FISDAP EMT CARDIOLOGY FINAL EXAM QUESTIONS & ANSWERS (2026–2027) |
120 DETAILED Q&A 100% CORRECT ALREADY GRADED A+
1. You respond to a 56-year-old male with sudden chest pain radiating to his left
arm. He is pale, diaphoretic, and anxious. His BP is 96/62, pulse 112, SpO₂ 94%
on room air. Which intervention should you do first?
A) Place the patient on 15 L O₂ by non-rebreather
B) Obtain a 12-lead ECG
C) Administer aspirin 324 mg
D) Apply oxygen by nasal cannula at 2–4 L/min
Answer: C) Administer aspirin 324 mg
Explanation: The priority in suspected acute coronary syndrome (ACS) is to limit
clot formation. Aspirin is proven to reduce mortality and should be given
immediately unless contraindicated. Oxygen is not required unless SpO₂ falls
below 94%. A 12-lead is critical but comes after lifesaving medication.
2. Which of the following rhythms is most likely to cause sudden cardiac arrest
in adults?
A) Sinus bradycardia
B) Atrial fibrillation
C) Ventricular fibrillation
D) First-degree AV block
Answer: C) Ventricular fibrillation
Explanation: VF is a chaotic rhythm with no effective contractions. It is the most
common cause of sudden cardiac arrest. Treatment is immediate defibrillation.
3. A 72-year-old female with CHF complains of difficulty breathing while lying
flat. What is this symptom called?
A) Apnea
,B) Orthopnea
C) Dyspnea on exertion
D) Paroxysmal nocturnal dyspnea
Answer: B) Orthopnea
Explanation: Orthopnea is shortness of breath when lying flat, relieved by sitting
up. Dyspnea on exertion occurs with activity. PND involves sudden nighttime
awakening with SOB.
4. You find a patient unconscious, pulseless, and apneic. The monitor shows
asystole. Which is the correct action?
A) Immediate defibrillation
B) Begin high-quality CPR and give epinephrine
C) Deliver synchronized cardioversion
D) Give atropine 1 mg IV
Answer: B) Begin high-quality CPR and give epinephrine
Explanation: Asystole is a non-shockable rhythm. The correct management is
continuous high-quality CPR with epinephrine every 3–5 minutes. Defibrillation
and cardioversion are not effective.
5. A patient in supraventricular tachycardia (SVT) suddenly becomes
hypotensive with a BP of 74/40 and altered mental status. What is the best
treatment?
A) Administer adenosine 6 mg IV
B) Provide synchronized cardioversion
C) Give amiodarone 150 mg IV
D) Start CPR
Answer: B) Provide synchronized cardioversion
Explanation: SVT with signs of instability (hypotension, AMS, chest pain, shock)
requires immediate synchronized cardioversion. Adenosine is first-line for stable
SVT, not unstable.
6. Which of the following is the best initial treatment for stable angina?
A) Morphine
B) Aspirin
C) Oxygen
D) Nitroglycerin
Answer: D) Nitroglycerin
Explanation: Stable angina is chest pain triggered by exertion, relieved by rest or
,nitroglycerin. Nitroglycerin reduces myocardial oxygen demand by dilating veins.
Aspirin is more critical in ACS, not chronic stable angina.
7. A 40-year-old patient has chest discomfort that worsens with inspiration and
improves when sitting forward. You hear a pericardial friction rub. Which
diagnosis is most likely?
A) Myocardial infarction
B) Aortic aneurysm
C) Pericarditis
D) Pulmonary embolism
Answer: C) Pericarditis
Explanation: Classic pericarditis pain increases with deep inspiration and
improves when leaning forward. The hallmark physical exam finding is a
pericardial friction rub.
8. During CPR on an adult, what is the correct compression-to-ventilation ratio
for two rescuers with an advanced airway in place?
A) 30:2
B) 15:2
C) Continuous compressions with 1 breath every 6 seconds
D) 5:1
Answer: C) Continuous compressions with 1 breath every 6 seconds
Explanation: Once an advanced airway is placed, compressions are continuous at
100–120 per minute, with 1 breath every 6 seconds (about 10 breaths per
minute).
9. Which of the following patients should not receive nitroglycerin?
A) Patient with chest pain and BP 122/80
B) Patient with a heart rate of 60
C) Patient with chest pain who took sildenafil within 24 hours
D) Patient with chest pain and a history of hypertension
Answer: C) Patient with chest pain who took sildenafil within 24 hours
Explanation: PDE-5 inhibitors like sildenafil (Viagra) combined with nitroglycerin
can cause severe life-threatening hypotension.
10. Which coronary artery most commonly causes an inferior wall MI when
occluded?
, A) Left anterior descending (LAD)
B) Right coronary artery (RCA)
C) Circumflex artery
D) Left main coronary artery
Answer: B) Right coronary artery (RCA)
Explanation: Inferior MIs usually involve the RCA, which supplies the inferior wall
and right ventricle. LAD causes anterior wall MIs.
Is this conversation helpful so far?
11.A 65-year-old male presents with sudden dizziness, diaphoresis, and a
systolic blood pressure of 74 mmHg. Monitor shows a regular narrow-
complex tachycardia at 220 beats per minute with absent P waves. Which is
the best next step?
A) Vagal maneuvers (carotid sinus massage)
B) Immediate synchronized cardioversion
C) Administer amiodarone IV/IO
D) Give aspirin and observe
Answer: B) Immediate synchronized cardioversion
Explanation: This patient has a very rapid, regular narrow-complex tachycardia
consistent with supraventricular tachycardia (SVT). The patient is
hemodynamically unstable (hypotension, altered perfusion). Unstable tachycardia
requires immediate synchronized cardioversion rather than pharmacologic
therapy or vagal maneuvers. Carotid massage is contraindicated if the patient is
unstable. Aspirin is irrelevant here.
12.A 50-year-old with chest pain has a 12-lead ECG showing ST-segment
elevation of 3 mm in leads V1–V4. Which territory is most likely affected
and what’s the priority?
A) Inferior wall; give sublingual nitroglycerin only
B) Anterior wall; activate STEMI system / transport to PCI center
C) Lateral wall; administer aspirin and observe
D) Posterior wall; start thrombolytics in the field
Answer: B) Anterior wall; activate STEMI system / transport to PCI center
Explanation: ST elevation in V1–V4 localizes to the anterior wall, typically due to
proximal LAD occlusion. This is a STEMI. The priority is rapid reperfusion —
activate the STEMI system/alert the receiving hospital and transport to a
percutaneous coronary intervention (PCI) center if available within local protocols
and time windows. Aspirin and nitroglycerin are adjuncts but the system
120 DETAILED Q&A 100% CORRECT ALREADY GRADED A+
1. You respond to a 56-year-old male with sudden chest pain radiating to his left
arm. He is pale, diaphoretic, and anxious. His BP is 96/62, pulse 112, SpO₂ 94%
on room air. Which intervention should you do first?
A) Place the patient on 15 L O₂ by non-rebreather
B) Obtain a 12-lead ECG
C) Administer aspirin 324 mg
D) Apply oxygen by nasal cannula at 2–4 L/min
Answer: C) Administer aspirin 324 mg
Explanation: The priority in suspected acute coronary syndrome (ACS) is to limit
clot formation. Aspirin is proven to reduce mortality and should be given
immediately unless contraindicated. Oxygen is not required unless SpO₂ falls
below 94%. A 12-lead is critical but comes after lifesaving medication.
2. Which of the following rhythms is most likely to cause sudden cardiac arrest
in adults?
A) Sinus bradycardia
B) Atrial fibrillation
C) Ventricular fibrillation
D) First-degree AV block
Answer: C) Ventricular fibrillation
Explanation: VF is a chaotic rhythm with no effective contractions. It is the most
common cause of sudden cardiac arrest. Treatment is immediate defibrillation.
3. A 72-year-old female with CHF complains of difficulty breathing while lying
flat. What is this symptom called?
A) Apnea
,B) Orthopnea
C) Dyspnea on exertion
D) Paroxysmal nocturnal dyspnea
Answer: B) Orthopnea
Explanation: Orthopnea is shortness of breath when lying flat, relieved by sitting
up. Dyspnea on exertion occurs with activity. PND involves sudden nighttime
awakening with SOB.
4. You find a patient unconscious, pulseless, and apneic. The monitor shows
asystole. Which is the correct action?
A) Immediate defibrillation
B) Begin high-quality CPR and give epinephrine
C) Deliver synchronized cardioversion
D) Give atropine 1 mg IV
Answer: B) Begin high-quality CPR and give epinephrine
Explanation: Asystole is a non-shockable rhythm. The correct management is
continuous high-quality CPR with epinephrine every 3–5 minutes. Defibrillation
and cardioversion are not effective.
