ACLS Test Prep 2 Questions with answers, Exams of Nursing

Download ACLS Test Prep 2 Questions with answers and more Exams Nursing in PDF only on Docsity! ACLS Test Prep 2 Questions with answers A 5-year-old child in supraventricular tachycardia has adequate pulses with the rhythm. Supplemental oxygen is in place and vital signs are stable except for the elevated heart rate. The most appropriate next intervention for this child is: ✔Vagal Maneuvers *Rationale:* Vagal maneuvers are a reasonable first intervention for supraventricular tachycardia in a hemodynamically stable patient, as this child is. A child has an advanced airway in place during cardiac arrest. How frequently should ventilations be given? ✔Every 6-8 Seconds 8-10 BPM *Rationale:* The latest AHA guidelines recommend one ventilation every six seconds, or 10 per minute, when an advanced airway is in place. You are using a bag-valve mask to resuscitate an infant, while another rescuer is performing chest compressions. What is the correct ratio of chest compressions to ventilations? ✔15 chest compressions to 2 ventilations *Rationale:* The AHA suggests that during a pediatric resuscitation with two or more rescuers present, the correct ratio of chest compressions to ventilations is 15:2. You are alone performing infant CPR. What is the correct ratio of chest compressions to ventilations? ✔30 chest compressions to 2 ventilations *Rationale:* The AHA suggests that during a pediatric resuscitation with only one rescuer present, the correct ratio of chest compressions to ventilations is 30:2. A 7 month old appears to be unconscious and not breathing. You check for a pulse at the ________ artery. ✔Brachial *Rationale:* Rescuers should use the brachial artery in the upper arm to check for a pulse. The artery is easily palpable in infants and young children. A clear sign of upper airway obstruction is: ✔A "whistling" sound during breathing *Rationale:* A "whistling" sound during breathing usually indicates *stridor.* Crying suggests full lung function, as does breath sounds in all lung fields. Decreased inspiratory effort is a non-specific sign, but may reflect a central process (i.e. consequence of head trauma). In children, which of the following is the most common form of arrest? ✔Respiratory arrest *Rationale:* Respiratory distress, failure, and arrest are the most common conditions prompting PALS care. In fact, most cases of pediatric cardiac arrest are preceded by respiratory issues. In small children, a rescue breath should be given: ✔Over one second *Rationale:* Rescue breaths and ventilations should be delivered over one second, regardless of the patient's age. What is the normal range of heart rates for an 8-year-old child? ✔*Answer:* 60-140 per minute *(The ACLS test I took says this. This is most likely a older ACLS test. According to 2015 Handbook of Emergency Cardiovascular Care it says for a school-age child the rate is 75-118.)* *Rationale:* Normal vital sign values change as children age. It is important to know what "normal" is for the age of your patient. The child you are caring for is very pale. You know that this pallor can be caused by all of the following EXCEPT: A) Anemia B) Heat C) Shock D) Albinism ✔Heat *Rationale:* Heat generally causes skin flushing and capillary dilation, which makes the skin red/pink. The other conditions result in pale skin. Anemia and shock are due to decreased blood flow through skin capillaries. Albinism is due to a congenital lack of skin pigment. Clinical signs of respiratory distress may include all of the following EXCEPT: A) Rapid respiratory rate ✔Asystole and PEA *Rationale:* While cardiac arrest in children is usually preceded by respiratory distress and failure, the two most common, immediate causes of cardiac arrest in children are asystole and PEA. What is the correct depth of chest compressions in an adult? ✔Between 2 and 2.4 inches *Rationale:* Previous guidelines had recommended a depth of at least 2 inches. This was based on the concept that rescuers tend to be too shallow, rather than too deep with their compressions. However, pressing too deeply is not good, either. So the recommendation is 2 to 2.4 inches or 5 to 6 centimeters. A victim probably has a neck injury. What is the correct way to open the airway? ✔Jaw thrust *Rationale:* A head tilt-chin lift is effective in opening the patient's airway, but may put stress on an unstable cervical spine. In a suspected neck injury, a jaw thrust without bending the victim's neck is preferable. How long should a pulse check last? ✔No more than 10 seconds *Rationale:* If you cannot feel a pulse, how long do you spend making sure you didn't just miss it? The AHA provides an answer: 10 seconds. If you haven't felt a pulse in 10 seconds, stop searching and start rescuing. Where should you check for a pulse in an adult? ✔Carotid artery *Rationale:* The most reliable and AHA-recommended place to check for a pulse in an adult is the carotid artery. Where should you check for a pulse in an infant? ✔Give 1 breath every 3 to 5 seconds *Rationale:* This child needs rescue breathing, not chest compressions. The correct rate for pediatric rescue breathing is 1 ventilation every 3 to 5 seconds. This equates to 12-20 breaths per minute. A child is gasping for breath but has a pulse rate of 100 per minute. The rescuers should: ✔ A child is not breathing but has a pulse rate of 50 per minute. The rescuers should: ✔Start CPR beginning with compressions *Rationale:* A pulse rate <60 bpm is consistent with cardiac arrest in children. Therefore, CPR is required, starting with chest compressions. A 50-year-old man who has been eating steak in a restaurant abruptly stands up and grabs his neck. The rescuer determines that the victim is choking. The best response is to: ✔Use abdominal thrusts *Rationale:* Abdominal thrusts, also known as the Heimlich maneuver, are the preferred way to dislodge a foreign object from an adult's airway. An infant who had been choking becomes unresponsive. The rescuer should: ✔Begin CPR *Rationale:* Back blows, chest thrusts, or abdominal thrusts are not to be used if the chocking victim becomes unconscious. Instead, CPR should begin immediately. Efforts to relieve choking should be stopped when: A) The obstruction is removed B) The victim becomes unresponsive C) The victim begins breathing normally D) Any of the above occurs ✔Any of the above occurs *Rationale:* There is no need to continue choking interventions if the object is dislodged and the patient can breathe once again. If a victim becomes unresponsive/unconscious, treat the situation as cardiopulmonary arrest and start CPR. Efforts to relieve chocking should be abandoned. Chest compressions for an adult are performed: ✔At a rate between 100 and 120 compressions per minute. *Rationale:* The most recent guidelines acknowledge that chest compressions can be performed too slowly and too quickly. Thus, a rate of 100 to 120 is the recommended range. The ratio of compressions to breaths in adults is: ✔30:2 *Rationale:* No matter how many rescuers are available (in adults), the correct ratio is 30 to 2. An adult patient in respiratory arrest with a pulse is ventilated via bag valve mask: ✔10 to 12 times per minute. *Rationale:* When there is no advanced airway in place, ventilations should be given 10 to 12 times per minute. This translates to one ventilation every 5 to 6 seconds. Hypotension following cardiac arrest is NOT treated with: A) IV calcium infusion B) IV dopamine infusion C) IV epinephrine infusion D) IV Ringer's lactate or IV normal saline ✔IV calcium infusion *Rationale:* Fluid resuscitation and/or "pressors" like epinephrine and dopamine are used to maintain blood pressure after cardiac arrest. Hypocalcemia, if present, can be treated separately but this is not a standard treatment for hypotension. The leader in team resuscitation must: ✔Be able to perform all the skills if needed *Rationale:* There is no special training required to be a team leader other than the ability to perform all facets of the resuscitation, if needed. While the team leader is often a physician, this is not essential as long as a team member is capable of prescribing ACLS medications.) Recommended ED door to balloon inflation time for a STEMI patient is: ✔No longer than 90 minutes. *Rationale:* Programs should be set up to have STEMI patients diagnosed, evaluated, and treated within 90 minutes of arriving to the emergency department. The effectiveness of CPR can be estimated by: A) Arterial diastolic blood pressure B) Quantitative waveform capnography C) Central venous oxygen saturation D) All of the above ✔All of the above