Paramedics Exam Cardiology and Resuscitation 3 — Questions and Answers
Question 1: A patient presents with a regular narrow-complex tachycardia at 160 bpm and is hemodynamically stable. Vagal maneuvers failed. What is the next appropriate treatment?
- Synchronized cardioversion at 50 J
- Adenosine 6 mg rapid IV push followed by 20 mL saline flush (Correct answer)
- Amiodarone 150 mg IV over 10 minutes
- Verapamil 5 mg IV over 2 minutes
Correct answer: Adenosine 6 mg rapid IV push followed by 20 mL saline flush
Adenosine 6 mg rapid IV push is the first-line drug for stable SVT after failed vagal maneuvers, as it transiently blocks AV node conduction.
Question 2: During post-resuscitation care after ROSC, what is the target oxygen saturation range to avoid hyperoxia?
- 88-92%
- 94-99% (Correct answer)
- 100%
- Greater than 96% at all times
Correct answer: 94-99%
Post-ROSC care targets SpO2 of 94-99% to prevent reperfusion injury from hyperoxia while ensuring adequate oxygenation.
Question 3: A 45-year-old female presents with syncope and the following ECG findings: prolonged QT interval and a twisting pattern around the baseline. What rhythm is this?
- Ventricular fibrillation
- Torsades de Pointes (Correct answer)
- Atrial flutter with variable block
- Polymorphic ventricular tachycardia
Correct answer: Torsades de Pointes
Torsades de Pointes is a polymorphic VT characterized by QRS complexes that twist around the isoelectric baseline, associated with a prolonged QT interval.
Question 4: For a witnessed, monitored VF arrest in a patient with an implanted pacemaker, how should defibrillator pads be positioned?
- Directly over the pacemaker generator for best conduction
- At least 8 cm away from the pacemaker generator (Correct answer)
- Standard anterior-apex positioning is always acceptable regardless of device location
- Posterior-anterior positioning only
Correct answer: At least 8 cm away from the pacemaker generator
Defibrillator pads should be placed at least 8 cm from an implanted device to prevent damage to the pacemaker and ensure effective current delivery.
Question 5: What is the recommended IV dose of epinephrine during cardiac arrest in an adult patient?
- 0.5 mg every 3-5 minutes
- 1 mg every 3-5 minutes (Correct answer)
- 2 mg every 3-5 minutes
- 1 mg every 1-2 minutes
Correct answer: 1 mg every 3-5 minutes
The standard ACLS dose of epinephrine in adult cardiac arrest is 1 mg IV/IO every 3-5 minutes.
Question 6: A patient presents with third-degree (complete) heart block. Which of the following best describes this rhythm?
- P waves conduct to ventricles with progressively increasing PR intervals
- Complete dissociation between atrial and ventricular activity with no relationship between P waves and QRS complexes (Correct answer)
- Intermittent failure of P waves to conduct, with normal PR intervals when conduction occurs
- Regular P waves with no QRS complexes
Correct answer: Complete dissociation between atrial and ventricular activity with no relationship between P waves and QRS complexes
Third-degree heart block features complete AV dissociation where atria and ventricles beat independently with no relationship between P waves and QRS complexes.
Question 7: A patient in cardiac arrest is receiving high-quality CPR. The ETCO2 remains below 10 mmHg despite two rescuers alternating compressions. What does this most likely indicate?
- Hyperventilation by the rescuer
- Inadequate compression depth or rate (Correct answer)
- ROSC has occurred
- The patient has severe COPD
Correct answer: Inadequate compression depth or rate
Persistently low ETCO2 during CPR despite proper technique suggests poor cardiac output from inadequate compression depth or rate.
Paramedics Exam Cardiology and Resuscitation 3
A patient presents with a regular narrow-complex tachycardia at 160 bpm and is hemodynamically stable.
Vagal maneuvers failed.
What is the next appropriate treatment?