ACLS FINAL EXAM VERSION A QUESTIONS WITH COMPLETE VERIFIED SOLUTIONS 2024/2025, Exams of Nursing

Download ACLS FINAL EXAM VERSION A QUESTIONS WITH COMPLETE VERIFIED SOLUTIONS 2024/2025 and more Exams Nursing in PDF only on Docsity! ACLS FINAL EXAM VERSION A QUESTIONS WITH COMPLETE VERIFIED SOLUTIONS 2024/2025 Advanced Cardiovascular Life SupportExam Version A (50 questions) Please do not mark on this exam. Record the best answer on the separateanswer sheet. 1. You find an unresponsive patient who is not breathing. After activating the emergency response system, you determine that there is no pulse. What is your next action? A. Open the airway with a head tilt–chin lift. B. Administer epinephrine at a dose of 1 mg/kg. C. Deliver 2 rescue breaths each over 1 second. D. Start chest compressions at a rate of at least 100/min. 2. 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 nonlaboredrespiratory rate is 14 breaths/min, and the pulse oximetry readingis 97%. What assessment step is most important now? A. PETCO2 B. Chest x-ray C. Laboratory testing D. Obtaining a 12-lead ECG 3. What is the preferred method of access for epinephrine administration during cardiac arrest in most patients? A. Intraosseous B. Endotracheal C. Central intravenous D. Peripheral intravenous 4. An activated AED does not promptly analyze the rhythm. What is yournext action? A. Begin chest compressions. B. Discontinue the resuscitation attempt. C. Check all AED connections and reanalyze. D. Rotate AED electrodes to an alternate position. 9. Which action increases the chance of successful conversion of ventricular fibrillation? A. Pausing chest compressions immediately after a defibrillation attempt B. Administering 4 quick ventilations immediately before a defibrillation attempt C. Using manual defibrillator paddles with light pressure against the chest D. Providing quality compressions immediately before a defibrillation attempt 10. Which situation BEST describes pulseless electrical activity? A. Asystole without a pulse B. Sinus rhythm without a pulse C. Torsades de pointes with a pulse D. Ventricular tachycardia with a pulse 11. What is the BEST strategy for performing high-quality CPRon a patient with an advanced airway in place? A. Provide compressions and ventilations with a 15:2 ratio. B. Provide compressions and ventilations with a 30:2 ratio. C. Provide a single ventilation every 6 seconds during the compression pause. D. Provide continuous chest compressions without pauses and 10 ventilationsper minute. 12. 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, younotice the presence of a waveform on the capnography screen and a PETCO2 level of 8 mm Hg. What is the significance of this finding? A. Chest compressions may not be effective. B. The endotracheal tube is no longer in the trachea. C. The patient meets the criteria for termination of efforts. D. The team is ventilating the patient too often (hyperventilation). 13. The use of quantitative capnography in intubated patients A. allows for monitoring of CPR quality. B. measures oxygen levels at the alveoli level. C. determines inspired carbon dioxide relating to cardiac output. D. detects electrolyte abnormalities early in code management. 14. For the past 25 minutes, an EMS crew has attempted resuscitation of a patient who originally presented in ventricularfibrillation. 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? A. Apply a transcutaneous pacemaker. B. Administer 1 mg of intravenous atropine. C. Administer 40 units of intravenous vasopressin. D. Consider terminating resuscitative efforts after consulting medical control. 15. Which is a safe and effective practice within the defibrillationsequence? A. Stop chest compressions as you charge the defibrillator. B. Be sure oxygen is not blowing over the patient’s chest during the shock. C. Assess for the presence of a pulse immediately after the shock. D. Commandingly announce “clear” after you deliver the defibrillation shock. 16. 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 apulse. What is your next action? A. Leave and get an AED. B. Begin chest compressions. C. Deliver 2 quick ventilations. D. Check the patient’s mouth for the presence of a foreign body. 17. What is an advantage of using hands-free defibrillation pads insteadof defibrillation paddles? A. Hands-free pads deliver more energy than paddles. B. Hands-free pads increase electrical arc. C. Hands-free pads allow for a more rapid defibrillation. D. Hands-free pads have universal adaptors that can work with any machine. 18. What action is recommended to help minimize interruptions in chest compressions during CPR? A. Continue CPR while charging the defibrillator. B. Perform pulse checks immediately after defibrillation. C. Administer IV medications only when delivering breaths. D. Continue to use an AED even after the arrival of a manual defibrillator. 19. Which action is included in the BLS Survey? A. Early defibrillation B. Advanced airway management C. Rapid medication administration D. Preparation for therapeutic hypothermia 29.