ACLS Provider Final 2024 110 QUESTIONS WITH COMPLETE SOLUTIONS, Exams of Nursing

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ACLS Provider Final 2023| 110 QUESTIONS| WITH COMPLETE SOLUTIONS The sequence for BLS for an Adult or Child who is unresponsive and pulseless. correct answer: C-A-B (Chest compressions, Airway, Breathing) A pulse check during the BLS survey should be performed for this length of time. correct answer: 5 to 10 seconds A likely indicator of a cardiac arrest in the unresponsive patient. correct answer: Agonal gasps After discovering an unresponsive patient, what is the next step in the assessment and management of this patient? correct answer: Check the patient's breathing and pulse Compressions rate in an arrest. correct answer: 100/min to 120/min The ratio of compressions to breaths for the Adult, Child and 1 rescuer infant arrest. correct answer: 30 compressions to 2 breaths The ratio of compressions to breaths for Infant 2-rescuer arrest. correct answer: 15 compressions to 1 breath What you should do if the patient is unconscious and apneic and you are uncertain rather or not a patient has a pulse correct answer: Begin compressions To properly ventilate a patient with a perfusing rhythm, what is the rate to squeeze the bag (BVM) correct answer: Once every 5 to 6 seconds The potential complication of excessive ventilations. correct answer: Decreased cardiac output Where to measure to appropriately size an oropharyngeal airway. correct answer: Measure from the corner of the mouth to the angle of the mandible When an advanced airway is in place, how should compressions be delivered? correct answer: Continuous chest compressions without pauses In the intubated patient, the technique to assess the quality of CPR. correct answer: Monitor the patient's PETCO2 Your next action if after 2 minutes of CPR an organized, nonshockable rhythm is identified. correct answer: Check a carotid pulse The recommendation for chest compression depth for an Adult and CHILD. correct answer: At least 2 inches (5 cm) but not more than 2.4 inches Components of High-Quality CPR correct answer: • Compress the chest hard and fast • Allow complete recoil after each compression • Chest compressions should be interrupted 10 seconds or less • Switching providers every 2 minutes or every 5 compression (if unable to determine exact time) cycles improves the quality of chest compressions • Continue CPR while the defibrillator charges The AHA position on routine use of cricoid pressure in cardiac arrest. correct answer: The guidelines do not recommend routine use of cricoid pressure in cardiac arrest. The definitive treatment for ventricular fibrillation correct answer: Prompt defibrillation The recommended next step after a defibrillation attempt correct answer: Resume CPR, starting with chest compressions One measure to minimize interruptions in chest compressions correct answer: Continue CPR while charging the defibrillator Action to take if during the use of an AED you are not directed to check the rhythm correct answer: Continue CPR (starting with chest compressions) then check the equipment. Measures to provide electrical safety during cardioversion or defibrillation. correct answer: • Being sure oxygen is not blowing over the patient's chest during the shock • Verbally and visually "clear" the field • Charge defibrillator when paddles are in place on the chest • Consider hands free pads An advantage of hands-free pads verses defibrillator paddles correct answer: Hands-free pads allows for more rapid defibrillation Physiology of how CPR is a survival advantage correct answer: Supplying a small amount of blood flow to the heart and reducing ischemia Problem and management of using of an AED with a hairy chest correct answer: If skin contact is not made AED pads the machine will not be able to analyze; remove the hair. Problem and management of using of an AED when the patient is partially submerged in water correct answer: Remove the patient from the water and dry off Problem and management of using of an AED when patient is lying on snow or ice correct answer: Use the AED If a patient has an implantable device such as a pacemaker/AICD that is not functioning the location you should place the universal pads correct answer: Place the AED pads on either side not directly on top of an implantable device An important intervention to manage an out-of-hospital resuscitation that achieves return to spontaneous circulation correct answer: Transport to a facility capable of coronary reperfusion (performing a PCI) Danger if you routinely administer high concentration of oxygen in the post arrest management of patients correct answer: Oxygen toxicity The cardiopulmonary and neurologic support during the post arrest correct answer: Therapeutic hypothermia and percutaneous coronary interventions (PCIs), Therapeutic hypothermia should be considered in these populations of adult patients who achieves return to spontaneous circulation correct answer: Patients who remain comatose after the arrest defined as the lack ability to follow commands without contraindications to inducing hypothermia Contraindications to inducing hypothermia correct answer: • Patients responding to verbal commands • Patients with potential to bleed or recent bleeding • Hemorrhagic stroke • Arrest due to trauma Target temperature goal and duration when inducing