SHARP ESO 2026 CORE EXAM TEST QUESTIONS AND
ANSWERS GUARANTEE A+
✔✔What is the immediate response required when symptoms of myocardial ischemia
are present? - ✔✔It is important to respond immediately when symptoms of myocardial
ischemia are present. A high priority is to provide pain relief.
✔✔How should chest pain be treated? - ✔✔1. O2 at a minimum of 4 L/min to maintain
SpO2 greater than or equal to 94%
2. nitroglycerin (NTG) 0.4mg sublingual if SBP ≥ 90 and/or MAP ≥ 60 mmHg and HR
>50 bpm
3. morphine sulfate 2mg IVP/IO every 5 minutes up to a total of 10mg if SBP ≥ 90
4. aspirin 325 mg
✔✔What diagnostic tests are recommended for chest pain evaluation? - ✔✔1. 12-lead
ECG t
2. Drawing serum CBC, BMP, PT/INR, PTT, and Troponin-HS if not done within 6
hours.
✔✔Clinical Signs of Hypotension - ✔✔Clinical signs of hypotension include cool,
clammy skin, oliguria, increased heart rate, and impaired sensorium.
✔✔Symptoms of Symptomatic Hypotension - ✔✔Symptomatic hypotension is indicated
by unstable symptoms such as decreased level of consciousness and confusion.
✔✔Treatment of Hypotension - ✔✔Hypotension should be treated based on its cause,
such as fluid replacement for hypovolemia and addressing arrhythmias first if present.
✔✔Management of Post-Anesthesia Hypotension - ✔✔Post-anesthesia hypotension is
treated with fluid replacement and Ephedrine.
✔✔How should symptomatic hypotension be treated if hypovolemia is known or
suspected? - ✔✔Infuse 250ml NS rapid bolus. Repeat in 5 minutes if no clinical
improvement.
✔✔What is the next step if SBP is less than 90mmHg after two 250 ml fluid boluses? -
✔✔Start Norepinephrine 4mg/250 mL NS at 2mcg/minute. Titrate until SBP ≥ 90 mmHg
and/or MAP ≥ 65 mmHg (max dose 32 mcg/minute).
, ✔✔What should be done if obvious blood loss is present? - ✔✔Draw stat hemoglobin
and hematocrit (H&H) and type and cross for 2 units PRBC.
✔✔What is the protocol for treating immediate post-anesthesia patients with persistent
hypotension? - ✔✔Administer Ephedrine 5mg IVP/IO. If no improvement within 3
minutes, repeat Ephedrine at 10mg IVP/IO. In the presence of obvious blood loss, draw
stat H&H and Type & Cross 2 units PRBCs.
✔✔What is the first sign of increased intracranial pressure (ICP)? - ✔✔Decreased level
of consciousness
✔✔What are signs of increased ICP that may indicate herniation? - ✔✔Hemiparesis,
decorticate or decerebrate posturing, fixed and dilated pupils
✔✔How is increased ICP defined when being monitored? - ✔✔ICP > 15 mmHg or as
specified by the MD
✔✔How should increased ICP be treated? - ✔✔1. Elevate HOB at least 30°
2. Hyperventilate the intubated patient with 100% FIO2 to maintain PCO2 26-30 mmHg.
3. Draw serum BMP, serum osmolality, and ABG
✔✔What are the causes of respiratory depression? - ✔✔Respiratory depression may be
caused by oversedation secondary to opioids or sedatives.
✔✔How is respiratory depression demonstrated? - ✔✔Respiratory depression is usually
demonstrated by a respiratory rate less than 10/minute and elevated ETCO2.
✔✔How should respiratory depression be treated? - ✔✔Treat respiratory depression
with O2 at minimum 10 L/min NRBM, titrate to patient response. If patient is apneic,
administer oxygen at 15L/min via ambu bag. Initiate ETCO2 monitoring. A Code Blue is
called immediately for respiratory arrest.
✔✔How should narcotic-associated respiratory depression be managed? -
✔✔Administer Naloxone (Narcan) as follows: For apnea, administer Naloxone 0.4 mg
IVP/IO/IM, repeat q 2 minutes x 4 to max of 2 mg if no improvement. For respiratory rate
<10, administer Naloxone 0.1mg IVP/IO/IM, repeat q2 minutes x 4 until RR > 10.
✔✔How should benzodiazepine-associated respiratory depression be managed? -
✔✔Administer Flumazenil (Romazicon) as follows: For apnea to RR < 10, administer
Flumazenil 0.2 mg IVP/IO over 15 seconds. May repeat in 45 seconds based on patient
response, not to exceed 0.6 mg.
