CCMA EXAM SCRIPT FINAL PAPER 2026
COMPLETE QUESTIONS AND ANSWERS REVIEW
▶ 3rd degree heart block. Answer: aka Complete heart block
Tx immediately w/ a pacemaker (any type)
▶ V-fib. Answer: Rate: Cannot be determined
Rhythm: Chaotic
P wave: Not identifiable
QRS: Not identifiable
TREATMENT
Assess Femoral or Carotid pulse
Call for help or push code button
CPR
Defibrillation
Epinephrine 1 mg
Amiodarone 300 mg followed by 150 mg
Followed by continuous infusion
▶ asystole. Answer: do CPR, then give Epinephrine 1 mg every 3-5 min
and intubation
▶ Pulseless Electrical Activity (PEA). Answer: This is a rhythm on the
monitor and no pulse (basically asystole)
▶ treatment for PEA. Answer: CPR, epinephrine, treat the underlying
cause
H: hypovolemia, hypoxia, hypothermia, hypo/hyper K+, H+ acidosis
T: toxins (overdose), tension pneumothorax, thrombosis (MI or PE),
tamponade
▶ classic s/s of ACS. Answer: Classic s/s
Midsternal pressure
May radiate to the jaw or down the left arm
May be associated with related s/s, such as SOB or fatigue
▶ Unstable angina. Answer: May see ST elevation but it goes back to
normal
, May occur at rest and require more frequent nitrate therapy
Tx: rest + nitroglycerin; drugs affecting platelets
▶ Variant = Prinzmetal's (vasospasms). Answer: Can happen at rest or
anytime
ST ↘ then ↗ during pain episodes
ST segment goes back to normal and Nitro won't help
Tx: CCB to relax muscles in the vessel
▶ treatment for angina. Answer: Maintain cardiac output
Bed rest
Keep pt calm
Want a HYPOmetabolic state
Pain relief = morphine + nitroglycerin
Both have vasodilatory properties
Cardiac Bundle, educate pt on:
Lipid lowering med - a -statin
Beta blockers - Metoprolol
Long-acting Nitrates - Isosorbide dinitrate, Isosorbide mononitrate
ACE inhibitors - Captopril, Lisinopril, Ramipril
▶ Beta1 BlockeRs (-olol). Answer: always check apical heart rate
▶ ACE Inhibitors → o p r i l. Answer: No NSAIDS
No salt substitute or K+ supplements
▶ nitroglycerin. Answer: Normal adverse effect = patient has a headache
Take 1 tablet, call 911 if not relieved, then take 2 more till ambulance
comes; don't exceed 3
▶ diagnosing acute MI. Answer: unrelieved with nitro
Serum troponin I (< 0.1 mcg/L)
▶ MI priorities. Answer: VS including O2 saturation
12 lead ECG (quickly!)
IV access (large bore in a large vein) - 2 IVs if possible
Blood sample for labs: CBC, cardiac enzymes and coagulation studies
▶ acute mi treatment. Answer: MONA
COMPLETE QUESTIONS AND ANSWERS REVIEW
▶ 3rd degree heart block. Answer: aka Complete heart block
Tx immediately w/ a pacemaker (any type)
▶ V-fib. Answer: Rate: Cannot be determined
Rhythm: Chaotic
P wave: Not identifiable
QRS: Not identifiable
TREATMENT
Assess Femoral or Carotid pulse
Call for help or push code button
CPR
Defibrillation
Epinephrine 1 mg
Amiodarone 300 mg followed by 150 mg
Followed by continuous infusion
▶ asystole. Answer: do CPR, then give Epinephrine 1 mg every 3-5 min
and intubation
▶ Pulseless Electrical Activity (PEA). Answer: This is a rhythm on the
monitor and no pulse (basically asystole)
▶ treatment for PEA. Answer: CPR, epinephrine, treat the underlying
cause
H: hypovolemia, hypoxia, hypothermia, hypo/hyper K+, H+ acidosis
T: toxins (overdose), tension pneumothorax, thrombosis (MI or PE),
tamponade
▶ classic s/s of ACS. Answer: Classic s/s
Midsternal pressure
May radiate to the jaw or down the left arm
May be associated with related s/s, such as SOB or fatigue
▶ Unstable angina. Answer: May see ST elevation but it goes back to
normal
, May occur at rest and require more frequent nitrate therapy
Tx: rest + nitroglycerin; drugs affecting platelets
▶ Variant = Prinzmetal's (vasospasms). Answer: Can happen at rest or
anytime
ST ↘ then ↗ during pain episodes
ST segment goes back to normal and Nitro won't help
Tx: CCB to relax muscles in the vessel
▶ treatment for angina. Answer: Maintain cardiac output
Bed rest
Keep pt calm
Want a HYPOmetabolic state
Pain relief = morphine + nitroglycerin
Both have vasodilatory properties
Cardiac Bundle, educate pt on:
Lipid lowering med - a -statin
Beta blockers - Metoprolol
Long-acting Nitrates - Isosorbide dinitrate, Isosorbide mononitrate
ACE inhibitors - Captopril, Lisinopril, Ramipril
▶ Beta1 BlockeRs (-olol). Answer: always check apical heart rate
▶ ACE Inhibitors → o p r i l. Answer: No NSAIDS
No salt substitute or K+ supplements
▶ nitroglycerin. Answer: Normal adverse effect = patient has a headache
Take 1 tablet, call 911 if not relieved, then take 2 more till ambulance
comes; don't exceed 3
▶ diagnosing acute MI. Answer: unrelieved with nitro
Serum troponin I (< 0.1 mcg/L)
▶ MI priorities. Answer: VS including O2 saturation
12 lead ECG (quickly!)
IV access (large bore in a large vein) - 2 IVs if possible
Blood sample for labs: CBC, cardiac enzymes and coagulation studies
▶ acute mi treatment. Answer: MONA
