Sharp ESO Exam Questions with Correct Answers Latest Update 2025/2026
End Tidal CO2 - Answers the maximum CO2 concentration at the end of each tidal breath, which
can be used to assess disease severity and response to treatment. Reflects cardiac output
during CPR. Can be used to measure the effectiveness of cardiac compressions and
assessment of return of spontaneous circulation (ROSC) after cardiac event
ROSC - Answers Return of spontaneous circulation is established with the presence of palpable
pulse, blood pressure, abrupt sustained increase in end tidal CO2 (typically > 40mmHg) after
cardiac arrest
therapeutic hypothermia - Answers Core temperature 32-36 C (89.6-96.8 F)
joules for defibrillation - Answers Defibrillation Joules: 200 joules
joules for cardioversion - Answers Cardioversion joules: 200 joules
Physicians may order 75-120-150-200 for conditions not covered in ESO policy
For the patient not following commands after 120 minutes of ROSC - Answers Consider
initiation of therapeutic hypothermia
Treatment of pulseless arrests - Answers Provide 2 minutes of CPR-avoiding interruptions in
compressions
Asystole treatment - Answers i. CPR (2 min.)
ii. O2 at 15 L/min. ambu bag
iii. Epinephrine 1 mg IVP/IO (use epinephrine 0.1 mg/ml), repeat q 3-5 minutes
iv. Repeat CPR and Epinephrine administration if no signs of ROSC
Unstable Bradycardia - Answers i. O2 at minimum 10 L/min. NRBM
ii. If transvenous leads or epicardial pacing wires present, connect to a pulse generator and
initiate pacing per protocol.
If no response, perform the following:
iii. Atropine 1 mg IVP/IO, repeat q 3-5 minutes max 3 mg
iv. Transcutaneous pacing as soon as possible
If above algorithm is ineffective:
v. Start dopamine 400 mg/250 ml D5W infusion at 5 mcg/kg/minute. Titrate to patient response
up to 20mcg/kg/minute
,If above algorithm is ineffective, start epinephrine 2 mg/ 250 ml NS @ 2 mcg/min., titrate to
patient response up to 10 mcg/minute
Pulseless Electrical Activity - Answers i. CPR 2 minutes and assess for possible causes
The H's:
-Hypovolemia
-Hypoxia
-Hydrogen ion (acidosis)
-Hypokalemia
-Hyperkalemia
-Hypoglycemia
-Hypothermia
The T's:
-Toxins
-Cardiac Tamponade
-Thrombosis
-Trauma
-Tension pneumothorax
ii. O2 at 15 L/min ambu bag
iii. Epinephrine 1 mg IVP/IO (use epinephrine 0.1 mg/mL), repeat q 3-5 minutes
iv. Repeat CPR and Epinephrine administration if no signs of ROSC
v. If hypovolemia known or suspected, infuse 250 mL NS may be substituted with LF if currently
infusing). Repeat in 5 minutes if no clinical improvement.
vi. Stat CXR
Ventricular Tachycardia (Wide Complex): Stable - Answers i. Call the physician for orders
ii. O2 at minimum 4 L/min. NC and adjust per patient status
iii. Obtain 12 lead EKG
, iv. Draw serum K and Mg
Ventricular Tachycardia (Wide Complex): Unstable - Answers i. O2 at minimum 10 L/min. NRBM
ii. If ventricular rate greater than 150:
-Biphasic: synchronized cardioversion (200 joules)
iii. If patient is awake and responsive, give midazolam (Versed) 0.5 mg IVP/ IO prior to
cardioversion. May repeat to a total of 1 mg to achieve sedation.
Note: Romazicon is the reversal agent for midazolam. If patient has signs and symptoms of
oversedation (ex: decreased level of consciousness, respiratory rate less than 10/min.)
Romazicon 0.2mg IVP/IO over 15 seconds. May repeat in 45 seconds based on patient
response, not to exceed 0.6mg.
iv. Draw serum K+ and Mg++.
Romazicon - Answers Reversal agent for midazolam
Standard Procedure Functions - Answers Emergency Standing Orders (ESOs) will be initiated by
ESO competency-validated RNs for life threatening conditions of adult patients in the absence
of a physician. In patient care areas without ESO competency validated RNs, the Rapid
Response Team or Code Blue will be called for assistance.
Emergency Standing Orders (ESO) - Answers Pre-established medical orders, approved by
appropriate medical staff to be administered in the absence of a physician. Orders specify
emergent treatment interventions for life-threatening conditions.
