AHA ACLS EXAM 2024 AND PRACTICE EXAM TEST BANK WITH A STUDY GUIDE, Exams of Nursing

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AHA ACLS EXAM 2024 AND PRACTICE

EXAM TEST BANK WITH A STUDY GUIDE (POST

TEST AND PRE TEST) | ACCURATE

AND VERIFIED QUESTIONS WITH

ANSWERS | VERIFIED FOR GUARANTEED

PASS

A patient has a rapid irregular wide-complex tachycardia; The ventricular rate is 138/min.; It is asymptomatic, with a BP of 110/70 mmHG; He has a h/o angina; What action is recommended next? - ANSWER>>a) Giving Adenosine: 6 mg IV bolus; b) Giving Lidocaine: 1.5 mg IV bolus; c) Performing synchronized cardioversion; d) Seeking expert consultation ✅; What tests should be performed for a patient with a suspected stroke within 2 hours of arrival? - ANSWER>>non contrast CT scan of the head SVT types - ANSWER>>1) Atrial fibrillation (A-fib);

2. Paroxysmal Supraventricular Tachycardia (PSVT):
3. Atrial Flutter (A-flutter);
4. Wolff-Parkinson-White syndrome; The patient is in cardiac arrest. High-quality chest compressions are being given. The patient is intubated, and an IV is being started. The rhythm is asystole.

What is the first drug/dose to administer? - ANSWER>>Epinephrine 1 mg IV/IO Transcutaneous Pacing - ANSWER>>Aka external pacing: is a temporary means of pacing a patient's heart during a medical emergency. It is accomplished by gradually delivering pulses of electric current (50- 100 mA) through the patient's chest until capture is reached (usually at a selected rate of 70), which stimulates the heart to contract at a regular pace. Which intervention is most appropriate for the treatment of a patient in asystole? - ANSWER>>Epinephrine A patient with sinus bradycardia and a heart rate of 42/min is diaphoretic and with a blood pressure of 80/60 mm Hg. What is the initial dose of atropine? - ANSWER>>0.5 mg of Atropine A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a total dose of 3 mg. A transcutaneous pacing has failed to capture. The patient is confused, and her BP is 88/56 mmHg. Which therapy is now indicated? - ANSWER>>Epinephrine infusion: 2-10 mcg/min. A monitored patient in the ICU developed a sudden onset of regular narrowcomplex tachycardia at a rate of 220/min. The patient's BP is 128/88 mm Hg, the PETCO2 is 38 mm Hg, and the pulse oximetry reading is 98%. There is a vascular (IV) access in the left arm, and the patient has not been given any basic active drugs. A 12 - lead ECG confirms SVT with no evidence of ischemia or infraction. The HR has not responded to vagal maneuvers.

What is your next action? - ANSWER>>Administer adenosine 6 mg IV push A patient with possible STEMI has ongoing chest discomfort. What is a contraindication to nitrate administration? - ANSWER>>Use of a phosphodiesterase inhibitors (eg. Viagra) within the previous 24 hours A patient is in pulseless V-tach (PEA). 2 shocks and 1 dose of epinephrine have been given. Which drug should be given next? - ANSWER>>Amiodarone 300 mg (first dose) What is the indication for the use of magnesium in cardiac arrest? - ANSWER>>Pulseless V-tach associated with Torsades des pointes Which is one way to minimize interruptions in chest compressions during CPR? - ANSWER>>Continue CPR while the defibrillator charges A 35-years-old woman has palpitations, light-headedness, and a stable tachycardia. The monitor shows a regular-narrow-monomorphic-complex QRS at a rate of 180/minutes. Vagal maneuvers have not been effective in terminating the rhythm. An IV has been established. Which drug should be administered? - ANSWER>>Adenosine 6 mg (first dose) Antiarrhythmic Infusion for Stable Wide-QRS Tachycardia: - ANSWER>>1) Procainamide IV: 20 (max 50) mg/min;

2. Amiodarone IV: 150mg/10 min.;

3. Sotalol IV: 100 mg/5 min.; A 57-years-old woman has palpitations, chest discomfort, and tachycardia. The monitor shows a regular wide-complex QRS at a rate of 180/min. She becomes diaphoretic, and her BP is 80/60 mm Hg. Which action do you take next? - ANSWER>>Perform Synchronized Cardioversion at 100J ROSC - ANSWER>>Return to spontaneous circulation after BLS. A patient is in refractory V-fib and has received multiple appropriate defibrillation shocks; Epinephrine 1 mg IV twice; An initial dose of amiodarone 300 mg IV. The patient is intubated. Which best describes the recommended (IV) 2nd dose of amiodarone for this patient? - ANSWER>>150 mg (half); You arrive on the scene with the code team. High-quality CPR is in progress. An AED has previously advised "no shock indicated". A rhythm check now finds asystole. After resuming high-quality compressions, which action do you take next? - ANSWER>>Establish IV or IO access You are caring for a 66-years-old man with a history of a large intracerebral hemorrhage two months ago. He is being evaluated for another acute stroke. The CT scan is negative for hemorrhage. The patient is receiving oxygen via nasal cannula at 2L/min., and an IV has been established.

His blood pressure is 180/100 mm Hg. Which drug do you anticipate giving to this patient? - ANSWER>>Aspirin A patient is in refractory V-fib. High-quality CPR is in progress. 1 dose of epinephrine was given after the 2nd shock. An antiarrhythmic drug (amiodarone or lidocaine) was given immediately after the 3rd shock. You are the team leader. Which medication do you order next? - ANSWER>>Epinephrine 1 mg Targeted Temperature Management (TTM) - ANSWER>>Post-cardiac arrest care: mild induced hypothermia (32°C-36°C) for 24-28 hrs to improve health outcomes during recovery after a period of stopped blood flow to the brain; Vagal Maneuvers - ANSWER>>Techniques used to stimulate the vagal nerve in order to slow the HR and halt an episode of superventricular tachycardia (SVT):

1. Bearing Down: Valsalva Maneuver to increase intrathoracic pressure and stimulate the vagus nerve;
2. Coughing: forceful and sustained;
3. Cold Stimulus to the Face: should last about 10 seconds (the reaction is similar to the "diver's reflex");

4. Gagging: a tongue depressor is briefly inserted into the mouth, touching the back of the throat;
5. Carotid Massage: pressure is applied underneath the angle of the jaw in a gentle circular motion for about 10 seconds: not be recommended with carotid artery stenosis and a history of smoking; A 62-years-old man suddenly experienced difficulty speaking and left-sided weakness. He meets initial criteria for fibronolytic therapy, and a CT scan of the brain is ordered. Which best describes the guidelines for antiplatelet and fibrinolytic therapy? - ANSWER>>Hold aspirin for at least 24 hours if rtPA is administered A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and a heparin infusion of 1000 units per hour are being administered. The patient did not take aspirin because he has a history of gastritis, which was treated 5 years ago. What is your next action? - ANSWER>>Give aspirin 160 to 325 mg to chew In which situation does bradycardia require treatment? - ANSWER>>Hypotension What is the recommended depth of chest compression for an adult victim? - ANSWER>>At least 2"

PVC Bigemini - ANSWER>>When a sinus beat is shortly followed by an premature ectopic beat (PVC), a pause, another normal beat, and then another PVC. PVC Trigeminy - ANSWER>>When 2 sinus beats are shortly followed by an premature ectopic beat (PVC), a pause, another 2 normal beat, and then another PVC and so on; JER - ANSWER>>• Present on an underlined rhythm (HR: 40-60);

• delayed heartbeat originating from an ectopic focus somewhere in the AV junction;
• P inverted after QRS or not detected;
• usually irregular;
• prolonged PR; What can cause PVCs? - ANSWER>>Stress, exhaustion, alcohol, caffeine, cocaine, methamphetamines, nicotine, etc.; Life Pack - ANSWER>>Set to shock:
• turn on and place paddles;
• set on 'paddles';
• set on 200-360J; A patient was in refractory V-fib. A 3rd shock has just been administered. Your team looks to you for instructions. What is your next action? - ANSWER>>Resume high-quality CPR

A 35-year-old woman presents with a chief complaint of palpitations. She has no chest discomfort, shortness of breath, or light-headedness. Her bloody pressure is 120/78 mm Hg. Which intervention is indicated first? - ANSWER>>Vagal maneuvers Which action is likely to cause air to enter the victim's stomach (gastric inflation) during bag-mask ventilation? - ANSWER>>Ventilating too quickly A patient has been resuscitated from cardiac arrest. During post-ROSC treatment, the patient becomes unresponsive, with V-fib. Which action is indicated next? - ANSWER>>Give immediate unsynchronized high-energy shock: defibrillation dose A patient's 12-lead ECG is transmitted by the paramedics and shows a STEMI. When the patient arrives in the emergency department, rhythm shows ST elevation. The patient has resolution of moderate (5/10) chest pain after 3 doses of sublingual nitroglycerin. Blood pressure is 104/70 mm Hg. Which intervention is most important in reducing this patient's in-hospital and 30 - day mortality rate? - ANSWER>>Reperfusion therapy (PCI and CABG) A patient becomes unresponsive. You are uncertain if a faint pulse is present. The rhythm is PEA. An IV is in place. Which action do you take next? - ANSWER>>Start high-quality CPR Your patient is not responsive and is not breathing. You can detect a palpable

carotid pulse. Which action do you take next? - ANSWER>>Start rescue breathing Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. You determine that he is unresponsive. Which is the next step in your assessment of this patient? - ANSWER>>Check the patient's breathing and pulse What is an effect of excessive ventilation? - ANSWER>>Decreased cardiac output Which is one of the signs that is likely indicative of cardiac arrest in an unresponsive patient? - ANSWER>>Agonal gasps Chest compression will produce a ______ end-tidal CO2 - ANSWER>>low PETCO2 reading > 45 mm Hg suggests __________. - ANSWER>>hypoventilation or asthma, COPD To proper ventilate a patient with a perfusing rhythm, how often do you squeeze the bag? - ANSWER>>Once every 5-6 seconds Which is an acceptable method of selecting an appropriate sized oropharingeal airway? - ANSWER>>Measure from the corner of the mouth to the angle of the mandible.

Which is one way to minimize interruptions in chest compression during CPR? - ANSWER>>Continue CPR while the defibrillation charges What is the minimum systolic pressure one should attempt to achieve with fluid administration or vasoactive agents in a hypotensive post-cardiac arrest patient who achieves ROSC? - ANSWER>>90mm Hg In addition to clinical assessment, which is the most reliable method to confirm and monitor correct placement of an endotracheal tube? - ANSWER>>Continuous Waveform Capnography (35-37mm Hg) 3 minutes into a cardiac resuscitation attempt, one member of your team inserts an endothracheal tube while another performs chest compression. Capnography shows a persistent waveform and a PETCO2 of 8mm Hg. Which is significance of this finding? - ANSWER>>Chest compression may not be effective. Contraindication for amiodarone adminstration - ANSWER>>A-fib exceeding 48hrs of duration During post-cardiac arrest care, which is the recommended duration of targeted temperature management after reaching the correct temperature range? - ANSWER>>≥24hrs A patient (with a pulse) is in respiratory distress with a blood pressure of *70/

mmHg* presents with the lead II ECG a SVT. Which is the appropriate treatment? - ANSWER>>Performing Synchronized Cardioversion A patient in a stable narrow-complex tachycardia, with a peripheral IV in place, is refractory to the first dose of adenosine (6mg). Which would you administer as second dose? - ANSWER>>Adenosine 12 mg (double) V-tach on the ECG - ANSWER>>P= ; HR = V only >100 Reg.; QRS = wide; Vasopressin IV/IO dose of ______ units can replace the first or second dose of epineprhine; - ANSWER>> _______ breaths/min with continuos chest compression - ANSWER>>8- 10 With Capnography in place, placement of the colorimetric CO2 is necessary. T/F? - ANSWER>>False CPR Quality Criteria - ANSWER>>1) Push hard ≥ 2" and fast ≥100/min;

2. Minimize interruption: max 10 seconds;
3. If no advanced airway are in place, compress at 30:2 rate and rotate every 2 minutes;
4. If PETCO2 <10mm HG, improve CPR;
5. If diastolic Pressure <20mm Hg, improve CPR;

Biphasic Shock Energy - ANSWER>>120-200J Monophasic Shock Energy - ANSWER>>360J STEMI on ECG - ANSWER>> STEMI evolution over time - ANSWER>> ED Assessment - ANSWER>>• Check vital signs;

• Obtain medical history;
• Review fibrinolytic checklist;
• Obtain blood studies;
• Obtain portable x-ray; You are evaluating a 58-year-old man with chest discomfort. His BP is 92/ mmHg, his HR is 92/min, 14 breaths/min, and his pulse oximetry is 97%. Which assessment step is most important now? - ANSWER>>Obtaining a 12-lead ECG Epinephrine acts as a _________, which _______ cerebral and coronary blood flow.
• ANSWER>>vasoconstrictor; increases; Amiodarone - ANSWER>>An antiarrhythmic drug used with refractory V- FIB or pulseless VT:
• Prevents the heart from speeding;
• It effects Na+, K+ and Ca+ channels and α and β blockers;

• Lowers defibrillation threshold; Average HR (bpm) - ANSWER>>The average adult male heart rate is 70- 72 bpm; There average for adult women is 78-82 bpm. Average BP in adults (mmHg) - ANSWER>>More than 120 over 80 and less than 140 over 90 (120/80-140/90) Average respiratory rate for adults - ANSWER>>The normal respiration rate for an adult at rest is 12-20 breaths per minute. (A respiration rate under 12 or over 25 breaths per minute while resting is considered abnormal); Bradycardia on a ECG - ANSWER>>P = ↑1:1; HR < 60; QRS = narrow; Sinus Tachycardia on the ECG - ANSWER>>P = ↑1:1; HR > 100 (even higher than 200); QRS = narrow; Your patient is in cardiac arrest and has been intubated. To assess CPR quality, which should you do? - ANSWER>>Monitor the patient's PETCO2 (The normal values is around 5% or 35-37 mm Hg);

SR with Bundle Branch Block on ECG - ANSWER>>P = ↑1:1; HR = reg. 60-100; QRS = wide; V-fib on the ECG - ANSWER>>P = ; HR = IRR. Chaotic; QRS = (Shock needed!) A-fib on the ECG - ANSWER>>P = fibrillating; HR = IRR. AR too fast to measure: (≤100 controlled, ≥100 uncontrolled); QRS = narrow; A-flutter - ANSWER>>P = fluttering; HR = A Reg. (250-350) and V?; QRS = narrow; SVT on the ECG - ANSWER>>(Impulse generated above the ventricles) P = hidden in QRS; HR = 150-250 reg.; QRS = narrow; A responder is caring for a patient with a h/o CHF. The patient is experiencing SOB, a BP of 68/50 mmHg, and HR of 190/min.

The patient lead II ECG displays the rhythm in the picture. Which best characterizes this patient's rhythm? - ANSWER>>Unstable SVT 2nd degree AV block type I on the ECG - ANSWER>>P↑ > QRS; HR = A. reg. V. irr.; PR = long, longer, longer...drop!; QRS = narrow; 2nd degree AV block type II on the ECG - ANSWER>>P↑ > QRS; HR = reg. 60-100; QRS = narrow/wide; PR = when related with QRS, it's constant; Do not rely on atropine in Mobitz type ____ or ____ degree AV. - ANSWER>>II; 3rd; Which temperature should be selected and maintained constant to achieve SR with 1st degree AV block on the ECG - ANSWER>>P = ↑1:1; HR = reg. 60- 100 ; PR = wide > .20; QRS = narrow; 3rd degree AV block on the ECG - ANSWER>>P↑ > QRS, unrelated; HR = A reg. V?; PR = non measurable; QRS = narrow/wide;

targeted temperature management after cardiac arrest? - ANSWER>>32° C - 36° C A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. If no pathway for medication administration is in place, which method is preferred? - ANSWER>>IV or IO A 45-years-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and reporting "crushing" chest discomfort. He is pale, diaphoretic, and cool to the touch (unstable). His radial pulse is very weak, BP is 64/40 mmHG, respiratory rate is * breaths/min* (hyperventilation), and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed V-tach, which then quickly changed to V-fib.

1. In addition to defibrillation, which intervention should be performed immediately?
2. Despite two defibrillations attempts, the patient remains in V-fib. Which drug do you administer first?
3. Based on this patient's initial presentation, which condition do you suspect led to the cardiac arrest? - ANSWER>>1) Chest compression ;
4. Epinephrine (1 mg);
5. ACS; A 68-years-old woman presents with lightheadedness, nausea, and chest discomfort. Your assessment find her awake and responsive but ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready, and fast. You are unable to obtain a blood pressure.

She has no obvious dependent edema, and her neck veins are flat. Her lung sounds are equal, with moderate rales present bilaterally. The cardiac monitor shows V-tach.

1. Based on this initial assessment, which adult ACLS algorhythm should you follow?
2. After your initial assessment of this patient, which intervention should be performed next?
3. The patient's pulse oximeter shows a reading of 84% on room air. Which initial action do you take?
4. If the patient became apneic and pulsess but the rhythm remained the same, which would take the highest priority? - ANSWER>>1) Tachycardia;
5. Synchronized Cardioversion;
6. Apply oxygen;
7. Perform defribillation; A patient has a witnessed loss of consciousness. The lead II ECG reveals V-fib. Which is the appropriate treatment? - ANSWER>>Defibrillation (SHOCK IT!) Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. You determine that he is unresponsive. Which is the next step in your assessment and management of this patient? - ANSWER>>Check the patient's breathing and pulse For STEMI patience, which best describes the recommended maximum goal time for emergency department door-to-balloon-inflation time for percutaneous coronary intervention? - ANSWER>>90 minutes

During CPR, 1 mg IV of epinephrine is recommended every _____ minutes - ANSWER>>3- 5 Consider continuos ________ with asynchronous _______ when the patient has an advanced airway - ANSWER>>compressions; ventilations; Synchronized Electrical Cardioversion - ANSWER>>therapeutic dose of electric current to the heart at a specific moment in the cardiac cycle, restoring the activity of the electrical conduction system of the heart with a stable patient with a QRS-t complex (100J). Defibrillation - ANSWER>>Therapeutic dose of electric current to the heart at a random moment (unsynchronized cardioversion) in the cardiac cycle with unstable patient, and is the most effective resuscitation measure for cardiac arrest associated with: V-fib and pulseless V-tach. With the drop in cardiac output, a patient may experience the following symptoms (these symptoms occur more frequently with a heart rate >150 beats per minute): - ANSWER>>• Shortness of air (Stable but serious symptoms)

• Palpitation feeling in chest (S)
• Dizziness (S)
• Rapid breathing (S)
• Numbness of body parts (S)
• Ongoing chest pain (Unstable)

