SHARP ESO EXAM QUESTIONS & ANSWERS
Nurse initiating ESO will document - Answer -1. Life threatening condition
2. Precipitating factors
3. Specific ESO implemented
4. Patient response
5. When and which physician was notified
ESO are initiated: - Answer -For life-threatening patient conditions in the absence of the
physician or specific orders
Adequate CPR - Answer -1. Push hard
2. Full chest recoil
3. Minimize interruptions
4. 100-120 compressions/min
5. 15 L O2 by bag mask (10 breaths per min)
6. 30:2
ETCO2 monitoring - Answer -Use to assess quality of CPR and evaluate return of rosc
How many breaths with advanced airway? - Answer -1 breath every 6 seconds
Targeted temperature management - Answer -Should be used on all patients not
following commands or purposeful movement within 120 mins after ROSC
What is a rapid bolus? - Answer -Fluids administered in 5-15 mins
Non invasive cardiac monitoring - Answer -Device that uses bioreactane to determine
cardiac output and is implemented where available by RRT or ICU RN to determine fluid
responsiveness and guide fluid resuscitation
Passive leg raise - Answer -Position patient flat on their back, and their legs are
elevated to 45 degrees.
These interventions are instituted for all emergency situations outlined in the ESO
Standardized Procedure: - Answer -1.
Obtain intravenous (IV)/intraosseous (IO) access
2. Begin IV infusion of normal saline (NS) at keep vein open (KVO). If IV access is
unavailable: Lidocaine, Epinephrine, Atropine, and Naloxone (Narcan) may be
administered via endotracheal route at doses of 2-2 1/2 times the IV dose.
3. If IV access is unavailable, Naloxone (Narcan) may be administered IM at the same
dose as IV administration
,4. Flush the IV line with 20mL of NS after each IV medication given and elevate the
extremity if applicable.
5. In applicable situations, obtain oxygen (O2) saturation
6.Monitor and document ETCO2 for code blue events.
7. Titrate oxygen to patients' response.
Signs (objective): - Answer -Tachypnea, apnea, respiratory depression, tachycardia,
bradycardia, arrhythmias, hypotension, decreased O2 saturation, dyspnea, change in
level of consciousness, increased intracranial pressure (ICP), status epilepticus
Symptoms (subjective) - Answer -Dizziness, lightheadedness, chest pain, shortness of
breath (SOB), chest pain, weakness, cold, diaphoresis, heart palpitations, anxiousness
What is the initial treatment for asystole? - Answer -Initiate CPR immediately
What is the recommended oxygen flow rate for a patient in asystole? - Answer -O2 at
15L/minute ambu bag (10 breaths/minute)
What medication is administered in asystole and how often? - Answer -Epinephrine
1mg IVP/IO (0.1 mg/mL), repeat every 3-5 min
How frequently should pulse checks be performed during CPR for asystole? - Answer -
Every 2 minutes
What should be verified before initiating treatment for asystole? - Answer -Verify with
pulse check and ensure that all leads are connected
Bradycardia - Initial Treatment - Answer -1. O2 at minimum 10 L/minute (NRBM)
Bradycardia - Atropine Administration - Answer -1. Atropine 1mg IVP/IO, repeat every
3-5 minutes up to a maximum of 3 mg
Bradycardia - Dopamine Administration - Answer -1. Start Dopamine 400mg/250 mL
D5W at 5 mcg/kg/minute if above algorithm is ineffective. ICU or RRT RN to titrate until
patient is asymptomatic.
