ACLS Final Exam Questions & Answers 2024, Exams of Nursing

Download ACLS Final Exam Questions & Answers 2024 and more Exams Nursing in PDF only on Docsity! ACLS Final Exam Questions & Answers 2024 ACLS Final Exam Questions & Answers 2024 A patient with suspected acute coronary syndromes (ACS) is placed on a cardiac monitor. The patient is complaining of dyspnea and is given supplemental oxygen. The provider determines that the oxygen is effective based on which SaO2 level? When a patient presents with potential ACS, the patient should have oxygen administered to maintain an SaO2 of at least 94%. tator. The development of which condition during A patient experiences cardiac arrest, and the resuscitation team initiates ventilations using a bag-valve-mask (BVM) resusci the provision of care would lead the team to suspect that improper BVM technique is being used? Complications can occur with the use of a BVM resuscitator due to improper technique . Delivering excessive volume or ventilating too fast creates excessive pressure that can damage the airways, lungs and other organs. Excessive volume can lead to tension pneumothorax. saturation (SaO2) of which condition? A healthcare prov ventilations are adequate bas End- ventilation. shortness of breath." Cardi separated by a flat baseline c atrial impulses, the AV nod Ratios of 3:1 and 4:1 are al A systematic responsiveness Assessment of a patient reveals an ETCO2 level of 55 mmHg and an arterial oxygen level of 88%. The provider would interpret these findings as indicative An SaO2 level of less than 90% (PaO2 of less than 50 mmHg) accompanied by ETCO2 values greater than 50 mmHg is indicative of respiratory failure. ider initiates ventilations to ensure adequate breathing and oxygenation. While ventilations are being performed, capnography is established to evaluate the adequacy of the ventilations. The healthcare provider determines that ed on which end-tidal carbon dioxide (ETCO2) value? tidal carbon dioxide values in the range of 35 to 45 mmHg confirm adequacy of A patient comes to the emergency department complaining of palpitations and "some ac monitoring is initiated and reveals the following ECG rhythm strip. The provider interprets this strip as indicating which arrhythmia? In atri l flutter, atrial contraction occurs at such a rapid rate that discrete P waves annot be seen on the strip. Instead, the baseline continually rises and falls, producing the "flutter" waves. In leads II and III, the flutter waves may be quite prominent, creating a "sawtooth" pattern. Because of the volume of e allows only some of the impulses to pass through to the ventricles. In atrial flutter, a 2:1 ratio is the most common (i.e., for every two flutter waves, only one impulse passes through the AV node to generate a QRS complex). so frequently seen. A person suddenly collapses while sitting in the sunroom of a healthcare facility. A healthcare provider observes the event and hurries over to assess the situation. The healthcare provider performs which assessment first? approach to assessment is necessary. The healthcare provider should first p rform a rapid assessment. A rapid assessment is a quick visual survey to ensure safety, to form an initial impression about the patient's condition, and to check for , breathing and a pulse if the patient appears to be unresponsive. This would be followed by a primary assessment and then a secondary assessment. A 35-year-old female patient's ECG is consistent with STEMI. The ECG reveals a new ST-segment elevation at the J point in leads V2 and V3 of at least which size? New ST-segment elevation at the J point in leads V2 and V3 of at least 0.15 mV (1.5 mm) in women 40 years or younger is considered diagnostic of STEMI. An ECG strip of a patient in the emergency department reveals the following rhythm. Which feature would the healthcare provider interpret as indicating atrial fibrillation? The shown in the following figure. Which agent would the team most likely administer? The ECG strip is showing bradycardia. Atropine is an anticholinergic drug that increases sinoatrial node firing by counteracting vagus nerve action to increase the heart rate. It is the first-line therapy for symptomatic bradycardia. A 0.5-mg bolus is given intravenously every 3 to 5 minutes, up to a maximum dose of 3 mg. The ECG rhythm strip of a patient who arrived in the emergency department complaining of dizziness, syncope and shortness of breath reveals sinus bradycardia. When reviewing the patient's medication history, the healthcare provider identifies which agent(s) as a potential cause of the patient's current condition? Medications associated with causing sinus bradycardia include β-blockers such as metoprolol and calcium channel blockers such as verapamil and digoxin. The emergency department team is providing care to a patient who is experiencing ventricular tachycardia. The patient's serum electrolyte levels are a contributing cause of the patient's current condition. Which electrolyte imbalance(s) would most likely be involved? Although ventricular tachycardia usually occurs in the presence of heart disease or damage, electrolyte derangements, including hypocalcemia, hypomagnesemia and hypokalemia, can also be involved. A patient experiencing an unstable bradyarrhythmia