FISDAP CARDIOLOGY (PARAMEDIC) TEST
BANK 700+ UPDATED QUESTIONS WITH
CORRECT ANSWERS-2024
You respond to a residence for a 68-year-old male with nausea, vomiting, and
blurred vision. As you are assessing him, he tells you that he has congestive heart
failure and atrial fibrillation, and takes numerous medications. The cardiac monitor
reveals atrial fibrillation with a ventricular rate of 50 beats/min. Which of the following
medications is MOST likely responsible for this patient's clinical presentation? -
CORRECT ANSWER ✅✅✅Digoxin.
This patient has classic signs of digitalis toxicity. Digoxin is commonly prescribed to
patients with congestive heart failure and atrial fibrillation (A-Fib) or atrial flutter (A-
Flutter). Its positive inotropic effects increase cardiac contractility and maintain
cardiac output, while its negative chronotropic effects control the ventricular rate of
the A-Fib or A-Flutter. Digitalis preparations (ie, Lanoxin, Digoxin) have a narrow
therapeutic index—that is, there is a fine line between a therapeutic and toxic dose.
You should suspect digitalis toxicity in any patient who takes Digoxin or Lanoxin and
presents with complaints such as nausea, vomiting, abdominal pain, anorexia, or
blurred/yellow vision. Additionally, virtually any cardiac dysrhythmia can be caused
by the toxic effects of digitalis. Treatment involves the administration of Digibind,
which is given at the hospital.
Which of the following is an absolute contraindication for fibrinolytic therapy? -
CORRECT ANSWER ✅✅✅Subdural hematoma 3 years ago.
According to current emergency cardiac care (ECC) guidelines, absolute
contraindications for fibrinolytic therapy include ANY prior intracranial hemorrhage
(ie, subdural, epidural, intracerebral hematoma); known structural cerebrovascular
lesion (ie, arteriovenous malformation); known malignant intracranial tumor (primary
or metastatic); ischemic stroke within the past 3 months, EXCEPT for acute ischemic
stroke within the past 3 hours; suspected aortic dissection; active bleeding or
bleeding disorders (except menses); and significant closed head trauma or facial
trauma within the past 3 months. Relative contraindications (eg, the physician may
deem fibrinolytic therapy appropriate under certain circumstances) include, a history
of chronic, severe, poorly-controlled hypertension; severe uncontrolled hypertension
on presentation (SBP > 180 mm Hg or DBP > 110 mm Hg); ischemic stroke greater
than 3 months ago; dementia; traumatic or prolonged (> 10 minutes) CPR or major
surgery within the past 3 weeks; recent (within 2 to 4 weeks) internal bleeding;
noncompressible vascular punctures; pregnancy; prior exposure (> 5 days ago) or
prior allergic reaction to streptokinase or anistreplase; active peptic ulcer; and
current use of anticoagulants (ie, Coumadin).
,A middle-aged man presents with chest discomfort, shortness of breath, and nausea.
You give him supplemental oxygen and continue your assessment. As your partner
is attaching the ECG leads, you should: - CORRECT ANSWER ✅✅✅Administer
up to 325 mg of aspirin.
Since oxygen has already been administered to this patient and your partner is
attaching the ECG leads, you should administer aspirin (160 to 325 mg, non-enteric-
coated). Early administration of aspirin has clearly been shown to reduce mortality
and morbidity in patients experiencing an acute coronary syndrome (ACS). After
establishing vascular access, you should assess his vital signs and then administer
0.4 mg of nitroglycerin (up to 3 doses, 5 minutes apart), provided that his systolic BP
is greater than 90 mm Hg. If 3 doses of nitroglycerin fail to completely relieve his
chest discomfort, consider administering 2 to 4 mg of morphine IV, provided that his
systolic BP remains above 90 mm Hg.
Which of the following ECG lead configurations is correct? - CORRECT ANSWER
✅✅✅To assess lead II, place the negative lead on the right arm and the positive
lead on the left leg.