Bradycardia - Epinephrine Administration - Answer -1. Start Epinephrine 2mg/250 mL
NS at 2mcg/minute if above algorithm is ineffective. Titrate to patient response up to 10
mcg/minute. (RRT or ICU RN Only)
What are common causes of Pulseless Electrical Activity (PEA)? - Answer -
Hypovolemia and hypoxia
, What is the recommended initial intervention for PEA? - Answer -CPR
What mnemonic is used to assess possible causes of PEA? - Answer -H's and T's:
Hypovolemia, hypoxia, hydrogen ion (acidosis), hypo/hyperkalemia, hypoglycemia,
hypothermia; Toxins, tamponade, thrombosis, trauma, tension pneumothorax
What is the recommended oxygen delivery method for PEA? - Answer -O2 at
15L/minute via ambu bag (10 breaths/minute)
What medication is administered for PEA? - Answer -Epinephrine 1mg IVP/IO
(0.1mg/ml), repeat every 3-5 minutes
What is the next step if hypovolemia is known or suspected in PEA? - Answer -Infuse
250 mL NS rapid bolus. Repeat in 5 minutes if no clinical improvement. If lactated
ringers (LR) already infusing, may use LR
What imaging study is recommended for PEA? - Answer -Stat chest x-ray (CXR)
What are the criteria for stable ventricular tachycardia? - Answer -Patient is conscious
with a systolic blood pressure (SBP) > 90 and does not have any unstable
signs/symptoms.
How should stable ventricular tachycardia be treated? - Answer -1. Call physician for
orders. 2. Administer oxygen at a minimum of 4L/min and titrate to patient response. 3.
Obtain a 12-lead ECG. 4. Draw serum potassium (K+) and magnesium (Mg++) levels.
What are the criteria for treating unstable ventricular tachycardia (VT)? - Answer -
Patient must be symptomatic, exhibiting one or more of the 'unstable' symptoms related
to the tachycardia.
How should unstable VT be treated? - Answer -The patient should be immediately
cardioverted and treated with O2, synchronized cardioversion, medications like
Midazolam, 12 Lead EKG, and serum K+ and Mg++ levels should be checked.
What is the reversal agent for benzodiazepines in the context of treating unstable VT? -
Answer -Flumazenil (Romazicon) 0.2 mg IVP over 15 seconds.
What is Ventricular Fibrillation (VF)? - Answer -VF is characterized by disorganized
ventricular depolarization that is irregular and unable to generate any cardiac output. It
can be coarse or fine.
What is the difference between coarse VF and fine VF? - Answer -Coarse VF usually
indicates a recent onset of VF that may be corrected with immediate defibrillation, while
fine VF indicates a more prolonged VF that is approaching asystole.
Nurse initiating ESO will document - Answer -1. Life threatening condition
2. Precipitating factors
3. Specific ESO implemented
4. Patient response
5. When and which physician was notified
ESO are initiated: - Answer -For life-threatening patient conditions in the absence of the
physician or specific orders
Adequate CPR - Answer -1. Push hard
2. Full chest recoil
3. Minimize interruptions
4. 100-120 compressions/min
5. 15 L O2 by bag mask (10 breaths per min)
6. 30:2
ETCO2 monitoring - Answer -Use to assess quality of CPR and evaluate return of rosc
How many breaths with advanced airway? - Answer -1 breath every 6 seconds
Targeted temperature management - Answer -Should be used on all patients not
following commands or purposeful movement within 120 mins after ROSC
What is a rapid bolus? - Answer -Fluids administered in 5-15 mins
Non invasive cardiac monitoring - Answer -Device that uses bioreactane to determine
cardiac output and is implemented where available by RRT or ICU RN to determine fluid
responsiveness and guide fluid resuscitation
Passive leg raise - Answer -Position patient flat on their back, and their legs are
elevated to 45 degrees.
These interventions are instituted for all emergency situations outlined in the ESO
Standardized Procedure: - Answer -1.
Obtain intravenous (IV)/intraosseous (IO) access
2. Begin IV infusion of normal saline (NS) at keep vein open (KVO). If IV access is
unavailable: Lidocaine, Epinephrine, Atropine, and Naloxone (Narcan) may be
administered via endotracheal route at doses of 2-2 1/2 times the IV dose.
3. If IV access is unavailable, Naloxone (Narcan) may be administered IM at the same
dose as IV administration
,4. Flush the IV line with 20mL of NS after each IV medication given and elevate the
extremity if applicable.
5. In applicable situations, obtain oxygen (O2) saturation
6.Monitor and document ETCO2 for code blue events.
