B. Attach the quantitative end tidal CO2 monitor.
17862 - A 62 year old female is in cardiac arrest and has
just been intubated. She has bilateral breath sounds and Once you have confirmed tube placement by visualization
absent epigastric sounds. What should you do? of the vocal cords, condensation in the tube, and bilateral
breath sounds without epigastric sounds the care provider
a. Check for moisture on the inside of the endotracheal
needs to use a commercial device for proper placement
tube.
and the gold standard is quantitative end tidal CO2 mon-
b. Attach the quantitative end tidal CO2 monitor.
itoring with wave form.
c. Ventilate with more force and confirm placement.
The correct answer is: Attach the quantitative end tidal CO2
d. Deflate the cutt and remove the endotracheal tube.
monitor.
A. Deliver an unsynchronized shock at 200J.
17591 - A 76 year old male is in cardiac arrest. Emergency
Medical Responders have been performing high-quality The first line treatment for a patient in cardiac arrest
CPR for 6 minutes. The ECG monitor shows monomorphic is early defibrillation. Endotracheal intubation is farther
ventricular tachycardia. What is should you do? down the algorhythm, medication should be given after
an IV is established and after defibrillation, and the an-
a. Deliver an unsynchronized shock at 200J.
tidysrhythmic should be administered as the second line
b. Administer amiodarone 300mg.
medication.
c. Perform endotracheal intubation.
The correct answer is: Deliver an unsynchronized shock at
d. Administer a round of epinephrine 1:10,000.
200J.
D. Assess the quality of chest compressions.
17863 - A bariatric 42 year old female is in cardiac arrest.
The EMR is having a hard time locating the correct land- If the provider (EMR) is having trouble locating the land-
marks for chest compressions. Vital signs are BP 0/0, P 0, marks then the most experienced provider needs to make
R assisted, ETCO2 8 mmHg. What should you do? sure that there is proper hand placement and proper
depth of compressions. You should not discontinue resus-
a. Perform endotracheal intubation.
citative ettorts at this stage. IO access would be later in the
b. Obtain intraosseous access.
algorithm as well as endotracheal intubation.
c. Discontinue resuscitative ettorts.
The correct answer is: Assess the quality of chest compres-
d. Assess the quality of chest compressions.
sions.
1/8
, 15378 - A 63 year old female complains of "funny heart D. Attempt a vagal maneuver.
beats" and dizziness when she stands. Vital signs are BP
122/82, P 188 and regular, R 20, SpO2 98%. What should Her vital signs are stable. She complains of dizziness and
you do? funny heart beats. Your initial intervention should be to
provide her with vagal maneuvers, this being less invasive.
a. Perform synchronized cardioversion. If vagal maneuvers are unsuccessful you should move
b. Obtain orthostatic blood pressure. onto adenosine then if the patients progresses to unstable
c. Administer 12 mg adenosine. provide the patient with synchronized cardioversion.
d. Attempt a vagal maneuver. The correct answer is: Attempt a vagal maneuver.
B. Initiate transcutaneous pacing.
Due to the patient being symptomatic you should initiate
13570 - A 56 year old male had a syncopal episode. He is immediate transcutaneous pacing. Increasing the heart
hypotensive and responsive to verbal stimulus only. The rate in the patient would also increase blood pressure
ECG shows a third-degree block with a rate of 32 bpm. which then would increase level of consciousness. At-
What should you do? ropine would not be a first line choice due to the high
degree block and the patients hemodynamic status. Fluid
a. Administer atropine 0.5 mg.
bolus would be given after the pacing was initiated and
b. Initiate transcutaneous pacing.
the patient remains hypotensive. Giving epinephrine to
c. Provide a fluid bolus.
an oxygen deprived myocardium could make the patient
d. Administer epinephrine 5 mcg/min.
worse due to the oxygen demand that would be placed
on the myocardium.
The correct answer is: Initiate transcutaneous pacing.
D. Discontinue resuscitation ettorts.
9143 - An 83 year old female was found submerged in
a bath tub. She is pulseless and apneic. A nursing home You should always check your lead placement in con-
attendant stated that she last saw her 1 hour ago taking firming asystole. During movement and CPR it is always
a bath. Her heart rhythm is asystolic after 20 minutes possible for the monitor leads to become disconnected
resuscitation ettorts. What should you do? showing the provider an asystolic rhythm. You could think
about discontinuing resuscitative ettorts after contacting
a. Administer 1 mg of Atropine.
medical control. Pacing would not be a good choice due
b. Check for loose ECG leads.
to down time. Atropine is not recommended for asystolic
2/8
17862 - A 62 year old female is in cardiac arrest and has
just been intubated. She has bilateral breath sounds and Once you have confirmed tube placement by visualization
absent epigastric sounds. What should you do? of the vocal cords, condensation in the tube, and bilateral
breath sounds without epigastric sounds the care provider
a. Check for moisture on the inside of the endotracheal
needs to use a commercial device for proper placement
tube.
and the gold standard is quantitative end tidal CO2 mon-
b. Attach the quantitative end tidal CO2 monitor.
itoring with wave form.
c. Ventilate with more force and confirm placement.
