Cardiac emergencies Flashcards
(201 cards)
1
Q
What is the target scene time for non-cardiac arrest cardiac patients? A. ≤ 10 minutes B. ≤ 15 minutes C. ≤ 20 minutes D. ≤ 25 minutes
A
B. ≤ 15 minutes
2
Q
How quickly should a 12-lead ECG be acquired on scene? A. < 2 minutes B. < 3 minutes C. < 5 minutes D. < 10 minutes
A
C. < 5 minutes
3
Q
What oxygen therapy is recommended for chest discomfort if SpO2 is < 94%? A. 15L via NRB B. 2L via nasal cannula C. 4L via nasal cannula D. Room air only
A
C. 4L via nasal cannula
4
Q
What is the target oxygen saturation range for cardiac patients? A. ≥ 90% B. 92–95% C. ≥ 94% and ≤ 99% D. 100%
A
C. ≥ 94% and ≤ 99%
5
Q
What should be done for suspected STEMI on 12-lead ECG? A. Wait for second ECG B. Contact Base Station C. Notify Receiving Facility as ‘Code STEMI’ D. Start dopamine
A
C. Notify Receiving Facility as ‘Code STEMI’
6
Q
Which of the following ECG findings confirms right-sided STEMI involvement? A. ST elevation in V1 B. ST elevation in V4R C. ST elevation in aVR D. ST depression in V6
A
B. ST elevation in V4R
7
Q
What ECG change supports diagnosis of posterior STEMI? A. ST elevation in V1–V3 B. ST elevation in aVL C. ST elevation in V7–V9 D. ST depression in V2
A
C. ST elevation in V7–V9
8
Q
What condition can mimic STEMI on ECG? A. Right bundle branch block B. Left bundle branch block C. First-degree AV block D. Junctional rhythm
A
B. Left bundle branch block
9
Q
Which of the following is NOT a contraindication for ‘Code STEMI’ activation? A. POLST marked ‘Comfort-Focused’ B. Active stroke C. Active GI bleed D. Left bundle branch block
A
D. Left bundle branch block
10
Q
What should EMS do with a high-risk cardiac patient en route? A. Avoid serial ECGs B. Use BVM C. Bring additional personnel D. Skip pain management
A
C. Bring additional personnel
11
Q
What is the initial dose of aspirin if the patient has NOT taken any prior to EMS arrival? A. 81 mg B. 162 mg C. 324 mg D. 500 mg
A
C. 324 mg
12
Q
How often can nitroglycerin be administered for chest pain? A. Every 2 minutes B. Every 3 minutes C. Every 5 minutes D. Once only
A
C. Every 5 minutes
13
Q
What systolic blood pressure is required before administering nitroglycerin? A. > 80 mmHg B. > 90 mmHg C. > 100 mmHg D. > 110 mmHg
A
C. > 100 mmHg
14
Q
What is the maximum dose of fentanyl allowed for pain management in cardiac patients with BP > 90? A. 200 mcg B. 300 mcg C. 400 mcg D. 500 mcg
A
B. 300 mcg
15
Q
What gauge IV catheter is recommended for STEMI patients? A. 20 gauge B. 22 gauge C. 18 gauge or larger D. 24 gauge
A
C. 18 gauge or larger
16
Q
How many 12-lead ECGs should be obtained during transport for suspected STEMI? A. One initial only B. At least two C. Sequential ECGs en route D. Only if symptoms worsen
A
C. Sequential ECGs en route
17
Q
Which of the following is a mimic of STEMI that EMS must consider? A. Hyperkalemia B. Hypercalcemia C. Hypoglycemia D. Hypothermia
A
A. Hyperkalemia
18
Q
What condition is indicated by DeWinter’s ST/T wave pattern? A. Posterior MI B. LAD occlusion C. Right ventricular infarct D. SVT
A
B. LAD occlusion
19
Q
What protocol should EMS follow for a patient with an implantable cardioverter-defibrillator (AICD)? A. Ignore device B. Disable with magnet C. Follow arrhythmia protocol D. Perform needle decompression
A
C. Follow arrhythmia protocol
20
Q
When should CPR be initiated in cardiac emergencies? A. Respiratory rate < 8 B. No carotid pulse or agonal rhythm C. Bradycardia D. Narrow complex tachycardia
A
B. No carotid pulse or agonal rhythm
21
Q
What intervention should be considered in pediatric cardiac arrest? A. Nitroglycerin SL B. Aspirin C. NG/OG tube D. Dopamine infusion
A
C. NG/OG tube
22
Q
Which of the following qualifies a patient for ‘Code STEMI’? A. ST elevation in one limb lead B. ST elevation in one precordial lead C. ST elevation in two contiguous precordial leads ≥ 2 mm D. T wave inversion in V1–V2
A
C. ST elevation in two contiguous precordial leads ≥ 2 mm
23
Q
What ECG lead confirms posterior STEMI when ST elevation is ≥ 1 mm? A. V3 B. aVR C. V9 D. aVL
A
C. V9
24
Q
What medication is administered first in a suspected ACS case? A. Fentanyl B. Nitroglycerin C. Aspirin D. Morphine
