SHARP ESO 2024/2025 ACTUAL EXAM 300
ACTUAL QUESTIONS AND CORRECT ANSWERS
WITH RATIONALE LATEST UPDATE
This comprehensive 300-question practice exam is designed for nurses seeking
competency in Sharp HealthCare's Emergency Standing Orders (ESO). It
features 300 unique, multiple-choice questions that systematically cover all
critical ESO protocols, including cardiac arrest algorithms (PEA, V-Fib,
Asystole, V-Tach), symptomatic bradycardia and hypotension management,
respiratory distress interventions, anaphylaxis treatment, status epilepticus,
opioid and benzodiazepine reversal, sepsis screening, and increased ICP
protocols. Each question includes a correct answer and a detailed evidence-
based rationale. This resource provides rigorous preparation for the ESO
certification exam by reinforcing clinical decision-making, medication
dosages, and proper documentation in life-threatening emergencies.
1. What is the primary definition of an Emergency Standing Order (ESO) at Sharp
HealthCare?
A) Orders given by a physician over the phone for a non-emergency condition
B) A protocol for routine patient admission assessments
C) Established medical orders to be administered in the absence of a physician
D) A checklist for discharge planning
Answer: C
Rationale: An Emergency Standing Order is a set of pre-established medical orders
approved by medical staff to be implemented in life-threatening situations when a
physician is not immediately available to provide direct orders.
2. An ESO-competent nurse must be proficient in the identification and treatment
of what type of patient conditions?
A) Chronic non-communicable diseases
B) Routine post-operative care needs
C) Life-threatening patient conditions
D) Minor injuries and lacerations
Answer: C
,Rationale: ESO competency requires the nurse to have the knowledge to identify
and treat life-threatening conditions, as these are the only scenarios where an ESO
is initiated.
3. When initiating an ESO, what is the first step a nurse should take in notifying a
patient's physician?
A) Send a secure text message to the physician
B) Call the physician directly
C) Call a Code Blue or the Rapid Response Team (RRT)
D) Document the intervention in the patient's chart
Answer: C
Rationale: The proper sequence for physician notification begins with activating
the emergency response system by calling Code Blue or the Rapid Response Team
(RRT) first, before contacting the patient's primary provider.
4. What is an essential piece of equipment that the Rapid Response Team (RRT)
brings to the bedside?
A) A portable ultrasound machine
B) A critical care cart
C) A portable X-ray machine
D) A defibrillator
Answer: B
Rationale: The RRT brings critical care equipment to the bedside, which includes
all necessary supplies for advanced life support interventions.
5. What does ETCO2 (end-tidal carbon dioxide) monitoring primarily reflect
during CPR?
A) The patient's oxygen saturation level
B) The effectiveness of chest compressions and cardiac output
C) The patient's neurological status
D) The blood pressure
Answer: B
Rationale: ETCO2 is a valuable indicator of cardiac output during CPR. The
measurement reflects the amount of CO2 being exhaled, which correlates with the
effectiveness of chest compressions and the return of spontaneous circulation
(ROSC).
6. What is the target temperature range for therapeutic hypothermia per Sharp ESO
protocol?
A) 28 to 32 degrees Celsius
,B) 32 to 36 degrees Celsius
C) 36 to 38 degrees Celsius
D) 38 to 40 degrees Celsius
Answer: B
Rationale: Therapeutic hypothermia is performed within a temperature range of 32
to 36 degrees Celsius, as per the ESO protocol.
7. When should therapeutic hypothermia be considered for a patient after ROSC?
A) Immediately upon return of spontaneous circulation
B) If the patient is not following commands or showing purposeful movement
within 120 minutes after ROSC
C) Only if the patient has a fever
D) If the patient is awake and alert
Answer: B
Rationale: Therapeutic hypothermia is indicated for patients who are not following
commands or showing purposeful movement within 120 minutes after the return of
spontaneous circulation (ROSC).
8. What are the "H's and T's" assessed for in a PEA (Pulseless Electrical Activity)
arrest?
A) To determine the patient's past medical history
B) To identify reversible causes of cardiac arrest
C) To check the patient's vital signs
D) To assess the patient's neurological status
Answer: B
Rationale: The H's (Hypovolemia, Hypoxia, Hydrogen ion/acidosis,
Hypo/Hyperkalemia, Hypoglycemia, Hypothermia) and T's (Toxins, Tamponade,
Thrombosis, Trauma, Tension pneumothorax) are a mnemonic used to identify and
treat reversible causes of PEA and asystole.
