ACLS Written Exam-Questions and Answers-Complete-100% Verified Answers, Exams of Cardiology

Download ACLS Written Exam-Questions and Answers-Complete-100% Verified Answers and more Exams Cardiology in PDF only on Docsity! You find an unresponsive pt. who is not breathing. After activating the emergency response system, you determine there is no pulse. What is your next action? You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 mum Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 97%. What assessment step is most important now? What is the preferred method of access for epi administration during cardiac arrest in most pts? An AED does not promptly analyze a rythm. What is your next step? You have completed 2 minutes of CPR. The ECG monitor displays the lead II rhythm below, and the patient has no pulse. Another member of your team resumes chest compressions, and an TV is in place. What management step is your next priority? During a pause in CPR, you see this lead Il ECG rhythm on the monitor. The patient has no pulse. What is the next action? ai 19385 #335) SET What is a common but sometimes fatal mistake in cardiac arrest management? Which action is a componant of high-quality chest comressions? Which action increases the chance of successful conversion of ventricular fibrillation? Which situation BEST describes pulseless electrical activity? What is the BEST strategy for performing high-quality CPR on a patient with an advanced airway in place? Three minutes after witnessing a cardiac arrest, onc member of your team inserts an endotracheal tube while another performs continuous chest compressions. During subsequent ventilation, you notice the presence of a waveform on the capnography screen and a PETCO2 level of 8 mm Hg. What is the significance of this finding? The use of quantitative capnography in intubated patients A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at a rate of 220/min. The patient's blood pressure is 128/58 mm Hg, the PETCO2? is 38 mm Hg, and the pulse oximetry reading is 98%. There is vascular access at the left internal jugular vein, and the patient has not been given any vasoactive drugs. A 12-lead ECG confirms a supraventricular tachycardia with no evidence of ischemia or infarction. The heart rate has not responded to vagal maneuvers. What is the next recommended intervention? Adenosine 6mg IV push You are recciving a radio report from an EMS team cn route with a paticnt who may be having an acute stroke. The hospital CT scanner is not working at this time. What should you do in this situation? Divert the patient to a hospital 15 minutes away with CT capabilities. Choose an appropriate indication to stop or withhold resuscitative efforts. Evidence of rigor mortis. A 49-year-old woman arrives in the emergency department with persistent epigastric pain. She had been taking oral antacids for the past 6 hours because she thought she had heartburn. The initial blood pressure is 118/72 mm Hg, the heart rate is 92/min and regular, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 96%. Which is the most appropriate intervention to perform next? Obtain a 12 lead ECG. A patient in respiratory failure becomes apncic but continucs to have a strong pulse. The heart rate is dropping rapidly and now shows a sinus bradycardia at a tate of 30/min. What intervention has the highest priority? Simple airway manuevers and assisted ventilations. What is the appropriate procedure for endotracheal tube suctioning after the appropriate catheter is selected? Suction during withdrawal but for no longer than 10 seconds. While treating a patient with dizziness, a blood pressure of 68/30 mm Hg, and cool, clammy skin, you sec this lead I] ECG rhythm: What is the first intervention ? Atropine 0.5mg A 68-year-old woman experienced a sudden onset of right arm weakness. EMS personnel measure a blood pressure of 140/90 mm Hg, a heart rate of 78/min, a nonlabored respiratory rate of 14 breaths/min, and a pulse oximetry reading of 97%. The lead II ECG displays sinus rhythm. What is the most appropriate action for the EMS team to perform next? Cincinnati Prehospital Stroke Scale assessment EMS is transporting a patient with a positive prehospital stroke assessment. Upon arrival in the emergency department, the initial blood pressure is 138/78 mm Hg, the pulse rate is 80/min, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95% on room air. The lead II ECG displays sinus rhythm. The blood glucose level is within normal limits. What intervention should you perform next? Head CT sean What is the proper ventilation rate for a patient in cardiac arrest who has an advanced airway in place? 