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WorksheetsMultiple choice questions (Grade 13)
Total questions: 89
Worksheet time: 50mins
What is the usual post-cardiac arrest target range for PETCO2 who achieves return of spontaneous circulation (ROSC)?
25–30 mm Hg
45–50 mm Hg
30–35 mm Hg
35–40 mm Hg
What is the purpose of a medical emergency team (MET) or rapid response team?
Prolonged interruptions in chest compressions.
Optimizing ventilation and oxygenation.
Determine if a pulse is present.
Improving patient outcomes by identifying and treating early clinical deterioration.
What is the recommendation of the use of cricoid pressure to prevent aspiration during cardiac arrest?
Encouraged for routine use
Mandatory for airway management
Recommended for all patients
Not recommended for routine use
What is the most appropriate intervention for a rapidly deteriorating patient who has the lead II ECG shown above?
Administration of IV or IO fluid bolus
Treat hypotension (SBP <90 mm Hg)
Epinephrine
Synchronized cardioversion
What is the proper ventilation rate for a patient in cardiac arrest who has an advanced airway in place?
8–10 breaths per minute
12–15 breaths per minute
15–20 breaths per minute
6–8 breaths per minute
What is the proper ventilation rate for a patient in cardiac arrest who has an advanced airway in place?
8–10 breaths per minute
12–15 breaths per minute
15–20 breaths per minute
6–8 breaths per minute
Which action improves the quality of chest compressions delivered during resuscitative attempts?
Allow full chest recoil after each compression
Compress only over the lower half of the sternum
Pause compressions for ventilations every 15 seconds
Apply cricoid pressure during compressions
Which is a contraindication to nitroglycerin administration in the management of acute coronary syndromes?
Right ventricular infarction
Sinus bradycardia without hypotension
Normal right-sided precordial leads
Absence of chest pain
What is the recommended oral dose of aspirin for patients suspected of having one of the acute coronary syndromes?
81 mg
160 to 325 mg
500 mg
40 mg
Family members found a 45-year-old woman unresponsive in bed. The patient is unconscious and in respiratory arrest. What is the recommended initial airway management technique?
Inserting a nasal airway
Performing a head tilt–chin lift maneuver
Performing a jaw thrust maneuver
Applying a neck brace and immobilizing the spine
Three minutes after witnessing a cardiac arrest, one member of your team inserts an ET tube while another performs continuous chest compressions. During subsequent ventilation, you notice the presence of a waveform on the capnography screen and a PETCO2 of 8 mm Hg. What is the significance of this finding?
The patient meets the criteria for termination of efforts.
Chest compressions may not be effective.
The team is ventilating the patient too often (hyperventilation).
Airway is not correctly placed.
Which condition is a contraindication to therapeutic hypothermia during the post-cardiac arrest period for patients who achieve return of spontaneous circulation (ROSC)?
Desire to provide coronary reperfusion
Responding to verbal commands
Synchronized cardioversion
Displaying clear social smile and laughter
What is the recommended next step after a defibrillation attempt?
Begin CPR, starting with chest compressions.
Administer medication immediately.
Apply oxygen and monitor breathing.
Check for pulse and blood pressure.
A responder is caring for a patient with a history of CHF. The patient is experiencing SOB, BP of 68/50 mm Hg, and a HR of 190/min. The patient’s lead II ECG is displayed above. Which of the following terms best describes this patient?
Continue CPR while charging the defibrillator.
Obtain a 12‑lead ECG and administer aspirin if not contraindicated.
Consider terminating resuscitative efforts after consulting medical control.
Unstable supraventricular tachycardia
What is the recommended first intravenous dose of amiodarone for a patient with refractory ventricular fibrillation?
150 mg
300 mg
75 mg
450 mg
Which rhythm requires synchronized cardioversion?
Unstable SVT
Pulseless VT
Stable SVT
Polymorphic VT
A patient remains in ventricular fibrillation despite 1 shock and 2 minutes of continuous CPR. The next intervention is to
Administer a second shock
Optimize ventilation and oxygenation
Provide 10 to 12 breaths per minute
Consider potential oxygen toxicity
A pt. has an onset of dizziness. The pt’s heart rate is 180, BP is 110/70, respiratory rate is 18, O2 sat is 98%. This is a regular narrow complex tach rhythm. What is the next intervention?