9. What is the maximum dose of Atropine that can be administered for
symptomatic bradycardia per ESO?
A) 1 mg
B) 2 mg
C) 3 mg
D) 4 mg
Answer: C
Rationale: For symptomatic bradycardia, the ESO protocol allows for Atropine 0.5
mg IVP/IO every 3-5 minutes, up to a maximum total dose of 3 mg (or 0.04
mg/kg).
, 10. If transcutaneous pacing is not available for a patient with symptomatic
bradycardia, what medication can be started?
A) Amiodarone
B) Adenosine
C) Dopamine
D) Epinephrine
Answer: C
Rationale: If pacing is ineffective or unavailable after Atropine administration, a
Dopamine infusion can be initiated at 5 mcg/kg/min and titrated to response up to
20 mcg/kg/min.
11. What is the starting dose for a Dopamine infusion in the treatment of
symptomatic bradycardia or symptomatic hypotension?
A) 2 mcg/kg/min
B) 5 mcg/kg/min
C) 10 mcg/kg/min
D) 20 mcg/kg/min
Answer: B
Rationale: The Dopamine infusion is typically started at 5 mcg/kg/min and titrated
up to a maximum of 20 mcg/kg/min to achieve the desired effect (e.g., SBP >90
mmHg or MAP >60 mmHg).
12. What is the reversal agent for Versed (Midazolam)?
A) Narcan (Naloxone)
B) Romazicon (Flumazenil)
C) Atropine
D) Epinephrine
Answer: B
Rationale: Romazicon (Flumazenil) is a specific benzodiazepine antagonist used to
reverse the effects of Versed, a benzodiazepine.
13. What is the recommended dose of Romazicon for reversing benzodiazepine-
induced respiratory depression?
A) 0.1 mg IVP, with a max of 0.4 mg
B) 0.2 mg IVP over 15 seconds, can be repeated up to a max of 0.6 mg
C) 1 mg IVP
D) 2 mg IVP
Answer: B
ACTUAL QUESTIONS AND CORRECT ANSWERS
WITH RATIONALE LATEST UPDATE
This comprehensive 300-question practice exam is designed for nurses seeking
competency in Sharp HealthCare's Emergency Standing Orders (ESO). It
features 300 unique, multiple-choice questions that systematically cover all
critical ESO protocols, including cardiac arrest algorithms (PEA, V-Fib,
Asystole, V-Tach), symptomatic bradycardia and hypotension management,
respiratory distress interventions, anaphylaxis treatment, status epilepticus,
opioid and benzodiazepine reversal, sepsis screening, and increased ICP
protocols. Each question includes a correct answer and a detailed evidence-
based rationale. This resource provides rigorous preparation for the ESO
certification exam by reinforcing clinical decision-making, medication
dosages, and proper documentation in life-threatening emergencies.
1. What is the primary definition of an Emergency Standing Order (ESO) at Sharp
HealthCare?
A) Orders given by a physician over the phone for a non-emergency condition
B) A protocol for routine patient admission assessments
C) Established medical orders to be administered in the absence of a physician
D) A checklist for discharge planning
Answer: C
Rationale: An Emergency Standing Order is a set of pre-established medical orders
approved by medical staff to be implemented in life-threatening situations when a
physician is not immediately available to provide direct orders.
2. An ESO-competent nurse must be proficient in the identification and treatment
of what type of patient conditions?
A) Chronic non-communicable diseases
B) Routine post-operative care needs
C) Life-threatening patient conditions
D) Minor injuries and lacerations
Answer: C
,Rationale: ESO competency requires the nurse to have the knowledge to identify
and treat life-threatening conditions, as these are the only scenarios where an ESO
is initiated.
3. When initiating an ESO, what is the first step a nurse should take in notifying a
patient's physician?
A) Send a secure text message to the physician
B) Call the physician directly
C) Call a Code Blue or the Rapid Response Team (RRT)
D) Document the intervention in the patient's chart
Answer: C
Rationale: The proper sequence for physician notification begins with activating
the emergency response system by calling Code Blue or the Rapid Response Team
(RRT) first, before contacting the patient's primary provider.