8-10 breaths per minute A 62-year-old man in the emergency department says that his heart is beating fast. He says he has no chest pain or shortness of breath. The blood pressure is 142/98 mm Hg, the pulse is 200/min, the respiratory rate is 14 breaths/min, and pulse oximetry is 95% on room air. What intervention should you perform next? Obtain a 12 lead ECG. You are evaluating a 48-year-old man with crushing substernal chest pain. The patient is pale, diaphoretic, cool to the touch, and slow to respond to your questions. The blood pressure is 58/32 mm Hg, the heart rate is 190/min, the respiratory rate is 18 breaths/min, and the pulse oximeter is unable to obtain a reading because there is no radial pulse. The lead Il ECG displays a regular wide- complex tachycardia. What intervention should you perform next? Synchronized cardioversion What is the initial priority for an unconscious patient with any tachycardia on the monitor? Determine whether pulses are present. Which rhythm requires synchronized cardioversion? Unstable supraventricular tachycardia What is the recommended second dose of adenosine for patients in refractory but stable narrow-complex tachycardia? 12mg What is the usual post-cardiac arrest target range for PETCO2 when ventilating a patient who achieves return of spontaneous circulation (ROSC)? 35-40mm Hg Which condition is a contraindication to therapeutic hypothermia during the post- cardiac arrest period for patients who achieve return of spontaneous circulation ROSC? Responding to verbal commands What is the potential danger of using ties that pass circumferentially around the patient's neck when securing an advanced airway? Which finding is a sign of ineffective CPR? PETCO2 <10 mm Hg How often should the team leader switch chest compressors during a resuscitation attempt? . Every 2 minutes IV/IO drug administration during CPR should be given rapidly during compressions What is the recommended first intravenous dose of amiodarone for a patient with refractory ventricular fibrillation? 300 mg A team leader orders 1 mg of epinephrine, and a team member verbally acknowledges when the medication is administered. What element of effective resuscitation team dynamics does this represent? Closed-loop communication How long should it take to perform a pulse check during the BLS Survey? 5 to 10 seconds Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. You determine that he is unresponsive and notice that he is taking agonal breaths. What is the next step in your assessment and management of this patient? Check the patient's pulse. An AED advises a shock for a pulseless patient lying in snow. What is the next action? Administer the shock immediately and continue as directed by the AED. Which treatment or medication is appropriate for the treatment of a patient in asystole? Epinephrine What is the minimum depth of chest compressions for an adult in cardiac arrest? 2 inches A patient with pulseless ventricular tachycardia is defibrillated. What is the next action? Start chest compressions at a rate of at least 100/min. You have completed your first 2-minute period of CPR. You see an organized, nonshockable rhythm on the ECG monitor. What is the next action? Have a team member attempt to palpate a carotid pulse. Emergency medical responders are unable to obtain a peripheral IV [or a patient in cardiac arrest. What is the next most preferred route for drug administration? Intraosseous (IO) What is the appropriate rate of chest compressions for an adult in cardiac arrest? At least 100/min You are receiving a radio report from an EMS team en route with a patient who may be having an acute stroke. The hospital CT scanner is not working at this time. What should you do in this situation? Divert the patient to a hospital 15 minutes away with CT capabilities. A 53-year-old man has shortness of breath, chest discomfort, and weakness. The patient's blood pressure is 102/59 mm Hg, the heart rate is 230/min, the respiratory rate is 16 breaths/min, and the pulse oximetry reading is 96%. The lead II ECG is displayed below. A patent peripheral 1V is in place. What is the next action? ‘Vagal maneuvers A 49-year-old man has retrosternal chest pain radiating into the left arm. The patient is diaphoretic, with associated shortness of breath. The blood pressure is 130/88 mm Hy, the heart rate is 110/min, the respiratory rate is 22 breaths/min, and the pulse oximetry value is 95%. The patient's 12-lead ECG shows ST-segment elevation in the anterior leads. First responders administered 160 mg of aspirin, and there is a patent peripheral IV. The pain is described as an 8 on a scale of | to 10 and is unrelieved after 3 doses of nitroglycerin. What is the next action? Administer 2 to 4 mg of morphine by slow IV bolus. A 56-year-old man reports that he has palpitations but not chest pain or difficulty breathing. The blood pressure