• Loss of consciousness (U) The pathway of choice for SVT in the tachycardia algorithm is based on whether the patient is stable or unstable: Unstable patients with SVT (w/pulse) are always treated with _____________; - ANSWER>>Synchronized cardioversion (the appropriate voltage for cardioverting SVT is 50-100 J); In cycle length of 400 ms (0.4 s) is what rate? - ANSWER>>150 bpm (60/0.4=150)
• Rate > 100 bpm with gradual onset
• P to QRS ratio 1:1 - ANSWER>>Tachycardia Which are known as the precordial leads? - ANSWER>>V1-V Which rate is equivalent to an interval of 800 ms (0.8 s)? - ANSWER>>60/0.8 = 75 bpm Which of the following are considered normal durations for the PR and QRS intervals? - ANSWER>>PR = 150 ms; QRS = 80 ms; Which structure accounts for most of the duration of the PR interval? - ANSWER>>AV node

The normal glucose level, during fasting, for non-diabetic patients is _______. - ANSWER>>70-100mg/dL After FAST - ANSWER>>1) Support ABCs;

2. Apply oxygen to bring above 94%
3. Check LKW;
4. Check blood count, coags, glucose; If the CT scan shows no hemorrhage, an Acute Ischemic Stroke is probable and Fibrinolytic Therapy is recommended after NIHSS screening: T/F - ANSWER>>True Fibrinolytic Therapy is recommended within 3 hrs from stroke onset: T/F - ANSWER>>True If the patient is not a candidate for Fibrinolytic Therapy on the NIH Stroke Scale, administer aspirin and send for a CT scan w/o contrast and obtain ECG: T/F - ANSWER>>True When stroke is suspected, check glucose level: T/F - ANSWER>>True If hemorrhage is present on CT scan, fibrinolytic Therapy is recommended: T/F - ANSWER>>False Possible causes for stroke - ANSWER>>1) Diabetes;
5. HTN;

3. Hypercholesterolemia;
4. Family History; Hyperglycemia - ANSWER>>blood glucose level >6.0 mmol/L (>108 mg/dL), 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? - ANSWER>>Start chest compressions of at least 100 per min. You are evaluating a 58 year old man with chest pain. The BP is 92/50 and a heart rate of 92/min, non-labored respiratory rate is 14 breaths/min and the pulse O2 is 97%. What assessment step is most important now? - ANSWER>>Obtaining a 12 lead ECG. What is the preferred method of access for epi administration during cardiac arrest in most pts? - ANSWER>>Peripheral IV An AED does not promptly analyze a rythm. What is your next step? - ANSWER>>Begin chest compressions. You have completed 2 min of CPR. The ECG monitor displays the lead below (PEA) and the pt. has no pulse. You partner resumes chest compressions and an IV is in place. What management step is your next priority? - ANSWER>>Administer 1mg of epinepherine During a pause in CPR, you see a narrow complex rythm on the monitor. The pt. has no pulse. What is the next action? - ANSWER>>Resume compressions

What is acommon but sometimes fatal mistake in cardiac arrest management? - ANSWER>>Prolonged interruptions in chest compressions. Which action is a componant of high-quality chest comressions? - ANSWER>>Allowing complete chest recoil Which action increases the chance of successful conversion of ventricular fibrillation? - ANSWER>>Providing quality compressions immediately before a defibrillation attempt. Which situation BEST describes PEA? - ANSWER>>Sinus rythm without a pulse What is the best strategy for perfoming high-quality CPR on a pt.with an advanced airway in place? - ANSWER>>Provide continuous chest compressionswithout pauses and 10 ventilations per minute. 3 min after witnessing a cardiac arrest, one memeber of your team inserts an ET tube while another performs continuous chest comressions. During subsequent bentilation, you notice the presence of a wavefom on the capnogrophy screen and a PETCO2 of 8 mm Hg. What is the significance of this finding? - ANSWER>>Chest compressions may not be effective. The use of quantitative capnography in intubated pt's does what? - ANSWER>>Allowsfor monitoring CPR quality For the past 25 min, EMS crews have attemptedresuscitation of a pt who originally presented with V-FIB. After the 1st shock, the ECG screen displayed asystole which has persisted despite 2 doses of epi, a fluid bolus, and high

