ACLS Test Prep (PALS, BLS, ACLS) Questions and Answers A+ Guide, Exams of Nursing

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Questions and Answers A+ Guide

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. - correct 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: - correct 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? - correct 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.

Questions and Answers A+ Guide

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? - correct 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? - correct 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. - correct 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: - correct answer ✅✅ A "whistling" sound during breathing

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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? - correct 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: - correct 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? - correct 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.)

Questions and Answers A+ Guide

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 - correct answer ✅✅ 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 B) Grunting respirations C) Warm, pink skin D) Diminished level of consciousness - correct answer ✅✅ Warm, pink skin

Questions and Answers A+ Guide

Rationale: Grunting respirations, rapid respiratory rate, and a diminished level of consciousness are signs of respiratory compromise. Warm, pink skin would not normally occur during the course of respiratory distress. Late and ominous signs of respiratory failure include all of the following EXCEPT: A) Rapid respiratory rate B) Cyanosis C) Bradycardia D) Diminished level of consciousness - correct 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 200. 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: - correct answer ✅✅ Supraventricular tachycardia

Questions and Answers A+ Guide

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? - correct 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 - correct answer ✅✅ All of the above Rationale: All of the features listed reflect high-quality CPR for pediatric patients.

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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: - correct 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 - correct 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:

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A) Baseline rate B) Level of activity C) Clinical condition D) All of the above - correct 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? For asystole, the team should do CPR until IV or IO access is achieved. The drug of choice for asystole is: - correct answer ✅✅ Epinephrine Rationale: Epinephrine is the drug of choice for the treatment of asystole. In school age children and infants, the two most common initial rhythms seen in pediatric cardiac arrest are: - correct answer ✅✅ Asystole and PEA Rationale: While cardiac arrest in children is usually preceded by respiratory distress and failure, the two most common,

Questions and Answers A+ Guide

immediate causes of cardiac arrest in children are asystole and PEA. What is the correct depth of chest compressions in an adult? - correct answer ✅✅ 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? - correct answer ✅✅ 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? - correct answer ✅✅ 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.

Questions and Answers A+ Guide

Where should you check for a pulse in an adult? - correct answer ✅✅ 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? - correct 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: - correct answer ✅✅ A child is not breathing but has a pulse rate of 50 per minute. The rescuers should: - correct 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.

Questions and Answers A+ Guide

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: - correct 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: - correct 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 - correct 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

Questions and Answers A+ Guide

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: - correct 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: - correct 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: - correct 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:

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A) IV calcium infusion B) IV dopamine infusion C) IV epinephrine infusion D) IV Ringer's lactate or IV normal saline - correct answer ✅✅ 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: - correct answer ✅✅ 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: - correct answer ✅✅ No longer than 90 minutes.

Questions and Answers A+ Guide

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 - correct answer ✅✅ All of the above Rationale: All of these measures can inform providers about the quality of CPR. The quantitative waveform capnography goal is at least 10 mm Hg during CPR. Arterial diastolic blood pressure should be at least 20 mm Hg during CPR. Central venous oxygen saturation as measured by a Swan-Ganz catheter or equivalent should be at least 30%. Narrow-complex supraventricular tachycardia is best treated with:

- correct answer ✅✅ Adenosine Rationale: The main drug treatment for narrow QRS complex SVT is adenosine. The other drugs are used in ACLS under different circumstances.

Questions and Answers A+ Guide

Pulseless electrical activity is treated with _______? - correct 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: - correct 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? - correct 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? - correct answer ✅✅ 150 BPM

Questions and Answers A+ Guide

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. - correct 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.

- correct 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. - correct answer ✅✅ True Rationale: Dosages less than 0.5 mg may cause a paradoxical slowing of the heart rate. During cardiopulmonary resuscitation, deliver oxygen at: - correct answer ✅✅ 100%

Questions and Answers A+ Guide

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: - correct 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 - correct answer ✅✅ Hypocalcemia Rationale: Hypocalcemia is not a common cause of PEA, nor is it part of the H's and T's mnemonic.

Questions and Answers A+ Guide

An EMT discovers STEMI on a 12-lead ECG in the ambulance. The best option is to: - correct answer ✅✅ Take the patient to a hospital capable of providing PCI, 15 minutes away. Rationale: PCI is the preferred treatment for STEMI. So much so, patients should be preferentially taken to hospitals that offer the procedure, even if it takes a slightly longer time. During travel time, the accepting hospital should activate the cardiac catheterization team. Which of the following signs is NOT part of the Cincinnati Prehospital Stroke Scale? A) Facial droop B) Arm drift C) Speech abnormality D) Confusion or disorientation - correct answer ✅✅ Confusion or disorientation Rationale: The Cincinnati Prehospital Stroke Scale can be remembered by the acronym FAST: Facial droop, Arm drift, Speech abnormality (slurring, usually), and Time. Time is not a symptom.