22 Aeromedical & Decision Making Practice Questions & Answers

1. 1. A pilot flying a single-engine airplane at 6,500 feet develops a headache, drowsiness, and blurred vision, and later testing shows that carbon monoxide has bound to a large share of the hemoglobin in the blood. Which type of hypoxia does carbon monoxide produce, and why?

   • A.Histotoxic hypoxia, because the cells of the body are themselves poisoned and can no longer make use of the oxygen delivered to them.
   • B.Hypoxic hypoxia, because the reduced barometric pressure at cruising altitude lowers the amount of oxygen forced across the lung membrane into the blood.
   • C.Stagnant hypoxia, because the poisoned blood slows in the extremities and no longer circulates oxygen out to the tissues that are working.
   • D.Hypemic hypoxia, because carbon monoxide binds to hemoglobin far more readily than oxygen does and cuts the blood's carrying capacity.✓ Answer

   Carbon monoxide attaches to hemoglobin about 200 times more readily than oxygen does, so the blood loses much of its ability to carry oxygen even though the lungs and circulation are working normally. That is exactly what hypemic hypoxia means, and the body may need up to 48 hours to clear the carbon monoxide.

   Source: FAA-H-8083-25 (PHAK), Chapter 17; AIM 8-1-4Report a problem with this question

2. 2. During a cross-country flight in an unpressurized airplane at 13,500 feet MSL, a pilot with no supplemental oxygen aboard notices a carefree, elated feeling, slowed thinking, and tingling fingertips. What is the appropriate action?

   • A.Stay at altitude and breathe deeply and rapidly for several minutes, which restores the oxygen the blood has been losing.
   • B.Descend to a lower altitude, and use supplemental oxygen for the remainder of the flight if any is carried aboard.✓ Answer
   • C.Remain at 13,500 feet but increase the cabin heat and open the fresh air vents to raise the oxygen reaching the cabin.
   • D.Continue the climb to a smoother altitude, since the symptoms described come from turbulence and fatigue rather than height.

   Oxygen is still about 21 percent of the air at altitude; it is the lower barometric pressure that keeps enough oxygen from crossing into the blood, so the only real fixes are to get back down or to breathe supplemental oxygen. Euphoria and impaired judgment come early, which is why the pilot must act on the symptoms rather than assess them.

   Source: FAA-H-8083-25 (PHAK), Chapter 17; AIM 8-1-2Report a problem with this question

3. 3. A student pilot on a first solo cross-country becomes anxious in unfamiliar airspace, begins breathing rapidly, and reports dizziness, tingling in the hands, and hot and cold sensations. Which action corrects this condition?

   • A.Slow the rate of breathing deliberately, breathe into a paper bag, or talk aloud until the breathing returns to normal.✓ Answer
   • B.Take an over-the-counter antihistamine from the flight bag, since the symptoms come from an allergic reaction to cabin air.
   • C.Climb several thousand feet and open the fresh air vent, so that cooler and drier air can help settle the breathing rate.
   • D.Breathe more deeply and more rapidly for a short period, so that the lungs can move additional oxygen into the bloodstream.

   Hyperventilation is an excessive rate and depth of breathing that washes carbon dioxide out of the blood; it is not a shortage of oxygen, so more or faster breathing makes it worse. Slowing the breathing, rebreathing into a bag, or simply talking aloud restores the carbon dioxide balance and the symptoms clear quickly.

   Source: AIM 8-1-3; FAA-H-8083-25 (PHAK), Chapter 17Report a problem with this question

4. 4. In flight on a cold day with the cabin heater on, a pilot smells exhaust fumes and soon feels a headache, dizziness, and loss of muscle power. What is the correct response, and why does the cabin heater matter here?