A
C. Aspirin
25
Which syndrome is identified by biphasic T waves or deeply inverted T waves in V2–V3? A. Brugada Syndrome B. Wellen’s Syndrome C. WPW D. Torsades de Pointes
B. Wellen’s Syndrome
26
What is the EMS priority for a cardiac arrest patient with a shockable rhythm? A. Administer aspirin B. Perform early defibrillation C. Transport immediately D. Start dopamine infusion
B. Perform early defibrillation
27
Which medication should be given for ventricular fibrillation after defibrillation? A. Adenosine B. Atropine C. Epinephrine D. Diltiazem
C. Epinephrine
28
What is the dose of epinephrine for adult cardiac arrest? A. 0.3 mg IM B. 1 mg IV/IO every 3–5 minutes C. 0.5 mg IM D. 2 mg IV push
B. 1 mg IV/IO every 3–5 minutes
29
What is the first dose of amiodarone for refractory VF/pulseless VT? A. 150 mg IV push B. 300 mg IV/IO push C. 1 mg/kg D. 5 mg/kg
B. 300 mg IV/IO push
30
What is the second dose of amiodarone for refractory VF/pulseless VT? A. 150 mg B. 300 mg C. 100 mg D. 75 mg
A. 150 mg
31
What is the compression-to-ventilation ratio for adults with an advanced airway in place? A. 30:2 B. 15:2 C. 10:1 D. Continuous compressions with 1 breath every 6 seconds
D. Continuous compressions with 1 breath every 6 seconds
32
How often should pulses be checked during cardiac arrest management? A. Every 1 minute B. Every 2 minutes C. Every 3 minutes D. After every 5 cycles
B. Every 2 minutes
33
What is the appropriate treatment for asystole? A. Defibrillation B. Cardioversion C. CPR and epinephrine D. Amiodarone
C. CPR and epinephrine
34
Which condition is treated with synchronized cardioversion? A. VFib B. Asystole C. Unstable SVT D. Torsades
C. Unstable SVT
35
What is the initial shock dose for synchronized cardioversion of unstable SVT? A. 50 J B. 100 J C. 120 J D. 200 J
B. 100 J
36
What is the maximum total dose of amiodarone in cardiac arrest? A. 150 mg B. 300 mg C. 450 mg D. 600 mg
C. 450 mg
37
When managing bradycardia with hypotension, what is the initial drug of choice? A. Amiodarone B. Dopamine C. Atropine D. Lidocaine
C. Atropine
38
What is the standard adult dose of atropine for symptomatic bradycardia? A. 0.3 mg IV B. 0.5 mg IV every 3–5 minutes (max 3 mg) C. 1 mg IV push D. 2 mg IV/IO
B. 0.5 mg IV every 3–5 minutes (max 3 mg)
39
What is the initial dose of dopamine infusion for bradycardia? A. 2 mcg/kg/min B. 5–10 mcg/kg/min C. 10–20 mcg/kg/min D. 1–5 mcg/kg/min
B. 5–10 mcg/kg/min
40
Which arrhythmia requires immediate defibrillation? A. SVT B. Sinus tachycardia C. VFib D. Atrial flutter
C. VFib
41
What is the first treatment for a patient in wide complex tachycardia with a pulse and stable vitals? A. Amiodarone B. Vagal maneuvers C. Synchronized cardioversion D. Adenosine
A. Amiodarone
42
What is the correct dose of adenosine for stable narrow complex tachycardia? A. 3 mg B. 6 mg rapid IV push, followed by 12 mg if no response C. 10 mg slow IV push D. 20 mg over 5 minutes
B. 6 mg rapid IV push, followed by 12 mg if no response
43
When should magnesium sulfate be considered in cardiac arrest? A. Asystole B. Torsades de Pointes C. SVT D. Bradycardia
B. Torsades de Pointes
44
What is the dose of magnesium sulfate for torsades in cardiac arrest? A. 1 gram IV B. 2 grams IV/IO push C. 500 mg IV/IO D. 4 grams IV
B. 2 grams IV/IO push
45
What is the priority intervention in pulseless electrical activity (PEA)? A. Defibrillation B. Amiodarone C. Epinephrine and CPR D. Atropine
C. Epinephrine and CPR
46
What condition can mimic PEA on monitor but actually has no pulse? A. VFib B. Agonal rhythm C. Asystole D. SVT
B. Agonal rhythm
47
Which treatment is appropriate for symptomatic 2nd-degree Type II AV block? A. Adenosine B. Amiodarone C. Atropine and pacing D. Defibrillation
C. Atropine and pacing
48
What is the first priority in managing ROSC (Return of Spontaneous Circulation)? A. Administer lidocaine B. Reassess rhythm C. Ensure adequate oxygenation and ventilation D. Begin transport immediately
C. Ensure adequate oxygenation and ventilation
49
What is the post-ROSC target SpO2 range? A. 85–89% B. 90–93% C. 94–99% D. 100%
C. 94–99%
50
