1. Which of the following is the MOST important intervention to prevent aspiration in a patient receiving mechanical ventilation?
A. Elevating the head of the bed.
B. Providing frequent oral care.
C. Using a cuffed endotracheal tube.
D. Administering proton pump inhibitors.
2. A patient presents with severe respiratory distress, stridor, and use of accessory muscles. What is the MOST appropriate initial intervention?
A. Administering a bronchodilator via nebulizer.
B. Performing immediate endotracheal intubation.
C. Applying continuous positive airway pressure (CPAP).
D. Administering high-flow oxygen via nasal cannula.
3. Which of the following is the MOST important factor in determining the success of resuscitation from cardiac arrest?
A. Administration of antiarrhythmic medications.
B. Early defibrillation.
C. Use of advanced airway techniques.
D. Rapid sequence intubation.
4. A patient with asthma exacerbation is not responding to initial bronchodilator therapy. What is the next appropriate step?
A. Administer antibiotics.
B. Administer intravenous magnesium sulfate.
C. Perform chest physiotherapy.
D. Initiate non-invasive positive pressure ventilation (NIPPV).
5. Which of the following is the MOST common cause of cardiac arrest in children?
A. Primary cardiac arrhythmias.
B. Congenital heart disease.
C. Respiratory failure or shock.
D. Sudden infant death syndrome (SIDS).
6. In the management of hypertensive emergency, what is the target reduction in mean arterial pressure (MAP) during the first hour?
A. No more than 10-20%.
B. No more than 20-30%.
C. No more than 30-40%.
D. No more than 40-50%.
7. A patient in septic shock requires fluid resuscitation. What is the initial fluid of choice?
A. Dextrose 5% in water (D5W).
B. 0.45% normal saline.
C. Albumin.
D. Crystalloid solution (e.g., normal saline or lactated Ringer`s).
8. Which of the following is the MOST reliable method for confirming endotracheal tube placement?
A. Auscultation of bilateral breath sounds.
B. Observation of chest rise.
C. End-tidal CO2 monitoring.
D. Esophageal detector device.
9. Which of the following is the MOST appropriate initial intervention for a patient presenting with pulseless ventricular tachycardia (VT)?
A. Administration of amiodarone.
B. Synchronized cardioversion.
C. Immediate defibrillation.
D. Application of a precordial thump.
10. In the management of acute myocardial infarction, what is the target time from arrival to percutaneous coronary intervention (PCI) in a PCI-capable hospital?
A. 30 minutes.
B. 60 minutes.
C. 90 minutes.
D. 120 minutes.
11. What is the primary goal of therapeutic hypothermia after cardiac arrest?
A. To reduce the risk of infection.
B. To minimize neurological damage.
C. To improve blood pressure control.
D. To prevent shivering.
12. In the management of a tension pneumothorax, what is the IMMEDIATE intervention?
A. Chest tube insertion.
B. Needle thoracostomy.
C. Supplemental oxygen administration.
D. Mechanical ventilation.
13. Which of the following is a contraindication for the use of fibrinolytic therapy in acute ischemic stroke?
A. Blood glucose level of 150 mg/dL.
B. Systolic blood pressure greater than 185 mmHg despite treatment.
C. Onset of symptoms greater than 3 hours but less than 4.5 hours.
D. Age greater than 80 years.
14. A patient presents with altered mental status, diaphoresis, and a blood glucose level of 30 mg/dL. What is the MOST appropriate initial intervention?
A. Administering intravenous insulin.
B. Administering intravenous dextrose.
C. Administering glucagon intramuscularly.
D. Monitoring the patient without intervention.
15. What is the recommended depth of chest compressions for adults during CPR?
A. At least 1 inch (2.5 cm).
B. At least 2 inches (5 cm).
C. At least 3 inches (7.6 cm).
D. At least 4 inches (10 cm).
16. A patient in hypovolemic shock requires fluid resuscitation. If crystalloid fluids are not effective, what is the next appropriate fluid to consider?
A. Dextrose 5% in water (D5W).
B. 0.45% normal saline.
C. Colloid solution (e.g., albumin).
D. Hypertonic saline.
17. A patient with a known history of anaphylaxis is exposed to an allergen. What is the MOST important medication to administer immediately?
A. Diphenhydramine.
B. Albuterol.
C. Epinephrine.
D. Methylprednisolone.
18. What is the preferred method for delivering oxygen to a spontaneously breathing patient with severe hypoxemia?
A. Simple face mask.
B. Nasal cannula.
C. Non-rebreather mask.
D. Venturi mask.
19. Which of the following is a sign of adequate ventilation during bag-mask ventilation?
A. Decreased heart rate.
B. Visible chest rise.
C. Absence of gastric distention.
D. Pupil constriction.
20. A patient presents with signs of opioid overdose. Which medication is the MOST appropriate initial treatment?
A. Flumazenil.
B. Naloxone.
C. Activated charcoal.
D. Gastric lavage.
21. What is the initial dose of epinephrine for the treatment of anaphylaxis in adults?
A. 0.1 mg IM.
B. 0.3 mg IM.
C. 0.5 mg IM.
D. 1.0 mg IM.
22. Which of the following is the MOST common cause of upper airway obstruction in an unconscious patient?
A. Foreign body aspiration.
B. Laryngospasm.
C. The tongue.
D. Epiglottitis.
23. A patient presents with bradycardia and hypotension. Which medication is the MOST appropriate initial treatment?
A. Amiodarone.
B. Atropine.
C. Adenosine.
D. Magnesium sulfate.
24. What is the MOST common early sign of increased intracranial pressure (ICP)?
A. Pupil dilation.
B. Bradycardia.
C. Decreased level of consciousness.
D. Hypertension.
25. A patient with a suspected cervical spine injury requires airway management. Which technique is MOST appropriate for opening the airway?
A. Head-tilt/chin-lift maneuver.
B. Jaw-thrust maneuver.
C. Triple airway maneuver.
D. Suctioning.
26. What is the recommended ratio of compressions to ventilations for adult CPR when performed by a single rescuer?
A. 15:2.
B. 30:2.
C. 30:1.
D. 15:1.
27. What is the target oxygen saturation range for most critically ill patients?
A. 80-85%.
B. 85-90%.
C. 92-96%.
D. 97-100%.
28. A patient is in cardiac arrest. After two minutes of CPR, the rhythm check reveals asystole. According to current ACLS guidelines, what is the next appropriate step?
A. Administer epinephrine 1 mg IV/IO.
B. Administer atropine 1 mg IV/IO.
C. Immediately resume chest compressions.
D. Perform transcutaneous pacing.
29. In the management of a patient with severe traumatic brain injury, what is the target cerebral perfusion pressure (CPP)?
A. 40-50 mmHg.
B. 50-60 mmHg.
C. 60-70 mmHg.
D. 70-80 mmHg.
30. What is the recommended compression rate for adult CPR?
A. 60-80 compressions per minute.
B. 80-100 compressions per minute.
C. 100-120 compressions per minute.
D. 120-140 compressions per minute.