therapeutic hypothermia who achieves return to spontaneous circulation after an arrest correct answer: 32 Degrees C to 36 Degrees C for a recommended duration of at least 24 hours. Once the patient with chest discomfort is assessed as being stable, the most important assessment or next step correct answer: Obtain a 12-Lead ECG The recommended goal from door-to-balloon inflation time for percutaneous coronary intervention (PCI) correct answer: 90 minutes. Management of a patient who is hemodynamically stable without chest pain in a tachycardic rhythm correct answer: 12-lead done before another procedure to different the cause of the tachycardia (AMI). The recommended dose of aspirin for a patient with chest pain correct answer: 160 to 325 mg. Target goal for oxyhemoglobin saturations in patients with acute coronary syndromes and/or stroke correct answer: Greater than or equal to 94% The next step once the primary survey is performed on a potential stroke victim correct answer: Perform the Cincinnati Prehospital Stroke Scale assessment According to the Adult Suspected Stroke Algorithm a critical action that should be performed by the EMS team to expedite the patient's care on arrival and reduce time to treatment correct answer: Alert the hospital Recommended time for a noncontrast CT scan of the head should be performed once a potential stroke victim arrives at the hospital correct answer: Within 25 minutes Meaning of F.A.S.T. Acronym in a potential stroke victim correct answer: • Facial Droop • Arm Drift • Speech ineffective • Time of onset of symptoms Action if a radio report is received in the pre-hospital setting that the CT scanner is inoperable and you are transporting a potential stroke patient correct answer: Diverted to a hospital that has CT capabilities One of the first intervention in the ED, once a CT scan is obtained, for a stroke victim correct answer: Start fibrinolytic therapy as soon as possible as long as • CT is normal without signs of hemorrhage • The patient has arrived within the 3 to 4 ½ hours from the onset of symptoms • No assessed contraindications are present Target range for Blood pressure prior to administering thrombolytics in a stroke victim correct answer: SBP less than 185 mmHg DBP less than 110 mmHg Right ventricular infarcts are most often associated with __________ myocardial infarctions correct answer: Inferior MI (Leads II, III, AVF) Considerations if right ventricular infarct suspected correct answer: • Obtain right-sided ECG • Nitrates and morphine may be contraindicated • Patient may require IV fluids for hypotension Caveat to obtain vascular access, drug delivery, or advanced airway placement correct answer: Should NOT interrupt CPR The location and leads used by Bob Page's mnemonic "I See All Leads" to describe location of infarcts correct answer: • I = Inferior ( Leads II, III, AVF) • See = Septal (V1 and V2) • All = Anterior left ventricle (V3 and V4) • Leads = High lateral (I and AVL) Low lateral left ventricle (V5 and V6) ECG changes associated with an acute MI (Injury) correct answer: ST segment elevation ST segment elevation in lead I and III considered correct answer: Nondiagnostic The preferred access for medications in the arrest is a large peripheral vein such as the antecubital. If unable to obtain a peripheral access, the next most preferred route correct answer: Intraosseous (IO) What the team leader should do to avoid inefficiencies during resuscitation correct answer: Clearly delegate tasks Team leader instructs a team member to give 0.5 mg of Atropine, to which the team member responds with "I'll draw up 0.5 mg of Atropine." This type of communication is called correct answer: Closed-loop communication Action the team leader or other team members should do if a team member is about to make a mistake during resuscitation attempt correct answer: Address the team member immediately The action that a Team Member is responsible to perform they feel they are unable to perform an assigned task because it is beyond the team member's scope of practice correct answer: Ask for a new task or role Action required by the Team Member Team member if they are uncertain if the correct amount of amiodarone was order by team leader, so the team member because of noise or other distractions correct answer: Should repeat the order and ask for verification Medical Emergency Teams (MET) or rapid response teams (RRT) have demonstrated the reduction of cardiac arrest in the inpatient environment. The primary purpose of a MET or RRT correct answer: Improving patient outcomes by identifying and treating early clinical deterioration Conditions where resuscitation efforts should be withheld correct answer: • There is a perceived safety threat to the provider • Signs of irreversible death (e.g., decapitation, rigor mortis, or decomposition) are present • If the patient has a medical directive excluding advanced cardiac life support techniques. ST elevation in V1 through V4 correct answer: Anterior MI (anteroseptal) ST depression in V1 through V4 correct answer: Potential Posterior MI Considerations with return of spontaneous circulation correct answer: • Ventilation and Vital Signs • Oxygenation • Medications • IV access, IV fluid administration • Therapeutic interventions (Induction of hypothermia, 12-Lead ECG, Chest x-ray Ventricular Fibrillation correct answer: Complete Heart Block correct answer: