Sharp ESO Exam Solved 100% Correct
Rated A+ 2025
End Tidal CO2 - Answer - ✔ the maximum CO2 concentration at the end of each tidal
breath, which can be used to assess disease severity and response to treatment.
Reflects cardiac output during CPR. Can be used to measure the effectiveness of
cardiac compressions and assessment of return of spontaneous circulation (ROSC)
after cardiac event
ROSC - Answer - ✔ Return of spontaneous circulation is established with the presence
of palpable pulse, blood pressure, abrupt sustained increase in end tidal CO2 (typically
> 40mmHg) after cardiac arrest
therapeutic hypothermia - Answer - ✔ Core temperature 32-36 C (89.6-96.8 F)
joules for defibrillation - Answer - ✔ Defibrillation Joules: 200 joules
joules for cardioversion - Answer - ✔ Cardioversion joules: 200 joules
Physicians may order 75-120-150-200 for conditions not covered in ESO policy
For the patient not following commands after 120 minutes of ROSC - Answer - ✔
Consider initiation of therapeutic hypothermia
Treatment of pulseless arrests - Answer - ✔ Provide 2 minutes of CPR-avoiding
interruptions in compressions
Asystole treatment - Answer - ✔ i. CPR (2 min.)
ii. O2 at 15 L/min. ambu bag
iii. Epinephrine 1 mg IVP/IO (use epinephrine 0.1 mg/ml), repeat q 3-5 minutes
iv. Repeat CPR and Epinephrine administration if no signs of ROSC
Unstable Bradycardia - Answer - ✔ i. O2 at minimum 10 L/min. NRBM
ii. If transvenous leads or epicardial pacing wires present, connect to a pulse generator
and initiate pacing per protocol.
If no response, perform the following:
iii. Atropine 1 mg IVP/IO, repeat q 3-5 minutes max 3 mg
iv. Transcutaneous pacing as soon as possible
If above algorithm is ineffective:
v. Start dopamine 400 mg/250 ml D5W infusion at 5 mcg/kg/minute. Titrate to patient
response up to 20mcg/kg/minute
If above algorithm is ineffective, start epinephrine 2 mg/ 250 ml NS @ 2 mcg/min., titrate
to patient response up to 10 mcg/minute
,Pulseless Electrical Activity - Answer - ✔ i. CPR 2 minutes and assess for possible
causes
The H's:
-Hypovolemia
-Hypoxia
-Hydrogen ion (acidosis)
-Hypokalemia
-Hyperkalemia
-Hypoglycemia
-Hypothermia
The T's:
-Toxins
-Cardiac Tamponade
-Thrombosis
-Trauma
-Tension pneumothorax
ii. O2 at 15 L/min ambu bag
iii. Epinephrine 1 mg IVP/IO (use epinephrine 0.1 mg/mL), repeat q 3-5 minutes
iv. Repeat CPR and Epinephrine administration if no signs of ROSC
v. If hypovolemia known or suspected, infuse 250 mL NS may be substituted with LF if
currently infusing). Repeat in 5 minutes if no clinical improvement.
vi. Stat CXR
Ventricular Tachycardia (Wide Complex): Stable - Answer - ✔ i. Call the physician for
orders
ii. O2 at minimum 4 L/min. NC and adjust per patient status
iii. Obtain 12 lead EKG
iv. Draw serum K and Mg
Ventricular Tachycardia (Wide Complex): Unstable - Answer - ✔ i. O2 at minimum 10
L/min. NRBM
ii. If ventricular rate greater than 150:
-Biphasic: synchronized cardioversion (200 joules)
iii. If patient is awake and responsive, give midazolam (Versed) 0.5 mg IVP/ IO prior to
cardioversion. May repeat to a total of 1 mg to achieve sedation.
Note: Romazicon is the reversal agent for midazolam. If patient has signs and
symptoms of oversedation (ex: decreased level of consciousness, respiratory rate less
than 10/min.) Romazicon 0.2mg IVP/IO over 15 seconds. May repeat in 45 seconds
based on patient response, not to exceed 0.6mg.
iv. Draw serum K+ and Mg++.
Romazicon - Answer - ✔ Reversal agent for midazolam
Standard Procedure Functions - Answer - ✔ Emergency Standing Orders (ESOs) will be
initiated by ESO competency-validated RNs for life threatening conditions of adult
, patients in the absence of a physician. In patient care areas without ESO competency
validated RNs, the Rapid Response Team or Code Blue will be called for assistance.
