ACLS Advanced Cardiovascular Life Support Exam Version C, Exams of Nursing

Download ACLS Advanced Cardiovascular Life Support Exam Version C and more Exams Nursing in PDF only on Docsity! ACLS Advanced Cardiovascular Life Support Exam Version C (50 questions)/ CORRECT VERIFIED ANSWERS/ 100% GUARANTEED PASS A concept that helps to promote effective and efficient teamwork and reduce the likelihood of errors is called _____. Select the correct answer to this question. Debriefing Crew resource management Problem solving Critical thinking - ANSWER 3 2 In a six-person high-performance resuscitation team, which tasks are responsibilities of the team members? Select all correct options that apply. Recording key data Sharing pertinent observations Ordering interventions Performing chest compressions Going to the pharmacy for medications - ANSWER 1,2,4 3 Which assessments would be included in a primary assessment? Select all correct options that apply. 1Checking for life-threatening injuries 2Obtaining a medication history 3Obtaining a health history 4Checking airway patency - ANSWER 1,4 When performing high-quality CPR on an adult without an advanced airway in place, what is the correct ratio of compressions to ventilations? Select the correct answer to this question. 15 compressions to 1 ventilation 15 compressions to 2 ventilations 30 compressions to 1 ventilation 30 compressions to 2 ventilations - ANSWER 30:2 When providing high-quality CPR to an adult, what is the proper rate for chest compressions? Select the correct answer to this question. 80 to 100 per minute 100 to 120 per minute 120 to 130 per minute 130 to 140 per minute - ANSWER 100-120bpm Which tasks are responsibilities of the team leader? Select all correct options that apply. Sets clear expectations Leads a debriefing session Assigns roles Administers medications - ANSWER 1,2,3 7 A team leader instructs a team member to perform an intervention. To practice good communication, the team member should do which of the following? Select all correct options that apply. 1.Acknowledge completion of the intervention. 2.Use nonverbal communication methods to indicate follow-through with the intervention. 3.Repeat the task back to the team leader. Closed-loop communication - ANSWER A communication technique used to prevent misunderstandings; the receiver confirms that the message has been received and understood. You use critical thinking when you - ANSWER Obtain an initial impression. Determine a course of action. Anticipate roles and functions as part of a team based on the patient's presentation and condition. Consistently re-evaluate the situation for changes, interpret these changes and apply them to the patient's care and treatment. Modify your actions based on the changes you observe. Team Leader Responsibilities - ANSWER The team leader: Assigns and understands team roles. Sets clear expectations. Prioritizes, directs and acts decisively. Encourages and allows team input and interaction. Focuses on the big picture. Monitors performance while providing support. Acts as a role model. Coaches the team. Re-evaluates and summarizes progress. Leads a debriefing session. Team Member Responsibilities - ANSWER Team members: Have the necessary knowledge and skills to perform their assigned role. Stay in their assigned role but assist others as needed, as long as they are able to maintain their own assigned responsibilities. Communicate effectively with the team leader if they: -Feel they are lacking any knowledge or skills to perform assigned roles. -Identify something that the team leader may have overlooked. -Recognize a dangerous situation or need for urgent action. Share information with other team members. Focus on achieving the goals. Ask pertinent questions and share pertinent observations. Participate in debriefing sessions. Crew Crew Resource Management - ANSWER is a concept that helps to promote effective and efficient teamwork and reduce the likelihood of errors. Crew resource management emphasizes using all available resources (including people, equipment and procedures) to reduce the likelihood of human error and promote effective and efficient teamwork. Crew resource management also guides team members to communicate directly and effectively with the team leader about dangerous or time-critical decisions. When a problem arises, team members must get the attention of the team leader, state their concern, describe the problem as they see it and suggest a solution. The team leader then provides direction, enabling the team to work together to resolve the issue. Six-Person High-Performance Resuscitation Team - ANSWER A typical six-person high-performance resuscitation team includes team members who perform the three CPR/defibrillator roles, as well as team members who perform the three leadership and supportive roles. Data Manager - ANSWER One team member is responsible for communicating and recording key data during the resuscitation effort (for example, data related to medication administration and interruptions to chest compressions). Airway manager and ventilator - ANSWER One team member is responsible for managing the airway and providing ventilations. A trained respiratory therapist, if available, would fill this role. Compressor - ANSWER One team member is responsible for chest compressions. AED/Defibrillator Operator - ANSWER One team member is responsible for managing the AED or defibrillator and for establishing any other monitoring. This team member also relieves the team member who is performing compressions. Team Leader - ANSWER One team member is responsible for prioritizing and directing the other team members' actions. Medication Administrator - ANSWER One team member is responsible for establishing vascular access and administering medications. Assess, Recognize and Care - ANSWER