ACLS Final Exam Study Guide
Questions And Answers
A .patient .in .cardiac .arrest .experiences .return .of .spontaneous .circulation. .As .part .of .post-
cardiac .arrest .care, .the .patient .is .receiving .mechanical .ventilation .at .an .initial .rate .of .10
.breaths/min .and .a .fraction .of .inspired .oxygen .
(FiO2) .of .0.30. .Which .finding(s) .would .indicate .the .need .for .change .in .the .ventilator .settings .to .opti
mize .the .patient's .ventilation .and .oxygenation? .- .(correct .answer) .-ETCO2 .55mmHg
PaCO2 .48 .mmHg
SaO2 .90%
- .Mechanical .ventilation .should .be .started .at .a .rate .of .10 .breaths .per .minute .and .adjusted .as .neces
sary .to .keep .carbon .dioxide .levels .in .physiologic .range .
(PaCO2 .between .35 .and .45 .mmHg .or .monitored .using .ETCO2). .The .minimum .fraction .of .inspired .ox
ygen .necessary .to .maintain .an .SaO2 .of .94% .to .99% .is .used.
A .28-year-
old .pregnant .patient .who .resides .in .transitional .housing .presents .to .the .emergency .department .wit
h .complaints .of .feeling .feverish .and .very .faint. .The .patient .tells .the .emergency .nurse .that .she .does .
not .know .when .she .became .pregnant. .Upon .palpation, .the .fundus .is .not .at .or .above .the .umbilicus.
.The .patient's .condition .quickly .deteriorates .and .she .goes .into .cardiac .arrest. .If .available .and .able .to
.be .used .without .impeding .or .delaying .the .resuscitation .effort, .what .diagnostic .tool .could .be .used .t
o .guide .decision-making .in .the .care .of .this .patient? .- .(correct .answer) .-Point .of .care .US
- .Gestational .age .is .an .important .consideration .when .determining .the .approach .to .a .pregnant .patie
nt .in .cardiac .arrest. .If .the .gestational .age .is .not .known .and .point-of-care .ultrasound .is .available .and
.able .to .be .performed .without .impeding .or .delaying .the .resuscitation .effort, .it .can .be .used .to .quickl
y .estimate .gestational .age .and .guide .decision-making.
A .patient's .ECG .reveals .a .narrow .QRS .complex .with .a .regular .rhythm, .indicating .a .narrow-
complex .supraventricular .tachyarrhythmia. .The .patient .is .not .showing .signs .of .hemodynamic .compro
mise. .Which .intervention .would .be .initiated .first .if .it .does .not .delay .other .interventions? .- .
(correct .answer) .-Vagal .Maneuver
, - .For .a .patient .who .is .not .showing .signs .of .hemodynamic .compromise .and .is .experiencing .a .narrow
-
complex .supraventricular .tachyarrhythmia, .vagal .maneuvers .are .attempted .first. .If .ineffective, .adeno
sine .is .given.
A .patient .is .in .cardiac .arrest. .The .underlying .cause .is .thought .to .be .opioid .toxicity. .Which .statement
.accurately .describes .the .use .of .naloxone .for .this .patient? .- .(correct .answer) .-
Naloxone .should .be .administered .as .soon .as .possible .but .is .not .a .priority .over .high-
quality .CPR .and .AED .use.
- .High-
quality .CPR .and .AED .use .are .the .priority .interventions .for .cardiac .arrest .caused .by .suspected .or .kno
wn .opioid .toxicity. .When .opioid .toxicity .is .the .suspected .or .known .cause .of .cardiac .arrest, .naloxone
.should .be .administered .as .soon .as .possible .without .disrupting .or .delaying .high-quality .CPR .and .AED
.use. .The .recommended .dose .of .naloxone .is .0.4 .to .2 .mg
.IV/IO/IM/IN/SC, .repeated .every .2 .to .3 .minutes .as .needed. .A .continuous .naloxone .infusion .may .be .
considered .if .there .is .the .potential .for .recurrence .of .respiratory .depression .
(for .example, .if .the .cause .of .the .opioid .toxicity .was .an .extended-release .or .long-
acting .opioid) .but .is .not .indicated .in .the .immediate .treatment .of .suspected .or .known .opioid .toxicity
.
For .a .patient .with .third-degree .atrioventricular .
(AV) .block .and .a .blood .pressure .of .70/48 .mmHg, .what .interventions .should .be .considered? .- .
(correct .answer) .-Atropine
Dopamine .infusion
Transcut. .Pacing
- .For .a .patient .with .third-degree .atrioventricular .
(AV) .block .and .signs .of .hemodynamic .compromise, .first-line .therapy .is .with .atropine. .Second-
line .therapies .include .transcutaneous .pacing .and .β-adrenergic .agonists, .such .as .dopamine. .Second-
line .therapies .should .be .considered .immediately .if .the .patient .has .third-
degree .AV .block. .Adenosine .is .not .used .in .the .treatment .of .bradyarrhythmia.
A .20-year-
old .man .with .respiratory .depression .is .brought .to .the .emergency .department .by .his .parents. .Opioid
.overdose .is .suspected, .and .an .initial .dose .of .naloxone .is .administered .at .10 .p.m. .The .patient .does .
not .respond .to .this .initial .dose. .The .team .would .expect .to .administer .a .second .dose .after .how .man
y .minutes? .- .(correct .answer) .-2-3 .minutes
A .patient .is .in .cardiac .arrest. .The .cardiac .monitor .shows .asystole. .In .addition .to .providing .continuou
s .high-quality .CPR, .what .is .the .other .priority .intervention .for .this .patient? .- .(correct .answer) .-
Administer .Epi .ASAP
Questions And Answers
A .patient .in .cardiac .arrest .experiences .return .of .spontaneous .circulation. .As .part .of .post-
cardiac .arrest .care, .the .patient .is .receiving .mechanical .ventilation .at .an .initial .rate .of .10
.breaths/min .and .a .fraction .of .inspired .oxygen .
(FiO2) .of .0.30. .Which .finding(s) .would .indicate .the .need .for .change .in .the .ventilator .settings .to .opti
mize .the .patient's .ventilation .and .oxygenation? .- .(correct .answer) .-ETCO2 .55mmHg
PaCO2 .48 .mmHg
SaO2 .90%
- .Mechanical .ventilation .should .be .started .at .a .rate .of .10 .breaths .per .minute .and .adjusted .as .neces
sary .to .keep .carbon .dioxide .levels .in .physiologic .range .
(PaCO2 .between .35 .and .45 .mmHg .or .monitored .using .ETCO2). .The .minimum .fraction .of .inspired .ox
ygen .necessary .to .maintain .an .SaO2 .of .94% .to .99% .is .used.
A .28-year-
old .pregnant .patient .who .resides .in .transitional .housing .presents .to .the .emergency .department .wit
h .complaints .of .feeling .feverish .and .very .faint. .The .patient .tells .the .emergency .nurse .that .she .does .
not .know .when .she .became .pregnant. .Upon .palpation, .the .fundus .is .not .at .or .above .the .umbilicus.
.The .patient's .condition .quickly .deteriorates .and .she .goes .into .cardiac .arrest. .If .available .and .able .to
.be .used .without .impeding .or .delaying .the .resuscitation .effort, .what .diagnostic .tool .could .be .used .t
o .guide .decision-making .in .the .care .of .this .patient? .- .(correct .answer) .-Point .of .care .US
- .Gestational .age .is .an .important .consideration .when .determining .the .approach .to .a .pregnant .patie
nt .in .cardiac .arrest. .If .the .gestational .age .is .not .known .and .point-of-care .ultrasound .is .available .and
.able .to .be .performed .without .impeding .or .delaying .the .resuscitation .effort, .it .can .be .used .to .quickl
y .estimate .gestational .age .and .guide .decision-making.
A .patient's .ECG .reveals .a .narrow .QRS .complex .with .a .regular .rhythm, .indicating .a .narrow-
complex .supraventricular .tachyarrhythmia. .The .patient .is .not .showing .signs .of .hemodynamic .compro
mise. .Which .intervention .would .be .initiated .first .if .it .does .not .delay .other .interventions? .- .
(correct .answer) .-Vagal .Maneuver
, - .For .a .patient .who .is .not .showing .signs .of .hemodynamic .compromise .and .is .experiencing .a .narrow
-
complex .supraventricular .tachyarrhythmia, .vagal .maneuvers .are .attempted .first. .If .ineffective, .adeno
sine .is .given.
A .patient .is .in .cardiac .arrest. .The .underlying .cause .is .thought .to .be .opioid .toxicity. .Which .statement
.accurately .describes .the .use .of .naloxone .for .this .patient? .- .(correct .answer) .-
Naloxone .should .be .administered .as .soon .as .possible .but .is .not .a .priority .over .high-
quality .CPR .and .AED .use.
- .High-
quality .CPR .and .AED .use .are .the .priority .interventions .for .cardiac .arrest .caused .by .suspected .or .kno
wn .opioid .toxicity. .When .opioid .toxicity .is .the .suspected .or .known .cause .of .cardiac .arrest, .naloxone
.should .be .administered .as .soon .as .possible .without .disrupting .or .delaying .high-quality .CPR .and .AED
.use. .The .recommended .dose .of .naloxone .is .0.4 .to .2 .mg
.IV/IO/IM/IN/SC, .repeated .every .2 .to .3 .minutes .as .needed. .A .continuous .naloxone .infusion .may .be .
considered .if .there .is .the .potential .for .recurrence .of .respiratory .depression .
(for .example, .if .the .cause .of .the .opioid .toxicity .was .an .extended-release .or .long-
acting .opioid) .but .is .not .indicated .in .the .immediate .treatment .of .suspected .or .known .opioid .toxicity
.
For .a .patient .with .third-degree .atrioventricular .
(AV) .block .and .a .blood .pressure .of .70/48 .mmHg, .what .interventions .should .be .considered? .- .
(correct .answer) .-Atropine
Dopamine .infusion
Transcut. .Pacing
- .For .a .patient .with .third-degree .atrioventricular .
(AV) .block .and .signs .of .hemodynamic .compromise, .first-line .therapy .is .with .atropine. .Second-
line .therapies .include .transcutaneous .pacing .and .β-adrenergic .agonists, .such .as .dopamine. .Second-
line .therapies .should .be .considered .immediately .if .the .patient .has .third-
degree .AV .block. .Adenosine .is .not .used .in .the .treatment .of .bradyarrhythmia.
A .20-year-
old .man .with .respiratory .depression .is .brought .to .the .emergency .department .by .his .parents. .Opioid
.overdose .is .suspected, .and .an .initial .dose .of .naloxone .is .administered .at .10 .p.m. .The .patient .does .
not .respond .to .this .initial .dose. .The .team .would .expect .to .administer .a .second .dose .after .how .man
y .minutes? .- .(correct .answer) .-2-3 .minutes
A .patient .is .in .cardiac .arrest. .The .cardiac .monitor .shows .asystole. .In .addition .to .providing .continuou
s .high-quality .CPR, .what .is .the .other .priority .intervention .for .this .patient? .- .(correct .answer) .-
Administer .Epi .ASAP
