Fisdap Cardiology Exam 2026 Question and
Answer | Real Questions and Answers | A+
Verified
• Which of the following is an absolute contraindication for fibrinolytic
therapy? -✓✓Subdural hematoma 3 years ago.
According to current emergency cardiac care (ECC) guidelines, absolute
contraindications for fibrinolytic therapy include ANY prior intracranial
hemorrhage (ie, subdural, epidural, intracerebral hematoma); known
structural cerebrovascular lesion (ie, arteriovenous malformation);
known malignant intracranial tumor (primary or metastatic); ischemic
stroke within the past 3 months, EXCEPT for acute ischemic stroke
within the past 3 hours; suspected aortic dissection; active bleeding or
bleeding disorders (except menses); and significant closed head trauma
or facial trauma within the past 3 months. Relative contraindications (eg,
the physician may deem fibrinolytic therapy appropriate under certain
circumstances) include, a history of chronic, severe, poorly-controlled
hypertension; severe uncontrolled hypertension on presentation (SBP >
180 mm Hg or DBP > 110 mm Hg); ischemic stroke greater than 3
months ago; dementia; traumatic or prolonged (> 10 minutes) CPR or
major surgery within the past 3 weeks; recent (within 2 to 4 weeks)
internal bleeding; noncompressible vascular punctures; pregnancy; prior
exposure (> 5 days ago) or prior allergic reaction to streptokinase or
anistreplase; active peptic ulcer; and current use of anticoagulants (ie,
Coumadin).
• A middle-aged man presents with chest discomfort, shortness of
breath, and nausea. You give him supplemental oxygen and continue
your assessment. As your partner is attaching the ECG leads, you
should: -✓✓Administer up to 325 mg of aspirin.
,Since oxygen has already been administered to this patient and your
partner is attaching the ECG leads, you should administer aspirin (160 to
325 mg, non-enteric-coated). Early administration of aspirin has clearly
been shown to reduce mortality and morbidity in patients experiencing
an acute coronary syndrome (ACS). After establishing vascular access,
you should assess his vital signs and then administer 0.4 mg of
nitroglycerin (up to 3 doses, 5 minutes apart), provided that his systolic
BP is greater than 90 mm Hg. If 3 doses of nitroglycerin fail to
completely relieve his chest discomfort, consider administering 2 to 4
mg of morphine IV, provided that his systolic BP remains above 90 mm
Hg.
• Which of the following ECG lead configurations is correct? -✓✓To
assess lead II, place the negative lead on the right arm and the positive
lead on the left leg.
According to the Einthoven triangle, lead I is assessed by placing the
negative (white) lead on the right arm and the positive (red) lead on the
left arm. Lead II is assessed by placing the negative lead on the right arm
and the positive lead on the left leg. Lead III is assessed by placing the
negative lead on the left arm and the positive lead on the left leg.
• A 61-year-old male presents with chest pressure that woke him up
from his nap 30 minutes ago. He is diaphoretic, anxious, and rates his
pain as an an 8 over 10. His past medical history is significant for
hypertension, type II diabetes, and coronary stent placement 2 months
ago. He takes lisinopril, Plavix, and Glucophage, and is wearing a
medical alert bracelet stating "allergic to salicylates." His blood pressure
is 160/100 mm Hg, pulse is 110 beats/min, and respirations are 22
breaths/min. The 12-lead ECG shows sinus tachycardia with 3-mm ST
segment elevation in leads V1 through V5. Which of the following
treatment modalities is MOST appropriate for this patient? -
✓✓Supplemental oxygen, vascular access, up to three 0.4 mg doses of
,nitroglycerin, and 2 to 4 mg of morphine sulfate if his systolic BP is
greater than 90 mm Hg and he is still experiencing pain.
The patient is experiencing an acute coronary syndrome (ACS). His 12-
lead ECG indicates anteroseptal injury with lateral extension (ST
elevation in leads V1 through V5). Appropriate treatment includes
oxygen (maintain an SpO2 of greater than 94%), vascular access, up to
three 0.4 mg doses of nitroglycerin (NTG), and 2 to 4 mg of morphine if
NTG fails to relieve his pain and his systolic BP is above 90 mm Hg.
Some EMS systems may use fentanyl (Sublimaze) for analgesia.
Aspirin, a salicylate, is also given to patients with ACS; however, this
patient is allergic to salicylates. Obtain a right-sided 12-lead ECG in
patients with signs of inferior wall injury (ST elevation in leads II, III,
aVF). Inferior wall infarctions may involve the right ventricle; a right-
sided 12-lead ECG will help confirm this. Apply the multi-pads to the
patient, not because he is at risk for bradycardia (more common with
inferior infarctions), but because he is at risk for cardiac arrest due to V-
Fib or pulseless V-Tach.
