▪ Spring Semester 2026 – HOSA EMT Cardiac Scenarios Exam Prep &
Competitive Event Practice Guide | Emergency Cardiac Care
Scenario-Based Questions with Verified Answers and Clinical
Rationales | ECG Basics, Cardiac Emergencies, BLS & ALS
Interventions, Patient Assessment, Airway Management, Shock,
STEMI, Arrhythmias – Fully Updated for the 2026 HOSA EMT
Competitive Events Examination
Question 1:
What is the most common initial rhythm found in a cardiac arrest patient?
• A) Asystole
• B) Ventricular Fibrillation (Correct Answer)
• C) Atrial Fibrillation
• D) Normal Sinus Rhythm
Rationale: Ventricular Fibrillation (VF) is the most common initial rhythm in adult
cardiac arrest cases. It is characterized by chaotic electrical activity in the ventricles,
preventing normal heart function.
Question 2:
When assessing a patient with chest pain, which of the following is the most
critical first step?
• A) Administer oxygen
• B) Perform a Primary Assessment (Correct Answer)
• C) Start an IV
• D) Obtain an ECG
Rationale: The Primary Assessment is crucial to determining the patient's airway,
breathing, and circulation status. It helps identify life-threatening conditions first.
Question 3:
Which medication is commonly used to manage a patient experiencing acute
myocardial infarction (MI)?
• A) Metoprolol
• B) Nitroglycerin (Correct Answer)
• C) Amiodarone
, • D) Aspirin
Rationale: Nitroglycerin is commonly administered to relieve chest pain and improve
blood flow during an acute myocardial infarction. It acts as a vasodilator, reducing the
heart's workload.
Question 4:
What is the recommended compression to ventilation ratio for adults in high-
quality CPR?
• A) 15:2
• B) 30:2 (Correct Answer)
• C) 10:1
• D) 5:1
Rationale: The recommended compression to ventilation ratio for adults in high-quality
CPR is 30:2. This helps maximize blood circulation while providing adequate
oxygenation.
Question 5:
In cases of suspected cardiac tamponade, which assessment finding is most
indicative?
• A) Jugular Venous Distention (Correct Answer)
• B) Bradycardia
• C) Hypotension
• D) Cyanosis
Rationale: Jugular Venous Distention (JVD) is a classic sign of cardiac tamponade,
indicating increased pressure in the right atrium due to fluid accumulation in the
pericardial space.
Question 1:
What is the most common initial rhythm found in a cardiac arrest patient?
• A) Asystole
• B) Ventricular Fibrillation (Correct Answer)
• C) Atrial Fibrillation
• D) Normal Sinus Rhythm
,Rationale: Ventricular Fibrillation is frequently the initial rhythm in adult cardiac
arrests. It involves disorganized electrical activity in the ventricles, resulting in the
heart's inability to pump blood effectively. Rapid defibrillation is essential for survival in
these cases.
Question 2:
When assessing a patient with chest pain, which of the following is the most
critical first step?
• A) Administer oxygen
• B) Perform a Primary Assessment (Correct Answer)
• C) Start an IV
• D) Obtain an ECG
Rationale: A Primary Assessment, which determines the patient's airway, breathing,
and circulation, is the fundamental step in emergency care. Identifying life-threatening
issues such as airway obstruction or severe bleeding must take precedence to stabilize
the patient.
Question 3:
Which medication is commonly used to manage a patient experiencing acute
myocardial infarction (MI)?
• A) Metoprolol
• B) Nitroglycerin (Correct Answer)
• C) Amiodarone
• D) Aspirin
Rationale: Nitroglycerin is administered to relieve acute chest pain associated with an
MI. It works by dilating blood vessels, thus reducing the heart's workload and improving
oxygen delivery to cardiac tissue. It is critical to assess blood pressure before
administration to avoid significant hypotension.
Question 4:
What is the recommended compression to ventilation ratio for adults in high-
quality CPR?
• A) 15:2
, • B) 30:2 (Correct Answer)
• C) 10:1
• D) 5:1
Rationale: The recommended ratio for adult high-quality CPR is 30 compressions to 2
ventilations, which has been shown to optimize blood flow and oxygenation during
cardiac arrest. This ratio is vital for maintaining circulation while providing necessary
ventilations when an advanced airway is not in place.
Question 5:
In cases of suspected cardiac tamponade, which assessment finding is most
indicative?
• A) Jugular Venous Distention (Correct Answer)
• B) Bradycardia
• C) Hypotension
• D) Cyanosis
Rationale: Jugular Venous Distention is a key sign of cardiac tamponade, attributable to
increased pressure in the superior vena cava due to fluid accumulation in the
pericardial sac. This condition inhibits the heart's ability to fill and pump, leading to
hemodynamic instability.
Question 6:
Which of the following patients is most at risk for developing coronary artery
disease?
• A) A 25-year-old male who jogs regularly
• B) A 52-year-old female smoker (Correct Answer)
• C) A 30-year-old vegetarian with normal blood pressure
• D) A 40-year-old male who practices yoga
Rationale: A 52-year-old female smoker is at a higher risk for coronary artery disease
due to the combined factors of age, gender, and smoking. Smoking is a significant
modifiable risk factor, while age and gender predispose individuals to cardiovascular
events.