   • A.Turn on the pitot heat and lean the mixture aggressively, because a rich mixture is what puts carbon monoxide into the cabin air.
   • B.Descend to a lower altitude and continue as planned, because carbon monoxide is flushed out of the blood within a few minutes.
   • C.Shut the heater off, open the fresh air vents, and land as soon as practicable, because heater air is warmed by the exhaust.✓ Answer
   • D.Leave the heater on but select maximum defrost, because sending the heated air to the windshield keeps the fumes away from the pilot.

   In most light airplanes cabin heat comes from air passed over a shroud around the exhaust, so a cracked exhaust system feeds carbon monoxide straight into the cabin and the defroster. Turning the heat off and ventilating removes the source, and landing promptly matters because the gas can take up to 48 hours to leave the blood.

   Source: AIM 8-1-4; FAA-H-8083-25 (PHAK), Chapter 17Report a problem with this question

5. 5. A pilot who is getting over a head cold feels increasing pain in the ears and above the eyebrows while descending for landing. Why does this happen on descent, and what is the best preventive practice?

   • A.Air pressure change affects only the balance organs of the inner ear, so a pilot should avoid head movements throughout the descent.
   • B.Air trapped in the ears and sinuses cannot equalize on descent, so a pilot should not fly with an upper respiratory infection.✓ Answer
   • C.Air expands during descent and stretches the eardrum outward, so a pilot should use a decongestant spray before every flight.
   • D.Air trapped in the ears and sinuses cannot equalize on the climb, so a pilot should climb at a shallower angle and level off often.

   On the climb the expanding air in the middle ear and sinuses pushes its own way out, but on descent the pilot must actively open the eustachian tube, and congestion from a cold or an allergy blocks it. Because sprays and oral decongestants either do not work well enough or degrade pilot performance, the FAA's answer is simply not to fly with an upper respiratory infection.

   Source: AIM 8-1-2; FAA-H-8083-25 (PHAK), Chapter 17Report a problem with this question

6. 6. On a dark night over open water with no visible horizon, a pilot rolls the wings level from a gradual turn and immediately feels strongly that the airplane is banked the other way, although the attitude indicator shows the wings level. What should the pilot do?

   • A.Make a shallow turn in the direction the body senses, because that relieves the sensation and re-centers the balance organs.
   • B.Trust the sensation of bank, because the inner ear detects a rolling motion more reliably than any gyroscopic instrument does.
   • C.Trust the attitude indicator and the other flight instruments, and fly the airplane by them until visual references return.✓ Answer
   • D.Level the wings by feel and then verify the result against the magnetic compass, which is not affected by aircraft attitude.

   This is the leans: a roll rate slow enough to escape the semicircular canals goes unnoticed, and the abrupt rollout is then felt as a bank in the opposite direction. The only reliable cure for any spatial disorientation is to disregard bodily sensations and fly by the flight instruments.

   Source: AIM 8-1-5; FAA-H-8083-25 (PHAK), Chapter 17Report a problem with this question

7. 7. A pilot in instrument conditions has been holding a steady standard-rate turn for about a minute when a chart slips to the floor; on bending down to retrieve it the pilot is overwhelmed by a sensation of tumbling and rotating on a different axis. Which illusion is this, and how is it avoided?

   • A.Graveyard spiral, avoided by relaxing back pressure whenever the altimeter shows the airplane descending in a turn.
   • B.Somatogravic illusion, avoided by delaying any pitch change until the airplane has finished accelerating along its flightpath.
   • C.The leans, avoided by rolling out of turns briskly enough that the inner ear can register the change in the rate of roll.
   • D.Coriolis illusion, avoided by keeping head movements to a minimum and by not reaching for dropped items during a turn.✓ Answer

   During a prolonged constant-rate turn the fluid in the semicircular canals settles and the turn is no longer sensed; a head movement in a different plane then sets that fluid moving again and produces an overwhelming false sense of rotation about another axis. Keeping the head still during turns, and securing loose items, is the practical defense.