ESO Competent Nurse - Answers RN who had successfully demonstrated the knowledge and
skills in identification and treatment of life-threatening conditions
Rapid Response Team - Answers A team PF health care professionals who bring critical care
expertise to the patient bedside
CPR (cardiopulmonary resuscitation) - Answers Includes circulation with compressions, airway
assessment and breathing (C-A-B)
Intraosseous (IO) Therapy - Answers Specialty Catheter inserted into the intraosseous space by
a trained physician or IO insertion validated RN. Safe and alternative route to IV therapy is
initiated when IV access is urgently needed but is not available
Comatose Adult - Answers No eye opening to pain and no purposeful motor response
Unstable - Answers Serious signs and symptoms related to the life-threatening rhythm or
conditions which may include:
End Tidal CO2 - Answers the maximum CO2 concentration at the end of each tidal breath, which
can be used to assess disease severity and response to treatment. Reflects cardiac output
during CPR. Can be used to measure the effectiveness of cardiac compressions and
assessment of return of spontaneous circulation (ROSC) after cardiac event
ROSC - Answers Return of spontaneous circulation is established with the presence of palpable
pulse, blood pressure, abrupt sustained increase in end tidal CO2 (typically > 40mmHg) after
cardiac arrest
therapeutic hypothermia - Answers Core temperature 32-36 C (89.6-96.8 F)
joules for defibrillation - Answers Defibrillation Joules: 200 joules
joules for cardioversion - Answers Cardioversion joules: 200 joules
Physicians may order 75-120-150-200 for conditions not covered in ESO policy
For the patient not following commands after 120 minutes of ROSC - Answers Consider
initiation of therapeutic hypothermia
Treatment of pulseless arrests - Answers Provide 2 minutes of CPR-avoiding interruptions in
compressions
Asystole treatment - Answers i. CPR (2 min.)
ii. O2 at 15 L/min. ambu bag
iii. Epinephrine 1 mg IVP/IO (use epinephrine 0.1 mg/ml), repeat q 3-5 minutes
iv. Repeat CPR and Epinephrine administration if no signs of ROSC
Unstable Bradycardia - Answers i. O2 at minimum 10 L/min. NRBM
ii. If transvenous leads or epicardial pacing wires present, connect to a pulse generator and
initiate pacing per protocol.
If no response, perform the following:
iii. Atropine 1 mg IVP/IO, repeat q 3-5 minutes max 3 mg
iv. Transcutaneous pacing as soon as possible
If above algorithm is ineffective:
v. Start dopamine 400 mg/250 ml D5W infusion at 5 mcg/kg/minute. Titrate to patient response
up to 20mcg/kg/minute
,If above algorithm is ineffective, start epinephrine 2 mg/ 250 ml NS @ 2 mcg/min., titrate to
patient response up to 10 mcg/minute
Pulseless Electrical Activity - Answers i. CPR 2 minutes and assess for possible causes
The H's:
-Hypovolemia
-Hypoxia
-Hydrogen ion (acidosis)
-Hypokalemia
-Hyperkalemia
-Hypoglycemia
-Hypothermia
The T's:
-Toxins
-Cardiac Tamponade
-Thrombosis
-Trauma
-Tension pneumothorax
ii. O2 at 15 L/min ambu bag
iii. Epinephrine 1 mg IVP/IO (use epinephrine 0.1 mg/mL), repeat q 3-5 minutes
iv. Repeat CPR and Epinephrine administration if no signs of ROSC
v. If hypovolemia known or suspected, infuse 250 mL NS may be substituted with LF if currently
infusing). Repeat in 5 minutes if no clinical improvement.
vi. Stat CXR
Ventricular Tachycardia (Wide Complex): Stable - Answers i. Call the physician for orders
ii. O2 at minimum 4 L/min. NC and adjust per patient status
iii. Obtain 12 lead EKG
, iv. Draw serum K and Mg
Ventricular Tachycardia (Wide Complex): Unstable - Answers i. O2 at minimum 10 L/min. NRBM
ii. If ventricular rate greater than 150:
-Biphasic: synchronized cardioversion (200 joules)
iii. If patient is awake and responsive, give midazolam (Versed) 0.5 mg IVP/ IO prior to
cardioversion. May repeat to a total of 1 mg to achieve sedation.
Note: Romazicon is the reversal agent for midazolam. If patient has signs and symptoms of
oversedation (ex: decreased level of consciousness, respiratory rate less than 10/min.)
Romazicon 0.2mg IVP/IO over 15 seconds. May repeat in 45 seconds based on patient
response, not to exceed 0.6mg.
iv. Draw serum K+ and Mg++.
Romazicon - Answers Reversal agent for midazolam
Standard Procedure Functions - Answers Emergency Standing Orders (ESOs) will be initiated by
ESO competency-validated RNs for life threatening conditions of adult patients in the absence
of a physician. In patient care areas without ESO competency validated RNs, the Rapid
Response Team or Code Blue will be called for assistance.
Emergency Standing Orders (ESO) - Answers Pre-established medical orders, approved by
appropriate medical staff to be administered in the absence of a physician. Orders specify
emergent treatment interventions for life-threatening conditions.
ESO Competent Nurse - Answers RN who had successfully demonstrated the knowledge and
skills in identification and treatment of life-threatening conditions
Rapid Response Team - Answers A team PF health care professionals who bring critical care
expertise to the patient bedside
CPR (cardiopulmonary resuscitation) - Answers Includes circulation with compressions, airway
assessment and breathing (C-A-B)
Intraosseous (IO) Therapy - Answers Specialty Catheter inserted into the intraosseous space by
a trained physician or IO insertion validated RN. Safe and alternative route to IV therapy is
initiated when IV access is urgently needed but is not available
Comatose Adult - Answers No eye opening to pain and no purposeful motor response
Unstable - Answers Serious signs and symptoms related to the life-threatening rhythm or
conditions which may include:
