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NREMT Paramedic study materials
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NREMT Paramedic practice questions

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Question 1Airway, Respiration, and Ventilation

A patient has severe midface trauma with clear fluid draining from the nose. Which airway adjunct should be avoided?

  1. Supraglottic airway
  2. Oropharyngeal airway
  3. Endotracheal tube
  4. Nasopharyngeal airway Correct answer.

Explanation

A nasopharyngeal airway can pass through a fractured cribriform plate or skull base and enter the cranial vault, so it is avoided when basilar skull fracture or severe midface trauma is suspected. Oral and supraglottic airways do not traverse the nasal cavity.

Question 2Airway, Respiration, and Ventilation

An unresponsive adult has no gag reflex and no spontaneous respirations. Which adjunct is most appropriate for maintaining airway patency?

  1. Nasal cannula
  2. Nasopharyngeal airway
  3. Nonrebreather mask
  4. Oropharyngeal airway Correct answer.

Explanation

An oropharyngeal airway is indicated in an unresponsive patient without a gag reflex because it holds the tongue away from the posterior pharynx and provides a channel for ventilation.

Question 3Airway, Respiration, and Ventilation

Which end-tidal CO2 value is expected in a healthy, adequately ventilated adult?

  1. 10 to 15 mmHg
  2. 20 to 25 mmHg
  3. 55 to 65 mmHg
  4. 35 to 45 mmHg Correct answer.

Explanation

Normal end-tidal CO2 in a healthy adult approximates arterial CO2 and falls between 35 and 45 mmHg. Values outside this range suggest hyperventilation, hypoventilation, or a change in perfusion.

Question 4Airway, Respiration, and Ventilation

A nonrebreather mask is applied to a spontaneously breathing patient. What oxygen flow rate is required for the reservoir to function properly?

  1. 4 to 6 L/min
  2. 6 to 8 L/min
  3. 10 to 15 L/min Correct answer.
  4. 1 to 4 L/min

Explanation

A nonrebreather needs a high flow, typically 10 to 15 L/min, to keep the reservoir bag inflated and to deliver close to 90% oxygen or more.

Question 5Airway, Respiration, and Ventilation

A patient with mild dyspnea and an SpO2 of 94% needs low-flow oxygen. What flow range is appropriate for a nasal cannula?

  1. 15 L/min
  2. 10 to 12 L/min
  3. 1 to 6 L/min Correct answer.
  4. 8 to 10 L/min

Explanation

A nasal cannula delivers roughly 24% to 44% oxygen at flows of 1 to 6 L/min. Higher flows do not reliably increase the inspired concentration and cause mucosal drying.

Question 6Airway, Respiration, and Ventilation

What oxygen concentration does a bag-valve-mask device deliver when it is attached to a reservoir and connected to 15 L/min of oxygen?

  1. 40%
  2. 60%
  3. 100% Correct answer.
  4. 21%

Explanation

A bag-valve-mask with a reservoir and a high oxygen flow delivers approximately 95% to 100% oxygen when it is squeezed correctly with a good mask seal.

Question 7Airway, Respiration, and Ventilation

A trauma patient with a suspected cervical spine injury needs manual airway opening. Which maneuver is preferred?

  1. Jaw thrust Correct answer.
  2. Head tilt-chin lift
  3. Cricoid pressure
  4. Blind finger sweep

Explanation

The jaw thrust displaces the mandible anteriorly and lifts the tongue without extending the neck, making it the preferred manual maneuver when cervical spine injury is suspected.

Question 8Airway, Respiration, and Ventilation

Which description matches a Miller laryngoscope blade?

  1. Curved tip that fits the vallecula
  2. Fiberoptic video capability
  3. Integrated oxygen channel
  4. Straight blade Correct answer.

Explanation

The Miller blade is a straight blade that is positioned to lift the epiglottis directly. This design is useful in infants and in patients with a long, floppy epiglottis.

Question 9Airway, Respiration, and Ventilation

An adult patient is vomiting and requires suctioning. Suction should be limited to a maximum of how many seconds?

  1. 60
  2. 45
  3. 30
  4. 15 Correct answer.

Explanation

Suctioning removes oxygen along with secretions and can cause hypoxemia, so it is limited to about 15 seconds in adults, 10 seconds in children, and 5 seconds in infants, with oxygen given between attempts.

Question 10Airway, Respiration, and Ventilation

Which method is the most reliable confirmation of endotracheal tube placement?

  1. Chest radiograph
  2. Auscultation of the epigastrium
  3. Presence of a cuff leak
  4. Waveform capnography Correct answer.

Explanation

Continuous waveform capnography detects exhaled CO2 breath by breath and is the most reliable confirmatory method. It also identifies later dislodgement in real time.

Question 11Airway, Respiration, and Ventilation

Which patient is not a candidate for CPAP?

  1. A 30-year-old who is unresponsive Correct answer.
  2. A 45-year-old with COPD exacerbation and SpO2 88%
  3. A 70-year-old with pneumonia and RR 30
  4. A 60-year-old with pulmonary edema and SpO2 86%

Explanation

CPAP requires a patient who can protect the airway and breathe spontaneously. An unresponsive patient is at high risk for aspiration and needs bag-valve-mask ventilation instead.

Question 12Airway, Respiration, and Ventilation

A capnogram shows a slanted upstroke that resembles a shark fin. What does this pattern suggest?

  1. Normal ventilation
  2. Hyperventilation
  3. Bronchospasm Correct answer.
  4. Hypoventilation

Explanation

A shark-fin or slanted upstroke reflects uneven emptying of alveoli, which is classically seen in bronchospasm and typically improves after bronchodilator treatment.

Question 13Airway, Respiration, and Ventilation

An intubated patient had an end-tidal CO2 of 38 mmHg. The reading suddenly falls to 2 mmHg with loss of the waveform. What is the most likely cause?

  1. Sodium bicarbonate administration
  2. Hyperventilation
  3. Metabolic alkalosis
  4. Tube dislodgement Correct answer.

Explanation

A sudden fall of the capnogram to near zero in an intubated patient most often means the tube is no longer in the trachea, whether dislodged, esophageal, or obstructed, and requires immediate assessment.

Question 14Airway, Respiration, and Ventilation

A needle thoracostomy is being performed using the traditional anterior approach for a tension pneumothorax. Where is the needle inserted?

  1. 5th intercostal space, midaxillary line
  2. 1st intercostal space, sternal border
  3. 6th intercostal space, posterior axillary line
  4. 2nd intercostal space, midclavicular line Correct answer.

Explanation

The traditional site is the second intercostal space in the midclavicular line, with the needle passed just above the top of the third rib. Some services instead use the fifth intercostal space at the anterior axillary line.

Question 15Airway, Respiration, and Ventilation

What is the purpose of applying cricoid pressure during bag-valve-mask ventilation?

  1. To open the airway in a trauma patient
  2. To limit gastric inflation Correct answer.
  3. To prevent vomiting during transport
  4. To confirm tube placement

Explanation

Pressure on the cricoid ring compresses the esophagus against the cervical spine, reducing air entry into the stomach and lowering the risk of regurgitation and aspiration.

Question 16Airway, Respiration, and Ventilation

A patient rescued from a house fire has an SpO2 of 99% but is confused with soot around the mouth. Why is this reading misleading?

  1. Nail polish on the fingers
  2. Severe peripheral vasoconstriction from shock
  3. Motion artifact
  4. Carbon monoxide poisoning Correct answer.

Explanation

Pulse oximetry cannot distinguish carboxyhemoglobin from oxyhemoglobin, so a fire victim with carbon monoxide poisoning may show a falsely normal or high reading despite poor oxygen delivery.

Question 17Airway, Respiration, and Ventilation

Why does a young child's head tend to flex forward into the chest when lying supine?

  1. The epiglottis is short and flat
  2. The trachea is wide
  3. The tongue is small
  4. The occiput is large Correct answer.

Explanation

A proportionally large occiput tilts the head forward when the child is supine, so a small pad under the shoulders is used to achieve a neutral sniffing position for ventilation.

Question 18Airway, Respiration, and Ventilation

During bag-valve-mask ventilation, the epigastrium progressively distends and chest rise decreases. What is the most likely cause?

  1. Use of an oropharyngeal airway
  2. Excessive oxygen flow rate
  3. Ventilating too forcefully Correct answer.
  4. A ventilation rate that is too slow

Explanation

Ventilating with too much volume or pressure forces gas past the glottis into the esophagus and stomach, causing gastric distension and reduced lung inflation.

Question 19Airway, Respiration, and Ventilation

What oxygen saturation range should be targeted for a patient with COPD who is at risk of carbon dioxide retention?

  1. 95 to 100 percent
  2. 88 to 92 percent Correct answer.
  3. 80 to 85 percent
  4. 70 to 80 percent

Explanation

Titrating oxygen to an SpO2 of 88% to 92% in patients at risk of hypercapnia reduces the chance of worsening CO2 retention while still correcting severe hypoxemia.

Question 20Airway, Respiration, and Ventilation

Which oxygen delivery device provides a predictable, fixed fraction of inspired oxygen?

  1. Nonrebreather mask
  2. Venturi mask Correct answer.
  3. Simple face mask
  4. Nasal cannula

Explanation

A Venturi mask uses an air-entrainment jet with color-coded adapters to deliver a precise FiO2, which is valuable when carbon dioxide retention must be avoided.

Question 21Airway, Respiration, and Ventilation

A capnogram shows the baseline rising above zero between breaths. What does this indicate?

  1. Hyperventilation
  2. A leaking tube cuff
  3. Rebreathing of exhaled CO2 Correct answer.
  4. Esophageal intubation

Explanation

CO2 that should not be present in inspired gas raises the baseline. This reflects rebreathing and may result from an exhausted CO2 absorber, a faulty valve, or inadequate fresh gas flow.

Question 22Airway, Respiration, and Ventilation

Which tidal volume is recommended for lung-protective ventilation of a patient with acute respiratory distress syndrome?

  1. 6 mL/kg Correct answer.
  2. 12 mL/kg
  3. 15 mL/kg
  4. 4 mL/kg

Explanation

Lung-protective ventilation uses about 6 mL/kg of predicted body weight to limit alveolar overdistension and barotrauma, accepting a modest rise in CO2 if necessary.

Question 23Airway, Respiration, and Ventilation

A patient is unresponsive with occasional gasping and no palpable pulse. What should be done first?

  1. Assist ventilations with a bag-valve-mask at 10 breaths per minute
  2. Apply high-flow oxygen by nonrebreather mask
  3. Insert an oropharyngeal airway and monitor the patient
  4. Begin chest compressions Correct answer.

Explanation

Agonal gasps are ineffective breathing and, in the absence of a pulse, represent cardiac arrest. Chest compressions must begin immediately to restore circulation.

Question 24Airway, Respiration, and Ventilation

Which structure is entered during a surgical cricothyrotomy?

  1. Cricotracheal ligament
  2. Thyrohyoid membrane
  3. Vocal cords
  4. Cricothyroid membrane Correct answer.

Explanation

A surgical cricothyrotomy incises the cricothyroid membrane between the thyroid and cricoid cartilages, the most accessible and relatively avascular site for a surgical airway.

Question 25Airway, Respiration, and Ventilation

A trauma patient with a suspected cervical spine injury is vomiting and has gurgling respirations. What is the best next action?

  1. Perform a head tilt-chin lift while the head is stabilized
  2. Suction the airway with inline stabilization Correct answer.
  3. Begin positive-pressure ventilation with a bag-valve-mask
  4. Insert an oropharyngeal airway before suctioning the mouth

Explanation

Visible vomit must be cleared before ventilations, and inline manual stabilization prevents neck movement while suctioning. Once the airway is clear, ventilation and adjunct placement can proceed.

Question 26Airway, Respiration, and Ventilation

How is the correct size of an oropharyngeal airway determined for an adult patient?

  1. Corner of the mouth to the angle of the jaw Correct answer.
  2. Upper incisors to the posterior pharynx
  3. Nostril to the tragus of the ear
  4. Corner of the mouth to the tip of the chin

Explanation

An oropharyngeal airway is sized by placing it against the face so the flange sits at the corner of the mouth and the tip reaches the angle of the mandible. That distance approximates the curve from the lips to the posterior pharynx, so the tip will sit just above the epiglottis without pushing the tongue backward.

Question 27Airway, Respiration, and Ventilation

What is the most common cause of upper airway obstruction in an unresponsive adult who is lying supine?

  1. Swelling of the epiglottis
  2. Loss of tongue tone against the pharynx Correct answer.
  3. Laryngospasm of the vocal cords
  4. Accumulated secretions pooling in the oropharynx

Explanation

When consciousness is lost, skeletal muscle tone including the genioglossus is lost, and the tongue falls posteriorly against the pharynx. This is why manual maneuvers and airway adjuncts that lift the tongue away from the posterior wall restore patency in most unresponsive patients.

Question 28Airway, Respiration, and Ventilation

A nasal cannula is applied at a flow of 1 to 6 L/min. What range of inspired oxygen concentration does this typically produce?

  1. 24% to 44% Correct answer.
  2. 21% to 25%
  3. 60% to 90%
  4. 40% to 60%

Explanation

A nasal cannula at 1 to 6 L/min delivers roughly 24% to 44% oxygen, increasing about 4% per liter of flow. The concentration is imprecise because it depends on the patient's inspiratory flow and entrained room air.

Question 29Airway, Respiration, and Ventilation

When ventilating an adult with a bag-valve-mask device, approximately how much of the bag should be squeezed with each breath?

  1. About two-thirds of the bag
  2. About half of the bag
  3. The entire bag with each breath
  4. About one-third of the bag Correct answer.

Explanation

An adult tidal volume is roughly 6 to 7 mL/kg, which corresponds to squeezing about one-third of a self-inflating bag while watching for visible chest rise. Delivering more than that raises airway and intrathoracic pressure and promotes gastric inflation.

Question 30Airway, Respiration, and Ventilation

Which finding makes a nasopharyngeal airway inappropriate for a patient who needs an airway adjunct?

  1. An intact gag reflex
  2. Spontaneous respirations at 20 per minute
  3. A history of asthma
  4. Clear fluid draining from the nose Correct answer.

Explanation

Clear fluid draining from the nose after head or facial trauma may be cerebrospinal fluid, which signals a disrupted skull base. Passing a tube through the nose in that setting risks driving the tube into the cranial vault, so an oropharyngeal airway or another approach is used instead.

Question 31Airway, Respiration, and Ventilation

An adult is unresponsive and breathing inadequately but has a palpable pulse. At what rate should bag-valve-mask breaths be delivered?

  1. 1 breath every 2 seconds
  2. 2 breaths every 30 compressions
  3. 1 breath every 6 seconds Correct answer.
  4. 1 breath every 10 seconds

Explanation

For an adult with a pulse but inadequate breathing, ventilations are given about once every 6 seconds, or roughly 10 breaths per minute. This rate provides adequate minute volume while limiting the rise in intrathoracic pressure that accompanies faster ventilation.

Question 32Airway, Respiration, and Ventilation

An infant has a palpable brachial pulse but is breathing inadequately. At what rate should rescue breaths be given?

  1. 1 breath each second
  2. 1 breath every 8 to 10 seconds
  3. 1 breath every 2 to 3 seconds Correct answer.
  4. 1 breath every 6 seconds

Explanation

Infants and children have a faster normal respiratory rate, so rescue breaths with a pulse present are given about every 2 to 3 seconds, or 20 to 30 per minute. Volumes are just enough to make the chest rise because pediatric lungs are easily overinflated.

Question 33Airway, Respiration, and Ventilation

A hypotensive trauma patient is cold and mottled with a weak radial pulse. The pulse oximeter reads 100% on room air. Which conclusion is most accurate?

  1. The reading is unreliable due to poor peripheral perfusion Correct answer.
  2. The reading suggests carbon monoxide poisoning
  3. The probe is likely on the wrong finger
  4. The reading confirms that oxygen delivery to tissues is adequate

Explanation

Pulse oximetry depends on detecting a pulsatile change in light absorption, which requires reasonable peripheral blood flow. In shock with cold, mottled skin the signal is poor and the displayed saturation may be artifactually normal, so the reading cannot be trusted and the patient must be treated on clinical grounds.

Question 34Airway, Respiration, and Ventilation

A nonrebreather mask is placed on a spontaneously breathing adult. Which oxygen flow rate keeps the reservoir inflated and delivers the highest fraction of inspired oxygen?

  1. 10 to 15 L/min Correct answer.
  2. 6 to 8 L/min
  3. 20 to 25 L/min
  4. 2 to 4 L/min

Explanation

A nonrebreather mask is set at 10 to 15 L/min, which is enough flow to keep the reservoir bag inflated before each breath and deliver roughly 90% or more oxygen. Lower flows allow the bag to collapse and room air to be entrained, reducing the inspired concentration.

Question 35Airway, Respiration, and Ventilation

A hypovolemic trauma patient is being ventilated with 10 cmH2O of positive end-expiratory pressure. The blood pressure falls further. What explains this change?

  1. Raised intrathoracic pressure lowers venous return Correct answer.
  2. PEEP directly depresses myocardial contractility
  3. PEEP raises systemic vascular resistance
  4. PEEP triggers a vagal reflex that causes bradycardia

Explanation

Positive end-expiratory pressure raises mean intrathoracic pressure, which impedes venous return to the right side of the heart. A patient who is already volume depleted cannot compensate by increasing preload, so cardiac output and blood pressure fall.