ANSWERS GUARANTEE A+
✔✔What is the immediate response required when symptoms of myocardial ischemia
are present? - ✔✔It is important to respond immediately when symptoms of myocardial
ischemia are present. A high priority is to provide pain relief.
✔✔How should chest pain be treated? - ✔✔1. O2 at a minimum of 4 L/min to maintain
SpO2 greater than or equal to 94%
2. nitroglycerin (NTG) 0.4mg sublingual if SBP ≥ 90 and/or MAP ≥ 60 mmHg and HR
>50 bpm
3. morphine sulfate 2mg IVP/IO every 5 minutes up to a total of 10mg if SBP ≥ 90
4. aspirin 325 mg
✔✔What diagnostic tests are recommended for chest pain evaluation? - ✔✔1. 12-lead
ECG t
2. Drawing serum CBC, BMP, PT/INR, PTT, and Troponin-HS if not done within 6
hours.
✔✔Clinical Signs of Hypotension - ✔✔Clinical signs of hypotension include cool,
clammy skin, oliguria, increased heart rate, and impaired sensorium.
✔✔Symptoms of Symptomatic Hypotension - ✔✔Symptomatic hypotension is indicated
by unstable symptoms such as decreased level of consciousness and confusion.
✔✔Treatment of Hypotension - ✔✔Hypotension should be treated based on its cause,
such as fluid replacement for hypovolemia and addressing arrhythmias first if present.
✔✔Management of Post-Anesthesia Hypotension - ✔✔Post-anesthesia hypotension is
treated with fluid replacement and Ephedrine.
✔✔How should symptomatic hypotension be treated if hypovolemia is known or
suspected? - ✔✔Infuse 250ml NS rapid bolus. Repeat in 5 minutes if no clinical
improvement.
✔✔What is the next step if SBP is less than 90mmHg after two 250 ml fluid boluses? -
✔✔Start Norepinephrine 4mg/250 mL NS at 2mcg/minute. Titrate until SBP ≥ 90 mmHg
and/or MAP ≥ 65 mmHg (max dose 32 mcg/minute).
, ✔✔What should be done if obvious blood loss is present? - ✔✔Draw stat hemoglobin
and hematocrit (H&H) and type and cross for 2 units PRBC.
✔✔What is the protocol for treating immediate post-anesthesia patients with persistent
hypotension? - ✔✔Administer Ephedrine 5mg IVP/IO. If no improvement within 3
minutes, repeat Ephedrine at 10mg IVP/IO. In the presence of obvious blood loss, draw
stat H&H and Type & Cross 2 units PRBCs.
✔✔What is the first sign of increased intracranial pressure (ICP)? - ✔✔Decreased level
of consciousness
✔✔What are signs of increased ICP that may indicate herniation? - ✔✔Hemiparesis,
decorticate or decerebrate posturing, fixed and dilated pupils
✔✔How is increased ICP defined when being monitored? - ✔✔ICP > 15 mmHg or as
specified by the MD
✔✔How should increased ICP be treated? - ✔✔1. Elevate HOB at least 30°
2. Hyperventilate the intubated patient with 100% FIO2 to maintain PCO2 26-30 mmHg.
3. Draw serum BMP, serum osmolality, and ABG
✔✔What are the causes of respiratory depression? - ✔✔Respiratory depression may be
caused by oversedation secondary to opioids or sedatives.
✔✔How is respiratory depression demonstrated? - ✔✔Respiratory depression is usually
demonstrated by a respiratory rate less than 10/minute and elevated ETCO2.
✔✔How should respiratory depression be treated? - ✔✔Treat respiratory depression
with O2 at minimum 10 L/min NRBM, titrate to patient response. If patient is apneic,
administer oxygen at 15L/min via ambu bag. Initiate ETCO2 monitoring. A Code Blue is
called immediately for respiratory arrest.
✔✔How should narcotic-associated respiratory depression be managed? -
✔✔Administer Naloxone (Narcan) as follows: For apnea, administer Naloxone 0.4 mg
IVP/IO/IM, repeat q 2 minutes x 4 to max of 2 mg if no improvement. For respiratory rate
<10, administer Naloxone 0.1mg IVP/IO/IM, repeat q2 minutes x 4 until RR > 10.
✔✔How should benzodiazepine-associated respiratory depression be managed? -
✔✔Administer Flumazenil (Romazicon) as follows: For apnea to RR < 10, administer
Flumazenil 0.2 mg IVP/IO over 15 seconds. May repeat in 45 seconds based on patient
response, not to exceed 0.6 mg.