Synchronized cardioversion
Determine if a pulse is present
Vagal maneuver
Obtain a 12-lead ECG
After verifying the absence of a pulse, you initiate CPR with adequate bag-mask ventilation. The patient’s lead II ECG appears above. What is your next action?
Intraosseous (IO) access
Administration of IV or IO fluid bolus
IV or IO access
Synchronized cardioversion
What is the initial priority for an unconscious pt. with any tachycardia on the monitor?
Check blood pressure
Assess respiratory rate
Monitor oxygen saturation
Determine if a pulse is present
A 56-year-old man reports palpitations without chest pain or difficulty breathing. BP is 132/68 mm Hg, pulse is 130/min and regular, respiratory rate is 12 breaths/min, and pulse oximetry 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?
Closed-loop communication
Seeking expert consultation
Apply the tachycardia algorithm to the stable patient with wide-complex tachycardia
Perform a head tilt–chin lift maneuver
What is the recommended assisted ventilation rate for patients in respiratory arrest with a perfusing rhythm?
10 to 12 breaths per minute
1 to 2 liters
12 to 24 hours
120 to 200 J
A pt. presents to the ER with dizziness and SOB with a sinus brady of 40/min. The initial atropine dose was ineffective and your monitor does not provide TCP. What is the appropriate dose of Dopamine for this pt?
10–20 mcg/kg/min
1–5 mcg/kg/min
5–15 mcg/kg/min
2–10 mcg/kg/min
How long should it take to perform a pulse check during the BLS Survey?
10 to 15 seconds
15 to 20 seconds
2 to 4 seconds
5 to 10 seconds
What is the recommended dose for adenosine for pts in refractory, but stable narrow complex tachycardia?
12 mg
8 mg
6 mg
10 mg
An AED does not promptly analyze a rhythm. What is your next step?
Determine palpable pulse
Begin chest compressions
Begin artificial ventilations
Attach the AED and analyze
EMS personnel arrive to find a patient in cardiac arrest. Bystanders are performing CPR. After attaching a cardiac monitor, the responder observes the rhythm strip shown above. What is the most important early intervention? (V-fib)
IV or IO access
Defibrillation
Potential oxygen toxicity—optimize ventilation and oxygenation
Administration of IV or IO fluid bolus to treat hypotension
You are evaluating a 58-year-old man with chest pain. The BP is 92/50, heart rate is 92/min, non-labored respiratory rate is 14 breaths/min, and pulse O2 is 97%. What assessment step is most important now?
Obtain a 12-lead ECG
Administer the shock immediately and continue as directed by the AED
Identify chest discomfort suggestive of ischemia
Administer 2 to 4 mg of morphine by slow IV bolus
Which action is a component of high-quality chest compressions?
Allowing complete chest recoil
Responding to verbal commands
Early defibrillation
Allows for monitoring CPR quality
Which treatment or medication is appropriate for the treatment of a patient in asystole?
Synchronized cardioversion
Atropine 0.5 mg
Epinephrine
Administer vasopressors
What is the recommended oral dose of aspirin for patients suspected of having one of the acute coronary syndromes?
160 to 325 mg
81 mg
325 to 650 mg
40 to 80 mg
You find an unresponsive patient who is not breathing. After activating the emergency response system, you determine there is no pulse. What is your next action?
Administer oxygen at 15 liters per minute
Start chest compressions at at least 100 per minute
Begin abdominal thrusts immediately
Start mouth-to-mouth resuscitation
What is the appropriate rate of chest compressions for an adult in cardiac arrest?
1 breath every 5–6 seconds
10 to 12 breaths per minute
At least 100 per minute
Not approximately 120 per minute
Which of the following is the recommended first choice for establishing intravenous access during the attempted resuscitation of a patient in cardiac arrest?
Carotid vessel
Antecubital vein
Subclavian vein
Jugular vein
What is the appropriate procedure for ET suctioning after the catheter is selected?
Suction during withdrawal, but not for longer than 10 seconds
Suction during insertion, but not for longer than 5 seconds
Suction only after withdrawing the catheter
Suction continuously for up to 30 seconds
Which finding is a sign of ineffective CPR?
Be sure oxygen is NOT blowing over the patient’s chest during shock
PETCO2 ≥ 10 mm Hg
PETCO2 < 10 mm Hg
Physiologic monitoring during CPR
Which is a safe and effective practice within the defibrillation sequence?