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 thepulse oximetry reading is 98%. There is vascular access at the leftinternal 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 vagal maneuvers. What is the next recommended intervention? A. Adenosine 6 mg IV push B. Amiodarone 300 mg IV push C. Synchronized cardioversion at 50 J D. Synchronized cardioversion at 200 J 30. You are receiving a radio report from an EMS team en route with a patient who may be having an acute stroke. The hospital CTscanner is not working at this time. What should you do in this situation? A. Contact the patient’s family to see what they would prefer. B. Have the EMS crew choose an appropriate patient disposition. C. Accept the report and provide care within your present capability. D. Divert the patient to a hospital 15 minutes away with CT capabilities. 31. Choose an appropriate indication to stop or withhold resuscitativeefforts. A. Arrest not witnessed B. Evidence of rigor mortis C. Patient age greater than 85 years D. No return of spontaneous circulation after 10 minutes of CPR 32.A 49-year-old woman arrives in the emergency department with persistent epigastric pain. She had been taking oral antacids for the past 6 hours because she thought she had heartburn. The initial blood pressure is 118/72 mm Hg, the heart rate is 92/min andregular, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 96%. Which is the most appropriate intervention to perform next? A. Administer oxygen. B. Obtain a 12-lead ECG. C. Evaluate for fibrinolytic eligibility. D. Administer sublingual nitroglycerin. 33.A patient in respiratory failure becomes apneic but continues to have a strong pulse. The heart rate is dropping rapidly and now shows a sinus bradycardia at a rate of 30/min. What intervention hasthe highest priority? A. Atropine IV push B. Epinephrine IV infusion C. Application of a transcutaneous pacemaker D. Simple airway maneuvers and assisted ventilation 38. What is the proper ventilation rate for a patient in cardiacarrest who has an advanced airway in place? A. 4 to 6 breaths per minute B. 8 to 10 breaths per minute C. 12 to 14 breaths per minute D. 16 to 18 breaths per minute 39.A 62-year-old man in the emergency department says that his heart is beating fast. He says he has no chest pain or shortness of breath. The blood pressure is 142/98 mm Hg, the pulse is 200/min, the respiratory rate is 14 breaths/min, and pulse oximetry is 95% onroom air. What intervention should you perform next? A. Obtain a 12-lead ECG. B. Give 150 mg of amiodarone. C. Administer 160 mg of aspirin. D. Administer 6 mg of adenosine. 40. You are evaluating a 48-year-old man with crushing substernalchest pain. The patient is pale, diaphoretic, cool to the touch, and slow to respond to your questions. The blood pressure is 58/32 mm Hg, the heart rate is 190/min, the respiratory rate is 18 breaths/min,and the pulse oximeter is unable to obtain a reading because there is no radial pulse. The lead II ECG displays a regular wide-complex tachycardia. What intervention should you perform next? A. Procedural sedation B. 12-lead ECG C. Amiodarone administration D. Synchronized cardioversion 41. What is the initial priority for an unconscious patient with anytachycardia on the monitor? A. Review the patient’s home medications. B. Evaluate the breath sounds. C. Determine whether pulses are present. D. Administer sedative drugs. 42. Which rhythm requires synchronized cardioversion? A. Unstable supraventricular tachycardia B. Atrial fibrillation C. Sinus tachycardia D. NSR on monitor but no pulse 43. What is the recommended second dose of adenosine forpatients in refractory but stable narrow-complex tachycardia? A. 3 mg B. 6 mg C. 9 mg D. 12 mg 44. What is the usual post–cardiac arrest target range for PETCO2 when ventilating a patient who achieves return of spontaneous circulation (ROSC)? A. 30 to 35 mm Hg B. 35 to 40 mm Hg C. 40 to 45 mm Hg D. 45 to 50 mm Hg 45. Which condition is a contraindication to therapeutic hypothermia during the post–cardiac arrest period for patients who achieve return of spontaneous circulation ROSC? A. Initial rhythm of asystole B. Responding to verbal commands C. Patient age greater than 60 years D. Desire to provide coronary reperfusion (eg, PCI) 46. What is the potential danger of using ties that pass circumferentially around the patient’s neck when securing an advanced airway? A. May interfere with effective ventilation B. Places the patient’s cervical spine at risk C. Obstruction of venous return from the brain D. Does not adequately secure the airway device 47. What is the most reliable method of confirming andmonitoring correct placement of an endotracheal tube? A. 5-point auscultation B. Colorimetric capnography C. Continuous waveform capnography D. Use of esophageal detection devices 48. What 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? A. 250 to 500 mL B. 500 to 1000 mL C. 1 to 2 L D. 2 to 3 L