acls_exam_versionA&B QUESTIONS AND ANSWERS GRADED A+, Exams of Nursing

Download acls_exam_versionA&B QUESTIONS AND ANSWERS GRADED A+ and more Exams Nursing in PDF only on Docsity! acls_exam_versionA&B QUESTIONS AND ANSWERS GRADED A+ acls_exam_versionA&B QUESTIONS AND ANSWERS GRADED A+ ACLS Exam Version A passed with A grade Advanced Cardiovascular Life Support Exam Version A (50 questions) Please do not mark on this exam. Record the best answer on the separate answer sheet. 1. You find an unresponsive patient who is not breathing. After activating the emergency response system, you determine that there is no pulse. What is your next action? A. Open the airway with a head tilt–chin lift. B. Administer epinephrine at a dose of 1 mg/kg. C. Deliver 2 rescue breaths each over 1 second. D. Start chest compressions at a rate of at least 100/min. 2. You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 97%. What assessment step is most important now? A. PETCO2 B. Chest x-ray C. Laboratory testing D. Obtaining a 12-lead ECG 3. What is the preferredmethod of access for epinephrine administration during cardiac arrest in most patients? A. Intraosseous B. Endotracheal C. Central intravenous ACLS Exam Version A D. Peripheral intravenous ACLS Exam Version A 5. You have completed 2 minutes of CPR. The ECG monitor displays the lead II rhythm below, and the patient has no pulse. Another member of your team resumes chest compressions, and an IV is in place. What management step is your next priority? A. Give 0.5 mg of atropine. B. Insert an advanced airway. C. Administer 1 mg of epinephrine. D. Administer a dopamine infusion. 6. During a pause in CPR, you see this lead II ECG rhythm on the monitor. The patient has no pulse. What is the next action? A. Establish vascular access. B. Obtain the patient’s history. C. Resume chest compressions. D. Terminate the resuscitative effort. 7. What is a common but sometimes fatal mistake in cardiac arrest management? A. Failure to obtain vascular access B. Prolonged periods of no ventilations C. Failure to perform endotracheal intubation D. Prolonged interruptions in chest compressions 8. Which action is a component of high-quality chest compressions? A. Allowing complete chest recoil B. Chest compressions without ventilation C. 60 to 100 compressions per minute with a 15:2 ratio ACLS Exam Version A D. Uninterrupted compressions at a depth of 1½ inches ACLS Exam Version A 9. Which action increasesthe chance of successful conversion of ventricular fibrillation? A. Pausing chest compressions immediately after a defibrillation attempt B. Administering 4 quick ventilations immediately before a defibrillation attempt C. Using manual defibrillator paddles with light pressure against the chest D. Providing quality compressions immediately before a defibrillation attempt 10. Which situation BEST describes pulseless electrical activity? A. Asystole without a pulse B. Sinus rhythm without a pulse C. Torsades de pointes with a pulse D. Ventricular tachycardia with a pulse 11. What is the BEST strategy for performing high- quality CPRon a patient with an advanced airway in place? A. Provide compressions and ventilations with a 15:2 ratio. B. Provide compressions and ventilations with a 30:2 ratio. C. Provide a single ventilation every 6 seconds during the compression pause. D. Provide continuous chest compressions without pauses and 10 ventilations per minute. 12. Three minutes after witnessing a cardiac arrest, one member of your team inserts an endotracheal tube while another performs continuous chest compressions. During subsequent ventilation, you notice the presence of a waveform on the capnography screen and a PETCO2 level of 8 mm Hg. What is the significance of this finding? A. Chest compressions may not be effective. B. The endotracheal tube is no longer in the trachea. C. The patient meets the criteria for termination of efforts. D. The team is ventilating the patient too often (hyperventilation). 13. The use of quantitative capnography in intubated patients A. allows for monitoring of CPR quality. B. measures oxygen levels at the alveoli level. C. determines inspired carbon dioxide relating to cardiac output. ACLS Exam Version A C. Administer IV medications only when delivering breaths. D. Continue to use an AED even after the arrival of a manual defibrillator. 