ACLS EXAM 70 QUESTIONS WITH COMPLETE SOLUTIONS, Exams of Nursing

Download ACLS EXAM 70 QUESTIONS WITH COMPLETE SOLUTIONS and more Exams Nursing in PDF only on Docsity! ACLS EXAM| 70 QUESTIONS| WITH COMPLETE SOLUTIONS Which two rhythms are shockable? correct answer: V-fib and pulseless V-tach How many breaths if someone has an advanced airway (intubated)? correct answer: one breath every 6 seconds What is the goal for depth of compressions? correct answer: At least 2 inches Titrate oxygen to maintain a saturation of correct answer: 94% or greater When would atropine be contraindicated with bradycardia? correct answer: If someone has had a heart transplant, their vagas nerve would have been cut. Atropine works on the vagas nerve. Dose of Epi when given IV infusion for bradycardia if atropine is ineffective correct answer: 2- 10 mcg per minute (titrate to pt response) Dose of Epinephrine for IV infusion for post-cardiac arrest (ROSC) hypotension correct answer: 0.1-0.5 mcg/kg What should you do immediately after ROSC? correct answer: Optimize ventilation and oxygenation Targeted temperature managment correct answer: 32 to 36 degrees C. If patient is unconscious, keep their body temperature during this range for the first 24 hours to preserve neuro function. How do you treat stable tachycardia? correct answer: With medications (Adenosine 6 mg first dose, 12 mg second dose) How do you treat unstable tachycardia? (ex. systolic <90...) correct answer: Synchronized cardioversion Which quality improvement component of systems of care best describes the capture and review of data related to resuscitation education, processes, and outcomes? correct answer: Measurement Which one of the following is an interdependent component of systems of care? correct answer: Structure Which is the max interval you should allow for an interruption in chest compressions correct answer: 10 seconds What is an effect of excessive ventilation? correct answer: Decreased cardiac output What is the recommended next step after a defibrillation attempt? correct answer: Resume CPR, starting with chest compressions How does complete chest recoil contribute to effective CPR? correct answer: Allows maximum blood return to the heart What is an advantage of a systematic approach to patient assessment? correct answer: Reduces the changes of missing important signs and symptoms What is the first step in the systematic approach to patient assesssment? correct answer: Initial impression Which action is part of the secondary assessment of a conscious patient? correct answer: Formulate a differential diagnosis Which is one of the H's and T's that represent a potentially reversible cause of cardiac arrest and other emergency cardiopulmonary conditions? correct answer: Hypothermia What should be the primary focus of the CPR Coach on a resuscitation team? correct answer: To ensure high quality CPR The CPR Coach Role can be blended into which of the following roles? correct answer: The monitor/defibrillator Which of the following is a responsibility of the CPR coach? correct answer: Coordinating compressor switches What is the recommended compression rate for high-quality CPR? correct answer: 100-120 compressions per minute Which best describes the length of time it should take to perform a pulse check during the BLS assessment? correct answer: 5-10 seconds Which is a component of high-quality CPR? correct answer: Depth of a least 2 inches Which component of high-quality CPR directly affects chest compression fraction? correct answer: Interruptions To properly ventilate a patient with a perfusing rhythm, how often do you squeeze the bag? correct answer: Once every 6 seconds Which is an acceptable method of selecting an appropriately sized oropharyngeal airway? correct answer: Measure from the corner of the mouth to the angle of the mandible Which action is likely to cause air to enter the victim's stomach (gastric inflation), during bag- mask ventilation? correct answer: Ventilating to quickly he has a history of gastritis, which was treated 5 years ago. What is your next action? correct answer: Give aspirin 162 to 325 mg to chew 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 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 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 amiodarone correct answer: Amiodarone (Cordarone) is used to treat and prevent an irregular heartbeat. It slows down nerve activity in the heart and relaxes an overactive heart. What is the indication for the use of magnesium in cardiac arrest? correct answer: pulseless ventricular tachycardia-associated torsades de pointes A patient with possible STEMI has ongoing chest discomfort. What is a contraindication to nitrate administration? correct answer: Use of phosphodiesterase inhibitors within the previous 24 hours Phosphodiesterase Inhibitors correct answer: Phosphodiesterase inhibitors are a class of medications that promote blood vessel dilation (vasodilation) and smooth muscle relaxation in certain parts of the body, such as the heart, lungs, and genitals. ex's: sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra). A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Which drug should be administered first? correct answer: Epinephrine 1 mg IV/IO 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 Which intervention is most appropriate for the treatment of a patient in asystole? correct answer: Epinephrine Epinephrine correct answer: Epinephrine is the primary drug used in the cardiac arrest algorithm. It is used for its potent vasoconstrictive effects and also for its ability to increase cardiac output. Epinephrine is considered a vasopressor. 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 Adenosine correct answer: Adenosine is the primary drug used in the treatment of stable narrow-complex SVT (Supraventricular Tachycardia). Now, adenosine can also be used for regular monomorphic wide-complex tachycardia. When given as a rapid IV bolus, adenosine slows cardiac conduction particularly affecting conduction through the AV node. 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 AED correct answer: automated external defibrillator (AED) is a lightweight, portable device that delivers an electric shock through the chest to the heart. The shock can potentially stop an irregular heart beat (arrhythmia) and allow a normal rhythm to resume following sudden cardiac arrest (SCA). defibrillation correct answer: the stopping of fibrillation of the heart by administering a controlled electric shock in order to allow restoration of the normal rhythm. used to treat life threatening conditions that affect the rhythm of the heart such as cardiac arrhythmia, ventricular fibrillation and pulseless ventricular tachycardia. Pulseless ventricular tachycardia correct answer: Pulseless ventricular tachycardia is a life- threatening cardiac arrhythmia in which coordinated ventricular contractions are replaced by very rapid but ineffective contractions, leading to insufficient organ perfusion and heart failure. Atropine correct answer: Atropine is useful for treating symptomatic sinus bradycardia and may be beneficial for any type of AV block at the nodal level. The recommended atropine dose for bradycardiais 0.5 mg IV every 3 to 5 minutes to a maximum total dose of 3 mg. pt in Vfib correct answer: If the patient remains in ventricular fibrillation, pharmacological treatment should begin. Epinephrine is the first drug given and may be repeated every 3 to 5 minutes. If epinephrine is not effective, the next medication in the algorithm is amiodarone 300 mg. defibrillation vs cardioversion correct answer: Defibrillation is nonsynchronized random administration of shock during a cardiac cycle. Cardioversion is a synchronized administration of shock during the R waves or QRS complex of a cardiac cycle. shockable rhythms correct answer: Ventricular Tachycardia(VTACH), Ventricular Fibrillation(VFIB), Supraventricular Tachycardia(SVT) no shock advised: AED edu. correct answer: a "No Shock Advised" message doesn't necessarily mean that the heart rhythm is back to normal; instead, it may mean that the victim is experiencing asystole or pulseless electrical activity; neither of which are treatable by shock. nonshockable rhythms correct answer: Pulseless electrical activity and asystole or flatlining are non-shockable, so they don't respond to defibrillation. Antiarrhythmic drug classes: correct answer: Sodium-channel blockers. Beta-blockers. Potassium-channel blockers. Calcium-channel blockers. Miscellaneous - adenosine. - electrolyte supplement (magnesium and potassium salts) - digitalis compounds (cardiac glycosides)