AHA ACLS WRITTEN EXAM 2024 QUESTIONS AND DETAILED ANSWERS| GUARANTEED PASS, Exams of Nursing

Download AHA ACLS WRITTEN EXAM 2024 QUESTIONS AND DETAILED ANSWERS| GUARANTEED PASS and more Exams Nursing in PDF only on Docsity! AHA ACLS WRITTEN EXAM 2024 QUESTIONS AND DETAILED ANSWERS| GUARANTEED PASS During your assessment, your patient suddenly loses consciousness. After calling for help and determining that the patient is not breathing, you are unsure whether the patient has a pulse. What is your next action? A. Leave and get an AED. B. Begin chest compressions. C. Deliver 2 quick ventilations. D. Checks the patient's moth for the presence of a foreign body. Correct Answer B. Begin chest compressions. 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. Correct Answer B. 5 to 10 seconds. What is the recommended compression rate for performing CPR? A. 60 to 80 per minute. B. 80 to 100 per minute. C. About 100 per minute. D. 100 to 120 per minute Correct Answer D. 100 to 120 per minute. Which action improves the quality of chest compressions delivered during a resuscitation attempts? 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. Correct Answer D. Switch providers about every 2 minutes or every 5 compression cycles. What is the most reliable method of confirming and monitoring correct placement of an endotracheal tube? A. 5-point auscultation. B, Colorimetric capnography. C. Continuous waveform capnography. D, Use of esophageal detection devices. Correct Answer C. Continuous waveform capnography. What is the proper ventilation rate for a patient who has an advance airway in place? A. 4 breaths per minute. B. 10 breaths per minute. C. 12 breaths per minute. D. 16 breaths per minute. Correct Answer B, 10 breaths per minute. which of the following is a sign of effective CPR? A. PETCO2 >= 10 mm Hg (1.33 kPa). B. Measure urine output of 1 mL/kg per hour. C. Patient temperature > 32 degree C D. Diastolic intra-arterial pressure <20 mm Hg. Correct Answer A. PETCO2 >= 10 mm Hg (1.33 kPa) What is the preferred method of access for epinephrine administration during cardiac arrest in most patients? A. Inraosseous. B. Endotracheal. C. Central intravenous. Which of the following is the recommended first choice for establishing intravenous access during the attempted resuscitation of a patient in cardiac arrest? Correct Answer Antecubital vein What is the recommended first intravenous dose of amiodarone for a patient with refractory ventricular fibrillation? Correct Answer 300mg IV/O drug administration during CPR should be Correct Answer Given rapidly during compressions How often should the team leader switch chest compressors during a resuscitation attempt? Correct Answer Every 2mins Which finding is a sign of ineffective CPR? Correct Answer PETCO2 <10mmHg 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? Correct Answer Closed loop communication How long should it take to perform a pulse check during the BLS Survey? Correct Answer 5 to 10sec 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? Correct Answer Check the px's pulse Which treatment or medication is appropriate for the treatment of a patient in asystole? Correct Answer Epinephrine An AED advises a shock for a pulseless patient lying in snow. What is the next action? Correct Answer Administer the shock immediately and continue as directed by the AED. What is the minimum depth of chest compressions for an adult in cardiac arrest? Correct Answer 2inches A patient with pulseless ventricular tachycardia is defibrillated. What is the next action? Correct Answer Star chest compressions at a rate ot at least 100/min. You have completed your first 2-minute period of CPR. You see an organized, nonshockable rhythm on the ECG monitor. What is the next action? Correct Answer Have a team member attempt to palpate a carotid pulse. Emergency medical responders are unable to obtain a pempheral Iv for a patient in cardiac arrest. What is the next most preferred route for drug administration? Correct Answer IO What is the appropriate rate of chest compressions for an adult in cardiac arrest? Correct Answer Atleast 100/min 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? Correct Answer Divert the patient to a hospital 15 minutes away with CT capabilities. 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? Correct Answer vagal maneuvers 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? Correct Answer Administer 2 to 4 mg of morphine by slow IV bolus. 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? Correct Answer Seeking expert consultation A postoperative patient in the ICU reports new chest pain. What actions have the highest priority? Correct Answer Obtain a 12- lead ECG and administer aspirin if not contraindicated. 