Increase oxygen flow over the patient’s chest during shock
Be sure oxygen is turned off completely during shock
Be sure oxygen is NOT blowing over the patient’s chest during shock
Ensure oxygen is directed at the patient’s face during shock
What is the recommended compression rate for performing CPR?
Optimizing ventilation and oxygenation
10 to 12 breaths per minute
At least 100 per minute (100–120)
Energy doses for cardioversion
What is the appropriate interval for an interruption in chest compressions?
20 seconds or less
10 seconds or less
30 seconds or less
5 seconds or less
What is the minimum systolic blood pressure one should attempt to achieve with fluid, inotropic, or vasopressor administration in a hypotensive post–cardiac arrest patient who achieves ROSC?
70 mm Hg
90 mm Hg
110 mm Hg
130 mm Hg
Which situation best describes pulseless electrical activity (PEA)?
Bradycardia with a regular pulse
Ventricular rhythm with a strong pulse
Atrial fibrillation with a rapid pulse
Sinus rhythm without a pulse
What is the first treatment priority for a patient who achieves ROSC?
Identifying and treating early clinical deterioration
Optimizing ventilation and oxygenation
Simple airway maneuvers and assisted ventilations
Providing quality compressions immediately before a defibrillation attempt
Which action improves the quality of chest compressions delivered during resuscitative attempts?
Switch providers about every 2 minutes or every 5 compression cycles
Increase compression rate to 150 per minute
Switch providers every 10 minutes or every 10 compression cycles
Maintain the same provider throughout the entire process
A monitored patient in the ICU developed a sudden onset of narrow complex tachycardia at a rate of 220/min. The patient's BP is 128/58, the PETCO2 is 38 mm Hg, and the O2 sat is 98%. There is an EJ established for vascular access. The patient denies taking any vasodilators. A 12-lead shows no ischemia or infarction. Vagal maneuvers are ineffective. What is the next intervention?
Adenosine 3 mg IV push
Adenosine 6 mg IV
Epinephrine 1 mg IV
Adenosine 12 mg IV
What is the danger of routinely administering high concentrations of oxygen during the post–cardiac arrest period for patients who achieve ROSC?
Potential oxygen toxicity
Decreased cerebral blood flow
Safety threats to providers
Optimize ventilation and oxygenation
Not recommended for routine use
What is a common but sometimes fatal mistake in cardiac arrest management?
Administering medication before compressions
Prolonged interruptions in chest compressions
Focusing solely on ventilation without compressions
Delaying defibrillation to assess rhythm
Which drug and dose are recommended for the management of a patient in refractory ventricular fibrillation?
Amiodarone 300 mg
Atropine 0.5 mg
Adenosine 6 mg
Lidocaine 100 mg
For the past 25 minutes, EMS crews have attempted resuscitation of a patient who originally presented with ventricular fibrillation. After the first shock, the ECG screen displayed asystole, which has persisted despite two doses of epinephrine, a fluid bolus, and high-quality CPR. What is your next treatment?
Transport the patient to a facility capable of performing PCI
Obtain a 12-lead ECG
Consider terminating resuscitative efforts after consulting medical control
Continue CPR while the defibrillator is charging
You are receiving a radio report from an EMS team en route with a patient who may be having a stroke. The hospital CT scanner is broken. What should you do?
Transport the patient to a facility capable of performing PCI
Establish IV or IO access
Use the PEA pathway of the cardiac arrest algorithm
Divert the patient to a hospital 15 minutes away with CT capabilities
Check the patient's pulse
Which is an appropriate and important intervention to perform for a patient who achieves ROSC during an out-of-hospital resuscitation?
Transport the patient to a facility capable of performing PCI
Transport the patient to a general medical facility
Discharge the patient with follow-up instructions
Monitor the patient at the scene for 24 hours
Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. He is unresponsive and is taking agonal breaths. What is the next step in your assessment and management of this patient?
Check the patient's pulse
Obtain a chest x-ray
Obtain a 12-lead ECG
Check the patient's pupil responses
A 68-year-old female patient experienced a sudden onset of right arm weakness. BP is 140/90, pulse is 78/min, respiratory rate is non-labored at 14/min, and O2 sat is 97%. Lead II in the ECG shows a sinus rhythm. What would be your next action?
ABC of Stress
Head CT scan
Cincinnati Stroke Scale
Early defibrillation
What is the recommended energy dose for biphasic synchronized cardioversion of atrial fibrillation?
10 to 12 breaths per minute
160 to 325 mg
0.1 to 0.5 mcg/kg per minute IV infusion
120 to 200 J
After verifying unresponsiveness and abnormal breathing, you activate the emergency response team. What is your next action?
Have a team member attempt to palpate a carotid pulse
Perform a rhythm check
Check for a pulse
Begin CPR, starting with chest compressions
Which of the following is an acceptable method of selecting an appropriately sized oropharyngeal airway (OPA)?
Measure from the corner of the mouth to the angle of the mandible
Measure from the chin to the forehead
Measure from the center of the mouth to the throat
Measure from the tip of the nose to the earlobe
A team leader orders 1 mg of epinephrine, and a team member verbally acknowledges when the medication is administered. What element of effective resuscitation team dynamics does this represent?
Closed-loop communication
Synchronized cardioversion
Indications for cardioversion
Call-out
Open-loop communication
What is the recommended IV fluid (normal saline or lactated Ringer's) bolus dose for a patient who achieves ROSC but is hypotensive during the post–cardiac arrest period?
500 to 750 mL
250 to 300 mL
1 to 2 liters
3 to 4 liters
During a pause in CPR, you see a narrow complex rhythm on the monitor and the patient has no pulse. What is the next action?
Determine whether pulses are present.
Resume compressions.
Check for a pulse.
What is the immediate danger of excessive ventilation during the post–cardiac arrest period for patients who achieve ROSC?
Suction during withdrawal, but not for longer than 10 seconds.
Administration of IV or IO fluid bolus.
Treat hypotension (SBP <90 mm Hg).
Decreased cerebral blood flow.
An 80-year-old woman presents to the emergency department with dizziness. She now states she is asymptomatic after walking around. Her blood pressure is 102/72 mm Hg. She is alert and oriented. After you start an IV, what is the next action?
Perform a head tilt–chin lift maneuver.
Conduct a problem-focused history and physical examination.
BLS and ACLS surveys.
A 62-year-old male in the ER says his heart is beating fast. He has no chest pain or shortness of breath. BP is 142/98, pulse rate is 200/min, respiratory rate is 14/min, and O2 saturation is 95% on room air. What should be the next evaluation?
Perform a chest X-ray.
Check blood sugar levels.
Obtain a 12‑lead ECG.
You are evaluating a 48-year-old male with crushing substernal pain. He is cool, pale, diaphoretic, and slow to respond to your questions. BP is 58/32, pulse is 190/min, respiratory rate is 18, and you are unable to obtain an O2 saturation due to no radial pulse. The ECG shows a wide complex tachycardia. What intervention should be next?
Optimizing ventilation and oxygenation.
Synchronized cardioversion.
You have completed your first 2‑minute period of CPR. You see an organized, nonshockable rhythm on the ECG monitor. What is the next action?
Optimize ventilation and oxygenation.
Have a team member attempt to palpate a carotid pulse.
A 49‑year‑old female arrives in the ER with persistent epigastric pain. She has been taking antacids orally for the past 6 hours because she had heartburn. BP is 118/72, heart rate is 92/min, respiratory rate is 14 and nonlabored, and O2 saturation is 96%. What is the most appropriate next action?
Obtain IV access.
Obtain a 12‑lead ECG.
Which of the following is a sign of effective CPR?
PETCO2 < 10 mm Hg
PETCO2 ≥ 20 mm Hg
What is the most reliable method of confirming and monitoring correct placement of an endotracheal tube?
Chest radiography
Continuous waveform capnography
You are transporting a patient with a positive stroke assessment. BP is 138, pulse is 80/min, respiratory rate is 12/min, O2 saturation is 95% on room air, and the ECG shows sinus rhythm. What is next?
Head CT scan.
ECG.
A patient with pulseless ventricular tachycardia is defibrillated. What is the next action?
Start chest compressions at a rate of at least 100/min.
Resume CPR.
Choose an appropriate indication to stop or withhold resuscitative efforts.
Arrest not witnessed.
Evidence of rigor mortis.
Which action increases the chance of successful conversion of ventricular fibrillation?
What survival advantage does CPR provide to a patient in ventricular fibrillation?
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?
Begin chest compressions.
Check for a pulse.
A 49-year-old man has retrosternal chest pain radiating into the left arm. The patient is diaphoretic, with associated shortness of breath. The blood pressure is 130/88 mm Hg, the heart rate is 110/min, the respiratory rate is 22 breaths/min, and the pulse oximetry value is 95%. The patient's 12-lead ECG shows ST-segment elevation in the anterior leads. First responders administered 160 mg of aspirin, and there is a patent peripheral IV. The pain is described as an 8 on a scale of 1 to 10 and is unrelieved after 3 doses of nitroglycerin. What is the next action?
Administer 2 to 4 mg of morphine by slow IV bolus
Administer adenosine 12 mg IV
Administer a second shock
Initiate the cardiac arrest algorithm
A postoperative patient in the ICU reports new chest pain. What actions have the highest priority?
Obtain a 12-lead ECG
Continue CPR while charging the defibrillator
Identify chest discomfort suggestive of ischemia
Prepare for EMS assessment and hospital transfer
What is the recommended initial intervention for managing hypotension in the immediate period after return of spontaneous circulation (ROSC)?
Administration of IV or IO fluid bolus
Perform suction during withdrawal for less than 10 seconds
Increase chest compression rate to at least 100/min
Avoid hyperventilation during ventilation
What is the recommended target temperature range for achieving therapeutic hypothermia after cardiac arrest?
33 to 36 degrees Celsius
35 to 37 degrees Celsius
30 to 32 degrees Celsius
32 to 34 degrees Celsius
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 brady rate at 30/min. What intervention has the highest priority?
Simple airway maneuvers and assisted ventilations
Initiate chest compressions immediately
Perform advanced airway procedures
Administer cardiac medications immediately
What is the potential danger to using ties that pass circumferentially around the patient's neck when securing an advanced airway?
Restriction of oxygen delivery to the lungs
Compression of arterial flow to the brain
Blockage of spinal fluid circulation
Obstruction of venous return from the brain
An AED advises a shock for a pulseless patient lying in snow. What is the next action?
Administer the shock immediately and continue as directed by the AED
Move the patient to a warm environment before shocking
Start chest compressions without delivering the advised shock
Administer 1 mg of epinephrine before defibrillation
What is an advantage of using hands-free defibrillation pads instead of defibrillation paddles?
Hands-free provides better contact with the chest
Hands-free allows for more accurate placement
Hands-free reduces the risk of skin burns
Hands-free allows for more rapid defibrillation
What is the preferred method of access for epinephrine administration during cardiac arrest in most patients?
Peripheral IV
PICC line
Central IV
Head CT scan
A patient presents to the ER with a new onset of dizziness and fatigue. On examination, the patient's heart rate is 35 beats/min, BP is 70/50, respiratory rate is 22 per min, O2 sat is 95%. What is the appropriate first medication?
Lidocaine 100 mg
Amiodarone 150 mg
Atropine 0.5 mg
Epinephrine 1 mg
Emergency medical responders are unable to obtain a peripheral IV for a patient in cardiac arrest. What is the next most preferred route for drug administration?
Endotracheal route
Intraosseous (IO)
Intramuscular route
Subcutaneous route
What action is recommended to help minimize interruptions in chest compressions during CPR?
Continue CPR while charging the defibrillator
Pause compressions for ventilation every minute
Stop compressions during AED analysis and charging
Deliver 10 ventilations per minute without compressions
What is the recommended dose of epinephrine for the treatment of hypotension in a post–cardiac arrest patient who achieves ROSC?
Not recommended for routine use
0.01 to 0.05 mcg/kg per minute IV infusion
0.1 to 0.5 mcg/kg per minute IV infusion
1 to 5 mg IV bolus
Which finding is a sign of ineffective CPR?
Chest recoil is incomplete between compressions
Compression rate is 100 to 120 per minute
Compression depth is at least 2 inches
Minimal interruptions in compressions
What is the danger of routinely administering high concentrations of oxygen during the post–cardiac arrest period for patients who achieve ROSC?
It can increase oxidative injury and worsen outcomes
It prevents hypoxemia without risks
It reduces carbon dioxide clearance leading to acidosis
It consistently lowers blood pressure
IV/IO drug administration during CPR should be
Given rapidly during compressions
Delayed until after three shocks
Administered only during ventilation pauses
Limited to epinephrine only
Which action improves the quality of chest compressions delivered during resuscitative attempts?
Switch providers about every 2 minutes or every 5 compression cycles
Increase compression rate above 140 per minute
Use circumferential neck ties to secure airway devices
Hold compressions during AED charging