is 132/68 mm Hg, the pulse is 130/min and regular, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95%. The lead II ECG displays a wide-complex tachycardia. What is the next action after establishing an IV and obtaining a 12-lead ECG? Seeking expert consultation A postoperative patient in the ICU reports new chest pain. What actions have the highest priority? Obtain a 12-lead ECG and administer aspirin if not contraindicated. An 80-year-old woman presents to the emergency department with dizziness. She now states she is asymptomatic after walking around. Her blood pressure is 102/72 mm Hg. She is alert and oriented. Her lead IIT ECG is below. After you start an IV, what is the next action? Conduct a problem-focused history and physical examination. re = What is the recommended oral dose of aspirin for patients suspected of having one of the acute coronary syndromes? 160 to 325 mg What is the immediate danger of excessive ventilation during the post-cardiac arrest period for patients who achieve ROSC? Deercased cerebral blood flow What is the recommended target temperature range for achieving therapeutic hypothermia after cardiac arrest? 32°C to 34°C What is the recommended duration of therapeutic hypothermia after reaching the target temperature? 12 to 24 hours What is the danger of routinely administering high concentrations of oxygen during the post- cardiac arrest period for patients who achieve ROSC? Potential oxygen toxicity What is the recommended dose of epinephrine for the treatment of hypotension in a post- cardiac arrest patient who achieves ROSC? 0.1 to 0.5 meg/kg per minute TV infusion You have completed 2 min of CPR. The ECG monitor displays the lead below (PEA) and the patient has no pulse. You partner resumes chest compressions and an TV is in place. What management step is your next priority? Administer Lmg of epinephrine NO PULSE A patient is in refractory ventricular fibrillation and has received multiple appropriate defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of 300 mg amiodarone IV. The patient is intubated. A second dose of amiodarone is now called for. The recommend second dose of amiodarone is ? 150 mg IV push A patient is in refractory ventricular fibrillation. High CPR is in progress and shocks have been given. One dose of epinephrine was given after the second shock. An anti arrhythmic drug was given immediately after the the third shock. What drug should the team leader request to be prepared for administration next? second dose of epinephrine | mg A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine has been given. Which is the next drug to anticipate to administer? amiodarone 300 mg You are monitoring a patient with chest discomfort who suddenly becomes unresponsive. You observe the following rhythm on the cardiac monitor. A defibrillator is present. What is your first action? Give a single shock what do you do after return of spontancous circulation maintain O2 sat at 94% treat hypotension (fluids vasopressor) 12 lead EKG if in coma consider hypothermia if not in coma and ekg shows STEMI or AMI consider re-perfusion what are the 5 h's and 5 t's hypovolemia hypoxia hydrogen ion (acidosis) hypo/hyperkalemia hypothermia tension pneumothorax tamponade, cardiac toxins thrombosis, pulmonary thrombosis, coronary Bradycardia require treatment when? chest pain or shortness of breath is present how do you treat non-symptomatic bradycardia monitor and observe what constitutes symptomatic bradycardia hypotension altered mental status signs of shock chest pain acute heart failure A paticnt with sinus bradycardia and a heart rate of 42 has diaphoresis and blood pressure of 80/60. What is the initial dose of atropine? 0.5 mg how do you treat symptomatic bradycardia give 0.5mg atropine every 3-5 mins to max of 3mg if that docsn't work try one of the following: transcutaneous pacing monomorphic ventricular tachycardia fine ventricular fibrillation second degree AV block type | wenckenbach second degree AV block mobitz type 2  third degree AV block asystole normal sinus rhythm +4 pulseless electrical activity agonal rhythm/asystole  The five links in the adult Chain of Survival 1- Immediate activation of EMS 2- Early CPR 3- Rapid defibrillation (not in peds) 4- Effective advanced life support 5- Integrated post-cardiac arrest care Type of breaths (not normal) that may be present in the first minutes after sudden cardiac arrest Agonal gasps To place the pads on the victims bare chest, Place one pad on the upper-right chest (below the collarbone) and place the other pad to the side of the left nipple, with the top edge of the pad a few inches below the armpit If the heart muscle resets and initiates an organized rhythm this is called ROSC return of spontaneous circulation