Paramedics Exam Cardiology & Resuscitation 2 — Questions and Answers
Question 1: A patient in ventricular fibrillation receives a 200J biphasic shock. The rhythm converts to pulseless electrical activity (PEA). What is the most appropriate next step?
- Deliver another shock immediately
- Resume high-quality CPR and search for reversible causes (Correct answer)
- Administer amiodarone 300mg IV
- Increase shock energy to 360J
Correct answer: Resume high-quality CPR and search for reversible causes
PEA requires CPR and treatment of reversible causes (Hs and Ts); defibrillation is not indicated for PEA.
Question 2: When performing CPR on an adult, what is the recommended chest compression-to-ventilation ratio for a single rescuer without an advanced airway?
- 15:2
- 30:2 (Correct answer)
- 5:1
- 30:1
Correct answer: 30:2
The 2020 AHA guidelines recommend a 30:2 compression-to-ventilation ratio for adult CPR without an advanced airway.
Question 3: A patient presents with a wide-complex tachycardia at 160 bpm with a pulse and stable blood pressure. Which drug is the first-line pharmacologic treatment?
- Adenosine 6mg rapid IV push
- Amiodarone 150mg IV over 10 minutes (Correct answer)
- Diltiazem 0.25 mg/kg IV
- Atropine 0.5mg IV
Correct answer: Amiodarone 150mg IV over 10 minutes
Amiodarone 150mg IV over 10 minutes is the preferred agent for stable wide-complex tachycardia of uncertain origin.
Question 4: Which of the following ECG findings is most consistent with right ventricular MI?
- ST elevation in leads V1-V4
- ST elevation in lead V4R (Correct answer)
- ST depression in leads II, III, aVF
- New left bundle branch block
Correct answer: ST elevation in lead V4R
ST elevation in right-sided lead V4R is the hallmark finding of right ventricular myocardial infarction.
Question 5: During cardiac arrest resuscitation, epinephrine 1mg IV/IO should be administered every:
- 2 minutes
- 3–5 minutes (Correct answer)
- 5–10 minutes
- Once only per resuscitation
Correct answer: 3–5 minutes
The AHA recommends epinephrine 1mg IV/IO every 3–5 minutes during cardiac arrest.
Question 6: A patient with suspected tension pneumothorax develops PEA during CPR. The correct immediate intervention is:
- Immediate defibrillation
- Needle decompression of the affected side (Correct answer)
- Sodium bicarbonate 1 mEq/kg IV
- Fluid bolus 500mL NS
Correct answer: Needle decompression of the affected side
Tension pneumothorax is a reversible cause of PEA and is treated with immediate needle decompression.
Question 7: Which post-cardiac arrest intervention has been shown to improve neurological outcomes in comatose survivors?
- Aggressive hyperventilation to lower PaCO2 below 35 mmHg
- Targeted temperature management (TTM) at 32–36°C (Correct answer)
- Immediate administration of high-dose corticosteroids
- Keeping SpO2 above 99%
Correct answer: Targeted temperature management (TTM) at 32–36°C
Targeted temperature management at 32–36°C for 24 hours improves neurological outcomes in comatose post-arrest survivors.
Paramedics Exam Cardiology & Resuscitation 2
A patient in ventricular fibrillation receives a 200J biphasic shock.
The rhythm converts to pulseless electrical activity (PEA).
What is the most appropriate next step?