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 Advanced Cardiovascular Life Support Exam Questions And Answers 2024 ACLS Final Exam Advanced Cardiovascular Life Support Exam Questions And Answers 2024 1. In which situation does bradycardia require treatment? -Ans| >> Hypotension 2. Which intervention is most appropriate for the treatment of a patient in asystole? Ans| >> Epinephrine 3. 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? Ans| >> Establish IV or IO access 4. 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 38mm 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 12lead ECG confirm a supraventricular tachycardia with no evidence of ischemia or infarction. The heart rate has not responded to vagal maneuvers. what is your next action? -Ans| >> Administer adenosine 6mg IV push 5. A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a total does 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? -Ans| >> Epinephrine 2 to 10 mcg/min 6. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Which drug should be administered first? -Ans| >> Epinephrine 1 mg IV/IO 7. 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 si ordered. Which best describes the guidelines for antiplatelet and fibrinolytic therapy? -Ans| >> Hold aspirin for at least 24 hours if rtPA is administered 8. 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 300mg IV. The patient is intubated. Which best describe the recommended second does of amiodarone for this patient? -Ans| >> 150 mg IV push Prof.Exams 9. A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a blood pressure of 80/60mm Hg. What is the initial does of atropine? -Ans| >> 0.5mg 10. 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? -Ans| >> Adenosine 6mg 11. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. If no pathway for medication administration is in place, which method is preferred? -Ans| >> IV or IO 12. What is the indication for the use of magnesium in cardiac arrest? -Ans| >> Pulseless ventricular tachycardia-associated torsades de pointes 13. 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? -Ans| >> Seeking expert consultation 14. 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? -Ans| >> Epinephrine 1mg IV/IO 15. A patient is in refractory ventricular fibrillation. High-quality CPR is in progress. One does 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. -Ans| >> Epinephrine 1 mg 16. A patient with possible STEMI has ongoing chest discomfort. What is a contraindication to nitrate administration? -Ans| >> Use of a phosphodiestrase inhibitor within the previous 24 hours 17. A 57-year-old woman has palpitation, chest discomfort, and tachycardia. The monitor shows a regular wide-QRS at a rate of 180/min. She becomes diaphoretic, and her blood pressure is 80/60 mm HG/ Which action do you take next? -Ans| >> Perform electrical cordioversion 18. A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and a heparin infusion of 1000 units per hour are being administered. The patient did not take aspirin because he has a history of gastritis, with was treated 5 years ago. What is your next action? -Ans| >> Give aspirin 160-325 mg to chew Prof.Exams 38. A patient becomes unresponsive. You are uncertain if a faint pulse is present. They rhythm shown here is seen on the cardiac monitor. An IV is in pace. Which action do you take next? -Ans| >> Start high-quality CPR 39. A patient has been resuscitated from cardiac arrest. During post-ROSC treatment, the patient becomes unresponsive, with the rhythm shown here. Which action is indicated next? -Ans| >> Give an immediate unsynchronized high-energy shock (defibrillation dose) 40. How often should you switch chest compressors to avoid fatigue? -Ans| >> About every 2 minutes 41. You find an unresponsive pt. who is not breathing. After activating the emergency response system, you determine there is no pulse. What is your next action? -Ans| >> Start chest compressions of at least 100 per min. 42. 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? -Ans| >> Obtaining a 12 lead ECG. 43. What is the preferred method of access for epi administration during cardiac arrest in most pts? -Ans| >> Peripheral IV 44. An AED does not promptly analyze a rythm. What is your next step? -Ans| >> Begin chest compressions. 45. 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? Ans| >> Administer 1mg of epinephrine 46. 