Which cardiac arrest rhythm does NOT require defibrillation? A. Pulseless VT B. VFib C. Asystole D. Torsades
C. Asystole
51
Question (Front)
Answer (Back)
52
What is the primary purpose of a 12-lead ECG in the field? A. Monitor SpO2 B. Assess heart rate C. Identify STEMI D. Evaluate blood pressure
C. Identify STEMI
53
When is transcutaneous pacing indicated? A. SVT B. Bradycardia unresponsive to atropine C. Sinus tachycardia D. Torsades
B. Bradycardia unresponsive to atropine
54
What is the initial pacing rate for transcutaneous pacing? A. 40 bpm B. 60 bpm C. 80 bpm D. 100 bpm
B. 60 bpm
55
Which drug may be administered for pain during transcutaneous pacing? A. Fentanyl B. Atropine C. Epinephrine D. Aspirin
A. Fentanyl
56
What is the primary treatment goal for chest pain patients? A. Lower BP B. Increase HR C. Reperfuse ischemic myocardium D. Sedation
C. Reperfuse ischemic myocardium
57
What is the priority in managing hypotension post-ROSC? A. Atropine B. Rapid transport C. Epinephrine drip or fluid bolus D. Magnesium
C. Epinephrine drip or fluid bolus
58
Which ECG finding suggests left main coronary artery occlusion? A. ST elevation in II, III, aVF B. ST elevation in V1–V3 C. ST elevation in aVR D. ST depression in V4–V6
C. ST elevation in aVR
59
What does ST depression in anterior leads with tall R waves in V1–V3 suggest? A. Anterior STEMI B. Right heart strain C. Posterior MI D. Pericarditis
C. Posterior MI
60
What should EMS do for suspected Brugada Syndrome on ECG? A. Administer adenosine B. Give magnesium C. Treat per V-Fib/pulseless VT protocol D. Ignore changes
C. Treat per V-Fib/pulseless VT protocol
61
What is the definition of ROSC? A. Patient alert B. Return of palpable pulse and measurable BP C. Normal ECG D. Oxygen saturation > 90%
B. Return of palpable pulse and measurable BP
62
What medication is contraindicated in right ventricular infarction? A. Aspirin B. Nitroglycerin C. Fentanyl D. Oxygen
B. Nitroglycerin
63
Which of the following is a side effect of nitroglycerin? A. Tachycardia B. Hypertension C. Headache D. Hyperglycemia
C. Headache
64
Which patients should receive an additional 15-lead ECG? A. Inferior STEMI B. Posterior leads V7–V9 elevation C. Lateral ischemia D. All of the above
D. All of the above
65
What does a wide complex tachycardia usually indicate? A. Atrial flutter B. Ventricular origin C. Sinus rhythm D. Normal ECG
B. Ventricular origin
66
What is the effect of adenosine on the heart? A. Slows SA node B. Blocks AV node conduction C. Increases cardiac output D. Stimulates sympathetic tone
B. Blocks AV node conduction
67
What is the first intervention for stable SVT? A. Synchronized cardioversion B. Amiodarone C. Vagal maneuvers D. Adenosine
C. Vagal maneuvers
68
When is lidocaine an acceptable alternative to amiodarone? A. Pediatric bradycardia B. Refractory VF/pulseless VT C. Asystole D. SVT
B. Refractory VF/pulseless VT
69
What is the adult dose of lidocaine in cardiac arrest? A. 0.5 mg/kg B. 1–1.5 mg/kg IV/IO C. 2–4 mg/kg D. 10 mg
B. 1–1.5 mg/kg IV/IO
70
Which of the following best describes PEA? A. Pulse present with no ECG B. Electrical activity on ECG without a palpable pulse C. No electrical activity D. Slow wide QRS and pulse
B. Electrical activity on ECG without a palpable pulse
71
What rhythm is commonly seen in hyperkalemia? A. Narrow complex tachycardia B. Sinus rhythm C. Peaked T waves progressing to sine wave D. T wave inversion
C. Peaked T waves progressing to sine wave
72
What should be done for a patient with suspected hyperkalemia and wide QRS? A. Administer calcium chloride B. Give aspirin C. Start CPR D. Shock immediately
A. Administer calcium chloride
73
What is a complication of untreated SVT? A. Pulmonary edema B. Hypoglycemia C. Renal failure D. Bradycardia
A. Pulmonary edema
74
What vital sign change may indicate perfusing ventricular tachycardia? A. Stable BP B. Decreased respiratory rate C. Increased temperature D. Normal ECG
A. Stable BP
75
Which of the following arrhythmias can be treated with adenosine? A. VFib B. Atrial fibrillation C. SVT D. Asystole
C. SVT
76