The correct answer is: Attach the quantitative end tidal CO2
d. Deflate the cutt and remove the endotracheal tube.
monitor.
A. Deliver an unsynchronized shock at 200J.
17591 - A 76 year old male is in cardiac arrest. Emergency
Medical Responders have been performing high-quality The first line treatment for a patient in cardiac arrest
CPR for 6 minutes. The ECG monitor shows monomorphic is early defibrillation. Endotracheal intubation is farther
ventricular tachycardia. What is should you do? down the algorhythm, medication should be given after
an IV is established and after defibrillation, and the an-
a. Deliver an unsynchronized shock at 200J.
tidysrhythmic should be administered as the second line
b. Administer amiodarone 300mg.
medication.
c. Perform endotracheal intubation.
The correct answer is: Deliver an unsynchronized shock at
d. Administer a round of epinephrine 1:10,000.
200J.
D. Assess the quality of chest compressions.
17863 - A bariatric 42 year old female is in cardiac arrest.
The EMR is having a hard time locating the correct land- If the provider (EMR) is having trouble locating the land-
marks for chest compressions. Vital signs are BP 0/0, P 0, marks then the most experienced provider needs to make
R assisted, ETCO2 8 mmHg. What should you do? sure that there is proper hand placement and proper
depth of compressions. You should not discontinue resus-
a. Perform endotracheal intubation.
citative ettorts at this stage. IO access would be later in the
b. Obtain intraosseous access.
algorithm as well as endotracheal intubation.
c. Discontinue resuscitative ettorts.
The correct answer is: Assess the quality of chest compres-
d. Assess the quality of chest compressions.
sions.
1/8
, 15378 - A 63 year old female complains of "funny heart D. Attempt a vagal maneuver.
beats" and dizziness when she stands. Vital signs are BP
122/82, P 188 and regular, R 20, SpO2 98%. What should Her vital signs are stable. She complains of dizziness and
you do? funny heart beats. Your initial intervention should be to
provide her with vagal maneuvers, this being less invasive.
a. Perform synchronized cardioversion. If vagal maneuvers are unsuccessful you should move
b. Obtain orthostatic blood pressure. onto adenosine then if the patients progresses to unstable
c. Administer 12 mg adenosine. provide the patient with synchronized cardioversion.
d. Attempt a vagal maneuver. The correct answer is: Attempt a vagal maneuver.
B. Initiate transcutaneous pacing.
Due to the patient being symptomatic you should initiate
13570 - A 56 year old male had a syncopal episode. He is immediate transcutaneous pacing. Increasing the heart
hypotensive and responsive to verbal stimulus only. The rate in the patient would also increase blood pressure
ECG shows a third-degree block with a rate of 32 bpm. which then would increase level of consciousness. At-
What should you do? ropine would not be a first line choice due to the high
degree block and the patients hemodynamic status. Fluid
a. Administer atropine 0.5 mg.
bolus would be given after the pacing was initiated and
b. Initiate transcutaneous pacing.
the patient remains hypotensive. Giving epinephrine to
c. Provide a fluid bolus.
an oxygen deprived myocardium could make the patient
d. Administer epinephrine 5 mcg/min.
worse due to the oxygen demand that would be placed
on the myocardium.
The correct answer is: Initiate transcutaneous pacing.
D. Discontinue resuscitation ettorts.
9143 - An 83 year old female was found submerged in
a bath tub. She is pulseless and apneic. A nursing home You should always check your lead placement in con-
attendant stated that she last saw her 1 hour ago taking firming asystole. During movement and CPR it is always
a bath. Her heart rhythm is asystolic after 20 minutes possible for the monitor leads to become disconnected
resuscitation ettorts. What should you do? showing the provider an asystolic rhythm. You could think
about discontinuing resuscitative ettorts after contacting
a. Administer 1 mg of Atropine.
medical control. Pacing would not be a good choice due
b. Check for loose ECG leads.
to down time. Atropine is not recommended for asystolic
2/8