Question 7:
Competitive Event Practice Guide | Emergency Cardiac Care
Scenario-Based Questions with Verified Answers and Clinical
Rationales | ECG Basics, Cardiac Emergencies, BLS & ALS
Interventions, Patient Assessment, Airway Management, Shock,
STEMI, Arrhythmias – Fully Updated for the 2026 HOSA EMT
Competitive Events Examination
Question 1:
What is the most common initial rhythm found in a cardiac arrest patient?
• A) Asystole
• B) Ventricular Fibrillation (Correct Answer)
• C) Atrial Fibrillation
• D) Normal Sinus Rhythm
Rationale: Ventricular Fibrillation (VF) is the most common initial rhythm in adult
cardiac arrest cases. It is characterized by chaotic electrical activity in the ventricles,
preventing normal heart function.
Question 2:
When assessing a patient with chest pain, which of the following is the most
critical first step?
• A) Administer oxygen
• B) Perform a Primary Assessment (Correct Answer)
• C) Start an IV
• D) Obtain an ECG
Rationale: The Primary Assessment is crucial to determining the patient's airway,
breathing, and circulation status. It helps identify life-threatening conditions first.
Question 3:
Which medication is commonly used to manage a patient experiencing acute
myocardial infarction (MI)?
• A) Metoprolol
• B) Nitroglycerin (Correct Answer)
• C) Amiodarone
, • D) Aspirin
Rationale: Nitroglycerin is commonly administered to relieve chest pain and improve
blood flow during an acute myocardial infarction. It acts as a vasodilator, reducing the
heart's workload.
Question 4:
What is the recommended compression to ventilation ratio for adults in high-
quality CPR?
• A) 15:2
• B) 30:2 (Correct Answer)
• C) 10:1
• D) 5:1
Rationale: The recommended compression to ventilation ratio for adults in high-quality
CPR is 30:2. This helps maximize blood circulation while providing adequate
oxygenation.
Question 5:
In cases of suspected cardiac tamponade, which assessment finding is most
indicative?
• A) Jugular Venous Distention (Correct Answer)
• B) Bradycardia
• C) Hypotension
• D) Cyanosis
Rationale: Jugular Venous Distention (JVD) is a classic sign of cardiac tamponade,
indicating increased pressure in the right atrium due to fluid accumulation in the
pericardial space.
Question 1:
What is the most common initial rhythm found in a cardiac arrest patient?
• A) Asystole
• B) Ventricular Fibrillation (Correct Answer)
• C) Atrial Fibrillation
• D) Normal Sinus Rhythm
,Rationale: Ventricular Fibrillation is frequently the initial rhythm in adult cardiac
arrests. It involves disorganized electrical activity in the ventricles, resulting in the
heart's inability to pump blood effectively. Rapid defibrillation is essential for survival in
these cases.
Question 2:
When assessing a patient with chest pain, which of the following is the most
critical first step?
• A) Administer oxygen
• B) Perform a Primary Assessment (Correct Answer)
• C) Start an IV
• D) Obtain an ECG
Rationale: A Primary Assessment, which determines the patient's airway, breathing,
and circulation, is the fundamental step in emergency care. Identifying life-threatening
issues such as airway obstruction or severe bleeding must take precedence to stabilize
the patient.
Question 3:
Which medication is commonly used to manage a patient experiencing acute
myocardial infarction (MI)?
• A) Metoprolol
• B) Nitroglycerin (Correct Answer)
• C) Amiodarone
• D) Aspirin
Rationale: Nitroglycerin is administered to relieve acute chest pain associated with an
MI. It works by dilating blood vessels, thus reducing the heart's workload and improving
oxygen delivery to cardiac tissue. It is critical to assess blood pressure before
administration to avoid significant hypotension.
Question 4:
What is the recommended compression to ventilation ratio for adults in high-
quality CPR?
• A) 15:2
, • B) 30:2 (Correct Answer)
• C) 10:1
• D) 5:1
Rationale: The recommended ratio for adult high-quality CPR is 30 compressions to 2
ventilations, which has been shown to optimize blood flow and oxygenation during
cardiac arrest. This ratio is vital for maintaining circulation while providing necessary
ventilations when an advanced airway is not in place.
Question 5:
In cases of suspected cardiac tamponade, which assessment finding is most
indicative?
• A) Jugular Venous Distention (Correct Answer)
• B) Bradycardia
• C) Hypotension
• D) Cyanosis
Rationale: Jugular Venous Distention is a key sign of cardiac tamponade, attributable to
increased pressure in the superior vena cava due to fluid accumulation in the
pericardial sac. This condition inhibits the heart's ability to fill and pump, leading to
hemodynamic instability.
Question 6:
Which of the following patients is most at risk for developing coronary artery
disease?
• A) A 25-year-old male who jogs regularly
• B) A 52-year-old female smoker (Correct Answer)
• C) A 30-year-old vegetarian with normal blood pressure
• D) A 40-year-old male who practices yoga
Rationale: A 52-year-old female smoker is at a higher risk for coronary artery disease
due to the combined factors of age, gender, and smoking. Smoking is a significant
modifiable risk factor, while age and gender predispose individuals to cardiovascular
events.
Question 7:
