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ACLS POST TEST (COPY)/UPDATED QUESTIONS WITH CORRECT ANSWERS /SURE A+/24/25
Typology: Exams
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1. 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: a. start fibrinolytic therapy ASAP 2. 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: 90 mins 3. Which is the recommended oral dose of ASA for a pt w/ suspected ACS? a. 81 mg b. 325-650 mg c. 160-325 mg d. 40 mg: 160-325 mg 4.chest compressions during for adult rate: 100-120/min 5. effect of excessive ventilation a. decresed cardiac output b. decreased intrathoracic pressure c. increased perfusion pressure d. increased venous return: decreased cardiac output
c. the team is ventilating the patient too often d. the patient meets the criteria for termination of efforts: a. chest compression may not be effective
c. amiodarone 300mg d. epi 1 mg: c. amiodarone 300mg
14. 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. The patient has returned of spontaneous circulation (ROSC) & is not able to follow commands. Which immediate post-cardiac arrest care intervention do you choose for the patient? a. extubate b. check glucose c. give epi d. initiate targeted temp. management: initiate targeted temperature manage- ment (the guideline no longer has post-arrest optimal glucose level) 15. A 45M has coronary artery stents placed 2 days ago. Today, he is in severe distress & crushing chest discomfort. he is pale, diaphoretic, & cool to the touch. His radial pulse is very weak. Blood pressure is 64/40 mm Hg, respira- tory rate is 28 bpm & O2 is 89%. cardiac monitor initially showed ventricular tachycardia, which quickly changed to v-fib. what would you have done first if the patient had not gone into v-fib? a. give atropine 1mg b. establish IV c. do a 12 lead d. performed synchronized cardioversion: performed synchronized cardiover- sion 16. During post-cardiac arrest, which is recommended duration of targeted temp. management after reaching the correct temperature range? a. at least 24 hours b. 0-8 hour c. at least 36 hours d. at least 48 hours: at least 24 hours 17. which is the primary purpose of medical emergency team or rapid re- sponse team? a. provide diagnostic consultation to emergency department patients b. provide online consultation to EMS personnel c. improving patient outcomes by identifying & treating early clinical deterio- ration
d. improving care for patients admitted to critical care units: c. improving patient outcomes by identifying & treating early clinical deterioration
18. A patient is respiratory distress, 70/50, presents with lead 2 ECG shown. appropriate treatment? a. defibrillation b. perform synchronized cardioversion c. administering adenosine 6mg IV pust d. perform vagal maneuvers: performing synchronized cardioversion 19. which of these tests should be performed for a patient w/ suspected stroke w/in 25 mins of hospital arrival? a. coagulation studies b. cardiac enzymes c. noncontrast CT scan of the head d. 12 lead ECG: non-contrast CT scan of the head 20. Which of the following signs are likely indicator of cardiac arrest in an unresponsive patient? a. slow, weak pulse rate b. cyanosis c. irregular, weak pulse d. agonal gasps: d. agnoal gasps 21.a patient is being resuscitated in a very noisy environment. A team mem- ber thinks he heard an order of 500mg of amiodarone IV. which is the best response from the team member?: I have an order to give 500mg of amiodarone IV. Is this correct? 22.Which is the recommended next step after a defibrillation attempt?: resume CPR, starting with chest compression 23.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?: unstable supraventicular tachycardia 24.which is one way to minimize interruptions in chest compressions during CPR?: continue CPR while the defibrillator charges 25. 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?: tachycardia wide complex (monophasic) tachycardia
26. 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?: synchronized cardioversiion 27.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?: perform defibrillation 28.Which best describes the rhythm?: monomorphic ventricular tachycardia 29.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?: 12mg 30.You instruct a team member to give 0.5mg atropine IV. Which response is an example of closed-loop communication?: I'll draw up 0.5mg of atropine 31.A patient has a witnessed loss of consciousness. The lead 2 ECG is shown. appropriate treatment?: defibrillation 32.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?: Give epi 1mg IV 33.to properly ventilate a patient w/ perfusing rhythm, how often do you squeeze the bag?: once every 5-6 seconds 34.Which is the recommended 1st IV dose of amiodarone for a patient w/ refractory ventricular fibrillation?: 300mg
35.Which best describes the length of time it should take to perform a pulse check during BLS assessment?: 5-10 seconds 36.Which best describes an action taken by the team leader to avoid ineffi- ciencies during a resuscitation attempt?: clearly delegate tasks 37.Which is the maximum interval you should allow for an interruption in chest compression?: 10 seconds 38.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?: address the team member immediately 39.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?: coronary reperfusion-capable medical center 40.which is an acceptable method of selecting an appropriately sized oropha- ryngeal airway?: measure from the corner of the mouth to the angle of the mandible 41.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?: ask for a new task or role 42.What is the minimum systolic blood pressure one should attempt to achieve w/ fluid administration or vasoactive agents in a hypotensive post-car- diac arrest patient who achieves return of spontaneous circulation?: 90 mmHg 43.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?: obtaining a 12 lead 44.As a team leader, when do you tell the chest compressors to switch?: about every 2 minutes 45.The patient's pulse ox shows a reading of 84% on room air. Which initial action do you take?: apply oxygen (I think I put Bag valve mask for this and I got it wrong)