   Source: AIM 8-1-5; FAA-H-8083-25 (PHAK), Chapter 17Report a problem with this question

8. 8. Ten miles from a busy nontowered airport, a pilot is hand-flying, trying to reprogram the GPS, listening for traffic, and answering a passenger's questions, and then notices the airplane has drifted 500 feet off altitude. What is the best way to manage this workload?

   • A.Fly the airplane first, then navigate, then communicate, and postpone the reprogramming until the airplane is stable.✓ Answer
   • B.Finish the GPS entries first, since an accurate flight plan loaded in the box removes most of the workload that follows it.
   • C.Ask the passenger to read the checklist aloud while continuing all of the tasks in the order in which they came up.
   • D.Report the altitude deviation on the common frequency and then work through the remaining tasks one at a time.

   Task management means recognizing an overload and then prioritizing: aviate, navigate, communicate. Programming an avionics box is the lowest-priority item and the one most likely to steal attention, so it is deferred until the airplane is trimmed, level, and clear of conflicting traffic.

   Source: FAA-H-8083-25 (PHAK), Chapter 2 (Aeronautical Decision-Making)Report a problem with this question

9. 9. A pilot who normally uses a 150-foot-wide runway is landing at an airport whose runway is 60 feet wide and slopes upward toward the far end. What error does this combination tend to produce, and why?

   • A.The pilot feels too high and tends to fly a lower approach, because both cues make the runway look farther away than it is.✓ Answer
   • B.The pilot feels too low and tends to fly a higher approach, because both cues make the runway look closer than it really is.
   • C.The pilot feels level and tends to flare late, because an upslope hides the change in the aiming point during the roundout.
   • D.The pilot feels too fast and tends to reduce power early, because a narrow surface exaggerates the sensation of groundspeed.

   A narrower than usual runway and an upsloping runway both make the pilot perceive a greater height than actually exists, and the natural correction is to descend, which puts the airplane low and short. Featureless terrain, haze, and rain on the windscreen create the same feels-high, flies-low error.

   Source: AIM 8-1-5; FAA-H-8083-25 (PHAK), Chapter 17Report a problem with this question

10. 10. A night approach is being made to a runway that lies beyond several miles of unlit desert, with no ground lights or terrain features between the pilot and the threshold. What is the most effective way to keep this approach from ending short of the runway?

    • A.Keep the runway lights fixed in the same spot on the windshield, which holds the airplane on a constant descent angle.
    • B.Aim well beyond the threshold and carry extra airspeed, so that a low approach can be arrested with power in the flare.
    • C.Use the VASI or PAPI, or an electronic glidepath, and cross-check the altimeter against known distances on the way inbound.✓ Answer
    • D.Fly the approach with the landing light off, so that the unlit ground ahead does not reflect glare back into the cockpit.

    An approach over featureless dark terrain, the so-called black hole, removes the visual cues that tell a pilot how high the airplane is, and the usual result is an approach flown far too low. A visual glideslope such as VASI or PAPI, or an electronic glidepath, replaces the missing cues with a reference that cannot be fooled by the darkness.

    Source: AIM 8-1-5; FAA-H-8083-25 (PHAK), Chapter 17Report a problem with this question

11. 11. A pilot searching for traffic on a moonless night finds that an object looked at directly seems to disappear. Which technique deals with this, and why does it work?

    • A.Look about 5 to 10 degrees off to the side of the object and shift the viewing point every few seconds, so the rods do the seeing.✓ Answer
    • B.Turn up the cockpit lighting and look out through the top of the windshield, so the eyes work at a comfortable brightness.
    • C.Sweep the eyes steadily across the whole windshield without pausing, so that motion keeps the image from fading out at all.
    • D.Look directly at the object for at least 10 seconds without blinking, to let the cones of the fovea gather enough light.

    At night the cones in the center of the visual field are nearly useless, which creates a night blind spot straight ahead, so the light-sensitive rods around the periphery must do the seeing. Off-center viewing places the image on the rods, and the viewing point must be shifted every few seconds because rods reach a chemical equilibrium and the image fades if it is held.

