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ACLS Test Prep (PALS, BLS, ACLS) These 50 questions and answers are found on. You can take the test there is you would rather study in a test format. You could also us the test study feature on quizlet. Hope this helps you study some basic ACLS. - ANSWER https://www.aclsmedicaltraining.com/practice-tests/ 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: - ANSWER 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? - ANSWER 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? - ANSWER 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? - ANSWER 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. - ANSWER 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: - ANSWER 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? - ANSWER 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: - ANSWER 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 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.)
C) Bradycardia D) Diminished level of consciousness - ANSWER Rapid respiratory rate Rationale: An elevated respiratory rate is a sign of early respiratory compromise. In late stages or overt respiratory failure, the respiratory rate is low or barely detectable. The 8-year-old child you are treating has a palpable pulse and a heart rate of
- You look at the monitor and see a rapid rhythm with narrow QRS complexes. There are no discernible P waves on the monitor. The rhythm is probably: - ANSWER Supraventricular tachycardia Rationale: The absence of P waves rules out a sinus rhythm, even sinus tachycardia. Ventricular tachycardia creates a wide QRS complex. You are doing CPR on a child with symptomatic bradycardia. An intravenous line is in place. What is the first drug of choice for the patient? - ANSWER Epinephrine Rationale: If oxygenation and ventilation fail to correct symptomatic bradycardia in a child, epinephrine should be given. While atropine is the recommended initial treatment choice for symptomatic bradycardia in adults, in children it is a secondary choice. Atropine is the initial treatment in children with AV block due to primary bradycardia, however. High-quality CPR for young children includes: A) Compress to a depth of at least one third of the child's chest diameter B) Compress at a rate between 100 and 120 compressions per minute C) Minimize interruptions to chest compressions D) All of the above - ANSWER All of the above Rationale: All of the features listed reflect high-quality CPR for pediatric patients.
You are the team leader on a team resuscitating a child without a pulse or respirations. When you look at the monitor, you see a disorganized rhythm with chaotic electrical activity. This rhythm is most likely: - ANSWER V-Fib Rationale: The ECG waveform described is most likely ventricular fibrillation. Ventricular tachycardia would create abnormal, but regular waveforms. Asystole is a "flat line" and PEA can be almost any rhythm, except asystole, ventricular tachycardia, or ventricular fibrillation. The goal of the PALS team in the treatment of shock is to: A) Improve oxygen delivery B) Prevent organ injury C) Stop the progression to cardiopulmonary failure D) All of the above - ANSWER All of the above Rationale: These are all important goals of shock management in children. Untreated shock may lead to cardiopulmonary failure, decreased blood perfusion, decreased oxygen delivery to the tissues, and organ damage. When evaluating a child's bradycardia, it is important to consider the child's: A) Baseline rate B) Level of activity C) Clinical condition D) All of the above - ANSWER All of the above Rationale: An abnormally slow heart rate must be evaluated in the context of the child's current condition. Is the child sleeping? What is her normal heart rate, i.e., is this slow for her? Most importantly, is the bradycardia causing symptoms or is it likely to cause symptoms imminently?
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? - ANSWER 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: - ANSWER A child is not breathing but has a pulse rate of 50 per minute. The rescuers should: - ANSWER 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: - ANSWER 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:
- ANSWER 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 - ANSWER 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: - ANSWER 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: - ANSWER 30: 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: - ANSWER 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 - ANSWER IV calcium infusion
Rationale: The main drug treatment for narrow QRS complex SVT is adenosine. The other drugs are used in ACLS under different circumstances. Pulseless electrical activity is treated with _______? - ANSWER Epinephrine Rationale: Epinephrine is the standard treatment for PEA. Unsynchronized cardioversion is not recommended because PEA is not considered a "shockable" rhythm. The correct sequence for basic life support is: - ANSWER CAB - Compressions, Airway, Breathing. Rationale: While ABC is easier to remember, the proper sequence for basic life support is now CAB; Compressions (circulation), Airway, Breathing. Which of the following is the correct initial dose of adenosine for the treatment of supraventricular tachycardia? - ANSWER 6 mg IV Rationale: The first dosage of adenosine is 6 mg IV. If 6 mg fails to achieve an effect, the subsequent dosage is 12 mg IV. At what heart rate does tachycardia usually become symptomatic? - ANSWER 150 BPM Rationale: While it depends on the patient, a useful rule of thumb is tachycardia starts to become symptomatic at 150 bpm. The textbook definition of tachycardia is a heart rate >100 bpm. Sinus bradycardia Rationale: There is a P wave at an appropriate length of time before a normal QRS complex during each heartbeat. The only apparent anomaly is that the rate is very slow. - ANSWER You are the paramedic on an ambulance transporting a 65-year-old female. The patient is connected to the monitor and you see this rhythm; she has a palpable pulse. What is the rhythm?
True or False: Pulse checks should be done for at least 10 seconds. - ANSWER False Rationale: They should be done for no more than 10 seconds. True or False: The initial recommended dosage of atropine for symptomatic bradycardia is 0.5 mg IV. - ANSWER True Rationale: Dosages less than 0.5 mg may cause a paradoxical slowing of the heart rate. During cardiopulmonary resuscitation, deliver oxygen at: - ANSWER 100% Rationale: CPR is performed during cardiac arrest and 100% oxygen should be administered during cardiac arrest. The goal for initiation of fibrinolytic therapy in appropriate stroke patients is:
- ANSWER Within 1 hour of arrival to the ED. Rationale: All diagnostic testing and checklists should be performed so that a fibrinolytic drug can be infused within 1 hour of arriving to the emergency department. The window from symptom onset is different (3 hours in most, 4.5 hours in some). The most common reversible causes of PEA are called the "H's and T's" and include all of the following EXCEPT: A) Hypovolemia B) Hypoxia C) Hypocalcemia D) Tamponade - ANSWER Hypocalcemia Rationale: Hypocalcemia is not a common cause of PEA, nor is it part of the H's and T's mnemonic.
