ACLS Final Exam With Complete Solutions Questions And Answers Are Correctly Answered, Exams of Nursing

Download ACLS Final Exam With Complete Solutions Questions And Answers Are Correctly Answered and more Exams Nursing in PDF only on Docsity! ACLS Final Exam With Complete Solutions Questions And Answers Are Correctly Answered A patient experiences cardiac arrest, and the resuscitation team initiates ventilations using a bag- valve-mask (BVM) resuscitator. The development of which condition during the provision of care would lead the team to suspect that improper BVM technique is being used? Select the correct answer to this question. Rib fracture Esophageal injury Pneumothorax Hypertension Correct Answer: Pneumothorax 1 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? Select the correct answer to this question. 5 to 10 mL 10 to 20 mL 20 to 30 mL 30 to 40 mL Correct Answer: 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. 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? Wide-complex ventricular rhythm and tall, peaked T waves ST-segment changes, T-wave inversion Flat T waves, prominent U waves and possibly prolonged QT intervals Narrow-complex ventricular tachycardia Correct Answer: Wide-complex ventricular rhythm and tall, peaked T waves In hyperkalemia the patient's 12-lead ECG rhythm strip will show wide-complex ventricular rhythm and tall, peaked T waves. A patient with an ischemic stroke arrives at the emergency department at 2 a.m. The patient's symptoms started about 12:30 a.m. After completing the necessary assessments, the healthcare team diagnoses an ischemic stroke, and the patient is determined to be a candidate for fibrinolytic therapy. To achieve the best outcomes, the team should initiate therapy for this patient no later than by which time? Select the correct answer to this question. 3:00 a.m. 5:30 a.m. 6:00 a.m. 8:30 a.m. Correct Answer: 1 3:00 a.m. A resuscitation team is debriefing following a recent event. A patient experienced cardiac arrest, and advanced cardiac life support was initiated. The patient required the placement of an advanced airway to maintain airway patency. Which statement indicates that the team performed high-quality CPR? Select the correct answer to this question. "We kept the rate of chest compressions to around 100 per minute but adjusted their depth to 1.5 inches while giving 1 ventilation every 3 seconds." "We delivered chest compressions at a rate of 80 to 100 per minute to a depth of at least 2 inches and gave 1 ventilation every 6 seconds." "We initiated chest compressions at a rate of 100 to 110 per minute to a depth of 2.4 inches and then gave 1 ventilation every 10 seconds." "We delivered 1 ventilation every 6 seconds and chest compressions at a rate of 100 to 120 compressions per minute." Correct Answer: 4 "We delivered 1 ventilation every 6 seconds and chest compressions at a rate of 100 to 120 compressions per minute." A patient with a suspected stroke arrives at the emergency department at 7:10 p.m. The stroke team ensures that a comprehensive neurologic assessment using the National Institutes of Health Stroke Scale (NIHSS) is completed and that brain imaging is performed by which time? 7:20 p.m. 7:30 p.m. 7:40 p.m. 7:50 p.m. Correct Answer: 2 Within 20 minutes of the patient's arrival, a comprehensive neurologic assessment should be completed and brain imaging should be performed. That would be 7:30 p.m. for this patient. 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? Select all correct options that apply. Hyperkalemia Hypochloremia Hypernatremia Hypomagnesemia Hypocalcemia Correct Answer: Hypomagnesemia Hypocalcemia A 30-year-old patient has been brought to the emergency department in cardiac arrest. The cardiac monitor shows the following rhythm. Interpretation of this rhythm would suggest which of the following as a possible precipitating factor? Correct Answer: The rhythm is ventricular fibrillation. Precipitating causes of ventricular fibrillation include electrocution, myocardial ischemia or infarction, shock, stimulant overdose and ventricular tachycardia. A patient is brought to the emergency department by their spouse. The spouse says, "I think it's a stroke." The stroke team assesses the patient using the National Institutes of Health Stroke Scale (NIHSS). Which area(s) would the team include in this assessment? Select all correct options that apply. Facial palsy Level of consciousness Language deficits Visual function Cranial nerve function Correct Answer: Level of consciousness Language deficits Visual function A patient is brought into the emergency department with a suspected opioid overdose. The patient is in cardiac arrest. Which action would be the team's priority? Select the correct answer to this question. Giving naloxone intravenously (IV) Obtaining a 12-lead electrocardiogram (ECG) Administering supplemental oxygen Initiating high-quality CPR Correct Answer: Initiating high-quality CPR Although no evidence supports any benefit to naloxone administration during cardiac arrest, administration of naloxone during both respiratory and cardiac arrest is recommended when opioid overdose is suspected. However, for a patient in cardiac arrest, high-quality CPR is prioritized over the administration of naloxone. A patient with a diagnosis of ACS is experiencing cardiogenic shock. Which adjuvant therapy would be contraindicated? Select the correct answer to this question. Direct thrombin inhibitor β-Blockers Glycoprotein IIb/IIIa inhibitors Heparin Correct Answer: β-Blockers The use of β-blockers is contraindicated in patients who are at risk for cardiogenic shock, low cardiac output and acute heart failure. 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: Select the correct answer to this question. 