NCOEMS- CARDIOLOGY, EMS TRAUMA, MEDICAL
EXAM NEWEST 2026 TEST BANK| COMPLETE 500 REAL
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+ (BRAND
NEW!!)
1. A 68-year-old male complains of substernal chest pressure
radiating to his jaw. He is diaphoretic and nauseated. His BP
is 90/60, HR 110, RR 22. What is the most appropriate
immediate intervention?
A) Aspirin 324 mg chewed
B) Nitroglycerin 0.4 mg SL
C) Morphine 4 mg IV
D) Normal saline bolus 250 mL
Answer: D
Rationale: Hypotension (SBP <100) is a contraindication to
1
,nitroglycerin because it reduces preload and can cause
cardiovascular collapse. This patient may have right ventricular
infarction or hypovolemia. A fluid bolus is indicated first to improve
perfusion pressure. Aspirin is important but does not address
immediate hypotension.
2. Which ECG finding is most specific for acute pericarditis?
A) ST elevation in leads II, III, aVF
B) ST depression in V1-V4
C) Diffuse concave ST elevation with PR depression
D) Deep Q waves in V1-V4
Answer: C
Rationale: Pericarditis causes diffuse, concave-up (saddle-shaped)
ST elevation with PR segment depression (due to atrial
2
,inflammation). This contrasts with myocardial infarction, which
shows convex ST elevation in a regional distribution.
3. A patient in cardiac arrest has a rhythm of wide-complex
tachycardia at 300 bpm with no identifiable P waves. The
monitor shows a "sine wave" pattern. What is the rhythm?
A) Ventricular tachycardia
B) Torsades de pointes
C) Ventricular fibrillation
D) Supraventricular tachycardia with aberrancy
Answer: B
Rationale: Torsades de pointes is a polymorphic ventricular
tachycardia with QRS complexes that twist around the baseline,
often at >200 bpm, giving a sine wave appearance. It is typically
caused by prolonged QT interval from medications (e.g.,
3
, antiarrhythmics, antipsychotics) or electrolyte disturbances
(hypomagnesemia, hypokalemia).
4. During CPR, you administer epinephrine 1 mg IV. How
often should this be repeated?
A) Every 2 minutes
B) Every 3-5 minutes
C) Every cycle of 30:2 compressions
D) Once per cardiac arrest
Answer: B
*Rationale: AHA guidelines recommend epinephrine every 3-5
minutes during cardiac arrest. Shorter intervals increase the risk
of arrhythmias without proven benefit; longer intervals reduce
the chance of ROSC. Epinephrine is given after the second shock
and then q3-5min.*
4
EXAM NEWEST 2026 TEST BANK| COMPLETE 500 REAL
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+ (BRAND
NEW!!)
1. A 68-year-old male complains of substernal chest pressure
radiating to his jaw. He is diaphoretic and nauseated. His BP
is 90/60, HR 110, RR 22. What is the most appropriate
immediate intervention?
A) Aspirin 324 mg chewed
B) Nitroglycerin 0.4 mg SL
C) Morphine 4 mg IV
D) Normal saline bolus 250 mL
Answer: D
Rationale: Hypotension (SBP <100) is a contraindication to
1
,nitroglycerin because it reduces preload and can cause
cardiovascular collapse. This patient may have right ventricular
infarction or hypovolemia. A fluid bolus is indicated first to improve
perfusion pressure. Aspirin is important but does not address
immediate hypotension.
2. Which ECG finding is most specific for acute pericarditis?
A) ST elevation in leads II, III, aVF
B) ST depression in V1-V4
C) Diffuse concave ST elevation with PR depression
D) Deep Q waves in V1-V4
Answer: C
Rationale: Pericarditis causes diffuse, concave-up (saddle-shaped)
ST elevation with PR segment depression (due to atrial
2
,inflammation). This contrasts with myocardial infarction, which
shows convex ST elevation in a regional distribution.
3. A patient in cardiac arrest has a rhythm of wide-complex
tachycardia at 300 bpm with no identifiable P waves. The
monitor shows a "sine wave" pattern. What is the rhythm?
A) Ventricular tachycardia
B) Torsades de pointes
C) Ventricular fibrillation
D) Supraventricular tachycardia with aberrancy
Answer: B
Rationale: Torsades de pointes is a polymorphic ventricular
tachycardia with QRS complexes that twist around the baseline,
often at >200 bpm, giving a sine wave appearance. It is typically
caused by prolonged QT interval from medications (e.g.,
3
, antiarrhythmics, antipsychotics) or electrolyte disturbances
(hypomagnesemia, hypokalemia).
4. During CPR, you administer epinephrine 1 mg IV. How
often should this be repeated?
A) Every 2 minutes
B) Every 3-5 minutes
C) Every cycle of 30:2 compressions
D) Once per cardiac arrest
Answer: B
*Rationale: AHA guidelines recommend epinephrine every 3-5
minutes during cardiac arrest. Shorter intervals increase the risk
of arrhythmias without proven benefit; longer intervals reduce
the chance of ROSC. Epinephrine is given after the second shock
and then q3-5min.*
4
