Free IBSC Flight Paramedic (FP-C) practice questions

Question 3

On direct laryngoscopy, a CCTP can visualize only the patient's epiglottis and no part of the glottic opening. Using the Cormack-Lehane grading system, how should this view be classified?

• Grade 1
• Grade 2
• Grade 3Correct
• Grade 4

Why: Cormack-Lehane grade 3 is defined as visualization of only the epiglottis, with no part of the glottic opening seen; this grade is associated with significant intubation difficulty. Grade 1 shows the entire glottic opening, grade 2 shows only the arytenoids or posterior glottis, and grade 4 shows only the tongue or soft palate. Primary reference: Critical Care Transport (Jones & Bartlett, 3rd Edition), Respiratory Emergencies and Airway Management, p. 470. Cross-reference: ASTNA Patient Transport: Principles and Practice (Mosby, 4th Edition), Airway Management, p. 496.

Question 4

A patient is seated upright and asked to open the mouth fully without phonating. The examiner can see the soft palate and the base of the uvula, but the posterior pharyngeal wall and tonsillar pillars are not visible. Which Mallampati class does this describe?

• Class I
• Class II
• Class IIICorrect
• Class IV

Why: Mallampati class III is defined by the posterior pharynx being obscured with only the base of the uvula and soft palate visible. Class I shows the entire posterior pharynx, class II shows the pharynx only partially exposed, and class IV shows no posterior structures at all, including the soft palate. Primary reference: Critical Care Transport (Jones & Bartlett, 3rd Edition), Respiratory Emergencies and Airway Management, p. 463. Cross-reference: ASTNA Patient Transport: Principles and Practice (Mosby, 4th Edition), Airway Management, p. 543.

Question 5

A CCTP is using the HEAVEN mnemonic to predict a difficult airway in an unconscious trauma patient. Which finding corresponds to the 'V' in this mnemonic and should prompt suctioning before any laryngoscopy attempt?

• Ventilator asynchrony
• Vomit, blood, or fluid noted in the pharynx or hypopharynxCorrect
• Ventricular dysrhythmia on the cardiac monitor
• Vagal bradycardia from airway manipulation

Why: In the HEAVEN mnemonic, V stands for vomit, blood, or fluid observed in the pharynx or hypopharynx before laryngoscopy, and clinically significant fluid should be suctioned before the attempt. The mnemonic does not address ventilator asynchrony, dysrhythmias, or vagal responses. Primary reference: Critical Care Transport (Jones & Bartlett, 3rd Edition), Respiratory Emergencies and Airway Management, p. 466.

Question 6

A CCTP recalls that roughly what proportion of emergency intubations performed in the out-of-hospital environment are classified as anatomically or physiologically difficult?

• Fewer than 5%
• About 20%Correct
• About 50%
• More than 80%

Why: The text states that an estimated 20% of all emergency intubations are classified as difficult, which is why systematic difficult-airway prediction tools such as LEMONS and HEAVEN are used before every attempt. The other proportions are not supported by the reference. Primary reference: Critical Care Transport (Jones & Bartlett, 3rd Edition), Respiratory Emergencies and Airway Management, p. 458.

Question 7

Which patient population is specifically noted to have a four-times higher rate of failed intubation compared with the general population, along with more anterior airway tissues and increased aspiration risk from the hormone relaxin?

• Patients with morbid obesity
• Pregnant patientsCorrect
• Patients with chronic obstructive pulmonary disease
• Older adults with osteoarthritis

Why: The text specifically flags pregnant patients as having a fourfold higher failed-intubation rate, a more anterior airway, friable tissues that bleed easily, and an aspiration risk elevated by the hormone relaxin. Obesity, COPD, and osteoarthritis are separately discussed airway-difficulty factors but are not linked to this specific fourfold statistic or to relaxin-mediated aspiration risk. Primary reference: Critical Care Transport (Jones & Bartlett, 3rd Edition), Respiratory Emergencies and Airway Management, p. 505.

Question 8

A CCTP is preparing to perform a cricothyrotomy and palpates the anterior neck to locate the cricothyroid membrane. Between which two cartilaginous landmarks does this membrane lie?

• The hyoid bone and the thyroid cartilage
• The thyroid cartilage and the cricoid cartilageCorrect
• The cricoid cartilage and the first tracheal ring
• The arytenoid cartilages and the epiglottis

Why: The cricothyroid membrane extends from the lower surface of the cricoid cartilage to the upper border of the thyroid cartilage, making it the surgical airway landmark between those two structures. The hyoid-thyroid space, the cricoid-to-first-tracheal-ring junction, and the arytenoid-epiglottis relationship are different anatomic relationships that are not the cricothyrotomy site. Primary reference: Critical Care Transport (Jones & Bartlett, 3rd Edition), Respiratory Emergencies and Airway Management, p. 387. Cross-reference: ASTNA Patient Transport: Principles and Practice (Mosby, 4th Edition), Airway Management, p. 490.

Question 9

In an adult patient, the cricothyroid membrane is approximately how many millimeters in vertical (superior-to-inferior) span, a detail relevant to needle or surgical cricothyrotomy?

• 1 to 2 mm
• 6 to 8 mmCorrect
• 15 to 20 mm
• 30 to 35 mm

Why: The reference specifically states that in adults the cricothyroid membrane spans approximately 6 to 8 mm from its superior to inferior border, a small target that explains why precise palpation of landmarks is essential before incision. The other values are too small or far too large to describe this membrane. Primary reference: Critical Care Transport (Jones & Bartlett, 3rd Edition), Respiratory Emergencies and Airway Management, p. 387.

Question 10

Which cranial nerve provides the strong sensory innervation to the larynx that, when overstimulated during laryngoscopy, can trigger a parasympathetic response with bradycardia and hypotension, particularly in pediatric patients?

• The glossopharyngeal nerve (cranial nerve IX)
• The vagus nerve (cranial nerve X)Correct
• The hypoglossal nerve (cranial nerve XII)
• The trigeminal nerve (cranial nerve V)

Why: The vagus nerve supplies strong sensory innervation to the larynx, and overstimulation during airway manipulation can provoke a parasympathetic surge with bradycardia and hypotension, an effect that is more pronounced in children. The glossopharyngeal nerve instead innervates the posterior tongue and valleculae, while the hypoglossal and trigeminal nerves are not described as the source of this vagal reflex. Primary reference: Critical Care Transport (Jones & Bartlett, 3rd Edition), Respiratory Emergencies and Airway Management, p. 387.