RQI 2025 ACLS Healthcare Provider Complete Q&A 2023.

Within the first 10 minutes, on the basis of the patient showing symptoms suggestive of myocardial ischemia, what will your first actions include (if not completed by EMS before arrival)? o Obtain a 12-lead electrocardiogram (ECG) o Administer a blood thinner o Administer aspirin and establish IV access o Activate the ST-segment elevation myocardial infarction (STEMI) team o If SPO2 is less than 90%, start oxygen o Assess airway, breathing, and circulation (ABCs) o Administer epinephrine 1 mg IV o Consider nitroglycerin, morphine and a P2Y inhibitor o Obtain a 12-lead electrocardiogram (ECG) o Administer aspirin and establish IV access o Activate the ST-segment elevation myocardial infarction (STEMI) team o If SPO2 is less than 90%, start oxygen o Assess airway, breathing, and circulation (ABCs) o Consider nitroglycerin, morphine and a P2Y inhibitor His initial vital signs are HR 120/min, BP 135/88 mm Hg, RR 23/min, SpO2 87%, and temperature 37.3C. When considering oxygen saturation, what is your course of action? o Intubate the patient immediately o Administer albuterol nebulizer o Do not start oxygen o Start oxygen at 4L/min via nasal cannula o Start oxygen at 4L/min via nasal cannula What additional question help you determine next steps? o Do you take any medication? o Do you have any allergies? o When was the last time you went to the doctor? o When did the symptoms start? o Have you had any recent falls? o Do you take any medication? o Do you have any allergies? o When did the symptoms start? Your patient continues to say that he has chest discomfort. What treatment can you repeat as long as it is not contradicted by vital signs? o Morphine sublingual every 1 to 3 minutes o Morphine IV every 1 to 3 minutes o Nitroglycerine sublingual or translingual every 3 to 5 minutes o Nitroglycerine every 1 to 3 minutes o Nitroglycerine sublingual or translingual every 3 to 5 minutes What is your interpretation of the patient's ECG tracing? o Anterior ST-segment elevation of myocardial infarction (STEMI) o Ventricular tachycardia o Posterior ST-segment elevation myocardial infarction (STEMI) o Normal sinus rhythm with premature ventricular contractions o Anterior ST-segment elevation of myocardial infarction (STEMI) With the diagnosis of STEMI, what is the most probable treatment? o Release to home o Admission to an intensive car unit o Admission for observation o Admission for PCI or fibrinolysis o Admission for PCI or fibrinolysis What is your goal for PCI when treating this patient? o Door-to-balloon inflation time of 30 minutes o First medical contact-to-balloon inflation time of 90 minutes o Door-to-needle time of 90 minutes o First medical contact-to-needle time of 30 minutes o First medical contact-to-balloon inflation time of 90 minutes The patient's vital signs show HR 92/min, RR 14/min, BP 130/86 mm Hg, SpO2 97%, and atrial fibrillation on the monitor. What additional assessment and stabilization activities should be completed with the first 10 minutes after the patient's arrival? o Establish IV access o Order an emergent CT scan or MRI of the brain and review patient history o Monitor for worsening symptoms o Activate the stroke team o Complete neurologic screening o Check glucose o Administer O2 o Establish IV access o Order an emergent CT scan or MRI of the brain and review patient history o Activate the stroke team o Complete neurologic screening o Check glucose What needs to be completed for this patient within 20 minutes after hospital arrival? o Neurologic assessment o Admission to a monitored bed o Interpretation of the emergent CT scan or MRI of the brain o Administration of fibrinolytic therapy o Neurologic assessment As part of the neurologic assessment, you perform a physical and neurologic examination. What are some of the general questions you need to ask?