Question 1 (1 point)

Which condition is an indication to stop or withhold resuscitative efforts?

a
b
c

Unwitnessed arrest
Safety threat to providers
Patient age greater than 85 years

No return of spontaneous circulation after 1 O minutes of CPR

d
Question 2 (1 point)
EMS is transporting a patient with a positive prehospital stroke assessment. Upon arrival in
the emergency department, the initial blood pressure is 138/78 mm Hg, the pulse rate is 80/min,
the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95% on room air. The lead
II ECG displays sinus rhythm. The blood glucose level is within normal limits. What intervention
should you perform next?
a

Immediate rtPA administration

Head CT scan

Administration of 100% oxygen

Transfer to the stroke unit

d
Question 3 (1 point)
What is the appropriate interval for an interruption in chest compressions?
a

Interruptions are never acceptable

10 seconds or less

15 to 20 seconds

10 to 15 seconds
d
Question 4 (1 point)
What is an advantage of using hands-free defibrillation pads instead of defibrillation paddles?
a
b
c

Hands-free pads have universal adaptors that can work with any machine.
Hands-free pads increase electrical arc.
Hands-free pads allow for a more rapid defibrillation.

Hands-free pads deliver more energy than paddles.

d
Question 5 (1 point)
What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse rate
of 80/min?
a

1 breath every 3 to 4 seconds

2 breaths every 6 to 8 seconds

2 breaths every 5 to 6 seconds

1 breath every 5 to 6 seconds

d
Question 6 (1 point)
What is the recommendation on the use of cricoid pressure to prevent aspiration during cardiac
arrest?
a Not recommended for routine use
b Recommended only for supraglottic airway insertion

c Recommended during every resuscitation attempt

d Recommended when the patient is vomiting
Question 7 (1 point)
A patient in respiratory failure becomes apneic but continues to have a strong pulse. The heart
rate is dropping rapidly and now shows a sinus bradycardia at a rate of 30/min. What intervention
has the highest priority?
a Application of a transcutaneous pacemaker
b Epinephrine IV infusion
c Simple airway maneuvers and assisted ventilation
d Atropine IV push
Question 8 (1 point)
A patient in respiratory distress and with a blood pressure of 70/50 mm Hg presents with the
following lead II ECG rhythm:

What is the appropriate next intervention?

a

Defibrillation

Adenosine 6 mg IV push

Amiodarone 150 mg IV

Synchronized cardioversion
d
Question 9 (1 point)
A 56-year-old man reports that he has palpitations but not chest pain or difficulty breathing.
The blood pressure is 132168 mm Hg, the pulse is 130fmin and regular, the respiratory rate is 12
breathslmin, and the pulse oximetry reading is 95%. The lead II ECG displays a wide-complex
tachycardia. What is the next action after establishing an IV and obtaining a 12-lead ECG?
a

Procedural sedation

Seeking expert consultation

Administration of IV epinephrine

Synchronized cardioversion
d
Question 10 (1 point)
A 49-year-old woman arrives in the emergency department with persistent epigastric pain. She
had been taking oral antacids for the past 6 hours because she thought she had heartburn. The
initial blood pressure is 118/72 mm Hg, the heart rate is 92/min and regular, the nonlabored
respiratory rate is 14 breaths/min, and the pulse oximetry reading is 96%. Which is the most
appropriate intervention to perform next?
a

Administer oxygen.

Administer sublingual nitroglycerin.

Obtain a 12-lead ECG.

Evaluate for fibrinolytic eligibility.

d
Question 11 (1 point)
What is the danger of routinely administering high concentrations of oxygen during the postcardiac
arrest period for patients who achieve ROSC?
a

Adverse hemodynamic effects

Potential oxygen toxicity

Decrease in cerebral blood flow

Increased intrathoracic pressure

d
Question 12 (1 point)
Which is an appropriate and important intervention to perform for a patient who achieves
ROSC during an out-of-hospital resuscitation?
a
b
c

Place a central venous catheter for hemodynamic monitoring.

Replace any supraglottic airway with an endotracheal tube.
Transport the patient to a facility capable of performing PCI.

Initiate an antiarrhythmic infusion.

d
Question 13 (1 point)
What is the recommended target temperature range for achieving therapeutic hypothermia
after cardiac arrest?
a

26C to 28C

29C to 31C

32C to 34C

35C to 37C
d
Question 14 (1 point)
Which condition is a contraindication to therapeutic hypothermia during the post-cardiac
arrest period for patients who achieve ROSC?
a Desire to provide coronary reperfusion (eg, PCI)
b Patient age greater than 60 years
c Initial rhythm of asystole
d Responding to verbal commands
Question 15 (1 point)
A patient presents to the emergency department with new onset of dizziness and fatigue. On
examination, the patient's heart rate is 35/min, the blood pressure is 70/50 mm Hg, the respiratory
rate is 22 breaths/min, and the oxygen saturation is 95%. What is the appropriate first medication?
a

Atropine 0.5 mg

Aspirin 160 mg chewed

Epinephrine 0.5 mg

Oxygen 12 to 15 Umin
d
Question 16 (1 point)
During a pause in CPR, you see this lead II ECG rhythm on the monitor. The patient has no
pulse. What is the next action?

Terminate the resuscitative effort.

Establish vascular access.

Resume chest compressions.

Obtain the patient's history.

d
Question 17 (1 point)
A patient has a witnessed loss of consciousness. The lead II ECG reveals this rhythm:

What is the appropriate next intervention?

a

Epinephrine 1 mg IV push

Defibrillation

Adenosine 6 mg IV push

Synchronized cardioversion
d
Question 18 (1 point)
What is the purpose of a medical emergency team (MET) or rapid response team (RRT)?
a
b
c

Providing online consultation to EMS personnel in the field

Improving care for deteriorating patients admitted to critical care units
Providing diagnostic consultation to emergency department patients

Improving patient outcomes by identifying and treating early clinical deterioration

d
Question 19 (1 point)
An activated AED does not promptly analyze the rhythm. What is your next action?
a Check all AED connections and reanalyze.
b Rotate AED electrodes to an alternate position.
c Begin chest compressions.
d Discontinue the resuscitation attempt.
Question 20 (1 point)
A responder is caring for a patient with a history of congestive heart failure. The patient is
experiencing shortness of breath, a blood pressure of 68/50 mm Hg, and a heart rate of 190/min.
The patient's lead II ECG is displayed below.

Which of the following terms best describes this patient?

Sinus tachycardia

Unstable supraventricular tachycardia

Stable supraventricular tachycardia

d Perfusing ventricular tachycardia

Question 21 (1 point)
Which treatment or medication is appropriate for the treatment of a patient in asystole?
a

Atropine

Epinephrine

Defibrillation

Transcutaneous pacing
d
Question 22 (1 point)
A patient has sudden onset of dizziness. The patient's heart rate is 160/min, blood pressure is
110/70 mm Hg, respiratory rate is 18 breaths/min, and pulse oximetry reading is 98% on room air.
The lead II ECG is shown below:

What is the next

appropriate intervention?
a

Normal saline 1 L bolus

Metoprolol 5 mg IV

Adenosine 6 mg IV

Vagal maneuvers
d
Question 23 (1 point)
A patient with pulseless ventricular tachycardia is defibrillated. What is the next action?
a Check for a pulse.
b Start chest compressions at a rate of at least 100/min.
c Repeat the unsynchronized shock, increasing to 200 J.
d Administer an IV antiarrhythmic.
Question 24 (1 point)
Which rhythm requires synchronized cardioversion?
a

Unstable supraventricular tachycardia

Atrial fibrillation

NSR on monitor but no pulse

d Sinus tachycardia
Question 25 (1 point)
What is the recommended compression rate for performing CPR?
a

About 100 per minute

At least 100 per minute

80 to 100 per minute

60 to 80 per minute
d
Question 26 (1 point)
What is the recommended first intravenous dose of amiodarone for a patient with refractory
ventricular fibrillation?
a

1 mg/kg

1 mg

300 mg.

1 meq/kg
d
Question 27 (1 point)
What survival advantages does CPR provide to a patient in ventricular fibrillation?
a Opposes the harmful effects of epinephrine
b Produces a small amount of blood flow to the heart
c Directly restores an organized rhythm
d Increases the defibrillation threshold
Question 28 (1 point)
IV/10 drug administration during CPR should be
a given rapidly during compressions.
b given by infusion.
c administered slowly during the pause for a pulse check.
d given before any defibrillation attempts.
Question 29 (1 point)
What is the proper ventilation rate for a patient in cardiac arrest who has an advanced airway in
place?
a

16 to 18 breaths per minute

12 to 14 breaths per minute

8 to 10 breaths per minute

4 to 6 breaths per minute

d
Question 30 (1 point)
Which action improves the quality of chest compressions delivered during a resuscitation
attempt?
a
b
c

Do not allow the chest to fully recoil with each compression.

Observe ECG rhythm to determine depth of compressions.
Switch providers about every 2 minutes or every 5 compression cycles.

Compress the upper half of the sternum at a rate of 150 compressions per minute.
d
Question 31 (1 point)
Which of the following is an acceptable method of selecting an appropriately sized
oropharyngeal airway (OPA)?
a
b
c

Measure from the thyroid cartilage to the angle of the mandible.

Estimate by using the formula Weight (kg)/8 + 2.
Estimate by using the size of the patient's thumb.

Measure from the corner of the mouth to the angle of the mandible.
d
Question 32 (1 point)
What is the recommended oral dose of aspirin for patients suspected of having one of the
acute coronary syndromes?
a

2 to 4 mg

160 to 325 mg

80 to 120 mg

400 to 600 mg
d
Question 33 (1 point)
For the past 25 minutes, an EMS crew has attempted resuscitation of a patient who originally
presented in ventricular fibrillation. After the first shock, the ECG screen displayed asystole,
which has persisted despite 2 doses of epinephrine, a fluid bolus, and high-quality CPR. What is
your next treatment?
a
b
c

Apply a transcutaneous pacemaker.

Administer 40 units of intravenous vasopressin.
Administer 1 mg of intravenous atropine.

Consider terminating resuscitative efforts after consulting medical control.

d
Question 34 (1 point)
After verifying the absence of a pulse, you initiate CPR with adequate bag-mask ventilation.
The patient's lead II ECG appears below. What is your next action?

a Consultation with cardiology for possible PCI

b Endotracheal tube placement
c IV or 10 access
d Application of a transcutaneous pacemaker
Question 35 (1 point)
During your assessment, your patient suddenly loses consciousness. After calling for help and
determining that the patient is not breathing, you are unsure whether the patient has a pulse.
What is your next action?
a
b
c
d

Check the patient's mouth for the presence of a foreign body.

Leave and get an AED.
Begin chest compressions.
Deliver 2 quick ventilations.