What does a delta wave on ECG suggest? A. Sinus tachycardia B. Wellen’s syndrome C. Wolff-Parkinson-White (WPW) syndrome D. Brugada syndrome
C. Wolff-Parkinson-White (WPW) syndrome
77
What is the most appropriate action for a patient in unstable VT with a pulse? A. Vagal maneuvers B. Adenosine C. Synchronized cardioversion D. Lidocaine
C. Synchronized cardioversion
78
What should you always do before delivering synchronized cardioversion? A. Administer calcium B. Administer aspirin C. Press 'Sync' button and confirm marker on R wave D. Turn defibrillator to 'Auto'
C. Press 'Sync' button and confirm marker on R wave
79
What energy level is used for synchronized cardioversion of unstable VT? A. 50 J B. 70 J C. 100 J D. 200 J
C. 100 J
80
Which drug is indicated for pain during synchronized cardioversion? A. Adenosine B. Epinephrine C. Fentanyl D. Lidocaine
C. Fentanyl
81
Which rhythm is typically treated with defibrillation rather than cardioversion? A. Atrial flutter B. SVT C. Ventricular fibrillation D. Atrial fibrillation
C. Ventricular fibrillation
82
Which ECG abnormality is most consistent with hyperkalemia? A. Prolonged QT B. Peaked T waves C. Inverted T waves D. ST elevation
B. Peaked T waves
83
What medication is used for calcium channel blocker overdose? A. Sodium bicarbonate B. Calcium chloride C. Magnesium sulfate D. Epinephrine
B. Calcium chloride
84
Which of the following medications should NOT be given in WPW with Afib? A. Amiodarone B. Adenosine C. Calcium chloride D. Procainamide
B. Adenosine
85
What is the best position for a hypotensive cardiac patient? A. Prone B. Supine or Trendelenburg C. Sitting up D. Left lateral
B. Supine or Trendelenburg
86
What is the goal end-tidal CO2 during post-ROSC care? A. 20–25 mmHg B. 30–35 mmHg C. 35–45 mmHg D. >50 mmHg
C. 35–45 mmHg
87
What is a common cause of pulseless electrical activity? A. High blood sugar B. Electrolyte imbalance C. Tachycardia D. Atrial flutter
B. Electrolyte imbalance
88
What is the effect of calcium chloride in hyperkalemia? A. Lowers potassium B. Stabilizes myocardial cells C. Increases renal excretion D. Slows AV conduction
B. Stabilizes myocardial cells
89
What is the indication for repeat ECGs during transport? A. Evaluate medication response B. Detect rhythm changes C. Confirm initial findings D. All of the above
D. All of the above
90
What is the treatment for a conscious adult with complete heart block and hypotension? A. Atropine only B. Transcutaneous pacing C. Epinephrine D. Adenosine
B. Transcutaneous pacing
91
Which ECG pattern may suggest pericarditis? A. Global ST elevation with PR depression B. ST elevation in II, III, aVF C. Inverted T waves D. Delta waves
A. Global ST elevation with PR depression
92
What condition is most likely with ST elevation in V1 and V2 and RBBB? A. Posterior MI B. Brugada Syndrome C. WPW D. Atrial flutter
B. Brugada Syndrome
93
What should be done for pulseless VT/VF not responding to defibrillation? A. Start dopamine B. Continue CPR and give amiodarone C. Start pacing D. Administer atropine
B. Continue CPR and give amiodarone
94
What is the preferred access for medication administration during cardiac arrest? A. Oral B. IM C. IV/IO D. Subcutaneous
C. IV/IO
95
Which leads represent the lateral wall of the heart? A. V1–V3 B. II, III, aVF C. I, aVL, V5, V6 D. aVR, V2
C. I, aVL, V5, V6
96
What is the most effective method to improve cardiac arrest survival? A. IV fluids B. Early CPR and defibrillation C. Airway intubation D. Dopamine infusion
B. Early CPR and defibrillation
97
What is the most appropriate action for a wide complex tachycardia with hypotension? A. Amiodarone B. Lidocaine C. Defibrillation D. Synchronized cardioversion
D. Synchronized cardioversion
98
Which ECG change requires immediate intervention? A. Sinus tachycardia B. First-degree AV block C. ST elevation in 2 contiguous leads D. Occasional PVCs
C. ST elevation in 2 contiguous leads
99
What is the maximum single dose of adenosine in stable SVT? A. 6 mg B. 12 mg C. 18 mg D. 24 mg
B. 12 mg
100
Which of the following should be avoided during CPR? A. Defibrillation B. Hyperventilation C. Epinephrine D. Chest compressions
B. Hyperventilation
101
When should you begin post-ROSC care? A. After 15 minutes of CPR B. After return of pulse and BP C. When SpO2 reaches 90% D. At hospital
B. After return of pulse and BP
102
Which of the following is considered a non-shockable rhythm? A. VFib B. Pulseless VT C. Asystole D. Torsades
C. Asystole
103
What is the best way to assess effectiveness of CPR? A. Check SpO2 B. Monitor EtCO2 C. Measure heart rate D. Check for pupil response
B. Monitor EtCO2
104
Which of the following is a reversible cause of cardiac arrest? A. Tachycardia B. Tension pneumothorax C. Hyperglycemia D. Hypertension
B. Tension pneumothorax
105
What EtCO2 value suggests high-quality CPR? A. < 10 mmHg B. 10–20 mmHg C. > 20 mmHg D. > 45 mmHg
C. > 20 mmHg
106
Which medication is used for beta-blocker overdose? A. Calcium chloride B. Atropine C. Glucagon D. Magnesium sulfate
C. Glucagon
107
What is a key finding in cardiac tamponade? A. Crackles B. Beck’s triad C. Delta waves D. Bradycardia
B. Beck’s triad
108
Which of the following is a H’s cause of cardiac arrest? A. Hyperventilation B. Hypovolemia C. Hypothermia D. Heart block
B. Hypovolemia
109
Which of the following is a T’s cause of cardiac arrest? A. Tension pneumothorax B. Tachycardia C. T-wave inversion D. Transient ischemia
A. Tension pneumothorax
110
Which type of MI most commonly causes hypotension with nitroglycerin? A. Anterior MI B. Lateral MI C. Posterior MI D. Right ventricular MI
D. Right ventricular MI
111
What is the compression depth for adult CPR? A. 1 inch B. 1.5 inches C. At least 2 inches D. 3 inches
C. At least 2 inches
112
What is the ventilation rate during CPR with advanced airway? A. 1 every 3 seconds B. 1 every 5 seconds C. 1 every 6 seconds D. 10–12 per minute
C. 1 every 6 seconds
113
What does pulseless VT require? A. Atropine B. Synchronized cardioversion C. Defibrillation D. Dopamine
C. Defibrillation
114
Which of the following is a contraindication for nitroglycerin? A. HR > 100 B. Recent use of erectile dysfunction meds C. Normal ECG D. Age over 65
B. Recent use of erectile dysfunction meds
115
What is the appropriate next step after ROSC with low BP? A. Begin CPR again B. Give IV fluids and consider vasopressors C. Check glucose D. Stop oxygen
B. Give IV fluids and consider vasopressors
116
What is the purpose of performing a 15-lead ECG? A. Evaluate atrial rhythms B. Confirm sinus rhythm C. Identify posterior or right-sided MI D. Rule out bradycardia
C. Identify posterior or right-sided MI
117
Which medication may be used for stable VT if amiodarone is unavailable? A. Lidocaine B. Atropine C. Adenosine D. Epinephrine
A. Lidocaine
118
What is the main side effect of lidocaine toxicity? A. Tachycardia B. Seizures C. Hypertension D. Vomiting
B. Seizures
119
Which of the following arrhythmias is most likely to be life-threatening? A. Atrial fibrillation B. SVT C. VFib D. Sinus tachycardia
C. VFib
120
What is the best way to increase coronary perfusion during cardiac arrest? A. Administer epinephrine B. Minimize interruptions in compressions C. Use high flow oxygen D. Place an advanced airway
B. Minimize interruptions in compressions
121
When is sodium bicarbonate indicated during cardiac arrest? A. Hyperkalemia or tricyclic overdose B. Asystole C. VFib D. Pulseless VT
A. Hyperkalemia or tricyclic overdose
122
Which intervention is most important in a witnessed cardiac arrest? A. IV access B. Early defibrillation C. Epinephrine D. Intubation
B. Early defibrillation
123
What ECG feature differentiates AFib from other arrhythmias? A. Regular R-R interval B. No P waves and irregularly irregular rhythm C. Delta waves D. Prolonged QT
B. No P waves and irregularly irregular rhythm
124
What is the compression rate during CPR? A. 80–100/min B. 100–120/min C. 130–150/min D. 60–80/min
B. 100–120/min
125
What is the appropriate response to return of a spontaneous pulse but no breathing? A. Stop compressions and ventilate B. Resume CPR C. Defibrillate D. Start pacing
A. Stop compressions and ventilate
126
Which of the following is part of Beck’s triad? A. Bounding pulses B. Muffled heart tones C. Pulmonary crackles D. Brisk cap refill
B. Muffled heart tones
127
