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1. Morphine sulfate is least likely to be used for:

a. Pulmonary edema

b. Cerebral edema

c. Acute MI management

d. Chest pain management

2. Endotracheal intubation does all the following except:

a. Reduce the risk of aspiration

b. Should be accomplished in 30 seconds or less

c. Permits tracheal suctioning

d. Provides a route for administration of atropine, lidocaine, and valium

3. Management of unstable patients may necessitate the use of electrical therapy.  Identify the correct initial and subsequent energy settings for the management of electrical therapy for unstable SVT patients.

a. 100, 200, 300, 360 joules monophasic or equivalent biphasic energy

b. 200, 200, 300, 360 joules monophasic or equivalent biphasic energy

c. 150, 300, 360 joules monophasic or equivalent biphasic energy

d. 200, 300, 360 joules monophasic or equivalent biphasic energy

4. Which of the following factors are least likely to reduce transthoracic resistance for defibrillation?

a. Administration of epinephrine before the defibrillation attempts

b. Application of firm paddle pressure or use of hands-free defibrillation pads

c. Use of a conduction gel

5. Which one of the following rhythms is seen most commonly in the first few minutes of cardiac arrest?

a. Asystole

b. Complete heart block

c. Idioventricular

d. Ventricular fibrillation

6. The rate of sinus tachycardia is:

a. Greater than 100 beats/minute up to when the "P" waves are no longer visible

b. 100-160 beats/minute

c. 60-100 beats/minute

d. Less than 60 beats/minute

7. What is the initial dose of atropine in an unstable bradycardia?

a. 0.5mg/kg

b. .04mg/kg

c. 0.5mg

d. 1.5mg

8. Dopamine infusions at 10-15mcg/kg/min will likely produce:

a. Peripheral vasoconstriction and marked tachycardia

b. Systemic vasoconstriction and increased renal perfusion

c. Renal blood vessel dilation and peripheral vasoconstriction

d. Beta receptor stimulating effects resulting in increased cardiac output

9. You have been called to a patient in cardiac arrest.  You find a 43 year old male who is unresponsive, pulseless and not breathing.  CPR is being properly performed. As the crash cart arrives you quick-look and see ventricular fibrillation.  Which of the following will you perform next?

a. Precordial thump, CPR, ET tube, Epi, and defibrillate

b. CPR, ET tube, IV, Epi, and defibrillate

c. Defibrillate with 360 joules monophasic or equivalent biphasic energy

d. CPR, ET tube, IV, lidocaine, and defibrillate

10. 62 year old male watching TV when he felt a "fluttering" chest.  He denies chest pain and SOB.  He is A&Ox4, but anxious. BP 150/84, Resp 16, HR 180.  EKG is a wide complex.  He has no significant past medical history and takes no medications. Which of the following is least likely to be indicated?

a. Synchronized cardioversion

b. Start oxygen therapy

c. Administer lidocaine

d. Administer verapamil

11. Atropine may be used in treating which of the following?

a. Asystole

b. Symptomatic sinus bradycardia

c. Ventricular tachycardia

d. Bradycardia pulseless electrical activity

12. During a resuscitation, the use of epinephrine are all correct except?

a. May be replaced by vasopressin within the first two rounds of a vasopressor

b. Given every 3-5 minutes

c. Given via an endotracheal tube at 1mg

d. Given at doses of 0.1mg/kg

13. A 36 year old female is complaining of heart palpitations.  She is A&Ox4, denies SOB and chest pain.  BP 144/80, Resp 14, HR 180. EKG is regular and narrow complex.  Which of the following medications would not be considered?

a. Adenosine

b. Lidocaine

c. Verapamil

d. Diltiazem

14. A 55 year old female complaining of chest pain. BP 126/72, Resp 14, HR 138.  EKG narrow complex and regular. Management includes:

a. Oxygen, vagal maneuvers, adenosine 6mg rapid IV push

b. Oxygen, IV, verapamil 2.5mg slow IV bolus

c. Oxygen, IV, nitro, morphine, lidocaine

d. Oxygen, IV, nitro, morphine

15. A 72 year old female in respiratory arrest. You have intubated the patient and note breath sounds are present on the right but diminished on the left.  What is the most likely the cause?

a. Left mainstem intubation

b. Mucous plug in the ET tube

c. Right mainstem intubation

d. Esophageal intubation

16. A 33 year old female with decreased level of consciousness.  BP 100/palp, Resp 24 shallow, HR 170.  EKG narrow and regular.  Which treatment first?

a. Administer a fluid challenge

b. Defibrillate with 200 joules

c. Administer adenosine

d. Administer supplemental oxygen

17. An 18 year old drive-by shooting. Responds only to painful stimuli with BP 60/40, Resp 28 labored, HR 140.  EKG sinus tachycardia.  GSW to right chest with absent breath sounds on right and diminished on left.  The right side of the chest is hyperresonant to percussion. How will you manage this patient?