a concept that describes the ongoing process of gathering data about the patient's condition, using that data to identify a problem and then intervening to address the problem. Because an acutely ill patient's condition can change rapidly (for better or for worse), you must continuously assess the patient, recognize what is happening with the patient and provide care accordingly. Assess - ANSWER is the process of gathering the data that help you to determine what is happening with the patient. To ensure that the most pressing problems are addressed first, take a phased, systematic approach to assessment: perform a rapid assessment, a primary assessment and (when the patient's condition allows) a secondary assessment. In an emergency situation, assessment is ongoing. Recognize - ANSWER After you gather assessment data, use critical thinking, your past clinical experience and your general knowledge to correctly interpret the meaning of the data and gain an understanding of the patient's clinical situation and care needs. This understanding enables you to determine your next steps. Care - ANSWER Implement appropriate care based on your understanding of the patient's condition. Proper care cannot be provided without effective assessment and accurate recognition of the patient's condition. Rapid assessment - ANSWER A quick survey to ensure safety; form an initial impression about the patient's condition; and, if the patient appears to be unresponsive, check for responsiveness, breathing and a pulse Auscultate both lungs and over the epigastrium Use capnography or an airway placement confirmation device Look for improved oxygen saturation values on pulse oximetry - ANSWER 2,3,4 When an advanced airway is in use, it is essential to confirm its placement initially, whenever the patient is moved and on an ongoing basis. Correct placement of an advanced airway is verified using both physical assessment (observing for bilateral chest rise and auscultating over the lungs and epigastrium) and a confirmation tool (such as capnography). Fogging in the tube and improved oxygen saturation values on pulse oximetry are not reliable methods of confirming advanced airway placement. 7 The resuscitation team decides to place an advanced airway in a patient who is in cardiac arrest. How should ventilations be provided following placement of the advanced airway? Two ventilations after each set of 30 compressions One ventilation every 6 seconds Two ventilations every 15 seconds One ventilation every 10 seconds - ANSWER 2 When a patient is receiving CPR and an advanced airway is in place, provide 1 ventilation every 6 seconds without pausing compressions. 8 Which assessment could be made during the rapid assessment? The patient's heart rate is irregular. The patient's heart rate is elevated. The patient is diaphoretic. The patient's capillary refill time is decreased. - ANSWER 3 The rapid assessment is a quick survey conducted as you approach the patient to check for safety, gain an initial impression about the patient's condition, and, if the patient appears to be unresponsive, check for responsiveness, breathing and a pulse. Assessing heart rate and rhythm and capillary refill time are assessments that would be carried out as part of the primary assessment. 9 When obtaining a 12-lead ECG, where should the electrodes for the limb leads be placed? Select the correct answer to this question. On the wrists and ankles On the upper arms and on the thighs or calves Under the clavicles and on the lower abdomen On the shoulders and ankles - ANSWER 2 For a 12-lead ECG, the limb electrodes should be placed on the limbs, not the torso. Place the arm electrodes on the upper arms and the leg electrodes on the thighs or calves, avoiding bony areas like the ankles. 10 Which anatomic landmark should be used to ensure proper placement of the precordial electrodes for a 12-lead ECG? The center of the sternum The nipples The angle of Louis (sternal angle) The xiphoid process - ANSWER 3 For proper landmarking when placing the precordial electrodes for a 12-lead ECG, first identify the angle of Louis (sternal angle), which is adjacent to the second rib. Then palpate down along the sternal border to identify the fourth intercostal space. Dont not check fo breathing and pulse for loner than - ANSWER 10 seconds Do not place AED pads over___________ - ANSWER pacemaker Hover hands over chest but do not touch during - ANSWER AED shock Switch compressions every ___ mins - ANSWER 2 A bag ventalition device holds ______mL - ANSWER 700 If capnography is less than 10 there may be probelm with _________ - ANSWER compressions Chest compression fraction - ANSWER The total percentage of time during a resuscitation attempt in which active chest compressions are being performed. needs to be at least 60% with a goal of 80 You should expect to see an ETCO2 value less than ___ in the presence of hyperventilation. Select the correct answer to this question. 