    Source: AIM 8-1-6; FAA-H-8083-25 (PHAK), Chapter 17Report a problem with this question

12. 12. A student pilot becomes nauseated, pale, and sweaty during the third training flight. What is the recommended way to deal with this, and why are motion sickness drugs discouraged for the pilot?

    • A.Open the vents, look at objects outside the airplane, limit head movement, and avoid the drugs because they cause drowsiness.✓ Answer
    • B.Take an over-the-counter motion sickness tablet before each lesson, because the drugs act only on the inner ear.
    • C.Close the vents and focus on the instrument panel, because holding a fixed gaze inside settles the conflicting sensations.
    • D.Stop all flight training until the condition disappears on its own, because further exposure to flight makes the symptoms worse.

    Motion sickness arises when the visual, vestibular, and postural senses send the brain conflicting messages about the state of the body, so fresh air and an outside visual reference reduce the conflict. Anti-motion-sickness medication is not recommended for a pilot because drowsiness and other performance effects are more dangerous than the nausea.

    Source: FAA-H-8083-25 (PHAK), Chapter 17Report a problem with this question

13. 13. A pilot stops drinking at 10 p.m. and plans to act as pilot in command at 7 a.m. the next morning. A breath test at 7 a.m. would show an alcohol concentration of 0.045. Under 14 CFR 91.17, what is this pilot's status?

    • A.The flight is permitted, because the 0.04 limit applies only after a law enforcement officer has requested a blood or breath test.
    • B.The flight is not permitted, because the rule also bars acting as a crewmember at an alcohol concentration of 0.04 or greater.✓ Answer
    • C.The flight is not permitted, because the rule requires 12 to 24 hours between the last drink and any flight as pilot in command.
    • D.The flight is permitted, because more than 8 hours have passed since the last drink and that is the controlling requirement.

    14 CFR 91.17(a) sets two independent bars: no crewmember duties within 8 hours of consuming any alcoholic beverage, and none while the alcohol concentration is 0.04 or greater. Satisfying the 8-hour interval does nothing if the concentration is still at or above the limit, and the widely quoted 12 to 24 hours is advisory guidance rather than the regulation.

    Source: 14 CFR 91.17(a)Report a problem with this question

14. 14. A private pilot has a head cold and has been taking an over-the-counter antihistamine whose label warns that it causes drowsiness. Under 14 CFR 61.53, what determines whether this pilot may act as pilot in command?

    • A.The rule turns on whether the condition or its treatment would prevent the pilot from meeting the medical certificate standards.✓ Answer
    • B.The rule turns on whether the drug is available only by prescription, so an over-the-counter product is outside it.
    • C.The rule turns on an 8-hour interval from the last dose, the same interval that is used for alcoholic beverages.
    • D.The rule turns on whether a second rated pilot is aboard who could take the controls if drowsiness appears.

    14 CFR 61.53 prohibits acting as pilot in command while knowing of a medical condition, or while taking medication for a condition, that would make the person unable to meet the requirements for the medical certificate held. The rule works by effect rather than by naming drugs, and the underlying illness can be disqualifying even when the medication is not.

    Source: 14 CFR 61.53Report a problem with this question

15. 15. A pilot flying a long leg on a hot summer day has had two cups of coffee and no water since morning. What is the first noticeable effect of dehydration, and what is the sound preventive practice?

    • A.Nausea appears first, and the pilot should replace fluids with coffee or a caffeinated soft drink, since those are absorbed the fastest.
    • B.Fatigue appears first, and the pilot should drink water steadily rather than wait for thirst, which starts only after a real deficit.✓ Answer
    • C.Muscle cramps appear first, and the pilot should carry salt tablets in the flight bag, since the sodium lost in sweat is the problem.
    • D.Blurred vision appears first, and the pilot should rely on thirst as the signal, because thirst tracks body water content very closely.

    The first noticeable effect of a critical loss of body water is fatigue, followed by headache, cramps, and dizziness, and coffee and other caffeinated drinks are diuretics that make the loss worse. Thirst is an unreliable alarm because it is triggered only after a substantial deficit has built up and it is switched off again by a small drink.

    Source: FAA-H-8083-25 (PHAK), Chapter 17Report a problem with this question

16. 16. After a difficult week at work, a pilot sleeps poorly for several nights and still feels worn out on the morning of a planned flight with family aboard. Applying the IMSAFE checklist, what is the correct conclusion?

    • A.Fly the trip as planned, because neither fatigue nor stress appears on the list of conditions that ground a pilot.
    • B.Carry coffee and fly the trip, because caffeine restores the alertness lost to several short nights of sleep.
    • C.Postpone the trip until after a full night of rest, because accumulated fatigue and stress degrade judgment unnoticed.✓ Answer
    • D.Add a fuel stop and fly the trip, because an hour of rest on the ground makes up for the sleep the pilot lost.

    Chronic fatigue builds when there is not enough recovery between episodes of acute fatigue, and its signature effect is impaired judgment, so the pilot takes risks that would otherwise be refused. It is true that stress and fatigue are not on the regulatory grounding list, which is precisely why IMSAFE exists as a self-assessment and why the answer is to postpone.

    Source: FAA-H-8083-25 (PHAK), Chapter 2; AIM 8-1-1Report a problem with this question

17. 17. A pilot has just completed a scuba dive that required a controlled ascent and now plans a flight that will cruise at 9,500 feet MSL. What waiting time applies, and why is it measured that way?

    • A.At least 12 hours, because the controlled ascent during the dive has already released the excess nitrogen dissolved in the tissues.
    • B.No waiting is required, because the cabin of an unpressurized airplane never reaches a pressure lower than the surface pressure.
    • C.At least 24 hours, because the guidance is keyed to the actual flight altitude above sea level, not to the cabin altitude.✓ Answer
    • D.At least 12 hours, because flights below 10,000 feet are treated the same way as flights that stay under 8,000 feet MSL.

    For flight altitudes above 8,000 feet the recommended wait is at least 24 hours after any scuba dive, and 9,500 feet is above that threshold. The guidance is written against actual flight altitude above sea level rather than cabin altitude because it allows for the possibility of losing pressurization in flight.

    Source: AIM 8-1-2; FAA-H-8083-25 (PHAK), Chapter 17Report a problem with this question

18. 18. A pilot tells a friend, I can get in there, watch me, and starts an approach into a field that the friend has just declined to use. Which hazardous attitude is this, and what is its antidote?

    • A.Impulsivity, and the antidote is to remind oneself not to be so fast, think first.
    • B.Invulnerability, and the antidote is to remind oneself that it really could happen to me.
    • C.Macho, and the antidote is to stop and remind oneself that taking chances is foolish.✓ Answer
    • D.Resignation, and the antidote is to remind oneself, I can make a difference.

    The macho attitude is the urge to prove that one is better than others by taking on a challenge that has just been refused, and the FAA antidote for it is the reminder that taking chances is foolish. Recognizing the attitude by name is what allows the pilot to apply the matching antidote in the moment.

    Source: FAA-H-8083-25 (PHAK), Chapter 2; AC 60-22Report a problem with this question

19. 19. A pilot skips the weight and balance computation before a flight with three passengers and full fuel, saying that the numbers in the handbook are written for lawyers rather than for pilots. Which hazardous attitude is being displayed?

    • A.Impulsivity, shown by feeling that something must be done immediately and then acting before thinking it through.
    • B.Anti-authority, shown by dismissing the rules and the published limits as something written for someone else.✓ Answer
    • C.Invulnerability, shown by believing that an accident is something that happens only to other pilots.
    • D.Resignation, shown by concluding that the outcome of the flight is out of the pilot's hands anyway.

    Anti-authority is the don't tell me attitude: rules, limits, and procedures are seen as unnecessary restrictions written by someone who does not understand the operation. Its antidote is the reminder to follow the rules because they are usually right, and here the skipped computation is exactly the kind of limit that protects the flight.