quality CPR. What is your next treatment? - ANSWER>>Consider terminating resuscitive efforts after consulting medical control. Which is a safe and effective practice within the defibrillation sequence? - ANSWER>>Be sure O2 is NOT blowing over the pt's chest during shock. During your assessment, your pt suddenly loses consciousness. After calling for help and determining that the pt. is not breathing, you are unsure whether the pt. has a pulse. What is your next action? - ANSWER>>Begin chest compressions. What is an advantage of using hands-free d-fib pads instead of d-fib paddles? - ANSWER>>Hands-free allows for more rapid d-fib. What action is recommended to help minimize interruptions in chest compressions during CPR? - ANSWER>>Continue CPR while charging the defibrillator. Which action is included in the BLS survey? - ANSWER>>Early defibrillation Which drug and dose are recommended for the management of a pt. in refractory V-FIB? - ANSWER>>Amioderone 300mg What is the appropriate intervalfor an interruption in chest compressions? - ANSWER>>10 seconds or less Which of the following is a sign of effective CPR? - ANSWER>>PETCO2 = or > 10mm Hg

What is the primary purpose of a medical emergency team or rapid response team? - ANSWER>>Identifying and treating early clinical deterioration. Which action improves the quality of chest compressions delivered during resuscitave attemepts? - ANSWER>>Shitch providers about every 2 min or every 5 compression cycles. What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse of 80 beats/min? - ANSWER>>1 breath every 5-6 seconds A pt. presents to the ER with a new onset of dizziness and fatugue. Onexamination, the pt's heart rate is 35 beats/min, BP is 70/50, resp. rate is 22 per min, O2 sat is 95%. What is the appropriate 1st medication? - ANSWER>>Atropine 0.5mg A pt. presents to the ER with dizziness and SOB with a sinus brady of 40/min. The initial atropine dose was ineffective and your monitor does not provide TCP. What is the appropriate dose of Dopamine for this pt? - ANSWER>>2- 10mcg/kg/min A pt. has an onset of dizziness. The pt.s heart rate is 180, BP is 110/70, resp. rate is 18, O2 sat is 98%. This is a reg narrow complex tach rythm. What is the next intervention? - ANSWER>>Vagal manuever. A monitored pt. in the ICU developed a suddent onset of narrow complex tach at a rate of 220/min. The pt's BP is 128/58, the PETCO2 is 38mm Hg, and the O2 sat

is 98%. There is an EJ established for vascular access. The pt. denies taking any vasodialators. A 12 lead shows no ischemia or infarction. Vagal manuevers are ineffective. What is the next intervention? - ANSWER>>Adenosine 12mg IV You receiving a radio report from an EMS team enroute with a pt. who may be having a stroke. The hospital CT scanner is broken. What should you do? - ANSWER>>Divert the pt. to a hospital 15 min away with CT capabilities. Choose an appropriate inidication to stop or withhold resuscitive efforts. - ANSWER>>Evidence of rigor mortis. A 49 y/ofmaile arrives in the ER with persistant epigastric pain. She has been taking antacids PO for the past 6 hours because she she had heartburn. BP is 118/72, heart rate is 92/min, resp. rate is 14 non-labored and O2 sat is 96%. What is the most appropriate next action? - ANSWER>>Obtain a 12 lead ECG. A pt. in respiratory failure becomes apneic but contineues to have a strong pulse. The heart rate is dropping paridly and now shows a sinus brady rate at 30/min. What intervention has the highest priority? - ANSWER>>Simple airway manuevers and assisted ventilations. What is the appropriate procedure for ET suctioning after the catheter is selected? - ANSWER>>Suction during withdrawl, but not for longer than 10 seconds. While treating a stable pt for dizziness, a BP of 68/30, cool and clammy, you see a brady rythm on the ECG. How do you treat this? - ANSWER>>Atropine 0.5mg