According to the Einthoven triangle, lead I is assessed by placing the negative
(white) lead on the right arm and the positive (red) lead on the left arm. Lead II is
assessed by placing the negative lead on the right arm and the positive lead on the
left leg. Lead III is assessed by placing the negative lead on the left arm and the
positive lead on the left leg.
A 61-year-old male presents with chest pressure that woke him up from his nap 30
minutes ago. He is diaphoretic, anxious, and rates his pain as an an 8 over 10. His
past medical history is significant for hypertension, type II diabetes, and coronary
stent placement 2 months ago. He takes lisinopril, Plavix, and Glucophage, and is
wearing a medical alert bracelet stating "allergic to salicylates." His blood pressure is
160/100 mm Hg, pulse is 110 beats/min, and respirations are 22 breaths/min. The
12-lead ECG shows sinus tachycardia with 3-mm ST segment elevation in leads V1
through V5. Which of the following treatment modalities is MOST appropriate for this
patient? - CORRECT ANSWER ✅✅✅Supplemental oxygen, vascular access, up
to three 0.4 mg doses of nitroglycerin, and 2 to 4 mg of morphine sulfate if his
systolic BP is greater than 90 mm Hg and he is still experiencing pain.
The patient is experiencing an acute coronary syndrome (ACS). His 12-lead ECG
indicates anteroseptal injury with lateral extension (ST elevation in leads V1 through
V5). Appropriate treatment includes oxygen (maintain an SpO2 of greater than 94%),
vascular access, up to three 0.4 mg doses of nitroglycerin (NTG), and 2 to 4 mg of
morphine if NTG fails to relieve his pain and his systolic BP is above 90 mm Hg.
Some EMS systems may use fentanyl (Sublimaze) for analgesia. Aspirin, a
salicylate, is also given to patients with ACS; however, this patient is allergic to
salicylates. Obtain a right-sided 12-lead ECG in patients with signs of inferior wall
injury (ST elevation in leads II, III, aVF). Inferior wall infarctions may involve the right
ventricle; a right-sided 12-lead ECG will help confirm this. Apply the multi-pads to the
patient, not because he is at risk for bradycardia (more common with inferior
infarctions), but because he is at risk for cardiac arrest due to V-Fib or pulseless V-
Tach.
,You and your team are performing CPR on a 70-year-old male. The cardiac monitor
reveals a slow, organized rhythm. His wife tells you that he goes to dialysis every
day, but has missed his last three treatments. She also tells you that he has high
blood pressure, hyperthyroidism, and has had several cardiac bypass surgeries.
Based on the patient's medical history, which of the following conditions is the MOST
likely underlying cause of his condition? - CORRECT ANSWER
✅✅✅Hyperkalemia.
Although any of the listed conditions could be causing this patient's condition, the
fact that he missed his last three dialysis treatments should make you most
suspicious for hyperkalemia. Dialysis filters metabolic waste products from the blood
in patients with renal insufficiency or failure. If the patient is not dialyzed, these waste
products, including potassium and other electrolytes, accumulate to toxic levels in
the blood. In addition to performing high-quality CPR, managing the airway, and
administering epinephrine, your protocols may call for the administration of calcium
chloride and sodium bicarbonate if hyperkalemia is suspected. Albuterol also has
been shown to be effective in treating patients with hyperkalemia becauses it causes
potassium to shift back into the cells; it can be nebulized down the ET tube or
administered intravenously. Follow your local protocols regarding the treatment for
suspected hyperkalemia.
Which of the following represents the MOST appropriate initial drug and dose that is
given to all adult patients in cardiac arrest? - CORRECT ANSWER ✅✅✅10 mL
of epinephrine 1:10,000 every 3 to 5 minutes.
Once vascular access has been obtained (IV or IO), the first drug and dose given to
all patients in cardiac arrest—regardless of the rhythm on the cardiac monitor—is
epinephrine 1 mg (10 mL) of a 1:10,000 solution, repeated every 3 to 5 minutes. You
may consider a one-time dose of vasopressin (40 units) to replace the first or second
dose of epinephrine, but not both. Higher doses of epinephrine may be necessary if
special circumstances exist (ie, severe beta-blocker toxicity). Consult with medical
control as needed.