4. What is an essential piece of equipment that the Rapid Response Team (RRT)
brings to the bedside?
A) A portable ultrasound machine
B) A critical care cart
C) A portable X-ray machine
D) A defibrillator
Answer: B
Rationale: The RRT brings critical care equipment to the bedside, which includes
all necessary supplies for advanced life support interventions.
5. What does ETCO2 (end-tidal carbon dioxide) monitoring primarily reflect
during CPR?
A) The patient's oxygen saturation level
B) The effectiveness of chest compressions and cardiac output
C) The patient's neurological status
D) The blood pressure
Answer: B
Rationale: ETCO2 is a valuable indicator of cardiac output during CPR. The
measurement reflects the amount of CO2 being exhaled, which correlates with the
effectiveness of chest compressions and the return of spontaneous circulation
(ROSC).
6. What is the target temperature range for therapeutic hypothermia per Sharp ESO
protocol?
A) 28 to 32 degrees Celsius
,B) 32 to 36 degrees Celsius
C) 36 to 38 degrees Celsius
D) 38 to 40 degrees Celsius
Answer: B
Rationale: Therapeutic hypothermia is performed within a temperature range of 32
to 36 degrees Celsius, as per the ESO protocol.
7. When should therapeutic hypothermia be considered for a patient after ROSC?
A) Immediately upon return of spontaneous circulation
B) If the patient is not following commands or showing purposeful movement
within 120 minutes after ROSC
C) Only if the patient has a fever
D) If the patient is awake and alert
Answer: B
Rationale: Therapeutic hypothermia is indicated for patients who are not following
commands or showing purposeful movement within 120 minutes after the return of
spontaneous circulation (ROSC).
8. What are the "H's and T's" assessed for in a PEA (Pulseless Electrical Activity)
arrest?
A) To determine the patient's past medical history
B) To identify reversible causes of cardiac arrest
C) To check the patient's vital signs
D) To assess the patient's neurological status
Answer: B
Rationale: The H's (Hypovolemia, Hypoxia, Hydrogen ion/acidosis,
Hypo/Hyperkalemia, Hypoglycemia, Hypothermia) and T's (Toxins, Tamponade,
Thrombosis, Trauma, Tension pneumothorax) are a mnemonic used to identify and
treat reversible causes of PEA and asystole.
9. What is the maximum dose of Atropine that can be administered for
symptomatic bradycardia per ESO?
A) 1 mg
B) 2 mg
C) 3 mg
D) 4 mg
Answer: C
Rationale: For symptomatic bradycardia, the ESO protocol allows for Atropine 0.5
mg IVP/IO every 3-5 minutes, up to a maximum total dose of 3 mg (or 0.04
mg/kg).
, 10. If transcutaneous pacing is not available for a patient with symptomatic
bradycardia, what medication can be started?
A) Amiodarone
B) Adenosine
C) Dopamine
D) Epinephrine
Answer: C
Rationale: If pacing is ineffective or unavailable after Atropine administration, a
Dopamine infusion can be initiated at 5 mcg/kg/min and titrated to response up to
20 mcg/kg/min.
11. What is the starting dose for a Dopamine infusion in the treatment of
symptomatic bradycardia or symptomatic hypotension?
A) 2 mcg/kg/min
B) 5 mcg/kg/min
C) 10 mcg/kg/min
D) 20 mcg/kg/min
Answer: B
Rationale: The Dopamine infusion is typically started at 5 mcg/kg/min and titrated
up to a maximum of 20 mcg/kg/min to achieve the desired effect (e.g., SBP >90
mmHg or MAP >60 mmHg).
12. What is the reversal agent for Versed (Midazolam)?
A) Narcan (Naloxone)
B) Romazicon (Flumazenil)
C) Atropine
D) Epinephrine
Answer: B
Rationale: Romazicon (Flumazenil) is a specific benzodiazepine antagonist used to
reverse the effects of Versed, a benzodiazepine.
13. What is the recommended dose of Romazicon for reversing benzodiazepine-
induced respiratory depression?
A) 0.1 mg IVP, with a max of 0.4 mg
B) 0.2 mg IVP over 15 seconds, can be repeated up to a max of 0.6 mg
C) 1 mg IVP
D) 2 mg IVP
Answer: B
