1. A 57 year old woman has palpitations. Chest discomfort and tachycardia.

The monitor
shows a regular wide – complex QRS at a rate of 180x/min. She becomes diaphoretic and
BP is 80/60mmHg. The next action is to:

a. Give amiodarone 300mg IV push

b. Obtain 12 lead ECG

c. Establish IV and give sedation for electrical cardioversion

d. Perform immediate electrical cardioversion

e. Give dopamine 2-20 mcg/kg/min

2. A patient is in refractory ventricular fibrillation. High quality CPR is in progress and shocks
have been given . one dose of epinephrine was given after 2nd shock. An antiarhythmia
drug was given immediately after 3rd shock . what drug should the leam teader request be
prepared for administration next?

a. Escalating dose epinephrine 3mg

b. Second dose of epinephrine 1mg

c. Repeat antiarrhythmia drug

d. Sodium bicarbonate 50 mEg

e. Atropine 1mg IV

3. Which of the following statements about the use of magnesium in cardiac arrest is most
accurate? (b)

a. Mg is indicated for VF refractory to shock and amiodarone or lidocaine

b. Mg is indicated in VF/ pulseless Vt associated with torsades de pointes

c. Mg is contraindicated in VT associated with a normal QT interval

d. Mg is indicated for shock – refractory monomorphic VT

4. You arrive on scene with the code team. High quality CPR is in progress. An AED has
previously advised no shock indicated. A rhythm check now find asystole. The next action
you should take is to: (C)

a. Call for a pulse check

b. Place combitube or laryngeal mask airway

c. Place IV or IO access

d. Attempt ETT intubation

5. A bradycardia rhythm is treated when (b)

 a. BP is < 100mmHg systolic with or without symptoms

b. Chest pain or shortness of breath is present

c. HR < 60/min with or without symptoms

d. The patient has an MI on the 12-lead ECG

6. A 35 yo woman has palpitations, lightheadedness 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 access has been established. What drug should
should be administered IV? (b)

a. Lidocaine 1mg/kg

b. Adenosine 6mg

c. Epinephrine 3-10 mcg/kg/min

d. Atropine 0.5 mg

7. A patient with a possible ST elevation MI has ongoing chest discomfort. Which of the
following would be a contraindication of administration of nitrates? (c)

a. Left ventricular infarct with bilateral rales

b. BP > 180mmHg

c. Use of phosphodiesterase inhibitor within 12 hrs

d. HR 90/min

8. A patient has sinus bradycardia with a rate of 36x/min. atropine has been administered to
a total dose of 3,g/ a transcutaneous pacemaker has failed to capture. The patient is
confused and BP is 100/60mmHg. Which of the following is now indicated? (c)

a. Give normal saline bolus 250mL to 500mL

b. Give additional 1mg atropine

c. Start dopamine 10-20mcg/kg/min

d. Start epinephrine 2-10 mcg/min

9. A patient is in cardiac arrest. V. Fibrillatio has been refractory to an initial shock of the
following, which drug and dose should be administered first by IV/IO route? (b)

a. Vasopressin 20U

b. Epinephrine 1mg

c. Atropine 1mg
 d. Sodium bicarbonate 50 mEg

10. Which of the following is most accurate regarding the administration of vasopressing
during cardiac arrest? (d)

a. Vasopressin is indicated for VF and pulseless CT prior to to the delivery of first

shock.

b. Vasopressin is recommended instead of epinephrine for the treatment of asystole

c. Vasopressin can be administered twice during cardiac arrest

d. The correct dose of Vasopressin in 40 U administered IV or IQ.

11. A patient has a rapid irregular wide-complex tachycardia.The ventricular rate is 138.He is
asymptomatic with a blood pressure of 110/70 mmHg.He has a history of angina.Which of
the following actions is recommended? (a)

a. Give lidocaine 1 to 1.5 mg IV bolus

b. Give adenosine 6 mg IV bolus

c. Immediate synchronized cardioversion

d. Seek expert consultation

12. A patient with possible ACS and bradycardia of 42 per minute has ongoing chest
discomfort.What in the initial dose of atropine? (c)

a. Atropine 1mg

b. Atropine 3 mg

c. Atropine 0.5mg

d. Atropine 0.1mg

13. Your patients has been intubated. IV/IO access is not available. Which combination of drugs
can be administered by the ETT route of administration? (d)

a. Vasopressin, amiodarone, lidocaine

b. Amiodarone, lidocaine, epinephrine

c. Epinephrine, vasopressine, amiodarone

d. Lidocaine, epinephrine, vasopressin

14. A patient is in refractory ventricular fibrillation and has received multiple appropriate
defibrillations, epinephrine 1mg twice, and an initial dose of lidocaine IV. The patient is
intubated. A second dose of lidocaine is now called for. The recommended second dose of
 lidocaine is: (c)

a. Give ETT dose 2-4mg/kg

b. 2-3 mg/kg IV push

c. 0.5 – 0.75mg/kgIV push

d. Start IV 1-2 mg/min

e. 1mg/kg IV push

15. A patient with a possible ACS has ongoing chest discomfort unresponsive to 3 syblingual
nitroglycerin tablets. There are no contraindications to 4mg of morphine sulfate was
administered. Shortly, BP falls to 88/60mmHg and the patient complains of increased chest
discomfort. You would: (a)

a. Start dopamine at 2 mcg/kg/min and titrate to BP 100mmHg systolic

b. Give normal saline 250-500 mL fluid bolus

c. Give an additional 2mg of morphine sulfate

d. Give nitroglycerine 0.4mg sublingually

16. A patient is in pulseless ventricular tachycardia. 2 shocks and 1 dose of epinephrine have
been given. The next drug/dose to anticipate to administer is: (b)

a. Vasopressin 40U

b. Amiodarone 300mg

c. Lidocaine 0.5mh/kg

d. Epinephrine 3mg

e. Amiodarone 150mg

17. A patient is in cardiac arrest. High quality chest compression are being given. The patient
is intubated and IV has been started. The rhythm is asystole. The first drug/dose to
administer is: (E)

a. Dopamine 2-20 mcg/kg/min IV/IO

b. Epinephrine 3mg via ETT

c. Atropine 1mg IV/IO

d. Atropine 0.5mg IV/IO

e. Epinephrine 1mg or vasopressing 40U IU/IO

18.

You arrive on scene to find CPR in progress. Nursing staff report that the patient was
recovering from a pulmonary embolism and suddenly collapsed . there is no pulse or
spontaneous respirations. High quality CPR is in progress and effective ventilation is being
provided with bag-mask. An IV has been initiated. You would now:

a. Initiate transcutaneous pacing

b. Give atropine 1mg IV

c. Give epinephrine 1mg IV

d. Give atropine 0.5mg IV

e. Order immediate ETT

19.

You are the code leader and arrive finding the above rhythm with CPR in progress. Team
members report that the patient was well but complained of chest pain and collapsed. She
has no pulse or respirations. Bag – mask ventilations are producing visible chest rise, high-
quality CPR is in progress, and an IV has been established. Your next order would be:

a. Administer atoprine 1mg

b. Administer amiodarone 300mg

c. Administer epinephrine 1mg

d. Start dopamine at 10-20 mcg/kg/min

e. Perform ETT

20.

This patient suddenly collapsed and is poorly responsive. The patient has a weak carotid
pulse. A cardiac monitor, oxygen, and an IV line have been initiated. The code cart with all
drugs and transcutaneous pacer is immediately available. Next you would:

a. Begin transcutaneous pacing

b. Initiate epinephrine at 2-10mcg/kg/min and titrate HR

c. Initiate dopamine at 10-20mcg/kg/min and titrate HR

d. Give atropine 1mg IV up to a total dose of 3mg

e. Initiate dopamine at 2-10mcg/kg/min and titrate HR

21.

You arrive on scene and fine a 56yo diabetic woman complaining of chest discomfort. She
is pale and diaphoretic, complaining of lightheadedness. Her BP is 80/60mmHg. The
cardiac monitor documents the rhythm above. She is receiving O2 4L/min by nasal cannule
and IV has been establish. Transcutaneous pacing has been requested but is not yet
available. Your next order is:

a. Give atropine 0.5mg IV

b. Morphine sulfate 4mg IV

c. Nitroglycerine 0.4mg SL

d. Start dopamine at 2-20 mcg/kg/min

e. Atropine 1mg/iv

22.

You are monitoring this patient after successful resuscitation. You note the above rhytm on
the cardiac monitor and document a rhythm strip for the patient’s chart. She has no
complaints and BP is 110/70mmHg. Now you would:

a. Administer sedation and begin immediate transcutaneous pacing at 80/min

b. Prepare for transcutaneous pacing (place pacing pad, do not pace)

c. Give atropine 1mg IV

d. Start dopamine 2-10 mcg/kg/min and titrate HR

e. Give atropine 0.5mg IV

23.

A patient presents with the above rhythm complaining of regular HR. she has no other
complaints. Past medical history is significant for a myocardial infarction 7years ago. BP is
110/70 mmHg. At this time you would:

a. Continue monitoring and seek expert consultation

b. Perform emergency synchronized cardioversion

c. Administer nitroglycering 0.4mg SL or spray

d. Administer lidocaine 1mg/kg IV

24. Which of the following is NOT one of the links in the chain of survival?

a. Early CPR

b. Early warning

c. Early defibrillation

d. Early access

25.

Following initiation of CPR and one shock for VF, this rhytm is present on the next rhythm
check. A second shock is given and chest compressions are immediately resumed. An IV is
in place and no drugs have been given. Bag-mask ventilations are producing visible chest
rise. What is your next order?

a. Prepare to give epinephrine 1mg IV

b. Perform ETT, administer 100% O2

c. Administer 3 sequential shock at 200 joules (biphasic)

d. Administer 3 sequential shock at 360J(monophasic)

e. Prepare to give amiodarone 300mgIV

26.

You are monitoring a patient. chest discomfort has been relieved with sublingual nitrates
and morphine sulfate 4mg IV. He suddenly has the above persistent rhythm. You ask about
symptoms and he reports mild palpitations, but otherwise he is clinically stable with
unchanged vital signs. Your next action is:

a. Give sedation and perform synchronized cardioversion

b. Give immediate unsynchronized shock

c. Administer magnesium sulfate 1-2g IV diluted in 10mLD5W given order 5-20min

d. Give immediate synchronized shock

e. Administer amiodarone 150mg over 10min, seek expert consultation

27. Which of the following most accurately characteristics when you should start chest
compression?
 a. As soon as you find that ther are no sign of circulation

b. After you have reassessed victim’s breathing

c. After giving the 2 initial ventilations

d. Whenever you find an unresponsive person

28. You have intubated the patient with PEA. You hear good bilateral breath sounds and you
see obvious bilateral chest rise. Two minutes after epinephrine 1mg IV is given, PEA
continues at 30bpm. Which of the following actions should be done next?

a. Administer atropine 1mg IV

b. Initiate transcutaneous pacing at a rate of 60bpm

c. Start dopamine IV infusion at 15-20 mcg/kg/min

d. Give epinephrine (1ml of 1:10.000 solution) IV/bolus

29. For which of the following PEA patients is sodium bicarbonate therapy likely to be most
effective?

a. A patient with hypercarbic acidosis due to a tension pneumothorax

b. A patient with brief arrest interval

c. A patient with documented severe hyperkalemia

d. A patient with documented severe hypokalemia

e. All patient with PEA

30. When a monitor attached to a person in cardiac arrest displays a flat line, you should
execute the flat line protocol. Which of the following actions is included in this protocol?

a. Check monitor display for sensitivity or grain

b. Obtain a right side 12-lead ECG

c. Change LEAD SELECT control from lead III to paddles and back

d. Administer a lower energy (100J) defibrillatory shock to bring out possible occult VF

e. Change the defibrillator