TL;DR
Study cardiac assessment techniques, pathophysiology, and emergency management of cardiovascular conditions. Cardiology is one of the most heavily weighted domains on the NREMT Paramedic Certification.
Free Cardiac Rhythms & Dysrhythmias Practice Questions
NREMT Paramedic Certification · Cardiology & Electrophysiology
This module covers Cardiac Rhythms & Dysrhythmias as part of the Cardiology & Electrophysiology section, testing your understanding of core concepts and their practical application.
| Exam | NREMT Paramedic Certification |
| Pass Rate | 67% |
| Duration | 150 minutes |
| Module | Cardiac Rhythms & Dysrhythmias |
Why Cardiac Rhythms & Dysrhythmias matters
Cardiac Rhythms & Dysrhythmias is a high-weight exam domain because cardiovascular emergencies are time-critical and require immediate recognition.
Sample Practice Questions (5)
1. A patient with second-degree AV block Type II develops sudden hemodynamic instability with a ventricular rate of 30 bpm. You administer atropine 0.5 mg IV with no effect. What is the MOST appropriate next intervention?
- Initiate transcutaneous pacing immediately
- Administer a second dose of atropine 0.5 mg and wait
- Administer adenosine 6 mg rapid IV push
- Perform synchronized cardioversion at 100 joules
2. A patient's monitor shows a wide-complex tachycardia where the QRS morphology continuously changes axis, creating a "twisting" appearance around the baseline. The rate is approximately 200 bpm. This rhythm is:
- Torsades de Pointes (polymorphic VT associated with prolonged QT)
- Monomorphic ventricular tachycardia
- Atrial fibrillation with WPW
- Ventricular fibrillation
3. A cardiac arrest patient has been in asystole for the past 15 minutes despite high-quality CPR and two doses of epinephrine. The monitor appears to show very fine fibrillatory activity. What is the MOST appropriate action?
- Confirm the rhythm in a second lead; if it remains flat or near-flat, continue treating as asystole
- Defibrillate immediately as this is fine VF
- Increase the monitor gain and defibrillate if the amplitude increases
- Administer amiodarone 300 mg IV for the fibrillatory activity
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Start practicing free →4. A patient with a history of implanted pacemaker presents with dizziness and a heart rate of 35 bpm. The monitor shows native P waves at 75 bpm with no pacemaker spikes visible. This indicates:
- Pacemaker failure to sense and/or capture — the device is not functioning properly
- The pacemaker is working correctly in demand mode
- The patient's intrinsic rhythm has overridden the pacemaker
- Normal pacemaker function with appropriate rate response
5. A patient has a wide-complex regular tachycardia at 150 bpm. You note AV dissociation with more QRS complexes than P waves, fusion beats, and capture beats on the rhythm strip. These findings confirm:
- Ventricular tachycardia
- SVT with aberrant conduction
- Atrial flutter with bundle branch block
- Accelerated idioventricular rhythm
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