ALS/ACLS - Red Cross Final Exam [Fall] Graded A

The resuscitation team suspects that hyperkalemia is the cause of cardiac arrest in a patient brought to the emergency department. Which finding on a 12-lead ECG would confirm this suspicion? - ANSWER-Wide-complex ventricular rhythm or tall, pointed T waves A patient with dyspnea 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 initiating cardiac monitoring, pulse oximetry, supplemental oxygen and 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-Atropine 0.5 mg every 4 to 5 minutes A patient experiencing an unstable bradyarrhythmia does not respond to atropine or transcutaneous pacing. Which intervention would the healthcare provider use next? - ANSWER-Administration of an epinephrine infusion A patient's ECG reveals a tachyarrhythmia. The patient is hemodynamically stable and has a heart rate ranging from 120 to 135 beats per minute. Based on the findings of the secondary assessment, which statement(s) by the patient would the team interpret as a possible contributing cause? - ANSWER-1. "I've had a terrible cold with a horrible cough and fever the past week." 2. "I've been so anxious lately because I just lost my job." 3. "I've been vomiting for the past 2 days from a gastrointestinal bug." A patient's ECG reveals a narrow QRS complex with a regular rhythm, indicating a narrow-complex supraventricular tachyarrhythmia. The patient is hemodynamically stable. Which intervention would be initiated first? - ANSWER-Vagal maneuvers A patient in the telemetry unit is stable. Cardiac monitoring indicates the patient has ventricular tachycardia with a pulse. Further assessment reveals that the corrected QT interval is greater than 0.46 seconds. Which treatment would be appropriate at this time? - ANSWER-Synchronized cardioversion An ECG strip of a patient in the emergency department reveals the following rhythm. Which feature would the healthcare provider interpret as indicating atrial fibrillation? - ANSWER-Absence of discrete P waves and presence of irregularly irregular QRS complexes A patient is brought into the emergency department. The patient does not have a pulse. The cardiac monitor shows the following rhythm. The team interprets this as which condition? - ANSWER-Ventricular tachycardia A patient with acute renal failure experiences cardiac arrest. Just before the cardiac arrest, the patient's ECG showed peaked T waves. What might be causing the patient's cardiac arrest? - ANSWER-Hyperkalemia A member of the resuscitation team is preparing to defibrillate a patient in cardiac arrest using a biphasic defibrillator. The team member would set the energy dose according to the manufacturer's recommendations, which is usually: - ANSWER-120 to 200 joules A member of the resuscitation team is preparing to administer medications intravenously to a patient in cardiac arrest. The team member follows each medication administration with a bolus of fluid. How much would the team member give? - ANSWER-10 to 20 mL A 30-year-old patient has been brought to the emergency department in full cardiac arrest. The cardiac monitor shows the following rhythm. Interpretation of this rhythm would suggest which of the following as a possible precipitating factor? - ANSWER-Electrocution Cardiac monitoring of a patient in cardiac arrest reveals ventricular fibrillation. What intervention would the team perform next? - ANSWER-Administer 1 shock. A patient has experienced return of spontaneous circulation (ROSC) after cardiac arrest. The healthcare team is conducting a secondary assessment to determine the possible cause of the patient's cardiac arrest. Before the arrest, the patient exhibited jugular venous distension, cyanosis, apnea and hyperresonance on percussion. The patient was also difficult to ventilate during the response. The team would most likely suspect which condition as the cause? - ANSWER-Tension pneumothorax A patient in cardiac arrest experiences return of spontaneous circulation. As part of post-cardiac arrest care, the patient is receiving mechanical ventilation. Which finding(s) would indicate the need for change in the ventilator settings to optimize the patient's ventilation and oxygenation? - ANSWER-1. SaO2 92% 2. PaCO2 35 mmHg 3. ETCO2 50 mmHg After cardiac arrest and successful resuscitation, the patient has a return of spontaneous circulation. The patient is unable to follow verbal commands and has a Glasgow Coma Scale score of 7. Targeted temperature management is initiated. Which method(s) would be appropriate for the resuscitation team to use? - ANSWER-1. Applying cooling blankets to the patient's body 2. Giving an ice-cold IV fluid bolus 3. Using an endovascular catheter A 40-year-old patient in the waiting room of the primary care provider's office approaches a staff member and says, "I'm having really severe, crushing chest pain that is moving to both my arms." The patient is diaphoretic and dyspneic. Which action would be appropriate for the staff member to take? - ANSWER-Activate the emergency medical services system. A patient with suspected acute coronary syndromes (ACS) is placed on a cardiac monitor. The patient is complaining of dyspnea and is given supplemental oxygen. The provider determines that the oxygen is effective based on which SaO2 level? - ANSWER-95% A 35-year-old female patient's ECG is consistent with STEMI. The ECG reveals a new ST-segment elevation at the J point in leads V2 and V3 of at least which size? - ANSWER-0.15 mV A patient with STEMI is experiencing chest pain that is refractory to sublingual nitroglycerin. Intravenous nitroglycerin is prescribed. When administering this medication, it would be titrated to maintain which systolic blood pressure? - ANSWER-90 mmHg A patient experiencing STEMI comes to the emergency department of a large medical center at 9:30 p.m. The patient states that the symptoms started about 8 p.m. After confirming the diagnosis and initiating care, the healthcare team schedules the patient for percutaneous coronary intervention (PCI). The facility is capable of administering PCI. To achieve the best outcomes, therapy should be administered to this patient by which time? - ANSWER-11:00 p.m. A patient presents to the emergency department with mild to moderate recurrent chest pain, without any nausea or vomiting. A 12-lead ECG is obtained and shows ST-segment depression with transient T-wave elevation indicative of NSTE-ACS. Cardiac enzyme levels are obtained and are not elevated. These findings suggest which condition? - ANSWER-Unstable angina A patient is being treated in the emergency department and is determined to have NSTE-ACS. Invasive management is planned based on which finding? - ANSWER-Ventricular tachycardia