The MOST appropriate initial action for a 54-year-old man who presents with the
following cardiac rhythm should consist of: - CORRECT ANSWER
✅✅✅Assessing the patient's clinical status.
When assessing the cardiac rhythm of any patient, you must interpret it in the
context of his or her clinical status. Before you reach for atropine or a pacemaker,
determine if the bradycardia is causing hemodynamic compromise (ie, hypotension,
altered mental status, chest pressure or discomfort, pulmonary edema). If the patient
is hemodynamically unstable, treat according to established ACLS guidelines (ie,
atropine, pacing, etc.). However, if the patient is hemodynamically stable, simply
monitor his or her clinical status and transport to the hospital.
When assessing a patient's pulse, you note that it is fast and has an irregularly
irregular pattern. On the basis of these findings, which of the following cardiac
, rhythms would MOST likely be seen on the cardiac monitor? - CORRECT ANSWER
✅✅✅Uncontrolled atrial fibrillation.
Of the cardiac rhythms listed, atrial fibrillation (A-Fib) is the only one that is irregularly
irregular. In fact, A-Fib is never seen as a regular rhythm. At a rate of less than 100
beats/min, A-Fib is said to be controlled. Uncontrolled A-Fib, or A-Fib with a rapid
ventricular rate (RVR), occurs when the ventricular rate exceeds 100 beats/min.
Second-degree AV block type I has a pattern that is regularly irregular; the P-R
interval progressively lengthens until a P wave is blocked. Ventricular tachycardia (V-
Tach) and supraventricular tachycardia (SVT) are typically regular rhythms.
What is the correct initial dose and rate of administration of amiodarone for a patient
with refractory ventricular fibrillation? - CORRECT ANSWER ✅✅✅300 mg via
rapid IV or IO push.
The correct initial dose and rate of administration of amiodarone for a patient with
refractory ventricular fibrillation or pulseless ventricular tachycardia is 300 mg rapid
IV or IO push. You may repeat amiodarone one time in 5 minutes at a dose of 150
mg rapid IV or IO push. For patients with hemodynamically stable narrow or wide-
complex tachycardias, the correct dose and rate of administration for amiodarone is
150 mg given over 10 minutes.
The main purpose of listening to heart sounds is to: - CORRECT ANSWER
✅✅✅Determine if the cardiac valves are functioning properly.
In general patient assessment, the main purpose of listening to heart sounds is to
identify the "lub-dub" that indicates the cardiac valves are functioning properly. S1
(lub) occurs near the beginning of ventricular contraction, when the tricuspid and
mitral valves close. S2 (dub) occurs near the end of the ventricular contraction, when
the pulmonary and aortic valves close. Although cardiac rate and regularity can be
assessed by listening to heart sounds (apical pulse), the quality of the heartbeat can
only be assessed by palpating the pulse. The point of maximal impulse (PMI)—also
called the apical thrust—is not heard, but rather seen. The PMI, which is normally
located on the left anterior part of the chest in the midclavicular line at the fifth
intercostal space, occurs when the heart's apex rotates forward with systole and
gently beats against the chest wall, producing a visible pulsation.
Which of the following represents the correct adult dosing regimen for adenosine? -
CORRECT ANSWER ✅✅✅6 mg, followed by 12 mg in 2 minutes if needed.
According to the 2010 guidelines for CPR and emergency cardiac care (ECC), the
correct dosing regimen of adenosine for a hemodynamically stable patient with a
narrow-complex tachycardia is 6 mg via rapid (over 1 to 3 seconds) IV push. If
needed, adenosine can be repeated in 1 to 2 minutes in a dose of 12 mg rapid IV
push.
You should interpret the following cardiac rhythm as: - CORRECT ANSWER
✅✅✅Atrial flutter with a fixed block.