does not respond to atropine or transcutaneous pacing. Which intervention would the healthcare provider use next? Epinephrine or dopamine may be administered to patients with symptomatic bradycardia if atropine and transcutaneous pacing are not effective. A patient's ECG reveals a tachyarrhythmia. The patient is hemodynamically stable and has a heart rate ranging from 120 to 135 beats per minute. Based on the findings of the secondary assessment, which statement(s) by the patient would the team interpret as a possible contributing cause? If the heart rate is between 100 and 150 beats per minute, the underlying cause is most likely a systemic one, such as anxiety, dehydration or infection. That condition is treated first. If the heart rate is 150 beats per minute or more, the tachycardia is likely caused by a cardiac condition, rather than a systemic one. A patient's ECG reveals a narrow QRS complex with a regular rhythm, indicating a narrow-complex supraventricular tachyarrhythmia. The patient is hemodynamically stable. Which intervention would be initiated first? For a patient who is hemodynamically stable and experiencing a narrow-complex supraventricular tachyarrhythmia, vagal maneuvers are attempted first. If ineffective, adenosine is given. A patient in the telemetry unit is stable. Cardiac monitoring indicates the patient has ventricular tachycardia with a pulse. Further assessment reveals that the corrected QT interval is greater than 0.46 seconds. Which treatment would be appropriate at this time? For a patient with ventricular tachycardia who is stable, has a pulse and has a corrected QT interval greater than 0.46 seconds, synchronized cardioversion is the recommended treatment. A patient is brought into the emergency department. The patient does not have a pulse. The cardiac monitor shows the following rhythm. The team interprets this as which condition? The cardiac monitor reveals ventricular tachycardia. In pulseless ventricular tachycardia, the ventricular rate is usually greater than 180 beats per minute, and the QRS complexes are very wide. A patient with acute renal failure experiences cardiac arrest. Just before the cardiac arrest, the patient's ECG showed peaked T waves. What might be causing the patient's cardiac arrest? Suspect hyperkalemia in all patients with acute or chronic renal failure who exhibit a wide-complex ventricular rhythm or tall, peaked T waves on an ECG before cardiac arrest. A member of the resuscitation team is preparing to defibrillate a patient in cardiac arrest using a biphasic defibrillator. The team member would set the energy dose according to the manufacturer's recommendations, which is usually: When using a biphasic defibrillator, the energy dose should be set at 120 to 200 joules. A member of the resuscitation team is preparing to administer medications intravenously to a patient in cardiac arrest. The team member follows each medication administration with a bolus of fluid. How much would the team member give? When administering medications during a cardiac arrest, all medications administrated through the IV or intraosseous infusion route should be followed by a 10 to 20 mL fluid bolus. A 30-year-old patient has been brought to the emergency department in full cardiac arrest. The cardiac monitor shows the following rhythm. Interpretation of this rhythm would suggest which of the following as a possible precipitating factor? The rhythm is ventricular fibrillation. Precipitating causes of ventricular fibrillation include electrocution, myocardial ischemia or infarction, shock, stimulant overdose and ventricular tachycardia. Cardiac monitoring of a patient in cardiac arrest reveals ventricular fibrillation. What intervention would the team perform next? The cardiac monitor is showing ventricular fibrillation, which is a shockable rhythm; therefore, the treatment is to administer 1 shock and then resume CPR. Medications are a secondary intervention. Advanced airway and capnography are delayed until at least 2 shocks have been given. The resuscitation team suspects that hyperkalemia is the cause of cardiac arrest in a patient brought to the emergency department. Which finding on a 12-lead ECG would confirm this suspicion? In hyperkalemia the patient's 12-lead ECG rhythm strip will show wide-complex ventricular rhythm or tall, pointed T waves. A patient has experienced return of spontaneous circulation (ROSC) after cardiac arrest. The healthcare team is conducting a secondary assessment to determine the possible cause of the patient's cardiac arrest. Before the arrest, the patient exhibited jugular venous distension, cyanosis, apnea and hyperresonance on percussion. The patient was also difficult to ventilate during the response. The team would most likely suspect which condition as the cause? Prearrest signs of tension pneumothorax in the advanced stage include jugular venous distension, cyanosis, apnea and hyperresonance on percussion. Difficulty ventilating the patient may also be a sign of tension pneumothorax. A patient in cardiac arrest experiences return of spontaneous circulation. As part of post-cardiac arrest care, the patient is receiving mechanical ventilation. Which finding(s) would indicate the need for change in the ventilator settings to optimize the patient's