She has a history of asthma and is currently taking albuterol
inhaler. On examination, she has diminished breath sounds bilaterally and
accessory muscle use. Her vital signs are BP 130/80 mmHg, HR 120 bpm, RR
28 breaths per minute, and SpO2 88% on room air. What is the most
appropriate initial treatment?
A) Administer albuterol and ipratropium via nebulizer, administer 0.3 mg
epinephrine IM, and start high-flow oxygen.
B) Start high-flow oxygen, administer 2 mg IV morphine, and prepare for
immediate transport.
C) Administer 2 g IV magnesium sulfate, start high-flow oxygen, and observe for
improvement.
D) Establish IV access, administer 0.4 mg sublingual nitroglycerin, and monitor
vitals every 5 minutes.
,Question 3:
A 65-year-old female with a history of COPD presents with confusion,
cyanosis, and peripheral edema. She is on home oxygen therapy. Her vital
signs are BP 90/60 mmHg, HR 130 bpm, RR 30 breaths per minute, and SpO2
82% on 2 L/min of oxygen. What is the next best step in managing this
patient?
A) Increase oxygen flow to 15 L/min via non-rebreather mask, initiate CPAP, and
prepare for transport.
B) Increase oxygen flow to 6 L/min via nasal cannula, administer 40 mg IV
furosemide, and prepare for transport.
C) Initiate high-flow oxygen, administer 0.3 mg epinephrine IM, and prepare for
immediate transport.
D) Establish IV access, administer 500 mL IV normal saline bolus, and prepare for
transport.
Question 4:
A 50-year-old male presents with severe abdominal pain radiating to his back.
He is diaphoretic and appears in distress. He has a history of hypertension
and aortic aneurysm repair. His vital signs are BP 80/50 mmHg, HR 110 bpm,
RR 24 breaths per minute, and SpO2 95% on room air. What is the most
likely diagnosis and initial management?
A) Acute pancreatitis; initiate IV fluids, administer 4 mg IV morphine, and prepare
for transport.
B) Aortic dissection; initiate IV fluids, administer 5 mg IV labetalol, and
prepare for rapid transport.
C) Acute myocardial infarction; administer 324 mg chewable aspirin, establish IV
access, and prepare for transport.
D) Gastrointestinal bleed; administer 500 mL IV normal saline bolus, and prepare
for transport.
Question 5:
A 29-year-old male presents with a generalized tonic-clonic seizure lasting 5
minutes. He has a history of epilepsy and missed his last dose of medication.
On arrival, he is postictal but regaining consciousness. His vital signs are BP
140/90 mmHg, HR 100 bpm, RR 18 breaths per minute, and SpO2 96% on
room air. What is the most appropriate management?
, A) Administer 2 mg IV lorazepam, establish IV access, monitor vital signs,
and prepare for transport.
B) Place in a recovery position, administer 10 mg intranasal midazolam, and
observe for further seizures.
C) Initiate high-flow oxygen, administer 5 mg IV diazepam, and prepare for rapid
transport.
D) Establish IV access, administer 1 g IV magnesium sulfate, and observe for
improvement.
Question 6:
A 60-year-old female presents with sudden onset of severe headache, nausea,
and vomiting. She has a history of hypertension and is currently taking
antihypertensive medication. Her vital signs are BP 200/110 mmHg, HR 100
bpm, RR 20 breaths per minute, and SpO2 98% on room air. On
examination, she has neck stiffness and photophobia. What is the most likely
diagnosis and initial management?
A) Migraine headache; administer 4 mg IV ondansetron, establish IV access, and
prepare for transport.
B) Subarachnoid hemorrhage; initiate high-flow oxygen, establish IV access,
and prepare for rapid transport.
C) Hypertensive emergency; administer 5 mg IV labetalol, establish IV access, and
prepare for transport.
D) Meningitis; administer 2 g IV ceftriaxone, initiate high-flow oxygen, and
prepare for transport.
Question 7:
A 35-year-old male presents with severe flank pain radiating to the groin,
hematuria, and nausea. He has no significant medical history. His vital signs
are BP 140/90 mmHg, HR 110 bpm, RR 22 breaths per minute, and SpO2
97% on room air. What is the most likely diagnosis and initial management?
A) Kidney stone; administer 4 mg IV morphine, establish IV access, and
prepare for transport.
B) Acute pyelonephritis; administer 1 g IV ceftriaxone, establish IV access, and
prepare for transport.
C) Acute cholecystitis; administer 4 mg IV ondansetron, establish IV access, and
prepare for transport.