BANK 700+ UPDATED QUESTIONS WITH
CORRECT ANSWERS-2024
You respond to a residence for a 68-year-old male with nausea, vomiting, and
blurred vision. As you are assessing him, he tells you that he has congestive heart
failure and atrial fibrillation, and takes numerous medications. The cardiac monitor
reveals atrial fibrillation with a ventricular rate of 50 beats/min. Which of the following
medications is MOST likely responsible for this patient's clinical presentation? -
CORRECT ANSWER ✅✅✅Digoxin.
This patient has classic signs of digitalis toxicity. Digoxin is commonly prescribed to
patients with congestive heart failure and atrial fibrillation (A-Fib) or atrial flutter (A-
Flutter). Its positive inotropic effects increase cardiac contractility and maintain
cardiac output, while its negative chronotropic effects control the ventricular rate of
the A-Fib or A-Flutter. Digitalis preparations (ie, Lanoxin, Digoxin) have a narrow
therapeutic index—that is, there is a fine line between a therapeutic and toxic dose.
You should suspect digitalis toxicity in any patient who takes Digoxin or Lanoxin and
presents with complaints such as nausea, vomiting, abdominal pain, anorexia, or
blurred/yellow vision. Additionally, virtually any cardiac dysrhythmia can be caused
by the toxic effects of digitalis. Treatment involves the administration of Digibind,
which is given at the hospital.
Which of the following is an absolute contraindication for fibrinolytic therapy? -
CORRECT ANSWER ✅✅✅Subdural hematoma 3 years ago.
According to current emergency cardiac care (ECC) guidelines, absolute
contraindications for fibrinolytic therapy include ANY prior intracranial hemorrhage
(ie, subdural, epidural, intracerebral hematoma); known structural cerebrovascular
lesion (ie, arteriovenous malformation); known malignant intracranial tumor (primary
or metastatic); ischemic stroke within the past 3 months, EXCEPT for acute ischemic
stroke within the past 3 hours; suspected aortic dissection; active bleeding or
bleeding disorders (except menses); and significant closed head trauma or facial
trauma within the past 3 months. Relative contraindications (eg, the physician may
deem fibrinolytic therapy appropriate under certain circumstances) include, a history
of chronic, severe, poorly-controlled hypertension; severe uncontrolled hypertension
on presentation (SBP > 180 mm Hg or DBP > 110 mm Hg); ischemic stroke greater
than 3 months ago; dementia; traumatic or prolonged (> 10 minutes) CPR or major
surgery within the past 3 weeks; recent (within 2 to 4 weeks) internal bleeding;
noncompressible vascular punctures; pregnancy; prior exposure (> 5 days ago) or
prior allergic reaction to streptokinase or anistreplase; active peptic ulcer; and
current use of anticoagulants (ie, Coumadin).
,A middle-aged man presents with chest discomfort, shortness of breath, and nausea.
You give him supplemental oxygen and continue your assessment. As your partner
is attaching the ECG leads, you should: - CORRECT ANSWER ✅✅✅Administer
up to 325 mg of aspirin.
Since oxygen has already been administered to this patient and your partner is
attaching the ECG leads, you should administer aspirin (160 to 325 mg, non-enteric-
coated). Early administration of aspirin has clearly been shown to reduce mortality
and morbidity in patients experiencing an acute coronary syndrome (ACS). After
establishing vascular access, you should assess his vital signs and then administer
0.4 mg of nitroglycerin (up to 3 doses, 5 minutes apart), provided that his systolic BP
is greater than 90 mm Hg. If 3 doses of nitroglycerin fail to completely relieve his
chest discomfort, consider administering 2 to 4 mg of morphine IV, provided that his
systolic BP remains above 90 mm Hg.
Which of the following ECG lead configurations is correct? - CORRECT ANSWER
✅✅✅To assess lead II, place the negative lead on the right arm and the positive
lead on the left leg.
According to the Einthoven triangle, lead I is assessed by placing the negative
(white) lead on the right arm and the positive (red) lead on the left arm. Lead II is
assessed by placing the negative lead on the right arm and the positive lead on the
left leg. Lead III is assessed by placing the negative lead on the left arm and the
positive lead on the left leg.
A 61-year-old male presents with chest pressure that woke him up from his nap 30
minutes ago. He is diaphoretic, anxious, and rates his pain as an an 8 over 10. His
past medical history is significant for hypertension, type II diabetes, and coronary
stent placement 2 months ago. He takes lisinopril, Plavix, and Glucophage, and is
wearing a medical alert bracelet stating "allergic to salicylates." His blood pressure is
160/100 mm Hg, pulse is 110 beats/min, and respirations are 22 breaths/min. The
12-lead ECG shows sinus tachycardia with 3-mm ST segment elevation in leads V1
through V5. Which of the following treatment modalities is MOST appropriate for this
patient? - CORRECT ANSWER ✅✅✅Supplemental oxygen, vascular access, up
to three 0.4 mg doses of nitroglycerin, and 2 to 4 mg of morphine sulfate if his
systolic BP is greater than 90 mm Hg and he is still experiencing pain.
The patient is experiencing an acute coronary syndrome (ACS). His 12-lead ECG
indicates anteroseptal injury with lateral extension (ST elevation in leads V1 through
V5). Appropriate treatment includes oxygen (maintain an SpO2 of greater than 94%),
vascular access, up to three 0.4 mg doses of nitroglycerin (NTG), and 2 to 4 mg of
morphine if NTG fails to relieve his pain and his systolic BP is above 90 mm Hg.
Some EMS systems may use fentanyl (Sublimaze) for analgesia. Aspirin, a
salicylate, is also given to patients with ACS; however, this patient is allergic to
salicylates. Obtain a right-sided 12-lead ECG in patients with signs of inferior wall
injury (ST elevation in leads II, III, aVF). Inferior wall infarctions may involve the right
ventricle; a right-sided 12-lead ECG will help confirm this. Apply the multi-pads to the
patient, not because he is at risk for bradycardia (more common with inferior
infarctions), but because he is at risk for cardiac arrest due to V-Fib or pulseless V-
Tach.
,You and your team are performing CPR on a 70-year-old male. The cardiac monitor
reveals a slow, organized rhythm. His wife tells you that he goes to dialysis every
day, but has missed his last three treatments. She also tells you that he has high
blood pressure, hyperthyroidism, and has had several cardiac bypass surgeries.
Based on the patient's medical history, which of the following conditions is the MOST
likely underlying cause of his condition? - CORRECT ANSWER
✅✅✅Hyperkalemia.
Although any of the listed conditions could be causing this patient's condition, the
fact that he missed his last three dialysis treatments should make you most
suspicious for hyperkalemia. Dialysis filters metabolic waste products from the blood
in patients with renal insufficiency or failure. If the patient is not dialyzed, these waste
products, including potassium and other electrolytes, accumulate to toxic levels in
the blood. In addition to performing high-quality CPR, managing the airway, and
administering epinephrine, your protocols may call for the administration of calcium
chloride and sodium bicarbonate if hyperkalemia is suspected. Albuterol also has
been shown to be effective in treating patients with hyperkalemia becauses it causes
potassium to shift back into the cells; it can be nebulized down the ET tube or
administered intravenously. Follow your local protocols regarding the treatment for
suspected hyperkalemia.
Which of the following represents the MOST appropriate initial drug and dose that is
given to all adult patients in cardiac arrest? - CORRECT ANSWER ✅✅✅10 mL
of epinephrine 1:10,000 every 3 to 5 minutes.
Once vascular access has been obtained (IV or IO), the first drug and dose given to
all patients in cardiac arrest—regardless of the rhythm on the cardiac monitor—is
epinephrine 1 mg (10 mL) of a 1:10,000 solution, repeated every 3 to 5 minutes. You
may consider a one-time dose of vasopressin (40 units) to replace the first or second
dose of epinephrine, but not both. Higher doses of epinephrine may be necessary if
special circumstances exist (ie, severe beta-blocker toxicity). Consult with medical
control as needed.
