CPR - Certified Paramedic Response Electrical Therapy Principles Questions and Answers 1

Question 1

A 68-year-old male is found to be in unstable atrial flutter. His vital signs are BP 80/50 mmHg, HR 160, and he has an altered mental status. Which of the following is the most appropriate initial energy setting for synchronized cardioversion using a biphasic defibrillator?

Accepted Answer

50-100 joules

Answer

For narrow-complex supraventricular tachycardias like atrial flutter, the recommended initial energy setting for synchronized cardioversion is typically lower. According to AHA guidelines, an initial shock of 50-100 joules is appropriate for symptomatic atrial flutter.

Question 2

You are performing transcutaneous pacing (TCP) on a patient with symptomatic bradycardia. After achieving electrical capture on the monitor, what is the most critical next step to ensure the therapy is effective?

Accepted Answer

Confirm mechanical capture by palpating a pulse.

Answer

While electrical capture (a pacer spike followed by a QRS complex) is necessary, it does not guarantee the heart is actually contracting and producing a pulse. The paramedic must confirm mechanical capture by palpating a central pulse (like the femoral) or observing an improved blood pressure. This ensures the electrical stimulation is resulting in effective cardiac output.

Question 3

Which of the following scenarios correctly describes the primary difference between synchronized cardioversion and defibrillation?

Accepted Answer

Defibrillation is an unsynchronized shock for pulseless, chaotic rhythms, while cardioversion is a synchronized shock for unstable tachycardias with a pulse.

Answer

The key distinction lies in the timing of the shock and the patient's cardiac status. Defibrillation is used for life-threatening, pulseless arrhythmias like Ventricular Fibrillation (VF) and pulseless Ventricular Tachycardia (VT), delivering an unsynchronized, high-energy shock. Synchronized cardioversion is used for patients who have a pulse but are unstable due to a tachyarrhythmia (e.g., atrial fibrillation, atrial flutter, stable VT); the shock is timed to the R-wave to avoid the vulnerable T-wave period.

Question 4

A paramedic is treating a 4-year-old child weighing 18 kg who is in ventricular fibrillation. According to current AHA guidelines, what is the recommended initial energy dose for defibrillation?

Accepted Answer

36 joules (2 J/kg)

Answer

Current pediatric advanced life support guidelines recommend an initial defibrillation dose of 2 J/kg for a shockable rhythm like ventricular fibrillation. For an 18 kg child, this calculates to 36 joules (18 kg * 2 J/kg).

Question 5

When preparing for electrical therapy, which of the following safety precautions is essential to prevent arcing and ensure effective energy delivery?

Accepted Answer

Ensuring the patient's chest is clean and dry.

Answer

Moisture (like sweat or water) on the chest can cause the electrical current to travel across the skin surface (arc) instead of through the heart, resulting in an ineffective shock and potential skin burns. Therefore, wiping the chest dry is a critical safety and efficacy step. Pads should not be placed over medication patches or implanted devices.

(CPR) Certified Paramedic Response Practice Test

(CPR) Certified Paramedic Response Practice Test

CPR - Certified Paramedic Response Electrical Therapy Principles Questions and Answers 1