19. Which action is included in the BLS Survey? A. Early defibrillation B. Advanced airway management C. Rapid medication administration ACLS Exam Version A D. Preparation for therapeutic hypothermia ACLS Exam Version A 20. Which drug and dose are recommended for the management of a patient in refractory ventricular fibrillation? A. Atropine 2 mg B. Amiodarone 300 mg C. Vasopressin 1 mg/kg D. Dopamine 2 mg/kg per minute 21. What is the appropriate interval for aninterruption in chest compressions? A. 10 seconds or less B. 10 to 15 seconds C. 15 to 20 seconds D. Interruptions are never acceptable 22. Which of the following is a sign of effective CPR? A. PETCO2 ≥10 mm Hg B. Measured urine output of 1 mL/kg per hour C. Patient temperature >32°C (89.6°F) D. Diastolic intra-arterial pressure <20 mm Hg 23. What is the primary purpose of a medical emergency team(MET) or rapid response team (RRT)? A. Identifying and treating early clinical deterioration B. Rapidly intervening with patients admitted through emergency department triage C. Responding to patients during a disaster or multiple-patient situation D. Responding to patients after activation of the emergency response system 24. Which action improves the quality of chest compressions delivered during a resuscitation attempt? A. Observe ECG rhythm to determine depth of compressions. B. Do not allow the chest to fully recoil with each compression. C. Compress the upper half of the sternum at a rate of 150 compressions per minute. D. Switch providers about every 2 minutes or every 5 compression cycles. 25. What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse rate ACLS Exam Version A 26.A patient presents to the emergency department with new onset of dizziness and fatigue. On examination, the patient’s heartrate is 35/min, the blood pressure is 70/50 mm Hg, the respiratoryrate is 22 breaths/min, and the oxygen saturation is 95%. What is the appropriate first medication? A. Atropine 0.5 mg B. Oxygen 12 to 15 L/min C. Epinephrine 0.5 mg D. Aspirin 160 mg chewed 27.A patient presents to the emergency department with dizziness and shortness of breath with a sinus bradycardia of 40/min. The initial atropine dose was ineffective, and your monitor/defibrillator is not equipped with a transcutaneous pacemaker. What is the appropriate dose of dopamine for this patient? A. 2 to 10 mg/min B. 2 to 10 mcg/kg per minute C. 10 to 15 mg/min D. 10 to 15 mcg/kg per minute 28.A patient has sudden onset of dizziness. The patient’s heart rate is 180/min, blood pressure is 110/70 mm Hg, respiratory rate is 18 breaths/min, and pulse oximetry reading is 98% on room air. The lead II ECG is shown below: What is the next appropriate intervention? A. Vagal maneuvers B. Metoprolol 5 mg IV C. Adenosine 6 mg IV D. Normal saline 1 L bolus ACLS Exam Version é American Heart Association. ACLS Exam Version A 29.A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at a rate of 220/min. The patient’s blood pressure is 128/58 mm Hg, the PETCO2 is 38 mm Hg, and the pulse oximetry reading is 98%. There is vascular access at the left internal jugular vein, and the patient has not been given any vasoactive drugs. A 12-lead ECG confirms a supraventricular tachycardia with no evidence of ischemia or infarction. The heart rate has not responded to vagal maneuvers. What is the next recommended intervention? A. Adenosine 6 mg IV push B. Amiodarone 300 mg IV push C. Synchronized cardioversion at 50 J D. Synchronized cardioversion at 200 J 30.You are receiving a radio report from an EMS team en route with a patient who may be having an acute stroke. The hospital CT scanner is not working at this time. What should you do in this situation? A. Contact the patient’s family to see what they would prefer. B. Have the EMS crew choose an appropriate patient disposition. C. Accept the report and provide care within your present capability. D. Divert the patient to a hospital 15 minutes away with CT capabilities. 31.Choose an appropriate indication to stop or withhold resuscitative efforts. A. Arrest not witnessed B. Evidence of rigor mortis C. Patient age greater than 85 years D. No return of spontaneous circulation after 10 minutes of CPR 32.A 49-year-old woman arrives in the emergency department with persistent epigastric pain. She had been taking oral antacids for the past 6 hours because she thought she had heartburn. The initial blood pressure is 118/72 mm Hg, the heart rate is 92/min and regular, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 96%. Which is the most appropriate intervention to perform next? A. Administer oxygen. B. Obtain a 12-lead ECG. C. Evaluate for fibrinolytic eligibility. D. Administer sublingual nitroglycerin. 