Emergency Standing Orders (ESO) - Answer - ✔ Pre-established medical orders,
approved by appropriate medical staff to be administered in the absence of a physician.
Orders specify emergent treatment interventions for life-threatening conditions.
ESO Competent Nurse - Answer - ✔ RN who had successfully demonstrated the
knowledge and skills in identification and treatment of life-threatening conditions
Rapid Response Team - Answer - ✔ A team PF health care professionals who bring
critical care expertise to the patient bedside
CPR (cardiopulmonary resuscitation) - Answer - ✔ Includes circulation with
compressions, airway assessment and breathing (C-A-B)
Intraosseous (IO) Therapy - Answer - ✔ Specialty Catheter inserted into the
intraosseous space by a trained physician or IO insertion validated RN. Safe and
alternative route to IV therapy is initiated when IV access is urgently needed but is not
available
Comatose Adult - Answer - ✔ No eye opening to pain and no purposeful motor
response
Unstable - Answer - ✔ Serious signs and symptoms related to the life-threatening
rhythm or conditions which may include:
Signs: tachypnea; apnea; respiratory depression; tachycardia; bradycardia; arrhythmias;
hypotension; decreased O2 saturation; dyspnea; change in level of consciousness;
increased intracranial pressure (ICP); status epilepticus
Symptoms: Dizziness; lightheadedness; shortness of breath; chest pain; weakness;
cold; diaphoretic; heart palpitations; anxiousness
Titrate to patient's response: - Answer - ✔ For the purpose of this policy, "patient
response" means improvement in the patient's symptom for which the intervention was
intended to relieve
Circumstance under which an ESO Competent RN may perform ESO standarized
procedures: - Answer - ✔ Emergency standing orders will be initiated by ESO
competency-validated RNs in the absense of a physician.
Scope of Supervision - Answer - ✔ The ESO standarized procedure will be institued
only in the absence of a physician and in accordance with the patient's code status
Notification of patient's physician - Answer - ✔ When a patient presents with a life-
threatening condition, the following steps will be taken:
Rated A+ 2025
End Tidal CO2 - Answer - ✔ the maximum CO2 concentration at the end of each tidal
breath, which can be used to assess disease severity and response to treatment.
Reflects cardiac output during CPR. Can be used to measure the effectiveness of
cardiac compressions and assessment of return of spontaneous circulation (ROSC)
after cardiac event
ROSC - Answer - ✔ Return of spontaneous circulation is established with the presence
of palpable pulse, blood pressure, abrupt sustained increase in end tidal CO2 (typically
> 40mmHg) after cardiac arrest
therapeutic hypothermia - Answer - ✔ Core temperature 32-36 C (89.6-96.8 F)
joules for defibrillation - Answer - ✔ Defibrillation Joules: 200 joules
joules for cardioversion - Answer - ✔ Cardioversion joules: 200 joules
Physicians may order 75-120-150-200 for conditions not covered in ESO policy
For the patient not following commands after 120 minutes of ROSC - Answer - ✔
Consider initiation of therapeutic hypothermia
Treatment of pulseless arrests - Answer - ✔ Provide 2 minutes of CPR-avoiding
interruptions in compressions
Asystole treatment - Answer - ✔ i. CPR (2 min.)
ii. O2 at 15 L/min. ambu bag
iii. Epinephrine 1 mg IVP/IO (use epinephrine 0.1 mg/ml), repeat q 3-5 minutes
iv. Repeat CPR and Epinephrine administration if no signs of ROSC
Unstable Bradycardia - Answer - ✔ i. O2 at minimum 10 L/min. NRBM
ii. If transvenous leads or epicardial pacing wires present, connect to a pulse generator
and initiate pacing per protocol.
