CMAA CERTIFICATION EVALUATION STUDY
GUIDE 2026 FULL QUESTIONS AND SOLUTIONS
▶ treatment for new onset A-Fib or A-Flutter w/ rate >180 bpm. Answer:
cardioversion
▶ treatment for long-standing Fib/Flutter. Answer: anticoagulation with
Heparin drip or warfarin for 6 weeks before cardioversion
▶ PR interval norm. Answer: 0.12-0.20 secs
3-5 boxes
▶ QRS complex norm. Answer: 0.06 - 0.12 secs
1 1/2 - 3 boxes
▶ indicated by short PR intervals. Answer: arrhythmias
▶ indicated by long PR intervals. Answer: heart blocks or other
pathological conditions
▶ indicated by ST elevation. Answer: myocardial injury (STEMI)
▶ STEMI. Answer: ST-segment elevation myocardial infarction
▶ NSTEMI. Answer: non-ST elevation myocardial infarction
▶ indicated by abnormal Q wave. Answer: myocardial infarction
▶ what does a prolonged QT interval put you at risk for. Answer:
ventricular dysrhythmias and sudden death
may be caused by electrolyte imbalance (hypokalemia, hypomagnesemia,
hypocalcemia), stroke, hypothermia, or meds
▶ Atrial rate. Answer: count p waves in 6 seconds and multiply by 10
▶ Ventricular rate. Answer: count QRS complexes and multiply by 10
▶ bradycardia treatment. Answer: atropine 0.5-1 mg
,(if atropine doesn't work, due to 3rd degree AV block)
temporary pacemaker
▶ supraventricular tachycardia (SVT). Answer: hr 160-240 bpm
regular rhythm
can't measure PR interval, no real p waves
▶ SVT treatment. Answer: adenosine
treat underlying cause
▶ P waves in normal sinus rhythm. Answer: identical and precede each
QRS
▶ what electrolyte imbalance in caused by premature ventricular
contraction PVC. Answer: hypokalemia
▶ treatment for a-fib or a-flutter for new onset with rate is <180 bpm.
Answer: Amiodarone
Beta blockers
Digoxin
▶ Amiodorone. Answer: Antidysrhythmic
chemical cardioversion
Monitor ECG for prolonged QT interval with use of antidysrhythmic
▶ 1st degree heart block. Answer: This prolongs the PR interval to > 0.20
sec
Rate: 60-100 bpm, rhythm is regular
This may be temporary due to ischemia
Treatment - Observe the patient
▶ 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
GUIDE 2026 FULL QUESTIONS AND SOLUTIONS
▶ treatment for new onset A-Fib or A-Flutter w/ rate >180 bpm. Answer:
cardioversion
▶ treatment for long-standing Fib/Flutter. Answer: anticoagulation with
Heparin drip or warfarin for 6 weeks before cardioversion
▶ PR interval norm. Answer: 0.12-0.20 secs
3-5 boxes
▶ QRS complex norm. Answer: 0.06 - 0.12 secs
1 1/2 - 3 boxes
▶ indicated by short PR intervals. Answer: arrhythmias
▶ indicated by long PR intervals. Answer: heart blocks or other
pathological conditions
▶ indicated by ST elevation. Answer: myocardial injury (STEMI)
▶ STEMI. Answer: ST-segment elevation myocardial infarction
▶ NSTEMI. Answer: non-ST elevation myocardial infarction
▶ indicated by abnormal Q wave. Answer: myocardial infarction
▶ what does a prolonged QT interval put you at risk for. Answer:
ventricular dysrhythmias and sudden death
may be caused by electrolyte imbalance (hypokalemia, hypomagnesemia,
hypocalcemia), stroke, hypothermia, or meds
▶ Atrial rate. Answer: count p waves in 6 seconds and multiply by 10
▶ Ventricular rate. Answer: count QRS complexes and multiply by 10
▶ bradycardia treatment. Answer: atropine 0.5-1 mg
,(if atropine doesn't work, due to 3rd degree AV block)
temporary pacemaker
▶ supraventricular tachycardia (SVT). Answer: hr 160-240 bpm
regular rhythm
can't measure PR interval, no real p waves
▶ SVT treatment. Answer: adenosine
treat underlying cause
▶ P waves in normal sinus rhythm. Answer: identical and precede each
QRS
▶ what electrolyte imbalance in caused by premature ventricular
contraction PVC. Answer: hypokalemia
▶ treatment for a-fib or a-flutter for new onset with rate is <180 bpm.
Answer: Amiodarone
Beta blockers
Digoxin
▶ Amiodorone. Answer: Antidysrhythmic
chemical cardioversion
Monitor ECG for prolonged QT interval with use of antidysrhythmic
▶ 1st degree heart block. Answer: This prolongs the PR interval to > 0.20
sec
Rate: 60-100 bpm, rhythm is regular
This may be temporary due to ischemia
Treatment - Observe the patient
▶ 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