5. A patient in supraventricular tachycardia (SVT) suddenly becomes
hypotensive with a BP of 74/40 and altered mental status. What is the best
treatment?
A) Administer adenosine 6 mg IV
B) Provide synchronized cardioversion
C) Give amiodarone 150 mg IV
D) Start CPR
Answer: B) Provide synchronized cardioversion
Explanation: SVT with signs of instability (hypotension, AMS, chest pain, shock)
requires immediate synchronized cardioversion. Adenosine is first-line for stable
SVT, not unstable.
6. Which of the following is the best initial treatment for stable angina?
A) Morphine
B) Aspirin
C) Oxygen
D) Nitroglycerin
Answer: D) Nitroglycerin
Explanation: Stable angina is chest pain triggered by exertion, relieved by rest or
,nitroglycerin. Nitroglycerin reduces myocardial oxygen demand by dilating veins.
Aspirin is more critical in ACS, not chronic stable angina.
7. A 40-year-old patient has chest discomfort that worsens with inspiration and
improves when sitting forward. You hear a pericardial friction rub. Which
diagnosis is most likely?
A) Myocardial infarction
B) Aortic aneurysm
C) Pericarditis
D) Pulmonary embolism
Answer: C) Pericarditis
Explanation: Classic pericarditis pain increases with deep inspiration and
improves when leaning forward. The hallmark physical exam finding is a
pericardial friction rub.
8. During CPR on an adult, what is the correct compression-to-ventilation ratio
for two rescuers with an advanced airway in place?
A) 30:2
B) 15:2
C) Continuous compressions with 1 breath every 6 seconds
D) 5:1
Answer: C) Continuous compressions with 1 breath every 6 seconds
Explanation: Once an advanced airway is placed, compressions are continuous at
100–120 per minute, with 1 breath every 6 seconds (about 10 breaths per
minute).
9. Which of the following patients should not receive nitroglycerin?
A) Patient with chest pain and BP 122/80
B) Patient with a heart rate of 60
C) Patient with chest pain who took sildenafil within 24 hours
D) Patient with chest pain and a history of hypertension
Answer: C) Patient with chest pain who took sildenafil within 24 hours
Explanation: PDE-5 inhibitors like sildenafil (Viagra) combined with nitroglycerin
can cause severe life-threatening hypotension.
10. Which coronary artery most commonly causes an inferior wall MI when
occluded?
, A) Left anterior descending (LAD)
B) Right coronary artery (RCA)
C) Circumflex artery
D) Left main coronary artery
Answer: B) Right coronary artery (RCA)
Explanation: Inferior MIs usually involve the RCA, which supplies the inferior wall
and right ventricle. LAD causes anterior wall MIs.
Is this conversation helpful so far?
11.A 65-year-old male presents with sudden dizziness, diaphoresis, and a
systolic blood pressure of 74 mmHg. Monitor shows a regular narrow-
complex tachycardia at 220 beats per minute with absent P waves. Which is
the best next step?
A) Vagal maneuvers (carotid sinus massage)
B) Immediate synchronized cardioversion
C) Administer amiodarone IV/IO
D) Give aspirin and observe
Answer: B) Immediate synchronized cardioversion
Explanation: This patient has a very rapid, regular narrow-complex tachycardia
consistent with supraventricular tachycardia (SVT). The patient is
hemodynamically unstable (hypotension, altered perfusion). Unstable tachycardia
requires immediate synchronized cardioversion rather than pharmacologic
therapy or vagal maneuvers. Carotid massage is contraindicated if the patient is
unstable. Aspirin is irrelevant here.
12.A 50-year-old with chest pain has a 12-lead ECG showing ST-segment
elevation of 3 mm in leads V1–V4. Which territory is most likely affected
and what’s the priority?
A) Inferior wall; give sublingual nitroglycerin only
B) Anterior wall; activate STEMI system / transport to PCI center
C) Lateral wall; administer aspirin and observe
D) Posterior wall; start thrombolytics in the field
Answer: B) Anterior wall; activate STEMI system / transport to PCI center
Explanation: ST elevation in V1–V4 localizes to the anterior wall, typically due to
proximal LAD occlusion. This is a STEMI. The priority is rapid reperfusion —
activate the STEMI system/alert the receiving hospital and transport to a
percutaneous coronary intervention (PCI) center if available within local protocols
and time windows. Aspirin and nitroglycerin are adjuncts but the system