35 mmHg 40 mmHg 45 mmHg 50 mmHg - ANSWER 1 2 Which underlying mechanism can lead to hypoxia in a patient with a right shift of the oxygen-hemoglobin dissociation curve? Select the correct answer to this question. Increased affinity for oxygen binding Decreased affinity for oxygen binding Decreased affinity for oxygen offloading Increased affinity for oxygen binding and decreased affinity for oxygen offloading - ANSWER 2 Hyperventilation leads to alkalosis and a _______ shift of the oxygen-hemoglobin dissociation curve. - ANSWER left 4 On rapid assessment, you note that your patient has increased work of breathing, as evidenced by tripod positioning, an inability to speak more than one or two words at a time and diaphoresis. What assessments should you obtain as part of your primary assessment? Airway patency 12-Lead ECG During this phase, "dead space" air (i.e., air in the airways from the bronchioles to the nasal cavity that does not contain carbon dioxide) is exhaled from the body. Respiratory upstroke - ANSWER The phase on the capnography waveform representing the exhalation of air containing carbon dioxide from the alveoli. epresenting air from the alveoli that contains carbon dioxide being exhaled from the body. For most patients, the respiratory upstroke should be nearly vertical. Inspiratory downslope - ANSWER The phase of the capnography waveform representing inhalation. uring this phase, inhalation occurs and the carbon dioxide is rapidly purged from the airways and alveoli. expiratory plateau - ANSWER During this phase, the last of the carbon dioxide- laden air from the most distal alveoli is exhaled from the body. The ETCO2 value is measured at the end of exhalation (point D), which represents the peak level. In a 12-lead ECG, the four limb leads produce views in the frontal plane. What are those views? Select all correct options that apply. V2 aVL I aVR V3 II III aVF - ANSWER 2,3,4,6,7,8 2 What parts of the heart's electrical conduction system play a role in ventricular contraction? Select all correct options that apply. Purkinje fibers Interventricular septum Bundle of His Bundle branches - ANSWER 1,3,4 3 To estimate the atrial rate, count the number of P waves over a 6-second period and multiply by ________. - ANSWER 10 4 A 12-lead ECG reveals a tachyarrhythmia with narrow QRS complexes (< 0.12 second). You would classify this arrhythmia as ________. - ANSWER 5 In third-degree AV block, there is no electrical communication between the atria and ventricles, so there is no relationship between the P waves and the _________. Select the correct answer to this question. QRS complexes ST segments T waves J point - ANSWER 1 In _________, atrial contraction occurs at such a rapid rate that discrete P waves separated by a flat baseline cannot be seen. Select the correct answer to this question. Ventricular tachycardia Atrial flutter Torsades des pointes Atrial fibrillation - ANSWER 2 1 When providing transcutaneous pacing, the appearance of wide QRS complexes and tall, broad T waves after each pacing spike confirms that mechanical capture has been achieved. - ANSWER false In the event of primary pacemaker dysfunction or failure, what part of the heart's conduction system can function as a backup pacemaker? Select the correct answer to this question. Purkinje fibers Left bundle branch Bundle of His Atrioventricular (AV) node - ANSWER 4 3 Sinus bradycardia is identical to normal sinus rhythm, except the rate is less than _____ bpm. Select the correct answer to this question. 60 70 80 90 - ANSWER What is the first-line therapy for an unstable patient with symptomatic bradycardia? Select the correct answer to this question. Lidocaine Magnesium sulfate Amiodarone Atropine - ANSWER 4 6 In third-degree AV block, there is no electrical communication between the atria and ventricles, so there is no relationship between the P waves and the _________. Sinus tachycardia Atrial flutter Atrial fibrillation Ventricular tachycardia - ANSWER 1,2,3 27 Synchronized cardioversion is indicated for the treatment of which arrhythmias? Select all correct options that apply. Atrial fibrillation Asystole Monomorphic ventricular tachycardia with a regular rhythm Pulseless electrical activity (PEA) Atrial flutter - ANSWER 1,3,5 28 In ventricular tachycardia, the QRS complexes are wide, lasting longer than: 90 milliseconds 100 milliseconds 110 milliseconds 120 milliseconds - ANSWER 4 14 A 12-lead ECG shows wide-complex ventricular tachycardia in a stable patient with a pulse. Which of the following may be indicated in the management of this patient? - ANSWER Expert consultation and/or an antiarrhythmic infusion 15 A 12-lead ECG reveals a tachyarrhythmia with narrow QRS complexes (< 0.12 second). You would classify this arrhythmia as ________. - ANSWER SVT (use the three letters not the word)( Which statement about electrocardiography is true? - ANSWER The 5-lead ECG uses 4 limb leads and 1 precordial lead to provide 7 views of the electrical activity of the heart. Which statements are true concerning a flat plateau on a capnogram? - ANSWER Alveolar emptying (exhalation) was complete. The ETCO2 level reached the peak level. A flat expiratory plateau indicates complete exhalation and emptying of carbon dioxide from the alveoli. This means that the ETCO2 reading is accurate and at peak levels. Loss of plateau is an indication of carbon dioxide trapping. Rebreathing is indicated by a rise in the baseline of the capnogram. A flat baseline indicates that the carbon dioxide has been completely purged from the airway. Which signs of possible respiratory compromise would be noted during the rapid assessment? - ANSWER difficulty speaking in complete sentences tripod position agitation During the rapid assessment (sometimes called the "doorway assessment"), you are gathering information about the patient's condition before you acquire a history or perform a physical examination. Signs of respiratory compromise that you may observe during the rapid assessment include difficulty speaking in complete sentences, tripod positioning and agitation. Which actions should be performed as part of the primary assessment of a patient with apparent respiratory compromise? - ANSWER establish pulse oximetry establish capnography establish vascular access Primary survey items include the standard ABCDE approach and some fundamental measurements to help to determine severity. Pulse oximetry and capnography can establish severity and indicate the need for supplemental oxygen, ventilation support or both. If not already in place, vascular access should be established. Obtaining a medical history and ordering diagnostic tests are done as part of the secondary survey.