Which condition may cause a false positive STEMI on ECG? A. Hypothermia B. Left bundle branch block C. Hypovolemia D. Bradycardia
B. Left bundle branch block
128
What is the preferred vascular access site in cardiac arrest if peripheral IV is unavailable? A. Central line B. Subcutaneous C. Intraosseous (IO) D. IM injection
C. Intraosseous (IO)
129
What rhythm is most commonly associated with sudden cardiac death? A. Atrial flutter B. SVT C. Ventricular fibrillation D. Junctional rhythm
C. Ventricular fibrillation
130
Which intervention is most appropriate for a conscious adult with symptomatic bradycardia and BP 78/40? A. Atropine 0.5 mg IV B. Defibrillation C. Amiodarone D. Lidocaine
A. Atropine 0.5 mg IV
131
Which rhythm often presents with irregularly irregular R-R intervals and absence of P waves? A. SVT B. Ventricular tachycardia C. Atrial fibrillation D. First-degree AV block
C. Atrial fibrillation
132
What is the maximum cumulative dose of lidocaine for cardiac arrest? A. 3 mg/kg B. 5 mg/kg C. 2 mg/kg D. 6 mg/kg
B. 5 mg/kg
133
Which of the following is a typical finding in WPW syndrome? A. Narrow QRS B. Prolonged PR interval C. Delta wave D. Peaked T wave
C. Delta wave
134
What’s the recommended dose for a fluid bolus in hypotension post-ROSC? A. 100 mL B. 250 mL C. 500–1000 mL NS IV/IO D. 50 mL/hr
C. 500–1000 mL NS IV/IO
135
Which of the following arrhythmias is best treated with vagal maneuvers first? A. Atrial fibrillation B. SVT C. VT with pulse D. Bradycardia
B. SVT
136
What does pulseless VT require immediately? A. Amiodarone B. Synchronized cardioversion C. Defibrillation D. Lidocaine
C. Defibrillation
137
Which arrhythmia may present with cannon A waves in the neck? A. SVT B. Third-degree AV block C. Atrial flutter D. Junctional tachycardia
B. Third-degree AV block
138
What is the dose of calcium chloride for hyperkalemia in adult cardiac arrest? A. 250 mg IV B. 500 mg IV C. 1 gram IV D. 2 grams IV
C. 1 gram IV
139
What is the role of sodium bicarbonate in cardiac arrest? A. Direct vasodilator B. Treats metabolic acidosis or tricyclic overdose C. Elevates HR D. Reduces seizure threshold
B. Treats metabolic acidosis or tricyclic overdose
140
What medication is contraindicated in bradycardia caused by hypothermia? A. Atropine B. Epinephrine C. Amiodarone D. All medications until warmed
D. All medications until warmed
141
Which part of the heart is viewed by leads II, III, and aVF? A. Lateral wall B. Anterior wall C. Inferior wall D. Septal wall
C. Inferior wall
142
Which cardiac condition causes pulsus paradoxus? A. Myocardial infarction B. Cardiac tamponade C. Atrial fibrillation D. Hypokalemia
B. Cardiac tamponade
143
Which of the following is a primary cause of pulseless electrical activity (PEA)? A. Ventricular tachycardia B. ST elevation C. Hypoxia D. SVT
C. Hypoxia
144
What does atropine do in bradycardia? A. Blocks beta receptors B. Decreases vagal tone C. Causes vasodilation D. Slows conduction
B. Decreases vagal tone
145
Which medication is recommended for bradycardia when atropine is ineffective? A. Lidocaine B. Dopamine infusion C. Amiodarone D. Magnesium sulfate
B. Dopamine infusion
146
Which rhythm is most likely to occur after defibrillation of VFib? A. Asystole B. Normal sinus rhythm C. PEA D. VT with pulse
C. PEA
147
What is the most common ECG change with hypokalemia? A. Peaked T waves B. U waves C. Sine wave pattern D. ST elevation
B. U waves
148
What treatment is recommended for Torsades de Pointes? A. Atropine B. Amiodarone C. Magnesium sulfate D. Sodium bicarbonate
C. Magnesium sulfate
149
What is the standard adult dose of magnesium sulfate for Torsades? A. 1 gram IV/IO B. 2 grams IV/IO over 1–2 minutes C. 4 grams IM D. 0.5 gram IV push
B. 2 grams IV/IO over 1–2 minutes
150
What should be done if a cardiac arrest patient has ROSC but remains unresponsive? A. Intubate and maintain oxygenation B. Start CPR again C. Administer atropine D. Administer aspirin
A. Intubate and maintain oxygenation
151
What medication should be avoided in wide complex tachycardia of uncertain origin? A. Amiodarone B. Lidocaine C. Adenosine D. Epinephrine
C. Adenosine
152
What is the initial energy dose for defibrillation in adult cardiac arrest? A. 100 J B. 120 J C. 150 J D. 200 J
D. 200 J
153
Which medication is given first for a patient in asystole? A. Amiodarone B. Atropine C. Epinephrine D. Dopamine
C. Epinephrine
154
Which ECG finding suggests pericarditis rather than MI? A. Localized ST elevation B. ST elevation in V1–V3 only C. Global ST elevation with PR depression D. Q waves in II, III, aVF
C. Global ST elevation with PR depression
155
Which rhythm is typically regular and narrow but fast? A. AFib B. SVT C. VFib D. Torsades
B. SVT
156
What medication is administered to manage bradycardia due to beta-blocker overdose? A. Glucagon B. Atropine C. Lidocaine D. Amiodarone
A. Glucagon
157
Which leads reflect the anterior wall of the heart? A. II, III, aVF B. V1–V4 C. V5–V6 D. I, aVL
B. V1–V4
158
What is the minimum SBP required for nitroglycerin administration? A. 80 mmHg B. 90 mmHg C. 100 mmHg D. 110 mmHg
C. 100 mmHg
159
Which of the following indicates successful defibrillation? A. Continued VFib B. Conversion to sinus rhythm with pulse C. Drop in BP D. Asystole
B. Conversion to sinus rhythm with pulse
160
What should you do after defibrillation during cardiac arrest? A. Check pulse immediately B. Start IV C. Resume CPR immediately D. Give aspirin
C. Resume CPR immediately
161
Which ECG feature confirms right ventricular infarction? A. ST elevation in V1–V3 B. ST elevation in V4R C. Inverted T waves in aVL D. Q waves in V6
B. ST elevation in V4R
162
Which rhythm is commonly associated with pulselessness despite electrical activity? A. AFib B. PEA C. Sinus rhythm D. SVT
B. PEA
163
What action is appropriate if a patient in SVT becomes unstable? A. Administer adenosine B. Begin CPR C. Synchronized cardioversion D. Defibrillation
C. Synchronized cardioversion
164
Which medication is used for wide complex tachycardia with a pulse? A. Amiodarone B. Atropine C. Adenosine D. Magnesium
A. Amiodarone
165
Which is a primary goal after ROSC? A. Defibrillation B. 12-lead ECG C. End-tidal CO2 monitoring and oxygenation D. Give atropine
C. End-tidal CO2 monitoring and oxygenation
166
Which rhythm has an irregularly irregular R-R interval with no P waves? A. SVT B. AFib C. Junctional rhythm D. Sinus tachycardia
B. AFib
167
Which of the following can lead to false STEMI diagnosis? A. LVH B. RBBB C. LBBB D. All of the above
D. All of the above
168
What is the most important factor in determining shock success? A. IV access B. Quality of chest compressions C. Airway placement D. Patient age
B. Quality of chest compressions
169
What is a possible complication of over-ventilation during CPR? A. Hyperoxia B. Increased cerebral perfusion C. Decreased venous return D. Tachycardia
C. Decreased venous return
170
What is the initial treatment for a witnessed VFib arrest? A. IV fluids B. CPR C. Immediate defibrillation D. Epinephrine
C. Immediate defibrillation
171
Which electrolyte disorder causes torsades de pointes? A. Hypokalemia B. Hypernatremia C. Hypomagnesemia D. Hypercalcemia
C. Hypomagnesemia
172
What is the primary concern with administering nitroglycerin to a patient with RV infarct? A. Reflex bradycardia B. Hypotension C. Seizure D. Tachycardia
B. Hypotension
173
What rhythm is treated with CPR and defibrillation, NOT synchronized cardioversion? A. VT with pulse B. AFib C. VFib D. SVT
C. VFib
174
Which heart block has a consistent PR interval and dropped QRS? A. First-degree AV block B. Second-degree Type I C. Second-degree Type II D. Third-degree block
C. Second-degree Type II
175
Which of the following is used to assess perfusion during CPR? A. SpO2 B. Heart sounds C. End-tidal CO2 D. Skin temp
C. End-tidal CO2
176
What is the action of epinephrine in cardiac arrest? A. Blocks vagus nerve B. Increases myocardial oxygen demand C. Increases coronary and cerebral perfusion pressure D. Lowers BP
C. Increases coronary and cerebral perfusion pressure
177
What is the priority intervention after defibrillating a patient in VFib? A. Administer amiodarone B. Check for pulse C. Resume CPR immediately D. Give oxygen
C. Resume CPR immediately
178
