You are caring for a patient with a suspected stroke whose symptoms started 2 hours ago. The CT was normal with no sign of hemorrhage. The patient does not have any contraindications to fibrinolytic therapy. Which treatment is best? a. start fibrinolytic therapy ASAP b. hold fibrinolytic therapy for 24 hours c. order an echo before fibrinolytic administration d. wait for MRI result 

ANSWER : a. start fibrinolytic therapy ASAP

For STEMI pt, maximum goal time for ED door-to-balloon-inflation time for PCI? a. 150 mins b. 180 mins c. 120 mins d. 90 mins

ANSWER : d. 90 mins

Which is the recommended oral dose of aspirin for a patient with suspected acute coronary syndrome? a. 81 mg b. 325-650 mg c. 160-325 mg d. 40 mg

ANSWER : c. 160-325 mg

chest compressions during for adult rate a. 40-60/min b. 60-80/min c. 80-100/min d. 100-120/min

ANSWER : d. 100-120/min

What is the effect of excessive ventilation? a. decresed cardiac output b. decreased intrathoracic 

pressure c. increased perfusion pressure d. increased venous return

ANSWER : a. decreased cardiac output

temperature to achieve targeted temperature management after cardiac arrest a. 30-34C b. 32-36C c. 

36-40C d. 38-42C

ANSWER : b. 32-36C

3 mins into cardiac arrest resuscitation attempt, one member of your team inserts an endotracheal tube 

while another performs chest compressions. Capnography shows a persistent waveform & a PETCO2 of 

8mmHg. What is the significance of the finding? a. chest compression may not be effective b. The 

endotrachael tube is in the esophagus c. the team is ventilating the patient too often d. the patient 

meets the criteria for termination of efforts

ANSWER : a. chest compression may not be effective

Your patient is in cardiac arrest and has been intubated. To assess CPR quality, you should? a. obtain a 

chest x-ray b. check the patient’s pulse c. monitor the patient’s PETCO2 d. obtain a 12-lead ECG

ANSWER : c. monitor the patient’s PETCO2

In addition to clinical assessment, which is the most reliable method to confirm & monitor correct 

placement of an endotracheal tube? a. arterial blood gas b. hemoglobin levels c. chest radiography d. 

continuous waveform capnography

ANSWER : d. continuous waveform capnography

A 45M had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting 

“crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial pulse is very weak, 

blood pressure is 64/40, respiratory is 28 bpm/min and O2 set is 89% on room air. 

ANSWER : answer has to do with acute coronary syndrome

A 45M had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting 

“crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial pulse is very weak, 

blood pressure is 64/40, respiratory is 28 bpm/min and O2 set is 89% on room air. When applied, the 

cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular 

fibrillation. WhIn addition to defibrillation, which intervention should be performed immediately?

ANSWER : a. chest compression

A 45M had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting 

“crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial pulse is very weak, 

blood pressure is 64/40, respiratory is 28 bpm/min and O2 set is 89% on room air. When applied, the 

cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular 

fibrillation. Despite 2 defibrillation attempts, the patient remains in V-fib. Which drug and dose should 

you administer?

ANSWER : c. epinephrine 1 mg

A 45M had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting 

“crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial pulse is very weak, 

blood pressure is 64/40, respiratory is 28 bpm/min and O2 set is 89% on room air. When applied, the 

cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular 

fibrillation. Despite the drug provided above and continued CPR, the patient remains in v-fib. Which drug 

should be administered next?

ANSWER : c. amiodarone 300mg

A 45M had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting 

“crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial pulse is very weak, 

blood pressure is 64/40, respiratory is 28 bpm/min and O2 set is 89% on room air. When applied, the 

cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular 

fibrillation. The patient has return of spontaneous circulation and is not able to follow commands. Which 

immediate post-cardiac arrest care intervention do you choose for the patient?

ANSWER : d. initiate targeted temperature management

A 45M had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting 

“crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial pulse is very weak, 

blood pressure is 64/40, respiratory is 28 bpm/min and O2 set is 89% on room air. When applied, the 

cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular 

fibrillation. Which would you have done first if the patient had not gone into ventricular fibrillation?