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? -Ans| >> Resume compressions 47. What is a common but sometimes fatal mistake in cardiac arrest management? - Ans| >> Prolonged interruptions in chest compressions. 48. Which action is a componant of high-quality chest comressions? -Ans| >> Allowing complete chest recoil Prof.Exams 49. Which action increases the chance of successful conversion of ventricular fibrillation? -Ans| >> Providing quality compressions immediately before a defibrillation attempt. 50. Which situation BEST describes pulseless electrical activity? -Ans| >> Sinus rythm without a pulse 51. What is the BEST strategy for performing high-quality CPR on a patient with an advanced airway in place? -Ans| >> Provide continuous chest compressions without pauses and 10 ventilations per minute. 52. 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? Ans| >> Chest compressions may not be effective. 53. The use of quantitative capnography in intubated patients -Ans| >> allows for monitoring of CPR quality. 54. For the past 25 minutes, an EMS crew has attempted resuscitation of a patient who originally presented in ventricular fibrillation. After the first shock, the ECG screen displayed asystole, which has persisted despite 2 doses of epinephrine, a fluid bolus, and high-quality CPR. What is your next treatment? -Ans| >> Consider terminating resuscitive efforts after consulting medical control. 55. Which is a safe and effective practice within the defibrillation sequence? -Ans| >> Be sure oxygen is not blowing over the patient's chest during the shock. 56. 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? -Ans| >> Begin chest compressions. 57. What is an advantage of using hands-free defibrillation pads instead of defibrillation paddles? -Ans| >> Hands-free pads allow for a more rapid defibrillation. 58. What action is recommended to help minimize interruptions in chest compressions during CPR? -Ans| >> Continue CPR while charging the defibrillator. 59. Which action is included in the BLS survey? -Ans| >> Early defibrillation Prof.Exams 60. Which drug and dose are recommended for the management of a patient in refractory ventricular fibrillation? -Ans| >> Amioderone 300mg 61. What is the appropriate interval for an interruption in chest compressions? -Ans| >> 10 seconds or less 62. Which of the following is a sign of effective CPR? -Ans| >> PETCO2 ≥10 mm Hg 63. What is the primary purpose of a medical emergency team (MET) or rapid response team (RRT)? -Ans| >> Identifying and treating early clinical deterioration. 64. Which action improves the quality of chest compressions delivered during a resuscitation attempt? -Ans| >> Switch providers about every 2 minutes or every 5 compression cycles. 65. What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse rate of 80/min? -Ans| >> 1 breath every 5-6 seconds 66. A patient presents to the emergency department with new onset of dizziness and fatigue. On examination, the patient's heart rate is 35/min, the blood pressure is 70/50 mm Hg, the respiratory rate is 22 breaths/min, and the oxygen saturation is 95%. What is the appropriate first medication? -Ans| >> Atropine 0.5mg 67. A patient 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? -Ans| >> 2 to 10 mcg/kg per minute 68. 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: -Ans| >> Vagal manuever. 69. 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 Prof.Exams 88. hat 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 period? -Ans| >> 1 to 2 Liters 89. What is the minimum systolic blood pressure one should attempt to achieve with fluid, inotropic, or vasopressor administration in a hypotensive post-cardiac arrest patient who achieves ROSC? -Ans| >> 90mm Hg 90. What is the first treatment priority for a patient who achieves ROSC? -Ans| >> Optimizing ventilation and oxygenation. 91. What should be done to minimize interruptions in chest compressions during CPR? Ans| >> Continue CPR while the defibrillator is charging. 92. Which condition is an indication to stop or withhold resuscitative efforts? -Ans| >> Safety threat to providers 93. 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? - Ans| >> IV or IO access 94. After verifying unresponsiveness and abnormal breathing, you activate the emergency response team. What is your next action? -Ans| >> Check for a pulse. 