Which ECG pattern is characteristic of Wellen's Syndrome? A. Deeply inverted or biphasic T waves in V2–V3 B. Delta wave C. Peaked T waves D. ST depression in V6
A. Deeply inverted or biphasic T waves in V2–V3
179
What condition is associated with a short PR interval and delta wave? A. Brugada syndrome B. AVNRT C. WPW syndrome D. Sinus bradycardia
C. WPW syndrome
180
What is the most common cause of sudden cardiac arrest in adults? A. Hypothermia B. Ventricular fibrillation C. SVT D. Pulmonary embolism
B. Ventricular fibrillation
181
What is the primary purpose of performing a 15-lead ECG? A. Evaluate atrial fibrillation B. Detect posterior and right ventricular infarction C. Confirm SVT D. Monitor electrolytes
B. Detect posterior and right ventricular infarction
182
Which of the following arrhythmias is most commonly associated with electrolyte imbalance? A. Sinus tachycardia B. Torsades de pointes C. Atrial flutter D. First-degree AV block
B. Torsades de pointes
183
What is the recommended treatment for unstable bradycardia after atropine fails? A. Epinephrine drip or transcutaneous pacing B. Amiodarone C. Magnesium D. Valsalva maneuver
A. Epinephrine drip or transcutaneous pacing
184
What is the most appropriate next step in a stable patient with wide-complex tachycardia? A. Vagal maneuvers B. Amiodarone 150 mg over 10 minutes C. Synchronized cardioversion D. Administer aspirin
B. Amiodarone 150 mg over 10 minutes
185
Which medication is preferred for sedation during synchronized cardioversion? A. Ketamine B. Atropine C. Versed (midazolam) D. Dopamine
C. Versed (midazolam)
186
What is the appropriate shock dose for defibrillation using a biphasic defibrillator? A. 100 J B. 120 J C. 150–200 J D. 360 J
C. 150–200 J
187
Which rhythm is an indication for immediate defibrillation? A. Sinus tachycardia B. PEA C. Pulseless VT D. Junctional rhythm
C. Pulseless VT
188
What is a key goal of high-performance CPR? A. Slower compressions B. Early intubation C. Minimized interruptions in chest compressions D. More defibrillation
C. Minimized interruptions in chest compressions
189
What is the first action for an unresponsive patient with no pulse? A. Check blood glucose B. Place IV C. Begin CPR D. Administer atropine
C. Begin CPR
190
Which electrolyte abnormality may cause bradycardia and hypotension? A. Hypernatremia B. Hypocalcemia C. Hyperkalemia D. Hypomagnesemia
C. Hyperkalemia
191
What is the first drug administered in adult cardiac arrest from PEA? A. Amiodarone B. Epinephrine 1 mg IV/IO C. Atropine 1 mg IV D. Lidocaine 100 mg IV
B. Epinephrine 1 mg IV/IO
192
What is a typical ECG finding in early hyperkalemia? A. Flattened T waves B. Prolonged PR interval C. Peaked T waves D. ST depression
C. Peaked T waves
193
When is synchronized cardioversion preferred over defibrillation? A. Pulseless VT B. Asystole C. Unstable SVT with a pulse D. VFib
C. Unstable SVT with a pulse
194
Which action best confirms correct ET tube placement during cardiac arrest? A. Bilateral breath sounds B. Chest rise C. Waveform capnography D. Pulse oximetry
C. Waveform capnography
195
What is the most appropriate treatment for symptomatic 3rd-degree AV block? A. Adenosine B. Atropine C. Transcutaneous pacing D. Amiodarone
C. Transcutaneous pacing
196
Which rhythm is irregular with narrow QRS complexes and no visible P waves? A. SVT B. AFib C. VT D. Bradycardia
B. AFib
197
What is the initial dose of adenosine for stable SVT? A. 3 mg B. 6 mg C. 12 mg D. 20 mg
B. 6 mg
198
Which treatment is inappropriate during active CPR for VFib? A. Defibrillation B. Atropine C. Epinephrine D. Amiodarone
B. Atropine
199
Which condition may falsely appear as STEMI on ECG? A. Hyperkalemia B. Early repolarization C. Hyperglycemia D. Hypocalcemia
B. Early repolarization
200
What is a key consideration before giving nitroglycerin to a patient with chest pain? A. Heart rate B. Lung sounds C. Erectile dysfunction medication use D. Blood glucose
C. Erectile dysfunction medication use
201
What is the next step for a patient who becomes pulseless during SVT? A. Adenosine B. Synchronized cardioversion C. Defibrillation and CPR D. Continue observation
C. Defibrillation and CPR