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? Correct Answer Conduct a problem-focused history and physical examination. What is the recommended target temperature range for achieving therapeutic hypothermia after cardiac arrest? Correct Answer 32- 34 DEGREES CELSIUS What is the recommended duration of therapeutic hypothermia after reaching the target temperature? Correct Answer 12 to 24 hours What is the danger of routinely administering high concentrations of oxygen during the post- cardiac arrest period for patients who achieve ROSC? Correct Answer Potential oxygen toxicity What is the recommended dose of epinephrine for the treatment of hypotension in a post- cardiac arrest patient who achieves ROSC? Correct Answer 0.1 to 0.5 mcg/kg per minute IV infusion What is the indication for the use of magnesium in cardiac arrest? Correct Answer pulseless ventricular tachycardia-associated with torsades de pointes A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a total dose of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is confused, and her blood pressure is 88/56 mm Hg. Which therapy is now indicated? Correct Answer epinephrine 2 to 10 mcg/min You are caring for a 66-year-old man with a history of a large intracerebral hemorrhage 2 months ago. He is being evaluated for another acute stroke. The CT scan is negative for hemorrhage. The patient is receiving oxygen via nasal cannula at 2 L/min, and an IV has been established. His blood pressure is 180/100 mm Hg. Which drug do you anticipate giving to this patient? Correct Answer aspirin A patient is in refractory ventricular fibrillation and has received multiple appropriate defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of amiodarone 300 mg IV. The patient is intubated. Which best describes the recommended second dose of amiodarone for this patient? Correct Answer 150 mg IV push You arrive on the scene with the code team. High-quality CPR is in progress. An AED has previously advised "no shock indicated." A rhythm check now finds asystole. After resuming high-quality compressions, which action do you take next? Correct Answer establish IV or IO access A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min. He is asymptomatic, with a blood pressure of 110/70 mm Hg. He has a history of angina. What action is recommended next? Correct Answer seeking expert consultation A patient is in cardiac arrest. High-quality chest compressions are being given. The patient is intubated, and an IV has been started. The rhythm is asystole. What is the first drug/dose to administer? Correct Answer epinephrine 1mg IV/IO A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a blood pressure of 80/60 mm Hg. What is the initial dose of atropine? Correct Answer 1 mg 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 in the left arm, 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 your next action? Correct Answer administer adenosine 6 mg IV push A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been given. Which drug should be given next? Correct Answer Amiodarone 300 mg A 62-year-old man suddenly experienced difficulty speaking and left-sided weakness. He meets initial criteria for fibrinolytic therapy, and a CT scan of the brain is ordered. Which best describes the guidelines for antiplatelet and fibrinolytic therapy? Correct Answer hold aspirin for at least 24 hours if rtPA is inititated A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia. The monitor shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been effective in terminating the rhythm. An IV has been established. Which drug should be administered? Correct Answer adenosine 6 mg A patient with possible STEMI has ongoing chest discomfort. What is a contraindication to nitrate administration? Correct Answer use of phosphodiesterase inhibitor within the previous 24 hours In which situation does bradycardia require treatment? Correct Answer hypotension A patient is in refractory ventricular fibrillation. High-quality CPR is in progress. One dose of epinephrine was given after the second shock. An antiarrhythmic drug was given immediately after the third shock. You are the team leader. Which medication do you order next? Correct Answer epinephrine 1 mg What is a team leaders first responsibility Correct Answer managing the team - clear roles and responsibilities What is ventilation rate and frequency for the adult patient with a pulse? What happens to the heart rate in a patient with severe hypoxia? (respiratory arrest) Correct Answer w/ pulse = rescue breathing, 1 breath every 6 seconds, 10 breaths per minute hypoxia - bradycardia initially What type of patient requires oral pharyngeal airway? When is it appropriate to place? Correct Answer unconscious/unresponsive no gag reflex After ROSC, what is the target PETCO2 reading? Correct Answer 35-45 mmHg What is the ventilation rate on the pulseless patient after advanced airway placement? Do you pause compressions during ventilation with ETT? Correct Answer (no advanced airway 30:2) advanced airway - 1 breath every 6 seconds, 10 times per minute Agonal breathing may indicate what? Correct Answer cardiac arrest (brainstem breathing) (ex: almost dead fish breathing on the dock) (ON TEST) What is the easiest way to open the airway of a patient who isnt breathing? Correct Answer least intrusive - head tilt chin lift intrusive - (c spine injury or unsure) jaw thrust Correct treatments for unstable bradycardia Correct Answer APP A - atropine, 1 mg q3-5 mins up to 3 mg, anticholinergic med working on parasympathetic side therefore competitive antagonist - normalizes HR (unresolved vagal tone) P - pacing, transcutaneous (pads placed on chest, same as defibrillation placement) P - pressers, epi 2-10 mcg/min, DA 5-20 mcg/kg/min, they are equal and accomplish same goal (faster and safer = DA per instructor, premixed) (epi grows bacteria if pre mixed, has to be mixed during code) What is true about PR interval in second degree type 2 block? Correct Answer consistent PR, every P wave is there but they dont always have QRS What is true about PR interval in second degree type 1 block? Correct Answer continuing prolongation, longer longer longer drop now you have a Weinkibach Relationship between the p wave and QRS in 3rd degree or complete heart block Correct Answer there is no