95. What is the recommendation on the use of cricoid pressure to prevent aspiration during cardiac arrest? -Ans| >> Not recommended for routine use 96. What survival advantages does CPR provide to a patient in ventricular fibrillation? Ans| >> Produces a small amount of blood flow to the heart 97. What is the recommended compression rate for performing CPR? -Ans| >> At least 100 per minute 98. EMS personnel arrive to find a patient in cardiac arrest. Bystanders are performing CPR. After attaching a cardiac monitor, the responder observes the following rhythm strip. What is the most important early intervention? -Ans| >> defibrillation 99. A patient remains in ventricular fibrillation despite 1 shock and 2 minutes of continuous CPR. The next intervention is to -Ans| >> administer a second shock. Prof.Exams 100. What is the recommended next step after a defibrillation attempt? -Ans| >> Begin CPR, starting with chest compressions. 101. Which of the following is the recommended first choice for establishing intravenous access during the attempted resuscitation of a patient in cardiac arrest? Ans| >> Antecubital vein 102. Which finding is a sign of ineffective CPR? -Ans| >> PETCO2 <10 mm Hg 103. How often should the team leader switch chest compressors during a resuscitation attempt? -Ans| >> . Every 2 minutes 104. IV/IO drug administration during CPR should be -Ans| >> given rapidly during compressions 105. What is the recommended first intravenous dose of amiodarone for a patient with refractory ventricular fibrillation? -Ans| >> 300 mg 106. 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? -Ans| >> Closed-loop communication 107. How long should it take to perform a pulse check during the BLS Survey? -Ans| >> 5 to 10 seconds 108. 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? -Ans| >> Check the patient's pulse. 109. An AED advises a shock for a pulseless patient lying in snow. What is the next action? -Ans| >> Administer the shock immediately and continue as directed by the AED. 110. Which treatment or medication is appropriate for the treatment of a patient in asystole? -Ans| >> Epinephrine 111. What is the minimum depth of chest compressions for an adult in cardiac arrest? Ans| >> 2 inches 112. A patient with pulseless ventricular tachycardia is defibrillated. What is the next action? -Ans| >> Start chest compressions at a rate of at least 100/min. Prof.Exams 113. 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? -Ans| >> Have a team member attempt to palpate a carotid pulse. 114. Emergency medical responders are unable to obtain a peripheral IV for a patient in cardiac arrest. What is the next most preferred route for drug administration? - Ans| >> Intraosseous (IO) 115. What is the appropriate rate of chest compressions for an adult in cardiac arrest? Ans| >> At least 100/min 116. 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? -Ans| >> Divert the patient to a hospital 15 minutes away with CT capabilities. 117. 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? -Ans| >> Vagal maneuvers 118. 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? -Ans| >> Administer 2 to 4 mg of morphine by slow IV bolus. 119. 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? -Ans| >> Seeking expert consultation 120. A postoperative patient in the ICU reports new chest pain. What actions have the highest priority? -Ans| >> Obtain a 12-lead ECG and administer aspirin if not contraindicated. Prof.Exams What drug should the team leader request to be prepared for administration next? -Ans| >> second dose of epinephrine 1 mg 145. A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine has been given. Which is the next drug to anticipate to administer? - Ans| >> amiodarone 300 mg 146. You are monitoring a patient with chest discomfort who suddenly becomes unresponsive. You observe the following rhythm on the cardiac monitor. A defibrillator is present. What is your first action? -Ans| >> Give a single shock 147. What do you do after return of spontaneous circulation -Ans| >> maintain O2 sat at 94% >>treat hypotension (fluids vasopressor) >>12 lead EKG >>if in coma consider hypothermia >>if not in coma and ekg shows STEMI or AMI consider re-perfusion 148. What are the 5 h's and 5 t's -Ans| >> The Hs and Ts is a mnemonic used to aid in remembering the possible reversible causes of cardiac arrest.