A responder is caring for a patient with a history of congestive heart failure. The patient is experiencing shortness of breath, a blood pressure of 68/50 mm Hg, and a heart rate of 190/min. The patient’s lead II ECG is displayed here. Which best characterizes this patient’s rhythm?

EMS providers are treating a patient with suspected stroke. According to the Adult Suspected Stroke Algorithm, which critical action performed by the EMS team will expedite this patient’s care on arrival and reduce the time to treatment?

For STEMI patients, which best describes the recommended maximum goal time for first medical contact–to–balloon inflation time for percutaneous coronary intervention?

Which best describes the length of time it should take to perform a pulse check during the BLS Assessment?

You instruct a team member to give 1 mg atropine IV. Which response is an example of closed-loop communication?

What should be the primary focus of the CPR Coach on a resuscitation team?

Which is the recommended oral dose of aspirin for a patient with a suspected acute coronary syndrome?

A patient in stable narrow-complex tachycardia with a peripheral IV in place is refractory to the first dose of adenosine. Which dose would you administer next?

In addition to clinical assessment, which is the most reliable method to confirm and monitor correct placement of an endotracheal tube?

How can you increase chest compression fraction during a code?

Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. You determine that he is unresponsive. Which is the next step in your assessment and management of this patient?

Which of the following signs is a likely indicator of cardiac arrest in an unresponsive patient?

Which best describes this rhythm?

A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting “crushing” chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths per minute, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation.

On the basis of this patient’s initial presentation, which condition do you suspect led to the cardiac
arrest?

A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting “crushing” chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths per minute, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation.

In addition to defibrillation, which intervention should be performed immediately?

A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting “crushing” chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths per minute, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation.

Despite 2 defibrillation attempts, the patient remains in ventricular fibrillation. Which drug and dose should you administer first to this patient?

A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting “crushing” chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths per minute, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation.
Despite the drug provided above and continued CPR, the patient remains in ventricular fibrillation.
Which other drug should be administered next?

A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting “crushing” chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths per minute, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation.

The patient has return of spontaneous circulation and is not able to follow commands. Which post– cardiac arrest care intervention do you choose for this patient?

A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting “crushing” chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths per minute, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation.

Which would you have done first if the patient had not gone into ventricular fibrillation?

What is the recommended range from which a temperature should be selected and maintained constantly to achieve targeted temperature management after cardiac arrest?

To properly ventilate a patient with a perfusing rhythm, how often do you squeeze the bag?

A patient has a witnessed loss of consciousness. The lead II ECG reveals this rhythm. Which is the appropriate treatment?

What is an effect of excessive ventilation?

Use this scenario to answer the next 4 questions:

A 68-year-old woman presents with light-headedness, nausea, and chest discomfort. Your assessment finds
her awake and responsive but appearing ill, pale, and grossly diaphoretic. Her radial pulse is weak, thready,
and fast. You are unable to obtain a blood pressure. She has no obvious dependent edema, and her neck
veins are flat. Her lung sounds are equal, with moderate rales present bilaterally. The cardiac monitor shows
the rhythm seen here.

On the basis of this patient’s initial assessment, which ACLS algorithm should you follow?

A 68-year-old woman presents with light-headedness, nausea, and chest discomfort. Your assessment finds
her awake and responsive but appearing ill, pale, and grossly diaphoretic. Her radial pulse is weak, thready,
and fast. You are unable to obtain a blood pressure. She has no obvious dependent edema, and her neck
veins are flat. Her lung sounds are equal, with moderate rales present bilaterally. The cardiac monitor shows
the rhythm seen here.

On the basis of this patient’s initial assessment, which ACLS algorithm should you follow?

A 68-year-old woman presents with light-headedness, nausea, and chest discomfort. Your assessment finds
her awake and responsive but appearing ill, pale, and grossly diaphoretic. Her radial pulse is weak, thready,
and fast. You are unable to obtain a blood pressure. She has no obvious dependent edema, and her neck
veins are flat. Her lung sounds are equal, with moderate rales present bilaterally. The cardiac monitor shows
the rhythm seen here.

On the basis of this patient’s initial assessment, which ACLS algorithm should you follow?

A 68-year-old woman presents with light-headedness, nausea, and chest discomfort. Your assessment finds
her awake and responsive but appearing ill, pale, and grossly diaphoretic. Her radial pulse is weak, thready,
and fast. You are unable to obtain a blood pressure. She has no obvious dependent edema, and her neck
veins are flat. Her lung sounds are equal, with moderate rales present bilaterally. The cardiac monitor shows
the rhythm seen here.

On the basis of this patient’s initial assessment, which ACLS algorithm should you follow?

What is the minimum systolic blood pressure one should attempt to achieve with fluid administration or vasoactive agents in a hypotensive post–cardiac arrest patient who achieves return of spontaneous circulation?

Which is the primary purpose of a medical emergency team or rapid response team?

Which best describes this rhythm?

A team member is unable to perform an assigned task because it is beyond the team member’s scope of practice. Which action should the team member take?

During post–cardiac arrest care, which is the recommended duration of targeted temperature management after reaching the correct temperature range?

Which is the recommended next step after a defibrillation attempt?

Which is the recommended next step after a defibrillation attempt?

Which of these tests should be performed for a patient with suspected stroke as soon as possible but no more than 20 minutes after hospital arrival?

Which is an acceptable method of selecting an appropriately sized oropharyngeal airway?

You are evaluating a 58-year-old man with chest discomfort. His blood pressure is 92/50 mm Hg, his heart rate is 92/min, his nonlabored respiratory rate is 14 breaths per minute, and his pulse oximetry reading is 97%. Which assessment step is most important now?

Three minutes into a cardiac arrest resuscitation attempt, one member of your team inserts an endotracheal tube while another performs chest compressions. Capnography shows a persistent waveform and a PETCO2 of 8 mm Hg. What is the significance of this finding?

Which type of atrioventricular block best describes this rhythm?

You have completed 2 minutes of CPR. The ECG monitor displays the lead II rhythm shown here, and the patient has no pulse. Another member of your team resumes chest compressions, and an IV is in place.
Which do you do next?

Which best describes an action taken by the Team Leader to avoid inefficiencies during a resuscitation attempt?

Which is the recommended first intravenous dose of amiodarone for a patient with refractory ventricular fibrillation?

Which is the maximum interval you should allow for an interruption in chest compressions?

A patient in respiratory distress and with a blood pressure of 70/50 mm Hg presents with the lead II ECG rhythm shown here. Which is the appropriate treatment?

You are caring for a patient with a suspected stroke whose symptoms started 2 hours ago. The CT scan was normal, with no signs of hemorrhage. The patient does not have any contraindications to fibrinolytic therapy.
Which treatment approach is best for this patient?

Which type of atrioventricular block best describes this rhythm?

Your patient is in cardiac arrest and has been intubated. To assess CPR quality, which should you do?

If a team member is about to make a mistake during a resuscitation attempt, which best describes the action that the Team Leader or other team members should take?

A patient is being resuscitated in a very noisy environment. A team member thinks he heard an order for 500 mg of amiodarone IV. Which is the best response from the team member?

You are performing chest compressions during an adult resuscitation attempt. Which rate should you use to perform the compressions?

Which facility is the most appropriate EMS destination for a patient with sudden cardiac arrest who achieved return of spontaneous circulation in the field?