ECC Cardiovascular Evaluation & Monitoring 5

Question 1

A patient develops new-onset atrial fibrillation with rapid ventricular response (RVR) and is hemodynamically unstable. The priority intervention is:

Accepted Answer

Immediate synchronized cardioversion

Answer

Hemodynamic instability with rapid AF requires immediate synchronized cardioversion rather than pharmacological rate or rhythm control.

Question 2

Which ECG change is most consistent with hyperkalemia at a serum potassium level of 6.5 mEq/L?

Accepted Answer

Peaked T waves and widened QRS

Answer

Hyperkalemia initially causes tall, peaked T waves and with progressive elevation leads to PR prolongation, QRS widening, and ultimately a sine wave pattern.

Question 3

When calculating mean arterial pressure (MAP), which formula is correct?

Accepted Answer

MAP = Diastolic BP + 1/3 (Systolic BP - Diastolic BP)

Answer

MAP equals diastolic BP plus one-third of the pulse pressure because the heart spends approximately two-thirds of the cardiac cycle in diastole.

Question 4

A patient presents with bradycardia, hypotension, and a first-degree heart block on ECG following an inferior STEMI. Which vessel is most likely occluded?

Accepted Answer

Right coronary artery

Answer

The right coronary artery supplies the inferior wall, the SA node (in ~60% of people), and the AV node, making RCA occlusion the cause of inferior MI with conduction disturbances.

Question 5

During post-cardiac arrest monitoring, which target is recommended for arterial oxygen saturation (SpO2) to avoid secondary brain injury?

Accepted Answer

SpO2 94-99%

Answer

Current guidelines recommend titrating oxygen to SpO2 94-99% post-arrest to avoid both hypoxia and hyperoxia, as excess oxygen may worsen neurological outcomes.

(ECC) Emergency Cardiovascular Care Certification Practice Test

(ECC) Emergency Cardiovascular Care Certification Practice Test

ECC Cardiovascular Evaluation & Monitoring 5