relationship, they are working independently from each other What is the most common cause of bradycardias? Correct Answer hypoxia What is the preferred med route for pulseless pt? 2nd choice? Correct Answer IV - antecubital fossa IO is second choice - same fluid rate as a central line When during the CPR cycle should meds be given? Correct Answer while youre doing chest compressions, early during the cycle! Need to be early to circulate the meds through the circulatory system What is the first drug all pulseless patients get? Dose? Correct Answer epinephrine 1 mg every 3-5 mins What is the second drug given for pulseless VT or VF rhythms, dose, freq Correct Answer amiodarone 300 mg 1st, 150 mg 2nd, 3-5 mins inbetween max - 450 mg IV push, half life 2 mths OR lidocaine 1-1.5 mg/kg, every 5 mins, give 1/2 dose again, but dont exceed 3mg/kg in total What antiarryhtmic is recommended for polymorphic VT or torsades, dose Correct Answer magnesium sulfate 1-2 g in D5W 5-20 mins drip realistically placed in syringe and pushed, IVP (real life 2 g push) What diagnostic tool should we use to first screen stable SVT, what is the recommended treatment for stable SVT, unstable SVT? Correct Answer diagnostic stable VT - 12 lead EKG tx stable VT - drugs (adenosine 6 mg (dx), then 12 mg (therapeutic) if not working, then non dihydro CCB) vagal maneuver (face in bucket of cold water, asking patient to bear down - blow through coffee stir straw) tried adenosine, tried vagal maneuvers - seek expert consult tx unstable VT - synchronized cardioversion 100 J What is the recommended treatment for stable VT with a pulse? For unstable VT with a pulse? Correct Answer stable VT - meds (amiodarone 150 mg bolus in 100 mL of D5 over 10 mins, can repeat over 10 mins, maintenance 1 mg per min for 6 hours) unstable VT - synchronized cardioversion at 100 J What is the first treatment option for all unstable bradycardias and blocks? Correct Answer atropine 1 mg every 3-5 mins, max 3 mg How is closed loop communication used in med admin during a code? What to do if told to give wrong dose/med? Correct Answer If a patient is non responsive or not following commands what is the recommended treatment and for how long? What is the target temp range? Correct Answer TTM 32-36 C at least 24 hrs If the 12 lead ECG shows ST elevation what is the tx plan? Correct Answer OANM ultimate goal PCI Excessive (hyper) ventilation can lead to what? Correct Answer decreased cerebral perfusion and decreased CO After ROSC what is the risk of extended over oxygenation Correct Answer O2 toxicity If out of hospital arrest what kind of hospital should patient be transported to Correct Answer PCI capable (cath lab) What electric therapy can be used for unstable bradycardia? Correct Answer transcutaneous pacing Synch cardioversion can be used on what rhythms and what joules for each? Correct Answer unstable tachys everything 100J, afib is the exception 200J defibrillation is actually unsynchronized cardioversion Safe defibrillation includes what steps Correct Answer eyes on patient visualize clear verbally clear when you hear clear put up JAZZ HANDS! What should your action be immediately following defibrillation Correct Answer high quality chest compressions Can an AED be used on a patient who is lying in the snow Correct Answer yes How often should we defib a patient that remain in pulseless VT or VF? Should we ever delay defib to give meds? Correct Answer every 2 mins NO What is the purpose of a rapid response team Correct Answer early identification of clinical deterioration and early treatment of clinically unstable patient (KNOW) Where in the rhythm is the shock delivered in synchronized cardioversion Correct Answer peak of R wave What is the door to reperfusion time in STEMI Correct Answer 90 minutes What is MONA (OANM)? Doses Correct Answer O - O2, 94% (ACS 90% - avoid O2 toxic before reperfusion), 2L nasal cannula if needed A - ASA 162-325 mg chewed non enteric coated N - NTG 0.4 mg SL spray or dissolving pills, up to 3x, be careful about BP (vasodilator) (contraindications - hypotension, PDE5i w/in 24 hrs or 48 hrs ER, right sided infarct-need adequate systemic BP, right side EKG to determine) M - morphine, dont need if ASA and NTG manage pain, only if pain is not managed What assessment tool is a priority in patient's with chest pain Correct Answer 12 lead EKG What are the contraindications to NTG admin in patients with chest pain Correct Answer contraindications - hypotension, PDE5i w/in 24 hrs or 48 hrs ER, right sided infarct-need adequate systemic BP, right side EKG to determine What are the contraindications to ASA Correct Answer bleeding of some kind (ex - ulcers, brain bleed, etc.) What is common symptom of ACS Correct Answer ACS - chest pain and SOB (same for MI) What is the difference between stable and unstable angina? Correct Answer BP What is the most important info needed on a patient with stroke symptoms? Correct Answer time of symptom onset What is the window of opportunity for fibrinolytic therapy in the CVA patient? Correct Answer 3-4.5 hours What is the adult suspected stroke algorithim? Who uses it? Correct Answer B - balance E - eyes tracking F - facial droop A - arm drift S - slurred speech T - time of symptoms onset Why must non contrast head CT be done ASAP on patients with stroke symptoms, how soon should it be done and if the hospital doesnt have a working CT what should you do Correct Answer r/o hemorrhagic stroke needs to be done within 20 mins if not working CT - need to be transferred