    Source: FAA-H-8083-25 (PHAK), Chapter 2; AC 60-22Report a problem with this question

20. 20. A pilot departs late, skips a thorough weather briefing, presses on as ceilings lower, and then descends below the minimum en route altitude to stay clear of cloud. What does the accident chain concept say about this sequence?

    • A.Only the final decision matters, so the descent below the minimum altitude is the one link that should have been avoided.
    • B.Each poor decision links to the next, and breaking any single link, such as diverting when ceilings lowered, prevents the accident.✓ Answer
    • C.The chain can no longer be broken once two poor decisions have been made, so the pilot's only remaining option is to continue.
    • D.The chain begins only when the airplane first enters cloud, so decisions made on the ground before departure are not part of it.

    Accidents are almost never the product of one bad decision; they are the end of a chain of small poor judgments, each of which narrows the options left to the pilot. Because every link is a decision point, removing any one of them, including the late departure or the skipped briefing, breaks the chain and prevents the outcome.

    Source: FAA-H-8083-25 (PHAK), Chapter 2 (Aeronautical Decision-Making)Report a problem with this question

21. 21. A pilot is asked to fly two colleagues home for an important meeting the next morning, the forecast is marginal, and the pilot is not instrument rated. Under the PAVE checklist, how should the meeting be treated, and what is the appropriate mitigation?

    • A.As an aircraft factor, mitigated by adding fuel so the airplane can hold clear of the weather until conditions improve.
    • B.As an environment factor, mitigated by planning a route around the weather and accepting a lower cruising altitude.
    • C.As a pilot factor, mitigated by reviewing instrument procedures the night before so the flight can be flown on a plan.
    • D.As an external pressure, mitigated by telling the colleagues in advance that the trip may have to be delayed or driven instead.✓ Answer

    In PAVE the E stands for external pressures, the influences that push a pilot to complete a flight for reasons that have nothing to do with safety, and a meeting someone else is counting on is the classic example. The FAA calls managing external pressure the single most important key to risk management, and the standard mitigation is to set expectations early so that delaying or driving stays an acceptable outcome.

    Source: FAA-H-8083-2 (Risk Management Handbook); FAA-H-8083-25 (PHAK), Chapter 2Report a problem with this question

22. 22. The airplane's handbook lists a maximum demonstrated crosswind of 15 knots, and a newly certificated pilot has set a personal limit of 10 knots. The reported crosswind component is 13 knots. What is the correct understanding of a personal minimums policy?

    • A.The pilot should not go, because personal minimums are set tighter than the handbook and apply until proficiency improves.✓ Answer
    • B.The pilot should raise the personal limit to 13 knots, because personal minimums are meant to track the conditions of the day.
    • C.The pilot may go, because the handbook figure is the real limit and the personal number is only a training guideline.
    • D.The pilot may go if a flight instructor is consulted by telephone, because that satisfies the intent of a personal minimum.

    Personal minimums are limits a pilot sets tighter than both the regulations and the aircraft handbook, based on that pilot's current experience and proficiency rather than on the conditions of a particular day. Raising the limit to fit the weather in front of you destroys the purpose of the tool, which is to make the go or no-go decision before the pressure to go exists.

    Source: FAA-H-8083-2 (Risk Management Handbook); FAA-H-8083-25 (PHAK), Chapter 2Report a problem with this question

Practice questions based on the aeronautical knowledge areas codified at 14 CFR 61.105(b) and on FAA handbooks (the Pilot's Handbook of Aeronautical Knowledge, the Airplane Flying Handbook) and the Aeronautical Information Manual. This site is not affiliated with or endorsed by the FAA. Taking the real knowledge test requires an endorsement from an authorized instructor or evidence of completing a ground training course. Charts, weather products and aircraft performance data are republished on a cycle — always fly and test from current official sources. About FAA airman testing →