a. Pericardiocentesis

b. Needle decompression of right thorax

c. Administer oxygen

d. Establish an IV NS or LR

18. What is the recommended dose of epinephrine 1:10000 via IV?

a. 1mg

b. 2mg

c. 3mg

d. 4mg

19. What is the recommended initial dose of amiodarone in ventricular fibrillation?

a. 150mg/kg

b. 150mg

c. 1.5mg/kg

d. 300mg

20.  Per 2011 Guidelines how many times is adenosine given?

a. 1 time

b. 2 times

c. 3 times

d. 4 times

21. What is the rate of compressions in a minute of CPR?

a. 80-100

b. 100

c. 100 plus

d. 80

22. When hyperventilating a patient before an intubation attempt the rate should be?

a. 12 per minute

b. 24 per minute

c. 30 per minute

d. 40 per minute

23. What is the dose of magnesium for a ventricular tachycardic rhythm?

a. 2mg

b. 2g

c. 3g

d. 1mg

24. What is the recommended does of atropine in asystole?

a. 1mg

b. 2mg

c. none

d. .5mg

25. What is the dose of the second round of adenosine?

a. 6mg

b. 18mg

c. 12mg

d. 30mg

26. When ventilating an intubated patient the ventilation rate should be?

a. Once every 3 to 5 seconds

b. Once every 4 seconds

c. Once every 5 to 6 seconds

d. Once every 6 to 8 seconds

27. What is the dose of procainamide in ventricular rhythms?

a. 20-50mg/kg/min

b. 17mg/kg

c. 20-30mg/min

d. 1-4mg/min

28. What is the current acronym for drugs that can be delivered down the ET tube?

a. NAVEL

b. LEAN

c. VEAL

d. EPSON

29. All are correct about using an orapharyngeal airway except:

a. Remove with gag reflex

b. Measure from corner of mouth to ear lobe

c. Eliminates the need for proper head positioning

d. Reduces gastric distension

30. A bag-valve-mask (AMBU) with a reservoir can deliver what percentage of oxygen?

a. 80-100%

b. 60-80%

c. 50-60%

d. 70%

31. Mouth-to-mask can deliver what percentage of oxygen to a victim when not attached to supplemental oxygen?

a. 21%

b. 16%

c. 50%

d. 80%

32. When ventilating a non-breathing patient with room air the amount of tidal volume should be around ___mL/kg over ____seconds.

a. 10mL/kg - 1 to 2 seconds

b. 5mL/kg - 3 to 4 seconds

c. 5mL/kg - 1 to 2 seconds

d. 18mL/kg - 2 seconds

33. This maneuver is used to reduce gastric distention when ventilating. One rescuer places downward pressure on the larynx while the other ventilates.

a. Cushing maneuver

b. Abdominal maneuvers

c. Sellick's maneuver

d. Tracheal gastric maneuver

34. All of the following are correct about the Esophageal-Tracheal Combitube except:

a. Inflate the proximal cuff with 100mL of air

b. Contraindicated in people under 4 feet tall

c. Minimal training requires

d. Device will only work appropriately when placed in the esophagus

35. All of the following are correct about the Pharyngotracheal Lumen Airway (PTL) except:

a. Contraindicated in patients over 50 years of age

b. Minimal training required

c. Contraindicated in patients under 5 feet tall

d. Both cuffs are inflate simultaneously when filled with air

36. Under new AHA guidelines a secondary airway assessment is to be performed once an ET tube is place.  This assessment includes constant capnography.

a. True

b. False

37. What is the minimum aged patient when using adult AED pads?

a. 1 year

b. 8 years

c. 12 years

d. Does not matter, the machine will adjust

38.  What treatment is preferred for high degree heart blocks?

a. Atropine .5 to 1mg

b. Pacing

c. Lidocaine .75mg/kg

d. Cardioversion 50-100 joules

39. What is the dose of vasopressin in the ventricular fibrillation algorithm?

a. 40 mg once

b. 40 Units once

c. 1mg every 3-5 minutes

d. 40 Units repeated once in 5 minutes

40.  Calcium chloride is clearly indicated in:

a. Hypokalemia

b. Hypercalcemia

c. Calcium channel blocker overdose

d. hypothermia

41. Amiodarone dose for a patient with a pulse in ventricular tachycardia is?

a. 300mg over 10 minutes

b. 150mg over 2 minutes

c. 3mg/kg every 20 minutes

d. 150mg over 10 minutes

42. What is the maximum dose of lidocaine IV?

a. 2mg/kg

b. 3mg/kg

c. 4mg/kg

d. 5mg.kg

43. What acronym is used to remember the medications to consider giving all ASC / MI patients?

a. SALLE

b. MONA

c. NOEL

d. DONA

44. Place the following priority goals in order when treating a cardiac patient?

a. Rhythm, BP, rate

b. Rate, rhythm, BP

c. BP, rate, rhythm

d. Rate, BP, rhythm

45. When looking at a 12-lead, what groupings would indicate an inferior MI?

a. Lead I, aVL, V5, V6

b. Lead V1, V2, V3, V4

c. Lead II, III, aVF

d. Lead II, V5, V6

46. List the preferred first line recommended ventricular drugs in the ventricular fibrillation algorithm.

a. Lidocaine

b. Magnesium

c. Amiodarone

d. Dopamine

47. What is the depth of compressions when performing CPR?

a. at least 2 inches

b. 1 1/2 to 2 inches

c. 2 to 2 1/2 inches

d. 1/2 to 1 inch

48. What is the most common cause of PEA?

a. Acidosis

b. Hypovolemia

c. MI

d. Cardiac tamponade

49. Under current guidelines you may cardiovert stable ventricular tachycardia immediately.

a. True

b. False

50. Acute pulmonary edema with a BP or 92/60 may receive the following drugs except:

a. Oxygen

b. Dobutamine

c. Morphine

d. Dopamine

51.

a. Atrial flutter

b. Ventricular tachycardia

c. Sinus with artifact

d. Atrial fibrillation

52.

a. Sinus with PAC

b. 2 degree type 2

c. 2 degree type 1

d. 3rd degree heart block

53.

a. Idioventricular

b. 2 degree type 2

c. 2 degree type 1

d. 3rd degree heart block

54.

a. Ventricular tachycardia

b. Ventricular fibrillation

c. Idioventricular

d. SVT

55.

a. Ventricular tachycardia

b. Ventricular fibrillation

c. Idioventricular

d. SVT

56.

a. Sinus bradycardia

b. Normal sinus

c. Junctional rhythm

d. Sinus tachycardia

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