The MOST appropriate initial action for a 54-year-old man who presents with the
following cardiac rhythm should consist of: - CORRECT ANSWER
✅✅✅Assessing the patient's clinical status.
When assessing the cardiac rhythm of any patient, you must interpret it in the
context of his or her clinical status. Before you reach for atropine or a pacemaker,
determine if the bradycardia is causing hemodynamic compromise (ie, hypotension,
altered mental status, chest pressure or discomfort, pulmonary edema). If the patient
is hemodynamically unstable, treat according to established ACLS guidelines (ie,
atropine, pacing, etc.). However, if the patient is hemodynamically stable, simply
monitor his or her clinical status and transport to the hospital.
When assessing a patient's pulse, you note that it is fast and has an irregularly
irregular pattern. On the basis of these findings, which of the following cardiac
, rhythms would MOST likely be seen on the cardiac monitor? - CORRECT ANSWER
✅✅✅Uncontrolled atrial fibrillation.
Of the cardiac rhythms listed, atrial fibrillation (A-Fib) is the only one that is irregularly
irregular. In fact, A-Fib is never seen as a regular rhythm. At a rate of less than 100
beats/min, A-Fib is said to be controlled. Uncontrolled A-Fib, or A-Fib with a rapid
ventricular rate (RVR), occurs when the ventricular rate exceeds 100 beats/min.
Second-degree AV block type I has a pattern that is regularly irregular; the P-R
interval progressively lengthens until a P wave is blocked. Ventricular tachycardia (V-
Tach) and supraventricular tachycardia (SVT) are typically regular rhythms.
What is the correct initial dose and rate of administration of amiodarone for a patient
with refractory ventricular fibrillation? - CORRECT ANSWER ✅✅✅300 mg via
rapid IV or IO push.
The correct initial dose and rate of administration of amiodarone for a patient with
refractory ventricular fibrillation or pulseless ventricular tachycardia is 300 mg rapid
IV or IO push. You may repeat amiodarone one time in 5 minutes at a dose of 150
mg rapid IV or IO push. For patients with hemodynamically stable narrow or wide-
complex tachycardias, the correct dose and rate of administration for amiodarone is
150 mg given over 10 minutes.
The main purpose of listening to heart sounds is to: - CORRECT ANSWER
✅✅✅Determine if the cardiac valves are functioning properly.
In general patient assessment, the main purpose of listening to heart sounds is to
identify the "lub-dub" that indicates the cardiac valves are functioning properly. S1
(lub) occurs near the beginning of ventricular contraction, when the tricuspid and
mitral valves close. S2 (dub) occurs near the end of the ventricular contraction, when
the pulmonary and aortic valves close. Although cardiac rate and regularity can be
assessed by listening to heart sounds (apical pulse), the quality of the heartbeat can
only be assessed by palpating the pulse. The point of maximal impulse (PMI)—also
called the apical thrust—is not heard, but rather seen. The PMI, which is normally
located on the left anterior part of the chest in the midclavicular line at the fifth
intercostal space, occurs when the heart's apex rotates forward with systole and
gently beats against the chest wall, producing a visible pulsation.
Which of the following represents the correct adult dosing regimen for adenosine? -
CORRECT ANSWER ✅✅✅6 mg, followed by 12 mg in 2 minutes if needed.
According to the 2010 guidelines for CPR and emergency cardiac care (ECC), the
correct dosing regimen of adenosine for a hemodynamically stable patient with a
narrow-complex tachycardia is 6 mg via rapid (over 1 to 3 seconds) IV push. If
needed, adenosine can be repeated in 1 to 2 minutes in a dose of 12 mg rapid IV
push.
You should interpret the following cardiac rhythm as: - CORRECT ANSWER
✅✅✅Atrial flutter with a fixed block.
