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1. A patient with dyspnea, inadequate blood pressure and a change in mental status
arrives at the emergency department. The healthcare team completes the necessary
assessments and begins to care for the patient, including initi- ating cardiac monitoring
and pulse oximetry; providing supplemental oxygen and ensuring adequate ventilation;
and obtaining vascular access. The team reviews the patient's ECG rhythm strip, as shown
in the following figure.Which agent would the team most likely administer?
Answer> sinus bradycardia - atropine 1 mg every 3 to 5 minutes
2. Cardiac monitoring indicates that a patient has a ventricular tachyarrhyth- mia. The
patient has a pulse and is not showing any signs of hemodynamic compromise. A 12-lead
ECG reveals an irregular rhythm with QRS complexes greater than 0.12 second in
duration. Which action would be appropriate at this time?
Answer> For a patient with a wide-complex tachyarrhythmia and no signs of hemodynamic
compromise, consider an antiarrhythmic medication (procainamide, amiodarone or
sotalol).
,3. rapid assessment is
Answer> a visual survey to ensure safety, form an initial impression about the patient's
condition (including looking for life-threatening bleeding), and determine the need for
additional resources. This would be followed by a primary assessment and then a
secondary assessment.
4. Which arterial carbon dioxide (PaCO2) value signifies adequate ventila- tions?
Answer> Arterial carbon dioxide (PaCO2) values in the range of 35 to 45 mmHg confirm
adequacy of ventilation.
5. A patient experiences cardiac arrest, and the resuscitation team initiates ventilations
using a bag-valve-mask (BVM) resuscitator. The development of which condition during
the provision of care would lead the team to suspect that improper BVM technique is
being used?
Answer> Complications can occur with the use of a BVM resuscitator due to improper
technique. Delivering excessive volume or ventilating too fast creates excessive pressure that
can damage the airways, lungs and other organs. Excessive volume can lead to tension
pneumothorax.
6. A resuscitation team is debriefing following a recent event. A patient expe- rienced
cardiac arrest, and advanced life support was initiated. The patient required the
, placement of an advanced airway to maintain airway patency. Which statement indicates
that the team performed high-quality CPR
Answer> When an advanced airway has been placed in a patient who is in cardiac arrest,
compressions should be delivered continuously (100 to 120 per minute) with no pauses for
ventilations.
7. Assessment of a patient reveals an ETCO2 level of 55 mmHg and an arterial oxygen
saturation (SaO2) level of 88%. The provider would interpret these findings as indicative
of which condition?
Answer> An SaO2 level of less than 90%
(PaO2 of less than 50 mmHg) accompanied by ETCO2 values greater than 50 mmHg is
indicative of respiratory failure.
8. A responsive patient is choking. What method should the provider use first to clear the
obstructed airway?
Answer> 5 back blows to clear the obstruction.
no longer using abdominal thrusts
9. A patient arrives at the emergency department complaining of shortness of breath.
The patient has a long history of chronic obstructive pulmonary disease. Assessment
reveals respiratory failure. Which action would be the initial priority to address the