Paramedics Exam Cardiology & Resuscitation 3 — Questions and Answers
Question 1: A 58-year-old male presents with diaphoresis, jaw pain, and an ECG showing ST elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?
- Left anterior descending artery
- Right coronary artery (Correct answer)
- Left circumflex artery
- Left main coronary artery
Correct answer: Right coronary artery
Inferior STEMI (ST elevation in II, III, aVF) is most commonly caused by occlusion of the right coronary artery.
Question 2: Which of the following is the correct energy setting for synchronized cardioversion of stable atrial flutter?
- 50–100J biphasic (Correct answer)
- 200J biphasic
- 360J monophasic
- 150–200J biphasic
Correct answer: 50–100J biphasic
Atrial flutter typically responds to low-energy synchronized cardioversion starting at 50–100J biphasic.
Question 3: A patient has third-degree (complete) heart block with a ventricular rate of 30 bpm and hypotension. Which treatment is most appropriate?
- Adenosine 6mg IV push
- Transcutaneous pacing (Correct answer)
- Diltiazem 0.25 mg/kg IV
- Amiodarone 300mg IV
Correct answer: Transcutaneous pacing
Transcutaneous pacing is the definitive prehospital treatment for symptomatic third-degree heart block.
Question 4: In ACLS, what is the maximum single IV/IO dose of adenosine for SVT?
- 6mg
- 12mg (Correct answer)
- 18mg
- 24mg
Correct answer: 12mg
The maximum single dose of adenosine is 12mg; if the initial 6mg dose fails, a repeat dose of 12mg may be given.
Question 5: Which rhythm is most commonly seen immediately after successful defibrillation of ventricular fibrillation?
- Normal sinus rhythm
- PEA or asystole (Correct answer)
- Atrial fibrillation
- Supraventricular tachycardia
Correct answer: PEA or asystole
Post-defibrillation PEA or asystole is common and requires immediate resumption of CPR for 2 minutes.
Question 6: For a patient in cardiac arrest with suspected hyperkalemia, which medication should be given to stabilize the cardiac membrane?
- Sodium bicarbonate 1 mEq/kg IV
- Calcium chloride 1g IV (Correct answer)
- Magnesium sulfate 2g IV
- Insulin 10 units IV
Correct answer: Calcium chloride 1g IV
Calcium chloride (or calcium gluconate) stabilizes the myocardial cell membrane against the effects of hyperkalemia.
Question 7: According to AHA guidelines, what is the recommended fraction of chest compressions (CCF) target during resuscitation?
- Greater than 50%
- Greater than 60% (Correct answer)
- Greater than 80%
- 100%
Correct answer: Greater than 60%
The 2020 AHA guidelines recommend a chest compression fraction of greater than 60% to maximize perfusion during CPR.
Paramedics Exam Cardiology & Resuscitation 3
A 58-year-old male presents with diaphoresis, jaw pain, and an ECG showing ST elevation in leads II, III, and aVF.
Which coronary artery is most likely occluded?