HFHS CRITICAL CARE ACTUAL EXAM PAPER
2026 QUESTIONS WITH ANSWERS GRADED
A+
◉ Normal PR interval . Answer: 0.12-0.20 seconds (3-5 small boxes)
◉ Normal QRS interval . Answer: 0.06 - 0.10 sec, anything greater
than 0.12 sec is considered prolonged
(1 - 3 small boxes)
◉ Normal QT interval . Answer: 0.36 to 0.44 seconds (9-11 boxes)
◉ Define pacing threshold. . Answer: The minimum amount of energy
needed required for the pacemaker to cause the cardiac mm to
depolarize/respond
--- ex. If there is failure to capture, try increasing the pacing threshold
◉ Define Cardioversion vs Defibrillation & give energy levels .
Answer: Cardioversion- Shock given to pt who has a pulse but it
hemodynamically unstable. ex. afib, aflutter, vtach with pulse
Defibrillation- shock given to pt who does NOT have a pulse. ex.
pulseless VTACH, vfib
,Biphasic energy- 120-200 joules
◉ First reaction to pulseless VTACH or vfib? & 2 drugs . Answer:
Defibrillate then EPI then amio
◉ First reaction to PEA/asystole? . Answer: not a shockable rhythm.
EPI only/reversible causes
◉ H & T's . Answer: Hypovolemia
Hypoxia
Hypoglycemia
Hydrogen/acidosis
Hypo-Hyperkalemia
Hypothermia
Cardiac Tamponade
Tension pneumo
Toxins
Pulmonary Thrombosis
Cardiac Thrombosis
◉ ACLS bradycardia . Answer: 1mg atropine every 3-5 mins up to 3mg
-If not effective consider transcutaneous pacing or dopamine/epi
infusion
, ◉ Hypokalemia on EKG . Answer: Flat t wave or u wave
◉ Hyperkalemia on EKG . Answer: peaked t wave
◉ Acidosis on EKG . Answer: Low amplitude of QRS
◉ Tension pneumo on EKG . Answer: Slow HR/Narrow QRS
◉ Cardiac tamponade/PE on EKG . Answer: Rapid HR/Narrow QRS
◉ ACLS tx for stable tachycardia . Answer: Vasovagal maneuvers;
adenosine 6mg then 12mg then progress to procainamide/amio bolus and
inufsion
◉ ACLS tx for unstable tachycardia . Answer: synchronized
cardioversion
◉ Define Point of Maximal Impulse . Answer: point of maximal
impulse against the chest that can be felt
-at apex of heart; L MCL, 5th ICS
2026 QUESTIONS WITH ANSWERS GRADED
A+
◉ Normal PR interval . Answer: 0.12-0.20 seconds (3-5 small boxes)
◉ Normal QRS interval . Answer: 0.06 - 0.10 sec, anything greater
than 0.12 sec is considered prolonged
(1 - 3 small boxes)
◉ Normal QT interval . Answer: 0.36 to 0.44 seconds (9-11 boxes)
◉ Define pacing threshold. . Answer: The minimum amount of energy
needed required for the pacemaker to cause the cardiac mm to
depolarize/respond
--- ex. If there is failure to capture, try increasing the pacing threshold
◉ Define Cardioversion vs Defibrillation & give energy levels .
Answer: Cardioversion- Shock given to pt who has a pulse but it
hemodynamically unstable. ex. afib, aflutter, vtach with pulse
Defibrillation- shock given to pt who does NOT have a pulse. ex.
pulseless VTACH, vfib
,Biphasic energy- 120-200 joules
◉ First reaction to pulseless VTACH or vfib? & 2 drugs . Answer:
Defibrillate then EPI then amio
◉ First reaction to PEA/asystole? . Answer: not a shockable rhythm.
EPI only/reversible causes
◉ H & T's . Answer: Hypovolemia
Hypoxia
Hypoglycemia
Hydrogen/acidosis
Hypo-Hyperkalemia
Hypothermia
Cardiac Tamponade
Tension pneumo
Toxins
Pulmonary Thrombosis
Cardiac Thrombosis
◉ ACLS bradycardia . Answer: 1mg atropine every 3-5 mins up to 3mg
-If not effective consider transcutaneous pacing or dopamine/epi
infusion
, ◉ Hypokalemia on EKG . Answer: Flat t wave or u wave
◉ Hyperkalemia on EKG . Answer: peaked t wave
◉ Acidosis on EKG . Answer: Low amplitude of QRS
◉ Tension pneumo on EKG . Answer: Slow HR/Narrow QRS
◉ Cardiac tamponade/PE on EKG . Answer: Rapid HR/Narrow QRS
◉ ACLS tx for stable tachycardia . Answer: Vasovagal maneuvers;
adenosine 6mg then 12mg then progress to procainamide/amio bolus and
inufsion
◉ ACLS tx for unstable tachycardia . Answer: synchronized
cardioversion
◉ Define Point of Maximal Impulse . Answer: point of maximal
impulse against the chest that can be felt
-at apex of heart; L MCL, 5th ICS