33.A patient in respiratory failure becomes apneic but ACLS Exam Version A 34.What is the appropriate procedure for endotracheal tube suctioning after the appropriate catheter is selected? A. Suction during insertion but for no longer than 30 seconds. B. Suction the mouth and nose for no longer than 30 seconds. C. Suction during withdrawal but for no longer than 10 seconds. D. Hyperventilate before catheter insertion, and then suction during withdrawal. 35.While treating a patient with dizziness, a blood pressure of 68/30 mm Hg, and cool, clammy skin, you see this lead II ECG rhythm: What is the most appropriate first intervention? A. Aspirin B. Atropine C. Lidocaine D. Nitroglycerin 36.A 68-year-old woman experienced a sudden onset of right arm weakness. EMS personnel measure a blood pressure of 140/90mm Hg, a heart rate of 78/min, a nonlabored respiratory rate of 14 breaths/min, and a pulse oximetry reading of 97%. The lead II ECG displays sinus rhythm. What is the most appropriate action for the EMS team to perform next? A. 12-lead ECG assessment B. Administration of 100% supplementary oxygen C. Cincinnati Prehospital Stroke Scale assessment D. Administration of a low-dose aspirin 37.EMS is transporting a patient with a positive prehospital stroke assessment. Upon arrival in the emergency department, the initial blood pressure is 138/78 mm Hg, the pulse rate is 80/min, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95% on room air. The lead II ECG displays sinus rhythm. The blood glucose level is within normal limits. What intervention should you perform next? ACLS Exam Version A A. Head CT scan B. Transfer to the stroke unit C. Immediate rtPA administration D. Administration of 100% oxygen ACLS Exam Version é American Heart Association. ACLS Exam Version A 43.What is the recommended second dose of adenosine for patients in refractory but stable narrow-complex tachycardia? A. 3 mg B. 6 mg C. 9 mg D. 12 mg 44.What is the usual post–cardiac arrest target range for PETCO2 when ventilating a patient who achieves return of spontaneous circulation (ROSC)? A. 30 to 35 mm Hg B. 35 to 40 mm Hg C. 40 to 45 mm Hg D. 45 to 50 mm Hg 45.Which condition is a contraindication to therapeutic hypothermia during the post–cardiac arrest period for patients who achieve return of spontaneous circulation ROSC? A. Initial rhythm of asystole B. Responding to verbal commands C. Patient age greater than 60 years D. Desire to provide coronary reperfusion (eg, PCI) 46.What is the potential danger of using ties that pass circumferentially around the patient’s neck when securing an advanced airway? A. May interfere with effective ventilation B. Places the patient’s cervical spine at risk C. Obstruction of venous return from the brain D. Does not adequately secure the airway device 47.What is the most reliable method of confirming andmonitoring correct placement of an endotracheal tube? A. 5-point auscultation B. Colorimetric capnography C. Continuous waveform capnography D. Use of esophageal detection devices 48.What is the recommended IV fluid (normal saline or Ringer’s lactate) bolus dose for a patient who achieves ROSC but is hypotensive during the post–cardiac arrest ACLS Exam Version A period? A. 250 to 500 mL B. 500 to 1000 mL ACLS Exam Version A C. 1 to 2 L ACLS Exam Version B LATEST 2023-2024 1 2 Advanced Cardiovascular Life Support Written Exam Version A © 2011 American Heart Association Advanced Cardiovascular Life Support Exam Version B (50 questions) Please do not mark on this exam. Record the best answer on the separate answer sheet. 1. What should be done to minimize interruptions in chest compressions during CPR? A. Perform pulse checks only after defibrillation. B. Continue CPR while the defibrillator is charging. C. Administer IV medications only when breaths are given. D. Continue to use AED even after the arrival of a manual defibrillator. 