100 to 150 joules 120 to 200 joules 300 joules 360 joules Correct Answer: 120 to 200 joules When using a biphasic defibrillator, the energy dose should be set at 120 to 200 joules 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 ventilation and oxygenation? Select all correct options that apply. PaCO2 35 mmHg SaO2 96% SaO2 92% ETCO2 50 mmHg ETCO2 40 mmHg Correct Answer: PaCO2 35 mmHg SaO2 92% ETCO2 50 mmHg 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? Select the correct answer to this question. Adenosine administration Sedation Vagal maneuvers Synchronized cardioversion Correct Answer: Vagal maneuvers A patient experiencing an unstable bradyarrhythmia does not respond to atropine. Which interventions could the healthcare provider use next? Select all correct options that apply. Carotid massage Epinephrine or dopamine infusio Transcutaneous pacing Synchronized cardioversion Correct Answer: Epinephrine or dopamine infusio Transcutaneous pacing 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? Correct Answer: ventricular tachycardia 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 supplemental oxygen dose is correct based on which SaO2 level? Select the correct answer to this question. 87% 91% 93% 95% Correct Answer: 95% A healthcare provider is establishing cardiac monitoring using a five-electrode system. The healthcare provider demonstrates proper use of the system by placing the green electrode in which location? Select the correct answer to this question. At the fourth intercostal space, right sternal border On the lower right abdomen On the lower left abdomen Under the left clavicle, at the midclavicular line Correct Answer: On the lower right abdomen 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? Select the correct answer to this question. Acidosis Hyperkalemia Hypoxia Hypothermia Correct Answer: Hyperkalemia 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. 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? Select all correct options that apply. Quinapril Verapamil Digoxin Metoprolol Losartan Correct Answer: Verapamil Digoxin Metoprolol Medications associated with causing sinus bradycardia include β-blockers such as metoprolol and calcium channel blockers such as verapamil and digoxin. A patient with STEMI is experiencing chest pain that is refractory to sublingual nitroglycerin. Intravenous nitroglycerin is prescribed. When administering this medication, it would be titrated to maintain which systolic blood pressure? Select the correct answer to this question. 60 mmHg 70 mmHg 80 mmHg 90 mmHg Correct Answer: 90 mmHg A patient presents to the emergency department with suspected ACS. Electrocardiogram and cardiac biomarkers show the patient has ST-segment elevation myocardial infarction (STEMI). Physical examination reveals signs of left ventricular dysfunction. Which finding(s) would support this? Select all correct options that apply. Weak peripheral pulses Chest pain Cool, clammy skin Crackles Hypotension Correct Answer: Weak peripheral pulses Hypotension Crackles A 20-year-old man with respiratory depression is brought to the emergency department by his parents. The parents state that "[They] found him at home with various needles and syringes around him, but [they] have no idea what he took." Opioid overdose is suspected, and an initial dose of naloxone is administered at 10 p.m. The patient does not respond to this initial dose. The team would expect to administer a second dose after how many minutes? Select the correct answer to this question. 2 minutes 4 minutes 6 minutes 8 minutes Correct Answer: 4 minutes 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? Select the correct answer to this question. Rapid assessment Secondary assessment Primary assessment Basic life support assessment Correct Answer: Rapid assessment The stroke team is assessing a patient with a suspected stroke. The patient is alert and able to carry on a conversation, although the patient has difficulty getting the words out. Testing confirms that the patient has had an ischemic stroke. Based on the patient's medical history, a history of which arrhythmia would alert the team to the patient's increased risk for stroke? Select the correct answer to this question. Ventricular fibrillation Atrial fibrillation Atrial tachycardia Bradycardia Correct Answer: atrial fibrillation 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? Narrow QRS complex with PP interval constant or slightly irregular Presence of wide QRS complexes that are bizarrely and consistently shaped Presence of flutter waves and sawtooth patterns Absence of discrete P waves and presence of irregularly irregular QRS complexes Correct Answer: Absence of discrete P waves and presence of irregularly irregular QRS complexes 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? Select the correct answer to this question. 0.10 mV 0.15 mV 0.2 mV 0.25 mV Correct Answer: 0.15 mV A patient presents to the emergency department with mild to moderate recurrent chest pain, without any nausea or vomiting. A 12-lead ECG is obtained and shows ST-segment depression with transient T-wave elevation indicative of NSTE-ACS. Cardiac serum markers are obtained and are not elevated. The patient's risk-stratification score indicates low risk. These findings suggest which condition? Select the correct answer to this question. Non-STEMI Myocardial infarction STEMI Unstable angina Correct Answer: Unstable angina The following capnogram is from a patient experiencing respiratory distress. At which point in the waveform would the patient's ETCO2 level be measured? Correct Answer: D A patient's capnogram reveals the following waveform. Which segment would the healthcare provider interpret as reflecting the beginning of exhalation? Correct Answer: A-B Cardiac monitoring of a patient in cardiac arrest reveals ventricular fibrillation. What intervention would the team perform next? Initiate capnography. Administer 1 shock. Provide post-cardiac arrest care. Insert an advanced airway. Correct Answer: Administer 1 shock A patient comes to the emergency department with a suspected stroke. The patient is alert and oriented and accompanied by a family member. The family member says, "I noticed he was slurring his words and had trouble walking, like his leg was numb." Which finding would suggest that the patient is experiencing a condition that mimics a stroke? Hyperkalemia Hypoglycemia Hyperglycemia Hypokalemia Correct Answer: Hypoglycemia