ANSWER : d. performed synchronized cardioversion

During post-cardiac arrest, which is recommended duration of targeted temp. management after 

reaching the correct temperature range? a. at least 24 hours b. 0-8 hour c. at least 36 hours d. at least 48 

hours

ANSWER : a. at least 24 hours

which is the primary purpose of medical emergency team or rapid response team? a. provide diagnostic 

consultation to emergency department patients b. provide online consultation to EMS personnel c. 

improving patient outcomes by identifying & treating early clinical deterioration d. improving care for 

patients admitted to critical care units

ANSWER : c. improving patient outcomes by identifying & treating early clinical deterioration

Which of these tests should be performed for a patient with suspected stroke within 25 mins of hospital 

arrival? a. coagulation studies b. cardiac enzymes c. noncontrast CT scan of the head d. 12 lead ECG

ANSWER : c. non-contrast CT scan of the head

Which of the following signs are likely indicator of cardiac arrest in an unresponsive patient? a. slow, 

weak pulse rate b. cyanosis c. irregular, weak pulse d. agonal gasps

ANSWER : d. agnoal gasps

a patient is being resuscitated in a very noisy environment. A team member thinks he heard an order of 

500mg of amiodarone IV. Which is the best response from the team member? 

ANSWER : I have an order to give 500mg of amiodarone IV. Is this correct?

Which is the recommended next step after a defibrillation attempt? a. check the ECG for evidence of a 

rhythm b. determine if a carotid pulse is present c. resume CPR, starting with chest compressions d. 

open the patient’s airway

ANSWER : c. resume CPR, starting with chest compressions

A responder is caring for a patient with a history of congestive heart failure. The patient is experiencing 

shortness of breath, 68/50 mmHg, heart rate 190/min. The patient’s lead 2 ECG is shown. Which best 

characterizes this patient’s rhythm? 

ANSWER : unstable supraventicular tachycardia

which is one way to minimize interruptions in chest compressions during CPR? 

ANSWER : continue CPR while the defibrillator charges

A 68F lightheadedness, nausea, chest discomfort. Your assessment finds her awake & responsive but 

ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready & fast. Your are unable to 

get a BP. She has no obvious dependent edema, & her neck veins are flat. Her lung sounds are equal w/ 

moderate rales present bilaterally. The cardiac monitor shows rhythm seen here. Based on the patient’s 

initial assessment, what adult ACLS algorithm should you follow? 

ANSWER : tachycardia wide complex (monophasic) tachycardia

A 68F lightheadedness, nausea, chest discomfort. Your assessment finds her awake & responsive but 

ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready & fast. Your are unable to 

get a BP. She has no obvious dependent edema, & her neck veins are flat. Her lung sounds are equal w/ 

moderate rales present bilaterally. The cardiac monitor shows rhythm seen here. After your initial 

assessment, which intervention should be preformed? 

ANSWER : synchronized cardioversiion

A 68F lightheadedness, nausea, chest discomfort. Your assessment finds her awake & responsive but 

ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready & fast. Your are unable to 

get a BP. She has no obvious dependent edema, & her neck veins are flat. Her lung sounds are equal w/ 

moderate rales present bilaterally. The cardiac monitor shows rhythm seen here. If the patient became 

apnic & pulseless but the rhythm remained the same, which would take the highest priority? 

ANSWER : perform defibrillation

Which best describes the rhythm? 

ANSWER : monomorphic ventricular tachycardia

A patient in stable narrow-complex tachycardia with a peripheral IV in place is refractory to the 1st dose 

of adenosine. Which dose would you administer next? 

ANSWER : 12mg

You instruct a team member to give 0.5mg atropine IV. Which response is an example of closed-loop 

communication? 

ANSWER : I’ll draw up 0.5mg of atropine

A patient has a witnessed loss of consciousness. The lead 2 ECG is shown. appropriate treatment? 

ANSWER : defibrillation

You have completed 2 mins of CPR. The ECG monitor shows the lead 2 rhythm, and the patient has no 

pulse. Another member of your team resumes chest compression, and an IV is in place. Which do you do 

next? 

ANSWER : Give epi 1mg IV

to properly ventilate a patient w/ perfusing rhythm, how often do you squeeze the bag? a. once every 10 

seconds b. once every 5 to 6 seconds c. once every 3 to 4 seconds d. once every 12 seconds

ANSWER : b. once every 5-6 seconds

Which is the recommended 1st IV dose of amiodarone for a patient w/ refractory ventricular fibrillation? 

a. 150 mg b. 250 mg c. 300 mg d. 100 mg

ANSWER : c. 300mg

Which best describes the length of time it should take to perform a pulse check during BLS assessment? 

a. 1 to 4 seconds b. 5 to 10 seconds c. 11 to 15 seconds d. 16 to 20 seconds

ANSWER : b. 5 to 10 seconds

Which best describes an action taken by the team leader to avoid inefficiencies during a resuscitation 

attempt? 

ANSWER : clearly delegate tasks

Which is the maximum interval you should allow for an interruption in chest compression? 

ANSWER : 10 seconds

If a team member is about to make a mistake during a resuscitation attempt, which best describes the 

action that the team leader or other team members should take? a. address the team member 

immediately b. conduct a debriefing after the resuscitation attempt c. remove the team member from 

the area d. reassign the team members

ANSWER : a. address the team member immediately

Which facility is the most appropriate EMS destination for a patient w/ a sudden cardiac arrest who 

achieved return of spontaneous circulation in the field? 

ANSWER : coronary reperfusion-capable medical center

which is an acceptable method of selecting an appropriately sized oropharyngeal airway? 

ANSWER : measure from the corner of the mouth to the angle of the mandible

A team member is unable to perform an assigned task because it is beyond the team member’s scope of 

practice. Which action should the team member take? 

ANSWER : ask for a new task or role

What is the minimum systolic blood pressure one should attempt to achieve w/ fluid administration or 

vasoactive agents in a hypotensive post-cardiac arrest patient who achieves return of spontaneous 

circulation? 

ANSWER : 90 mmHg

You are evaluating a 58M w/ chest discomfort, BP 92/50, heart rate 92/min, his non-labored respiratory 

rate is 14 bpm, and his pulse oximetry reading is 97%. Which assessment step is most important now? 

ANSWER : obtaining a 12 lead

As a team leader, when do you tell the chest compressors to switch? a. about every 2 minutes b. about 

every 5 minutes c. only when they tell you that they are fatigued d. about every 7 minutes

ANSWER : a. about every 2 minutes

The patient’s pulse ox shows a reading of 84% on room air. Which initial action do you take? 

ANSWER : apply oxygen (I think I put Bag valve mask for this and I got it wrong)

 

1. You find an unresponsive patient who is not breathing. After activating the emergency response system, you determine that there is no pulse. What is your next action?

A. Open the airway with a head tilt–chin lift.

B. Administer epinephrine at a dose of 1 mg/kg.

C. Deliver 2 rescue breaths each over 1 second.

D. Start chest compressions at a rate of at least 100/min.(CORRECT ANSWER)

2. You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 97%. What assessment step is most important now?

A. PETCO2

B. Chest x-ray

C. Laboratory testing

D. Obtaining a 12-lead ECG(CORRECT ANSWER)

3. What is the preferred method of access for epinephrine administration during cardiac arrest in most patients?

A. Intraosseous

B. Endotracheal

C. Central intravenous

D. Peripheral intravenous(CORRECT ANSWER)

4. An activated AED does not promptly analyze the rhythm. What is your next action?

A. Begin chest compressions.(CORRECT ANSWER)

B. Discontinue the resuscitation attempt.

C. Check all AED connections and reanalyze.

D. Rotate AED electrodes to an alternate position.

5. You have completed 2 minutes of CPR. The ECG monitor displays the lead II rhythm below, and the patient has no pulse. Another member of your team resumes chest compressions, and an IV is in place. What management step is your next priority?

A. Give 0.5 mg of atropine.

B. Insert an advanced airway.

C. Administer 1 mg of epinephrine.(CORRECT ANSWER)

D. Administer a dopamine infusion.

 

6. 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?

A. Establish vascular access.

B. Obtain the patient’s history.

C. Resume chest compressions.(CORRECT ANSWER)

D. Terminate the resuscitative effort.

7. What is a common but sometimes fatal mistake in cardiac arrest management?

A. Failure to obtain vascular access

B. Prolonged periods of no ventilations

C. Failure to perform endotracheal intubation

D. Prolonged interruptions in chest compressions(CORRECT ANSWER)

8. Which action is a component of high-quality chest compressions?

A. Allowing complete chest recoil(CORRECT ANSWER)

B. Chest compressions without ventilation

C. 60 to 100 compressions per minute with a 15:2 ratio

D. Uninterrupted compressions at a depth of 1½ inches

9. What should be done to minimize interruptions in chest compressions during CPR?

A. Perform pulse checks only after defibrillation.

B. Continue CPR while the defibrillator is charging.(CORRECT ANSWER)

C. Administer IV medications only when breaths are given.

D. Continue to use AED even after the arrival of a manual defibrillator.

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

A. Unwitnessed arrest

B. Safety threat to providers(CORRECT ANSWER)

C. Patient age greater than 85 years

D. No return of spontaneous circulation after 10 minutes of CPR

11. 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. IV or IO access(CORRECT ANSWER)

B. Endotracheal tube placement

C. Consultation with cardiology for possible PCI

D. Application of a transcutaneous pacemake

12. After verifying unresponsiveness and abnormal breathing, you activate the emergency response team. What is your next action?

A. Retrieve an AED.

B. Check for a pulse. (CORRECT ANSWER)

C. Deliver 2 rescue breaths.

D. Administer a precordial thump.