[1] A variety of disease processes can lead to a cardiac arrest; however, they usually boil down to one or more of the "Hs and Ts". a) hypovolemia b) hypoxia c) hydrogen ion (acidosis) d) hypo/hyperkalemia e) hypothermia a) tension pneumothorax b) tamponade, cardiac c) toxins d) thrombosis, pulmonary (PE) e) thrombosis, coronary 149. Bradycardia require treatment when? -Ans| >> chest pain or shortness of breath is present 150. how do you treat non-symptomatic bradycardia -Ans| >> monitor and observe Prof.Exams 151. what constitutes symptomatic bradycardia -Ans| >> hypotension a) altered mental status b) signs of shock c) chest pain d) acute heart failure 152. A patient with sinus bradycardia and a heart rate of 42 has diaphoresis and blood pressure of 80/60. What is the initial dose of atropine? -Ans| >> 0.5 mg 153. how do you treat symptomatic bradycardia -Ans| >> give 0.5mg atropine every 35 mins to max of 3mg a) if that doesn't work try one of the following: b) transcutaneous pacing c) 2-10mcg/kg / minute dopamine infusion d) 2-10mcg per minute epinephrine infusion 154. What is considered a tachycardia requiring treatment -Ans| >> over 150 per minute 155. when do you consider cardioversion -Ans| >> if persistent tachycardia is causing: a) hypotension b) altered mental status c) signs of shock d) chest pain e) acute heart failure 156. if persistent tachycardia does not present with symptoms what do you need to consider -Ans| >> wide QRS? >> greater than 0.12 seconds 157. Your patient has been intubated. IV/IVO access is not available. Which combination of drugs can be administered by endotracheal route? -Ans| >> Lidocaine, epinephrine, vasopressin a) reentry supraventricular tachycardia b) polymorphic ventricular tachycardia - aka torsades c) atrial fibrilation d) sinus tachycardia e) coarse ventricular fibrillation f) atrial flutter Prof.Exams g) reentry supraventricular tachycardia h) sinus bradycardia i) monomorphic ventricular tachycardia j) fine ventricular fibrillation k) second degree AV block type 1 wenckenbach l) second degree AV block mobitz type 2 m) third degree AV block a) asystole b) normal sinus rhythm c) pulseless electrical activity d) agonal rhythm/asystole 158. The five links in the adult Chain of Survival -Ans| >> 1- Immediate activation of EMS a) 2- Early CPR b) 3- Rapid defibrillation (not in peds) c) 4- Effective advanced life support d) 5- Integrated post-cardiac arrest care 159. Type of breaths (not normal) that may be present in the first minutes after sudden cardiac arrest -Ans| >> Agonal gasps 160. To place the pads on the victims bare chest, Place one pad on the upper-right chest (below the collarbone) and place the other pad -Ans| >> to the side of the left nipple, with the top edge of the pad a few inches below the armpit 161. If the heart muscle resets and initiates an organized rhythm this is called -Ans| >> ROSC return of spontaneous circulation 162. a patient is in cardiac arrest. ventricular fibrillation has been refractory to an initial shock. if no pathway for medication is in place, preferred method? -Ans| >> IV or IO 163. 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 100/60 mm HG. What is now indicated? -Ans| >> EPI 2-10 mcg/min 164. A patient with ST-segment elevation MI has ongoing chest discomfort. Fibrinolytic therapy has been ordered. Heparin 4000 units IV bolus was administered, and a heparin infusion of 1000 units per hour is being administered. ASA was not Prof.Exams 189. When can you use magnesium in cardiac arrest? -Ans| >> VF/pulseless VT associated with torsades de pointes 190. 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 should you do? -Ans| >> Seek expert consultation 191. A patient with possible ST-segment elevation MI has ongoing chest discomfort. What is a containdication to the administration of nitrates? -Ans| >> Phosphodiesterase inhibitor within 12 hours 192. Bradycardia requires treatment when? -Ans| >> Chest pain or shortness of breath 193. You patient has been intubated. IV/IO access is not available. Which combination of drugs can be administered by the endotracheal route? -Ans| >> Lidocaine, epinephrine, vasopressin 194. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Which drug and dose should be administered first by the IV/IO route? Ans| >> Epinephrine 1 mg 195. A patient is in refractory ventricular fibrillation. High quality CPR is in progress, and shocks have been given. One dose of epinephrine was given after the second shock. An antiarrhythmic drug was given immediately after the third shock. What drug should the team leader request to be prepared for administration next? -Ans| >> Second dose of epinephrine 1 mg 196. A 62 year old man suddenly experienced difficulty speaking and left-sided weakness. He was brought into the emergency department. He meets initial criteria for fibrinolytic therapy, and a CT scan of the brain is ordered. What are the guidelines for antiplatelet and fibrinolytic therapy? -Ans| >> Do not give ASA for at least 24 hours if rtPA is administered 197. A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been given. Which is the next drug/dose to anticipate to administer? -Ans| >> Amiodarone 300 mg 198. A patient is in refractory ventricular fibrillation and has received multiple appropriate defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of 300 mg amiodarone IV. The patient is intubated A second dose of amiodarone is now called for. The recommended second dose of amiodarone is what? -Ans| >> 150 mg IV push Prof.Exams 199. A 57 year old woman has palpitations, chest discomfort, and tachycardia. The monitor shows a regular wide-complex QRS at a rate of 180 bpm. She becomes diaphoretic and her blood pressure is 80/60 mm Hg. What is the next action? - Ans| >> Perform immediate electrical cardioversion 200. 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. What drug should be administered IV? -Ans| >> Adenosine 6 mg 201. 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. Which is the first drug/dose to administer? -Ans| >> Epinephrine 1 mg or vasopressin 40 units IV or IO 202. A patient with ST-segment elevation MI has ongoing chest discomfort. Fibrinolytic therapy has been ordered. Heparin 4000 units IV bolus was administered, and a heparin infusion of 1000 units per hour is being administered. ASA was not taken by the patient because he had a history of gastritis treated 5 years ago. What is the next action? -Ans| >> Give ASA 160-325 chewed immediately 203. What is the dose of vasopressin and how is it administered (in cardiac arrest)? Ans| >> 40 units administered IV or IO 204. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. What is the recommended route for drug administration during CPR? Ans| >> IV or IO 205. 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 100/60 mm HG. What is now indicated? -Ans| >> Epinephrine 2 to 10 mcg/min 206. 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, your next action is to what? Ans| >> Gain IV or IO access 207. A patient with a possible acute coronary syndrome has ongoing chest discomfort unresponsive to 3 SL NTG tablets. There are no contraindications, and 4 mg of morphine sulfate was administered. Shortly afterward, blood pressure falls to Prof.Exams 88/60 mm Hg, and the patient has increased chest discomfort. What should you do? -Ans| >> Give normal saline 250 mL to 500 mL fluid bolus 208. Supraventricular Tachycardia -Ans| >> 209. Atrial fibrillation -Ans| >> 210. Second deg AV block: Mobitz 1 -Ans| >> 211. Second deg AV block: Mobitz 2 -Ans| >> Intermittent non-conducted P waves without progressive prolongation of the PR interval (compare this to Mobitz I). 212. Ventricular fibrillation -Ans| >> 213. Third deg AV block -Ans| >> 214. Sinus bradycardia -Ans| >> 215. Ventricular fibrillation -Ans| >> 216. Atrial flutter -Ans| >> 217. Pulseless electrical activity -Ans| >> Push Epi Always 218. Second deg AV block: Mobitz 2 -Ans| >> 219. Supraventricular tachycardia -Ans| >> 220. Polymorphic ventricular tachycardia -Ans| >> 221. Sinus bradycardia -Ans| >> 222. Sinus tachycardia -Ans| >> 223. Ventricular fibrillation -Ans| >> 224. Agonal rhythm into asystole -Ans| >> 225. If patient is in cardiac arrest and the rhythm is asystole and CPR is beign given. What is the first drug you should give? (a) Atropine 0.5 mg IV/IO (b) Atropine 1 mg IV/IO Prof.Exams 237. A monitored pt in the ICU developed a sudden onset of narrow-complex tachycardia at a rate of 200. Pt's BP is 128/58, PETCO2 is 38, and pulse oximetry reading is 98%. There is vascular access in the left arm, and pt has not been given any vasoactive drugs. 