ACLS Post Test (copy) 44 QUESTIONS WITH COMPLETE SOLUTIONS, Exams of Nursing

Download ACLS Post Test (copy) 44 QUESTIONS WITH COMPLETE SOLUTIONS and more Exams Nursing in PDF only on Docsity! ACLS Post Test (copy) 44 QUESTIONS\ WITH COMPLETE SOLUTIONS You are caring for a patient with a suspected stroke whose symptoms started 2 hours ago. The CT was normal with no sign of hemorrhage. The patient does not have any contraindications to fibrinolytic therapy. Which treatment is best? a. start fibrinolytic therapy ASAP b. hold fibrinolytic therapy for 24 hours c. order an echo before fibrinolytic administration d. wait for MRI result correct answer: a. start fibrinolytic therapy ASAP For STEMI pt, maximum goal time for ED door-to-balloon-inflation time for PCI? a. 150 mins b. 180 mins c. 120 mins d. 90 mins correct answer: d. 90 mins Which is the recommended oral dose of aspirin for a patient with suspected acute coronary syndrome? a. 81 mg b. 325-650 mg c. 160-325 mg d. 40 mg correct answer: c. 160-325 mg chest compressions during for adult rate a. 40-60/min b. 60-80/min c. 80-100/min d. 100-120/min correct answer: d. 100-120/min What is the effect of excessive ventilation? a. decresed cardiac output b. decreased intrathoracic pressure c. increased perfusion pressure d. increased venous return correct answer: a. decreased cardiac output temperature to achieve targeted temperature management after cardiac arrest a. 30-34C b. 32-36C c. 36-40C d. 38-42C correct answer: b. 32-36C 3 mins into cardiac arrest resuscitation attempt, one member of your team inserts an endotracheal tube while another performs chest compressions. Capnography shows a persistent waveform & a PETCO2 of 8mmHg. What is the significance of the finding? a. chest compression may not be effective b. The endotrachael tube is in the esophagus c. the team is ventilating the patient too often d. the patient meets the criteria for termination of efforts correct answer: a. chest compression may not be effective Your patient is in cardiac arrest and has been intubated. To assess CPR quality, you should? a. obtain a chest x-ray b. check the patient's pulse c. monitor the patient's PETCO2 d. obtain a 12-lead ECG correct answer: c. monitor the patient's PETCO2 In addition to clinical assessment, which is the most reliable method to confirm & monitor correct placement of an endotracheal tube? a. arterial blood gas b. hemoglobin levels c. chest radiography d. continuous waveform capnography correct answer: d. continuous waveform capnography A 45M had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting "crushing" chest discomfort. He is pale, diphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40, respiratory is 28 bpm/min and O2 set is 89% on room air. correct answer: answer has to do with acute coronary syndrome A 45M had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting "crushing" chest discomfort. He is pale, diphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40, respiratory is 28 bpm/min and O2 set is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation. WhIn addition to defibrillation, which intervention should be performed immediately? a. chest compression b. vasoactive meds c. vascular access d. advanced airway correct answer: a. chest compression Which is the recommended next step after a defibrillation attempt? a. check the ECG for evidence of a rhythm b. determine if a carotid pulse is present c. resume CPR, starting with chest compressions d. open the patient's airway correct answer: c. resume CPR, starting with chest compressions A responder is caring for a patient with a history of congestive heart failure. The patient is experiencing shortness of breath, 68/50 mmHg, heart rate 190/min. The patient's lead 2 ECG is shown. Which best characterizes this patient's rhythm? correct answer: unstable supraventicular tachycardia which is one way to minimize interruptions in chest compressions during CPR? correct answer: continue CPR while the defibrillator charges A 68F lightheadedness, nausea, chest discomfort. Your assessment finds her awake & responsive but ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready & fast. Your are unable to get a BP. She has no obvious dependent edema, & her neck veins are flat. Her lung sounds are equal w/ moderate rales present bilaterally. The cardiac monitor shows rhythm seen here. Based on the patient's initial assessment, what adult ACLS algorithm should you follow? correct answer: tachycardia wide complex (monophasic) tachycardia A 68F lightheadedness, nausea, chest discomfort. Your assessment finds her awake & responsive but ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready & fast. Your are unable to get a BP. She has no obvious dependent edema, & her neck veins are flat. Her lung sounds are equal w/ moderate rales present bilaterally. The cardiac monitor shows rhythm seen here. After your initial assessment, which intervention should be preformed? correct answer: synchronized cardioversiion A 68F lightheadedness, nausea, chest discomfort. Your assessment finds her awake & responsive but ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready & fast. Your are unable to get a BP. She has no obvious dependent edema, & her neck veins are flat. Her lung sounds are equal w/ moderate rales present bilaterally. The cardiac monitor shows rhythm seen here. If the patient became apnic & pulseless but the rhythm remained the same, which would take the highest priority? correct answer: perform defibrillation Which best describes the rhythm? correct answer: monomorphic ventricular tachycardia A patient in stable narrow-complex tachycardia with a peripheral IV in place is refractory to the 1st dose of adenosine. Which dose would you administer next? correct answer: 12mg You instruct a team member to give 0.5mg atropine IV. Which response is an example of closed- loop communication? correct answer: I'll draw up 0.5mg of atropine A patient has a witnessed loss of consciousness. The lead 2 ECG is shown. appropriate treatment? correct answer: defibrillation You have completed 2 mins of CPR. The ECG monitor shows the lead 2 rhythm, and the patient has no pulse. Another member of your team resumes chest compression, and an IV is in place. Which do you do next? correct answer: Give epi 1mg IV to properly ventilate a patient w/ perfusing rhythm, how often do you squeeze the bag? a. once every 10 seconds b. once every 5 to 6 seconds c. once every 3 to 4 seconds d. once every 12 seconds correct answer: b. once every 5-6 seconds Which is the recommended 1st IV dose of amiodarone for a patient w/ refractory ventricular fibrillation? a. 150 mg b. 250 mg c. 300 mg d. 100 mg correct answer: c. 300mg Which best describes the length of time it should take to perform a pulse check during BLS assessment? a. 1 to 4 seconds b. 5 to 10 seconds c. 11 to 15 seconds d. 16 to 20 seconds correct answer: b. 5 to 10 seconds Which best describes an action taken by the team leader to avoid inefficiencies during a resuscitation attempt? correct answer: clearly delegate tasks Which is the maximum interval you should allow for an interruption in chest compression? correct answer: 10 seconds If a team member is about to make a mistake during a resuscitation attempt, which best describes the action that the team leader or other team members should take? a. address the team member immediately b. conduct a debriefing after the resuscitation attempt c. remove the team member from the area d. reassign the team members correct answer: a. address the team member immediately Which facility is the most appropriate EMS destination for a patient w/ a sudden cardiac arrest who achieved return of spontaneous circulation in the field? correct answer: coronary reperfusion-capable medical center 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 A team member is unable to perform an assigned task because it is beyond the team member's scope of practice. Which action should the team member take? correct answer: ask for a new task or role What is the minimum systolic blood pressure one should attempt to achieve w/ fluid administration or vasoactive agents in a hypotensive post-cardiac arrest patient who achieves return of spontaneous circulation? correct answer: 90 mmHg You are evaluating a 58M w/ chest discomfort, BP 92/50, heart rate 92/min, his non-labored respiratory rate is 14 bpm, and his pulse oximetry reading is 97%. Which assessment step is most important now? correct answer: obtaining a 12 lead As a team leader, when do you tell the chest compressors to switch? a. about every 2 minutes b. about every 5 minutes c. only when they tell you that they are fatigued d. about every 7 minutes correct answer: a. about every 2 minutes The patient's pulse ox shows a reading of 84% on room air. Which initial action do you take? correct answer: apply oxygen (I think I put Bag valve mask for this and I got it wrong)