2. Which condition is an indication to stop or withhold resuscitative efforts? A. Unwitnessed arrest B. Safety threat to providers C. Patient age greater than 85 years D. No return of spontaneous circulation after 10 minutes of CPR 3. After verifying the absence of a pulse, you initiate CPR with adequate bag-mask ventilation. The patient’s lead II ECG appears below. What is your next action? A. IV or IO access B. Endotracheal tube placement C. Consultation with cardiology for possible PCI D. Application of a transcutaneous pacemaker 4. After verifying unresponsiveness and abnormal breathing, you activate the emergency response team. What is your next action? A. Retrieve an AED. ACLS Exam Version A B. Check for a pulse. C. Deliver 2 rescue breaths. D. Administer a precordial thump. ACLS Exam Version A 13. IV/IO drug administration during CPR should be A. given rapidly during compressions. B. administered slowly during the pause for a pulse check. C. given by infusion. D. given before any defibrillation attempts. 14. How often should the team leader switch chest compressors during a resuscitation attempt? A. Every minute B. Every 2 minutes C. Every 3 minutes D. Every 4 minutes 15. Which finding is a sign of ineffective CPR? A. PETCO2 <10 mm Hg B. Patient temperature >32°C (89.6°F) C. Diastolic intra-arterial pressure ≥20 mm Hg D. Measured patient urine output of 1 mL/kg per hour ACLS Exam Version A 16. A team leader orders 1 mg of epinephrine, and a team member verbally acknowledges when the medication is administered. What element of effective resuscitation team dynamics does this represent? A. Clear messages B. Knowing one’s limitations C. Closed-loop communication D. Clear roles and responsibilities 17. How long should it take to perform a pulse check during the BLS Survey? A. 1 to 5 seconds B. 5 to 10 seconds C. 10 to 15 seconds D. 15 to 20 seconds 18. Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. You determine that he is unresponsive and notice that he is taking agonal breaths. What is the next step in your assessment and management of this patient? A. Apply the AED. B. Check the patient’s pulse. C. Open the patient’s airway. D. Check for the presence of breathing. 19. Which treatment or medication is appropriate for the treatment of a patient in asystole? A. Atropine B. Epinephrine C. Defibrillation D. Transcutaneous pacing 20. An AED advises a shock for a pulseless patient lying in snow. What is the next action? A. Place a backboard beneath the patient and administer the shock. B. Move the patient off the snow to bare ground and deliver the shock. C. Remove any snow beneath the patient and then administer the shock. D. Administer the shock immediately and continue as directed by the AED. 21. What is the minimum depth of chest compressions for an adult in cardiac arrest? A. 1 inch B. 1½ inches C. 2 inches D. 2½ inches 27. A 53-year-old man has shortness of breath, chest discomfort, and weakness. The patient’s blood pressure is 102/59 mm Hg, the heart rate is 230/min, the respiratory rate is 16 breaths/min, and the pulse oximetry reading is 96%. The lead II ECG is displayed below. A patent peripheral IV is in place. What is the next action? A. Acquisition of a 12-lead ECG B. Vagal maneuvers C. Procedural sedation D. Immediate defibrillation 28. A 49-year-old man has retrosternal chest pain radiating into the left arm. The patient is diaphoretic, with associated shortness of breath. The blood pressure is 130/88 mm Hg, the heart rate is 110/min, the respiratory rate is 22 breaths/min, and the pulse oximetry value is 95%. The patient’s 12-lead ECG shows ST- segment elevation in the anterior leads. First responders administered 160 mg of aspirin, and there is a patent peripheral IV. The pain is described as an 8 on a scale of 1 to 10 and is unrelieved after 3 doses of nitroglycerin. What is the next action? A. Administer an additional dose of aspirin. B. Administer an additional nitroglycerin tablet. C. Administer high-flow oxygen via an oxygen mask. D. Administer 2 to 4 mg of morphine by slow IV bolus. 29. A 56-year-old man reports that he has palpitations but not chest pain or difficulty breathing. The blood pressure is 132/68 mm Hg, the pulse is 130/min and regular, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95%. The lead II ECG displays a wide-complex tachycardia. What is the next action after establishing an IV and obtaining a 12-lead ECG? A. Administration of IV epinephrine B. Seeking expert consultation C. Procedural sedation D. Synchronized cardioversion 30. A postoperative patient in the ICU reports new chest pain. What actions have the highest priority? A. Administer an IV fluid bolus and obtain arterial blood gas. B. Start dopamine at 2 mcg/kg per minute and obtain a chest x-ray. C. Send blood to the laboratory for chemistry and cardiac enzymes. ACLS Exam Version A D. Obtain a 12-lead ECG and administer aspirin if not contraindicated. 31. An 80-year-old woman presents to the emergency department with dizziness. She now states she is asymptomatic after walking around. Her blood pressure is 102/72 mm Hg. She is alert and oriented. Her lead II ECG is below. After you start an IV, what is the next action? A. Give an IV fluid bolus. B. Give atropine and monitor for changes in mental status. C. Start an epinephrine infusion and titrate to patient response. D. Conduct a problem-focused history and physical examination. 32. What is the recommended oral dose of aspirin for patients suspected of having one of the acute coronary syndromes? A. 2 to 4 mg B. 80 to 120 mg C. 160 to 325 mg D. 400 to 600 mg 33. A responder is caring for a patient with a history of congestive heart failure. The patient is experiencing shortness of breath, a blood pressure of 68/50 mm Hg, and a heart rate of 190/min. The patient’s lead II ECG is displayed below. Which of the following terms best describes this patient? A. Sinus tachycardia B. Perfusing ventricular tachycardia C. Stable supraventricular tachycardia D. Unstable supraventricular tachycardia ACLS Exam Version A 39. A patient in respiratory distress and with a blood pressure of 70/50 mm Hg presents with the following lead II ECG rhythm: What is the appropriate next intervention? A. Defibrillation B. Amiodarone 150 mg IV C. Adenosine 6 mg IV push D. Synchronized cardioversion 40. A patient has a witnessed loss of consciousness. The lead II ECG reveals this rhythm: What is the appropriate next intervention? A. Defibrillation B. Adenosine 6 mg IV push C. Epinephrine 1 mg IV push D. Synchronized cardioversion 41. What is the recommended energy dose for biphasic synchronized cardioversion of atrial fibrillation? A. 50 to 75 J B. 75 to 100 J C. 120 to 200 J D. 200 to 300 J 42. Which of the following is an acceptable method of selecting an appropriately sized oropharyngeal airway (OPA)? A. Estimate by using the size of the patient’s thumb. B. Estimate by using the formula Weight (kg)/8 + 2. C. Measure from the thyroid cartilage to the angle of the mandible. D. Measure from the corner of the mouth to the angle of the mandible. 43. Which is a contraindication to nitroglycerin administration in the management of acute coronary syndromes? A. Heart rate greater than 80/min B. Right ventricular infarction and dysfunction C. Phosphodiesterase inhibitor use more than 72 hours ago D. Systolic blood pressure greater than 100 mm Hg 44. What is the recommended initial intervention for managing hypotension in the immediate period after return of spontaneous circulation (ROSC)? A. Atropine bolus B. Administration of IV or IO fluid bolus C. Placement of a central line to monitor pulmonary wedge pressure D. Phenylephrine hydrochloride titrated to keep systolic blood pressure >100 mm Hg 45. Which is an appropriate and important intervention to perform for a patient who achieves ROSC during an out-of-hospital resuscitation? A. Initiate an antiarrhythmic infusion. B. Transport the patient to a facility capable of performing PCI. C. Replace any supraglottic airway with an endotracheal tube. D. Place a central venous catheter for hemodynamic monitoring. 46. What is the immediate danger of excessive ventilation during the post–cardiac arrest period for patients who achieve ROSC? A. Oxygen toxicity B. Pulmonary hypertension C. Decreased cerebral blood flow D. Ventilation/perfusion mismatch 47. What is the recommended target temperature range for achieving therapeutic hypothermia after cardiac arrest? A. 26C to 28C B. 29C to 31C C. 32C to 34C D. 35C to 37C ACLS Exam Version A 48. What is the recommended duration of therapeutic hypothermia after reaching the target temperature? A. 0 to 12 hours B. 12 to 24 hours C. 24 to 36 hours D. 36 to 48 hours 49. What is the danger of routinely administering high concentrations of oxygen during the post– cardiac arrest period for patients who achieve ROSC? A. Potential oxygen toxicity B. Adverse hemodynamic effects C. Decrease in cerebral blood flow D. Increased intrathoracic pressure 50. What is the recommended dose of epinephrine for the treatment of hypotension in a post– cardiac arrest patient who achieves ROSC? A. 2 to 10 mg/min IV infusion B. 0.1 to 0.5 mcg/kg per minute IV infusion C. 1 mg IV push every 3 to 5 minutes D. 10 mg IV push every 3 to 5 minutes Advanced Cardiovascular Life Support Written Exam Version B © 2011 American Heart Association