• You and your team are performing CPR on a 70-year-old male. The
cardiac monitor reveals a slow, organized rhythm. His wife tells you that
he goes to dialysis every day, but has missed his last three treatments.
She also tells you that he has high blood pressure, hyperthyroidism, and
has had several cardiac bypass surgeries. Based on the patient's medical
history, which of the following conditions is the MOST likely
underlying cause of his condition? -✓✓Hyperkalemia.
Although any of the listed conditions could be causing this patient's
condition, the fact that he missed his last three dialysis treatments should
make you most suspicious for hyperkalemia. Dialysis filters metabolic
waste products from the blood in patients with renal insufficiency or
failure. If the patient is not dialyzed, these waste products, including
potassium and other electrolytes, accumulate to toxic levels in the blood.
In addition to performing high-quality CPR, managing the airway, and
administering epinephrine, your protocols may call for the
, administration of calcium chloride and sodium bicarbonate if
hyperkalemia is suspected. Albuterol also has been shown to be effective
in treating patients with hyperkalemia becauses it causes potassium to
shift back into the cells; it can be nebulized down the ET tube or
administered intravenously. Follow your local protocols regarding the
treatment for suspected hyperkalemia.
• Which of the following represents the MOST appropriate initial drug
and dose that is given to all adult patients in cardiac arrest? -✓✓10 mL
of epinephrine 1:10,000 every 3 to 5 minutes.
Once vascular access has been obtained (IV or IO), the first drug and
dose given to all patients in cardiac arrest—regardless of the rhythm on
the cardiac monitor—is epinephrine 1 mg (10 mL) of a 1:10,000
solution, repeated every 3 to 5 minutes. You may consider a one-time
dose of vasopressin (40 units) to replace the first or second dose of
epinephrine, but not both. Higher doses of epinephrine may be necessary
if special circumstances exist (ie, severe beta-blocker toxicity). Consult
with medical control as needed.
• The MOST appropriate initial action for a 54-year-old man who
presents with the following cardiac rhythm should consist of: -
✓✓Assessing the patient's clinical status.
When assessing the cardiac rhythm of any patient, you must interpret it
in the context of his or her clinical status. Before you reach for atropine
or a pacemaker, determine if the bradycardia is causing hemodynamic
compromise (ie, hypotension, altered mental status, chest pressure or
discomfort, pulmonary edema). If the patient is hemodynamically
unstable, treat according to established ACLS guidelines (ie, atropine,
pacing, etc.). However, if the patient is hemodynamically stable, simply
monitor his or her clinical status and transport to the hospital.
Answer | Real Questions and Answers | A+
Verified
• Which of the following is an absolute contraindication for fibrinolytic
therapy? -✓✓Subdural hematoma 3 years ago.
According to current emergency cardiac care (ECC) guidelines, absolute
contraindications for fibrinolytic therapy include ANY prior intracranial
hemorrhage (ie, subdural, epidural, intracerebral hematoma); known
structural cerebrovascular lesion (ie, arteriovenous malformation);
known malignant intracranial tumor (primary or metastatic); ischemic
stroke within the past 3 months, EXCEPT for acute ischemic stroke
within the past 3 hours; suspected aortic dissection; active bleeding or
bleeding disorders (except menses); and significant closed head trauma
or facial trauma within the past 3 months. Relative contraindications (eg,
the physician may deem fibrinolytic therapy appropriate under certain
circumstances) include, a history of chronic, severe, poorly-controlled
hypertension; severe uncontrolled hypertension on presentation (SBP >
180 mm Hg or DBP > 110 mm Hg); ischemic stroke greater than 3
months ago; dementia; traumatic or prolonged (> 10 minutes) CPR or
major surgery within the past 3 weeks; recent (within 2 to 4 weeks)
internal bleeding; noncompressible vascular punctures; pregnancy; prior
exposure (> 5 days ago) or prior allergic reaction to streptokinase or
anistreplase; active peptic ulcer; and current use of anticoagulants (ie,
Coumadin).
• A middle-aged man presents with chest discomfort, shortness of
breath, and nausea. You give him supplemental oxygen and continue
your assessment. As your partner is attaching the ECG leads, you
should: -✓✓Administer up to 325 mg of aspirin.
,Since oxygen has already been administered to this patient and your
partner is attaching the ECG leads, you should administer aspirin (160 to
325 mg, non-enteric-coated). Early administration of aspirin has clearly
been shown to reduce mortality and morbidity in patients experiencing
an acute coronary syndrome (ACS). After establishing vascular access,
you should assess his vital signs and then administer 0.4 mg of
nitroglycerin (up to 3 doses, 5 minutes apart), provided that his systolic
BP is greater than 90 mm Hg. If 3 doses of nitroglycerin fail to
completely relieve his chest discomfort, consider administering 2 to 4
mg of morphine IV, provided that his systolic BP remains above 90 mm
Hg.
• Which of the following ECG lead configurations is correct? -✓✓To
assess lead II, place the negative lead on the right arm and the positive
lead on the left leg.
According to the Einthoven triangle, lead I is assessed by placing the
negative (white) lead on the right arm and the positive (red) lead on the
left arm. Lead II is assessed by placing the negative lead on the right arm
and the positive lead on the left leg. Lead III is assessed by placing the
negative lead on the left arm and the positive lead on the left leg.
• A 61-year-old male presents with chest pressure that woke him up
from his nap 30 minutes ago. He is diaphoretic, anxious, and rates his
pain as an an 8 over 10. His past medical history is significant for
hypertension, type II diabetes, and coronary stent placement 2 months
ago. He takes lisinopril, Plavix, and Glucophage, and is wearing a
medical alert bracelet stating "allergic to salicylates." His blood pressure
is 160/100 mm Hg, pulse is 110 beats/min, and respirations are 22
breaths/min. The 12-lead ECG shows sinus tachycardia with 3-mm ST
segment elevation in leads V1 through V5. Which of the following
treatment modalities is MOST appropriate for this patient? -
✓✓Supplemental oxygen, vascular access, up to three 0.4 mg doses of
,nitroglycerin, and 2 to 4 mg of morphine sulfate if his systolic BP is
greater than 90 mm Hg and he is still experiencing pain.
The patient is experiencing an acute coronary syndrome (ACS). His 12-
lead ECG indicates anteroseptal injury with lateral extension (ST
elevation in leads V1 through V5). Appropriate treatment includes
oxygen (maintain an SpO2 of greater than 94%), vascular access, up to
three 0.4 mg doses of nitroglycerin (NTG), and 2 to 4 mg of morphine if
NTG fails to relieve his pain and his systolic BP is above 90 mm Hg.
Some EMS systems may use fentanyl (Sublimaze) for analgesia.
Aspirin, a salicylate, is also given to patients with ACS; however, this
patient is allergic to salicylates. Obtain a right-sided 12-lead ECG in
patients with signs of inferior wall injury (ST elevation in leads II, III,
aVF). Inferior wall infarctions may involve the right ventricle; a right-
sided 12-lead ECG will help confirm this. Apply the multi-pads to the
patient, not because he is at risk for bradycardia (more common with
inferior infarctions), but because he is at risk for cardiac arrest due to V-
Fib or pulseless V-Tach.
• You and your team are performing CPR on a 70-year-old male. The
cardiac monitor reveals a slow, organized rhythm. His wife tells you that
he goes to dialysis every day, but has missed his last three treatments.
She also tells you that he has high blood pressure, hyperthyroidism, and
has had several cardiac bypass surgeries. Based on the patient's medical
history, which of the following conditions is the MOST likely
underlying cause of his condition? -✓✓Hyperkalemia.
Although any of the listed conditions could be causing this patient's
condition, the fact that he missed his last three dialysis treatments should
make you most suspicious for hyperkalemia. Dialysis filters metabolic
waste products from the blood in patients with renal insufficiency or
failure. If the patient is not dialyzed, these waste products, including
potassium and other electrolytes, accumulate to toxic levels in the blood.
In addition to performing high-quality CPR, managing the airway, and
administering epinephrine, your protocols may call for the
, administration of calcium chloride and sodium bicarbonate if
hyperkalemia is suspected. Albuterol also has been shown to be effective
in treating patients with hyperkalemia becauses it causes potassium to
shift back into the cells; it can be nebulized down the ET tube or
administered intravenously. Follow your local protocols regarding the
treatment for suspected hyperkalemia.
• Which of the following represents the MOST appropriate initial drug
and dose that is given to all adult patients in cardiac arrest? -✓✓10 mL
of epinephrine 1:10,000 every 3 to 5 minutes.
Once vascular access has been obtained (IV or IO), the first drug and
dose given to all patients in cardiac arrest—regardless of the rhythm on
the cardiac monitor—is epinephrine 1 mg (10 mL) of a 1:10,000
solution, repeated every 3 to 5 minutes. You may consider a one-time
dose of vasopressin (40 units) to replace the first or second dose of
epinephrine, but not both. Higher doses of epinephrine may be necessary
if special circumstances exist (ie, severe beta-blocker toxicity). Consult
with medical control as needed.
• The MOST appropriate initial action for a 54-year-old man who
presents with the following cardiac rhythm should consist of: -
✓✓Assessing the patient's clinical status.
When assessing the cardiac rhythm of any patient, you must interpret it
in the context of his or her clinical status. Before you reach for atropine
or a pacemaker, determine if the bradycardia is causing hemodynamic
compromise (ie, hypotension, altered mental status, chest pressure or
discomfort, pulmonary edema). If the patient is hemodynamically
unstable, treat according to established ACLS guidelines (ie, atropine,
pacing, etc.). However, if the patient is hemodynamically stable, simply
monitor his or her clinical status and transport to the hospital.