Question 36Airway, Respiration, and Ventilation

After an endotracheal tube has been placed and its position confirmed in an average adult, at what depth should it be secured at the teeth?

  1. 21 to 23 cm Correct answer.
  2. 18 to 20 cm
  3. 27 to 29 cm
  4. 24 to 26 cm

Explanation

In an average adult, securing the tube at 21 to 23 cm at the incisors places the tip in the mid-trachea, well above the carina. Depth should always be reassessed with auscultation and a thoracic radiograph because body habitus varies.

Question 37Airway, Respiration, and Ventilation

A responsive patient with an intact gag reflex requires an airway adjunct. What is the expected result of inserting an oropharyngeal airway?

  1. It will trigger gagging and possible vomiting Correct answer.
  2. It will function as a bite block for suctioning
  3. It will suppress the gag reflex
  4. It will be tolerated without any difficulty

Explanation

An oropharyngeal airway rests against the posterior tongue and pharynx, which stimulates the gag reflex in a patient who is still responsive. Gagging can lead to vomiting and aspiration, so a nasopharyngeal airway is preferred when the gag reflex is intact.

Question 38Airway, Respiration, and Ventilation

A patient in status asthmaticus is being ventilated with a bag-valve-mask. Chest rise becomes progressively harder to achieve and the blood pressure is falling. What is the most appropriate action?

  1. Allow more time for exhalation between breaths Correct answer.
  2. Increase the rate of ventilation
  3. Squeeze the bag more forcefully
  4. Apply cricoid pressure to the cricoid cartilage

Explanation

Severe bronchospasm prolongs exhalation, so a normal or fast ventilation rate does not allow complete emptying of the lungs. Air trapping raises intrathoracic pressure, impairs venous return, and causes hypotension; slowing the rate and allowing a longer expiratory phase is the priority.

Question 39Airway, Respiration, and Ventilation

A trauma patient has lost a large volume of blood and has a hemoglobin of 5 g/dL. The pulse oximeter reads 99% on room air. Which conclusion is most accurate?

  1. The SpO2 is falsely elevated by dyshemoglobin
  2. Tissue oxygen delivery is adequate because saturation is normal
  3. Saturation is normal but arterial oxygen content is low Correct answer.
  4. Supplemental oxygen will fully restore tissue oxygen delivery

Explanation

SpO2 measures the percentage of available hemoglobin binding sites occupied by oxygen, not the total amount of oxygen in the blood. With severe anemia there are few binding sites, so content and delivery fall even though the percentage saturated remains normal; treatment requires restoring oxygen-carrying capacity.

Question 40Airway, Respiration, and Ventilation

An adult who has had a total laryngectomy with a permanent stoma requires positive-pressure ventilation. How should the rescuer ventilate this patient?

  1. Ventilate through a mask sealed over the stoma Correct answer.
  2. Ventilate with a bag-valve-mask over the mouth and nose
  3. Ventilate through a nasal cannula at 15 L/min
  4. Perform mouth-to-mouth ventilation while sealing the stoma

Explanation

After total laryngectomy the trachea ends at the stoma on the anterior neck and no longer communicates with the pharynx. Positive-pressure ventilation must therefore be delivered through the stoma using a pediatric mask or a tracheostomy tube adapter, with the mouth and nose left alone.

Question 41Cardiology and Resuscitation

What compression depth is recommended for an adult in cardiac arrest?

  1. No more than 1.5 inches (4 cm)
  2. About 1 inch (2.5 cm)
  3. At least 3 inches (7.5 cm)
  4. At least 2 inches (5 cm) Correct answer.

Explanation

Adult compressions should be at least 5 cm (2 inches) deep and no more than about 6 cm (2.4 inches), allowing full chest recoil between compressions. Shallower compressions generate inadequate forward flow, while excessive depth increases the risk of injury.

Question 42Cardiology and Resuscitation

Which rhythms are treated with a defibrillation shock?

  1. VF or pulseless VT Correct answer.
  2. First-degree AV block or sinus bradycardia
  3. Sinus tachycardia or atrial flutter
  4. Asystole or PEA

Explanation

Only ventricular fibrillation and pulseless ventricular tachycardia are shockable; both represent disorganized or rapid ventricular activity that a shock can terminate. Organized rhythms with a pulse are treated with synchronized cardioversion instead, and asystole or PEA are not shockable.

Question 43Cardiology and Resuscitation

Two rescuers are performing CPR on an adult who does not have an advanced airway. What compression-to-ventilation ratio should be used?

  1. 30:2 Correct answer.
  2. 15:2
  3. 10:2
  4. 5:1

Explanation

Adult CPR without an advanced airway uses 30 compressions to 2 ventilations, regardless of whether one or two rescuers are present. Once an advanced airway is placed, compressions become continuous with one breath every 6 seconds.

Question 44Cardiology and Resuscitation

What is the initial IV/IO dose of epinephrine for an adult in cardiac arrest?

  1. 0.1 mg of 1:10,000
  2. 0.5 mg of 1:10,000
  3. 3 mg of 1:10,000
  4. 1 mg of 1:10,000 Correct answer.

Explanation

The standard adult cardiac arrest dose is 1 mg of the 1:10,000 concentration given IV or IO and repeated every 3 to 5 minutes. The 1:10,000 concentration is used because it delivers the dose in a small volume suitable for bolus administration.

Question 45Cardiology and Resuscitation

An adult is unresponsive and pulseless, and the monitor shows a flat line that is confirmed in a second lead. What is the appropriate action?

  1. Give atropine 1 mg IV
  2. Deliver a precordial thump
  3. Start CPR and give epinephrine Correct answer.
  4. Defibrillate at maximum energy

Explanation

Confirmed asystole is a non-shockable rhythm, so management is high-quality CPR with epinephrine 1 mg every 3 to 5 minutes while reversible causes are sought. Shocking asystole provides no benefit and interrupts compressions.

Question 46Cardiology and Resuscitation

A patient has a regular narrow-complex tachycardia at 180/min, is alert, and has a normal blood pressure. What should be attempted first?

  1. Vagal maneuvers Correct answer.
  2. Synchronized cardioversion at 100 J
  3. Amiodarone 150 mg over 10 minutes
  4. Adenosine 6 mg IV push

Explanation

In a stable patient with a regular narrow-complex tachycardia, vagal maneuvers are the first step because they are noninvasive and may terminate AV node-dependent rhythms. Adenosine is used if vagal maneuvers fail, and cardioversion is reserved for instability.

Question 47Cardiology and Resuscitation

A patient is diaphoretic and hypotensive with a heart rate of 42/min, and IV access is established. Which drug is indicated first?

  1. Epinephrine 1 mg IV push
  2. Amiodarone 150 mg IV
  3. Adenosine 6 mg
  4. Atropine 1 mg IV Correct answer.

Explanation

Symptomatic bradycardia is treated first with atropine 1 mg IV, repeated every 3 to 5 minutes to a maximum of 3 mg. If atropine is ineffective, transcutaneous pacing or an epinephrine or dopamine infusion is used.

Question 48Cardiology and Resuscitation

After a manual defibrillator delivers a shock for ventricular fibrillation, what should you do immediately?

  1. Give epinephrine before resuming compressions
  2. Reassess the rhythm for 10 seconds
  3. Resume chest compressions right away Correct answer.
  4. Check the carotid pulse for 10 seconds

Explanation

Compressions are resumed immediately after a shock, beginning with chest compressions, and the rhythm is not rechecked until the next 2-minute cycle ends. This minimizes the hands-off interval and preserves coronary perfusion pressure.

Question 49Cardiology and Resuscitation

What is the initial dose of adenosine for a stable narrow-complex supraventricular tachycardia?

  1. 0.5 mg/kg IV
  2. 1 mg IV push
  3. 12 mg slow IV push
  4. 6 mg rapid IV push Correct answer.

Explanation

Adenosine is given as 6 mg by rapid IV push followed by a saline flush, then 12 mg if the first dose fails. Rapid administration is required because the drug has a half-life of only a few seconds.

Question 50Cardiology and Resuscitation

What is the first dose of amiodarone for ventricular fibrillation that persists after defibrillation and epinephrine?

  1. 2 g IV/IO
  2. 300 mg IV/IO bolus Correct answer.
  3. 1 mg/kg IV/IO
  4. 150 mg over 10 minutes

Explanation

For shock-refractory VF or pulseless VT, amiodarone is given as a 300 mg IV/IO bolus, followed by a second dose of 150 mg if needed. The 150 mg over 10 minutes dose is used for stable ventricular arrhythmias with a pulse.