If no response, perform the following:
iii. Atropine 1 mg IVP/IO, repeat q 3-5 minutes max 3 mg
iv. Transcutaneous pacing as soon as possible
If above algorithm is ineffective:
v. Start dopamine 400 mg/250 ml D5W infusion at 5 mcg/kg/minute. Titrate to patient
response up to 20mcg/kg/minute
If above algorithm is ineffective, start epinephrine 2 mg/ 250 ml NS @ 2 mcg/min., titrate
to patient response up to 10 mcg/minute
,Pulseless Electrical Activity - Answer - ✔ i. CPR 2 minutes and assess for possible
causes
The H's:
-Hypovolemia
-Hypoxia
-Hydrogen ion (acidosis)
-Hypokalemia
-Hyperkalemia
-Hypoglycemia
-Hypothermia
The T's:
-Toxins
-Cardiac Tamponade
-Thrombosis
-Trauma
-Tension pneumothorax
ii. O2 at 15 L/min ambu bag
iii. Epinephrine 1 mg IVP/IO (use epinephrine 0.1 mg/mL), repeat q 3-5 minutes
iv. Repeat CPR and Epinephrine administration if no signs of ROSC
v. If hypovolemia known or suspected, infuse 250 mL NS may be substituted with LF if
currently infusing). Repeat in 5 minutes if no clinical improvement.
vi. Stat CXR
Ventricular Tachycardia (Wide Complex): Stable - Answer - ✔ i. Call the physician for
orders
ii. O2 at minimum 4 L/min. NC and adjust per patient status
iii. Obtain 12 lead EKG
iv. Draw serum K and Mg
Ventricular Tachycardia (Wide Complex): Unstable - Answer - ✔ i. O2 at minimum 10
L/min. NRBM
ii. If ventricular rate greater than 150:
-Biphasic: synchronized cardioversion (200 joules)
iii. If patient is awake and responsive, give midazolam (Versed) 0.5 mg IVP/ IO prior to
cardioversion. May repeat to a total of 1 mg to achieve sedation.
Note: Romazicon is the reversal agent for midazolam. If patient has signs and
symptoms of oversedation (ex: decreased level of consciousness, respiratory rate less
than 10/min.) Romazicon 0.2mg IVP/IO over 15 seconds. May repeat in 45 seconds
based on patient response, not to exceed 0.6mg.
iv. Draw serum K+ and Mg++.
Romazicon - Answer - ✔ Reversal agent for midazolam
Standard Procedure Functions - Answer - ✔ Emergency Standing Orders (ESOs) will be
initiated by ESO competency-validated RNs for life threatening conditions of adult
, patients in the absence of a physician. In patient care areas without ESO competency
validated RNs, the Rapid Response Team or Code Blue will be called for assistance.
Emergency Standing Orders (ESO) - Answer - ✔ Pre-established medical orders,
approved by appropriate medical staff to be administered in the absence of a physician.
Orders specify emergent treatment interventions for life-threatening conditions.
ESO Competent Nurse - Answer - ✔ RN who had successfully demonstrated the
knowledge and skills in identification and treatment of life-threatening conditions
Rapid Response Team - Answer - ✔ A team PF health care professionals who bring
critical care expertise to the patient bedside
CPR (cardiopulmonary resuscitation) - Answer - ✔ Includes circulation with
compressions, airway assessment and breathing (C-A-B)
Intraosseous (IO) Therapy - Answer - ✔ Specialty Catheter inserted into the
intraosseous space by a trained physician or IO insertion validated RN. Safe and
alternative route to IV therapy is initiated when IV access is urgently needed but is not
available
Comatose Adult - Answer - ✔ No eye opening to pain and no purposeful motor
response
Unstable - Answer - ✔ Serious signs and symptoms related to the life-threatening
rhythm or conditions which may include:
Signs: tachypnea; apnea; respiratory depression; tachycardia; bradycardia; arrhythmias;
hypotension; decreased O2 saturation; dyspnea; change in level of consciousness;
increased intracranial pressure (ICP); status epilepticus
Symptoms: Dizziness; lightheadedness; shortness of breath; chest pain; weakness;
cold; diaphoretic; heart palpitations; anxiousness
Titrate to patient's response: - Answer - ✔ For the purpose of this policy, "patient
response" means improvement in the patient's symptom for which the intervention was
intended to relieve
Circumstance under which an ESO Competent RN may perform ESO standarized
procedures: - Answer - ✔ Emergency standing orders will be initiated by ESO
competency-validated RNs in the absense of a physician.
Scope of Supervision - Answer - ✔ The ESO standarized procedure will be institued
only in the absence of a physician and in accordance with the patient's code status
Notification of patient's physician - Answer - ✔ When a patient presents with a life-
threatening condition, the following steps will be taken:
