1. In which situation does bradycardia require treatment?
Answer: Hypotension
2. Which intervention is most appropriate for the treatment of a patient inasystole?
Answer: Epinephrine
3. You arrive on the scene with the code team. High-quality CPR is in progress.An AED has
previousy advised "no shock indicated." A rhythm check now finds asystole. After resuming
high-quality compressions, which action do you take next?
Answer: Establish IV or IO access
4. A monitored patient in the ICU developed a sudden onset of narrow-complextachycardia at a
rate of 220/min. The patient's blood pressure is 128/58 mm Hg, the PETCO2 is 38mm Hg,
and the pulse oximetry reading is 98%. There is vascular access in the left arm, and the
patient has not been given any vasoactive drugs. A 12-lead ECG confirm a supraventricular
tachycardia withno evidence of ischemia or infarction. The heart rate has not responded to
vagal maneuvers. what is your next action?
Answer: Administer adenosine 6mg IV push
5. A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been
administered to a total does of 3 mg. A transcutaneous pacemaker has failed to capture. The
patient is confused, and her blood pressure is 88/56 mmHg. Which therapy is now indicated?
Answer: Epinephrine 2 to 10 mcg/min
6. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock.
Which drug should be administered first?
Answer: Epinephrine 1 mgIV/IO
7. A 62-year-old man suddenly experienced difficulty speaking and left-sidedweakness. He
meets initial criteria for fibrinolytic therapy, and a CT scan of the brain si ordered. Which best
describes the guidelines for antiplatelet andfibrinolytic therapy?
Answer: Hold aspirin for at least 24 hours if rtPA is administered
8. A patient is in refractory ventricular fibrillation and has received multipleappropriate
defribillation shocks, epinephrine 1 mg IV twice, and an initial dose of amiodarone 300mg
IV. The patient is intubated. Which best describethe recommended second does of amiodarone
for this patient?
Answer: 150 mg IV push
9. A patient with sinus bradycardia and a heart rate of 42/min has diaphoresisand a blood
pressure of 80/60mm Hg. What is the initial does of atropine?
,Answer: - 0.5mg
10. A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia. The
monitor shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not
been effective in terminating the rhythm.An IV has been established. Which drug should be
administered?
Answer: Adenosine6mg
11. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock.
If no pathway for medication administration is in place, whichmethod is preferred?
Answer: IV or IO
12. What is the indication for the use of magnesium in cardiac arrest?
Answer: Pulse-less ventricular tachycardia-associated torsades de pointes
13. A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min.
He is asymptomatic, with a blood pressure of 110/70 mm Hg. He has a history of angina. What
action is recommended next?
Answer: Seeking expertconsultation
14. A patient is in cardiac arrest. High-quality chest compressions are beinggiven. The patient
is intubated, and an IV has been started. The rhythm is asystole. What is the first drug/dose to
administer?
Answer: Epinephrine 1mg IV/IO
15. A patient is in refractory ventricular fibrillation. High-quality CPR is in progress. One
does of epinephrine was given after the second shock. An antiarrhythmic drug was given
immediately after the third shock. You are theteam leader. Which medication do you order
next.
Answer: Epinephrine 1 mg
16. A patient with possible STEMI has ongoing chest discomfort. What is a contraindication
to nitrate administration?
Answer: Use of a phosphodiestrase inhibitorwithin the previous 24 hours
17. A 57-year-old woman has palpitation, chest discomfort, and tachycardia. The monitor
shows a regular wide-QRS at a rate of 180/min. She becomes diaphoretic, and her blood
pressure is 80/60 mm HG/ Which action do you takenext?
Answer: Perform electrical cardioversion
18. A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IVbolus and a
heparin infusion of 1000 units per hour are being administered. The patient did not take aspirin
because he has a history of gastritis, with wastreated 5 years ago. What is your next action?
Answer: Give aspirin 160-325 mg to chew
, 19. You are caring for a 66-year-old man with a history of a large intracerebralhemorrhage 2
months ago. He is being evaluated for another acute stroke. The CT scan is negative for
hemorrhage. The patient is receiving oxygen via
nasal cannula at 2L/min, and an IV has been established. His blood pressure is 180/100mm
Hg. Which drug do you anticipate giving to this patient?
Answer: Aspirin
20. A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have
been given. Which drug should be given next?
Answer: Amiodarone300mg
21. What is the maximum interval for pausing chest compressions?
Answer: 10 seconds
22. Your patient is a 56-year-old woman with a history of type 2 diabetes who reports feeling
dizzy. She is pale and diaphoretic. Her blood pressure is80/66mm Hg. The cardiac monitor
documents the rhythm shown here. She is receiving oxygen at 4L/min by nasal cannula, and
an Iv has been established.What do you administer next?
Answer: Atropine 0.5mg IV
23. A 35-year-old woman presents with a chief complaint of palpitations. She has no chest
discomfort, shortness of breath, or light-headedness. Her blood pressure is 120/78mm Hg.
Which intervention is indicated first?
Answer: Vagal maneuvers
24. Which action should you take immediately after providing an AED shock?-
Answer: Resume chest compressions
25. What action minimizes the risk of air entering the victim's stomach during-bag mask
ventilation?
Answer: Ventilating until you see the chest rise
26. You are providing bag-mask ventilations to a patient in respiratory arrest.How often
should you provide ventilation?
Answer: About every 5-6 seconds
27. After initiation of CPR and 1 shock for ventricular fibrillation, this rhythm is present on
the next rhythm check. A second shock is given, and chest compressions are resumed
immediately. An IV is in place, and no drugs havebeen given. Bag-mask ventilations are
producing visible chest rise. What is your next intervention?
Answer: Give epinephrine 1mg IV/IO
28. A patient's 12-lead ECG is transmitted by the paramedics and shows a STEMI. When the
patient arrives in the emergency department, the rhythm shown here is seen on the cardiac
monitor. The patient has resolution of moderate (5/10) chest pain after 3 doses of sublingual
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