12 lead EKG confirms a supraventricular tachycardia w/ no evidence of ischemia or infarction. Heart rate has not responded to vagal manuevers. What is your next action? (a) Administer adenosine 6 mg IV push (b) Administer amiodarone 300 mg IV push (c) Perform synchronized cardioversion at 50 J (d) Perform synchronized cardioversion at 200 J -Ans| >> (a) Administer adenosine 6 mg IV push 238. In which situation does bradycardia require treatment? (a) 12-lead ECG showing a normal sinus rhythm (b) Hypotension (c) Diastolic blood pressure > 90 (d) Systolic blood pressure > 100 -Ans| >> (b) Hypotension 239. A 67 yr old woman has palpitations, chest discomfort, and tachycardia. The monitor shows a regular wide-complex QRS at a rate of 180/min. She becomes diaphoretic, and her blood pressure is 80/60. Which action do you take next? (a) Establish IV access (b) Obtain a 12 lead EKG (c) Perform electrical cardioversion (d) Seek expert consultation -Ans| >> (c) Perform electrical cardioversion 240. Pt w/ sinus bradycardia and a heart rate of 42 has diaphoresis and a blood pressure of 80/60. What is the initial dose of atropine? (a) 0.1 mg (b) 0.5 mg (c) 1 mg (d) 3 mg -Ans| >> (b) 0.5 mg 241. A pt w/ STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and a heparin infusion of 1000 units per hr are being administered. The pt did not take aspirin because he has a hx of gastritis, which was treated 5 yrs ago. What is your next action? (a) Give aspirin 160 to 325 mg to chew (b) Give clopidogrel 300 mg orally (c) Give enteric-coated aspirin 75 mg orally Prof.Exams (d) Give enteric-coated aspirin 325 mg rectally -Ans| >> (a) Give aspirin 160 to 325 mg to chew 242. 62 yr old man suddenly expereinced 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? (a) Give aspirin 160 to 325 mg to be chewed immediately (b) Give aspirin 160 mg and clopidogrel 75 mg orally (c) Give heparin if the CT scan is negative for hemorrhage (d) Hold aspirin for at least 24 hrs if rtPA is administered -Ans| >> (d) Hold aspirin for at least 24 hrs if rtPA is administered 243. A patient has sinus bradycardia w/ a heart rate of 36. Atropine has been administered to a total dose of 3 mg. A transcutaneous pacemaker has failed to capture. The pt is confused, and her BP is 88/56. Which therapy is now indicated? (a) Atropine 1 mg (b) Epinephrine 2 to 10 mcg/min (c) Adenosine 6 mg (d) Normal saline 250 mL to 500 mL bolus -Ans| >> (b) Epinephrine 2 to 10 mcg/min 244. A 45 yr old woman with a hx of palpitations develops light-headedness and palpitations. She has received adenosine 6 mg IV for the rhythm shown here, without conversion of the rhythm. She is now extremely apprehensive. Her BP is 128/70 mm Hg. What is the next appropriate intervention? (a) Administer adenosine 12 mg IV (b) Perform unsynchronized cardioversion (c) Perform vagal maneuvers (d) Perform synchronized cardioversion -Ans| >> (a) Administer adenosine 12 mg IV 245. Which action is likely to cause air to enter the victim's stomach (gastric inflation) during bag-mask ventilation? (a) Giving breaths over 1 second (b) Ventilating too quickly (c) Providing a good seal btwn the face and mask (d) Providing just enough volume for chest to rise -Ans| >> (b) Ventilating too quickly 246. What is the recommended depth of chest compressions for an adult victim? -Ans| >> At least 2 inches 247. You are the code team leader and arrive to find a patient with CPR in progress. On the next rhythm check, you see electrical activity on the monitor. She has no Prof.Exams pulse or respirations. Bag-mask ventilations are producing visible chest rise, and IO access has been established. Which intervention would be your next action? (a) Atropine 1 mg (b) Dopamine at 10 to 20 mcg/kg per min (c) Epinephrine 1 mg (d) Intubation and administration of 100% oxygen -Ans| >> (c) Epinephrine 1 mg 248. How often should you switch chest compressors to avoid fatigue? -Ans| >> Every 2 minutes 249. You are providing bag-mask ventilation to a pt in respiratory arrest. How often should you provide ventilations? -Ans| >> About every 5-6 secs 250. Which intervention is most important in reducing this patient's in-hospital and 30 day mortality rate? (a) Application of transcutaenous pacemaker (b) Atropine administration (c) Nitroglycerin administration (d) Reperfusion therapy -Ans| >> (d) Reperfusion therapy 251. How does complete chest recoil contribute to effective CPR? (a) Allows maximum blood return to the heart (b) Reduces rescuer fatigue (c) Reduces the risk of rib fractures (d) Increases the rate of chest compressions -Ans| >> (a) Allows maximum blood return to the heart 252. A patient was in refractory ventricular fibrillation. A third shock has just been administered. Your team looks to you for instructions. What is your next action? (a) Check the carotid pulse (b) Give amiodarone 300 mg IV (c) Give atropine 1 mg IV (d) Resume high-quality chest compressions -Ans| >> (d) Resume high-quality chest compressions 253. A patient has been rususcitated from cardiac arrest. During post-ROSC treatment, pt becomes unresponsive, with ventricular fibrillation. Which action is indicated next? (a) Give an immediate unsynchronized high-energy shock (defibrillation dose) (b) Give lidocaine 1 to 1.6 mg/kg IV (c) Perform synchronized cardioversion Prof.Exams 272. What should the tidal volume be for adequate ventilations? -Ans| >> 500-600 mL or half of a bag squeeze 273. What should be the first thing you do when you arrive on scene? -Ans| >> See if patient is conscious or unconscious 274. What do you do next If the patient is unconscious when you first arrive on scene? -Ans| >> Initiate BLS 275. If a patient is not responsive when you first arrive on scene, what should you do next? -Ans| >> Call code 276. Get AED 277. During BLS, should you check breathing and pulse (a) Separately (b) Simultaenously -Ans| >> (b) Simultaenously 278. If pt is not breathing normally but has pulse, what should you do? -Ans| >> Bypass chest compressions and ventilate every 5-6 seconds 279. After intubating someone, what should you do next? -Ans| >> Provide 1 ventilation every 6 seconds 280. What should you assess for in the Disability function of ABCDE? -Ans| >> Neurologic function - Alert - Pain - Voice - Unresponsive 281. What are the H's of PEA? -Ans| >> Hypovolemia 282. Hypoxia 283. H+ (acidosis) 284. HyperK+ 285. HypoK+ 286. Hypothermia 287. What are the T's of PEA? -Ans| >> Trauma 288. Tension PTX 289. Tamponade 290. Toxins 291. Thrombosis (Pulmonary or Coronary) Prof.Exams 292. Why should you not excessively ventilate? -Ans| >> Causes gastric insufflation 293. Incr intrathoracic pressure 294. Decr venous return and CO 295. Decr survival 296. When do you use oropharyngeal airways? -Ans| >> Unconscious pts 297. No gag reflex pts 298. When do you use a nasopharyngeal airway? -Ans| >> Conscious, semiconscious, or unconscious pts with or without gag flex 299. Oropharyngeal airway -Ans| >> 300. Nasopharyngeal airway -Ans| >> 301. When should you proceed with an advanced airway? -Ans| >> Difficult to bag mask vent 302. Airway compromise 303. Need to isolate airway 304. What should you use to monitor ET tube? -Ans| >> Waveform capnography 305. If waveform capnography jumps up, it may indicate... -Ans| >> ROSC 306. If a patient is in cardiac arrest what are the first two steps? -Ans| >> (1) CPR 307. (2) Attach AED 308. What rhythms are shockable? -Ans| >> VFib or pulseless VTach 309. What rhythms are NOT shockable -Ans| >> Asystole or PEA 310. How often should you give epinephrine? -Ans| >> Every 3-5 minutes 311. When should you consider giving amiodarone? -Ans| >> After you have given 3 shocks and 3 CPR sessions and they are still in VF or pVT 312. When should you determine if the rhythm is shockable for asystole or PEA in the cardiac arrest algorithm? -Ans| >> After the first CPR session (2 minutes) 313. When should you start treating reversible causes of asystole or PEA? -Ans| >> After the second CPR session Prof.Exams 314. Bradycardia is categorized as a HR less than... -Ans| >> 50 315. When should you give atropine? -Ans| >> When there is bradycardia and perfusion is low 316. If atropine fails in treating bradycardia, what should you do? -Ans| >> (1) Transcutaneous pacing 317. (2) Dopamine 318. (3) Epinephrine 319. If atropine, tcp, dopamine, epinephrine all fail to tx bradycardia, what should you do? -Ans| >> (1) Seek expert consultation 320. (2) Transcutaneous pacing 321. When should you use synchronized cardioversion in tachycardia? -Ans| >> If the pt is hemodynamically unstable 322. What should you do if you encounter a pt who has a pulseless tachycardia? -Ans| >> Manage it like a cardiac arrest algorithm 323. Most symptomatic tachycardias will present with a HR of greater than -Ans| >> 150 324. If a tachycardia patient is hemodynamically stable, what is the next thing you should assess? -Ans| >> If QRS is wide (>= 0.120 sec) 325. If QRS is not wide for a tachycardia patient, what should you do next? -Ans| >> (1) Vagal manuevers 326. (2) Adenosine 327. (3) Bblock or CCB 328. (4) Expert consultation 329. What things do you need to do after ROSC? -Ans| >> (1) Optimize ventilation and oxygenation 330. (2) Treat Hypotension 331. (3) EKG 332. (4) See if pt follows commands 333. During post ROSC, what things do you need to do to optimize ventilation and oxygenation? -Ans| >> - O2 > 94% - Advanced airway + capnography