7. Titrate oxygen to patients' response.
Signs (objective): - Answer -Tachypnea, apnea, respiratory depression, tachycardia,
bradycardia, arrhythmias, hypotension, decreased O2 saturation, dyspnea, change in
level of consciousness, increased intracranial pressure (ICP), status epilepticus
Symptoms (subjective) - Answer -Dizziness, lightheadedness, chest pain, shortness of
breath (SOB), chest pain, weakness, cold, diaphoresis, heart palpitations, anxiousness
What is the initial treatment for asystole? - Answer -Initiate CPR immediately
What is the recommended oxygen flow rate for a patient in asystole? - Answer -O2 at
15L/minute ambu bag (10 breaths/minute)
What medication is administered in asystole and how often? - Answer -Epinephrine
1mg IVP/IO (0.1 mg/mL), repeat every 3-5 min
How frequently should pulse checks be performed during CPR for asystole? - Answer -
Every 2 minutes
What should be verified before initiating treatment for asystole? - Answer -Verify with
pulse check and ensure that all leads are connected
Bradycardia - Initial Treatment - Answer -1. O2 at minimum 10 L/minute (NRBM)
Bradycardia - Atropine Administration - Answer -1. Atropine 1mg IVP/IO, repeat every
3-5 minutes up to a maximum of 3 mg
Bradycardia - Dopamine Administration - Answer -1. Start Dopamine 400mg/250 mL
D5W at 5 mcg/kg/minute if above algorithm is ineffective. ICU or RRT RN to titrate until
patient is asymptomatic.
Bradycardia - Epinephrine Administration - Answer -1. Start Epinephrine 2mg/250 mL
NS at 2mcg/minute if above algorithm is ineffective. Titrate to patient response up to 10
mcg/minute. (RRT or ICU RN Only)
What are common causes of Pulseless Electrical Activity (PEA)? - Answer -
Hypovolemia and hypoxia
, What is the recommended initial intervention for PEA? - Answer -CPR
What mnemonic is used to assess possible causes of PEA? - Answer -H's and T's:
Hypovolemia, hypoxia, hydrogen ion (acidosis), hypo/hyperkalemia, hypoglycemia,
hypothermia; Toxins, tamponade, thrombosis, trauma, tension pneumothorax
What is the recommended oxygen delivery method for PEA? - Answer -O2 at
15L/minute via ambu bag (10 breaths/minute)
What medication is administered for PEA? - Answer -Epinephrine 1mg IVP/IO
(0.1mg/ml), repeat every 3-5 minutes
What is the next step if hypovolemia is known or suspected in PEA? - Answer -Infuse
250 mL NS rapid bolus. Repeat in 5 minutes if no clinical improvement. If lactated
ringers (LR) already infusing, may use LR
What imaging study is recommended for PEA? - Answer -Stat chest x-ray (CXR)
What are the criteria for stable ventricular tachycardia? - Answer -Patient is conscious
with a systolic blood pressure (SBP) > 90 and does not have any unstable
signs/symptoms.
How should stable ventricular tachycardia be treated? - Answer -1. Call physician for
orders. 2. Administer oxygen at a minimum of 4L/min and titrate to patient response. 3.
Obtain a 12-lead ECG. 4. Draw serum potassium (K+) and magnesium (Mg++) levels.
What are the criteria for treating unstable ventricular tachycardia (VT)? - Answer -
Patient must be symptomatic, exhibiting one or more of the 'unstable' symptoms related
to the tachycardia.
How should unstable VT be treated? - Answer -The patient should be immediately
cardioverted and treated with O2, synchronized cardioversion, medications like
Midazolam, 12 Lead EKG, and serum K+ and Mg++ levels should be checked.
What is the reversal agent for benzodiazepines in the context of treating unstable VT? -
Answer -Flumazenil (Romazicon) 0.2 mg IVP over 15 seconds.
What is Ventricular Fibrillation (VF)? - Answer -VF is characterized by disorganized
ventricular depolarization that is irregular and unable to generate any cardiac output. It
can be coarse or fine.
What is the difference between coarse VF and fine VF? - Answer -Coarse VF usually
indicates a recent onset of VF that may be corrected with immediate defibrillation, while
fine VF indicates a more prolonged VF that is approaching asystole.
